2. Use of a health advocacy essay to improve competence

M. Borgaonkar, D. Pace, P. Jeon

Abstract


We set out to determine if essay writing on health advocacy could improve scores on a Health Advocacy observed structured clinical exam (OSCE) station.
A Health Advocacy station was used as one of ten stations at the annual resident OSCE in 2006. Subsequently, residents were instructed to write an essay regarding their actions as a health advocate, either in general or relating to a specific situation. For the 2007 OSCE, a different Health Advocacy station was used that was similar to the previous year in terms of the issues that residents needed to address and the scoring structure. The results on the OSCE stations between the two years were compared using Student’s T-test. Regression analysis was used to identify any predictors for a higher score.
The number of residents taking the OSCE in 2006 and 2007 were 17 and 13, respectively. Nine residents completed the OSCE in both years. The number of PGY-1’s taking the OSCE for the first time in 2006 and 2007 were 8 and 4, respectively. Compliance with the essay writing was 100%. The mean score on the Health Advocacy station was significantly higher in 2007 compared to 2006 (53.0 ± 14.6 compared to 65.6 ± 10.0 vs. 53.0 ± 14.6; p=0.01). The mean score of PGY-1’s in 2007 tended to be higher than PGY-1’s in 2006 (67.5 ± 11.4 vs. 54.5 ± 12.3; p=0.11), suggesting the improvement was not due to having taken the OSCE previously. Regression analysis did not identify and other predictors of higher score on the OSCE station.
These results suggest that essay writing by residents about actions they have taken as health advocates improves knowledge about the CanMEDS competency of Health Advocacy, as measured in an OSCE station. The non-randomized design of the study does not exclude the possibility of other factors influencing the improvement in score.
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DOI: http://dx.doi.org/10.25011/cim.v30i4.2762

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