P3B173: Legislative Advocacy 101: A Novel Curriculum for Pediatric Residents

Background: It is important for pediatricians to be prepared to support the passage of informed legislation that promotes the health and wellness of our patients. Longitudinal advocacy curriculum has shown effectiveness in changing resident clinical practice. Despite an Accreditation Council for Graduate Medical Education (ACGME) requirement for community pediatrics and advocacy training in pediatric residency programs, there are no defined standards to guide training regarding legislative advocacy. Furthermore, there are a limited number of studies looking at how to best train pediatricians about this topic. We hypothesize that a novel advocacy curriculum can demonstrate changes in residents’ attitudes about, and confidence in, participation in legislative advocacy.

Project Description: There were 2 interventions in our observational study: (1) Creation of asynchronously-taught legislative advocacy modules integrated into the advocacy rotation curriculum. Modules covered topics including the organization and structure of state and federal government, and how to find and contact their local legislators, (2) A skills session workshop for pediatric residents to practice learned skills with simulated in-person meetings, virtual sessions/phone calls, and email/social media interactions with policymakers. Anonymous, paired pre- and post- skill session surveys were administered online. Survey participation was voluntary and had no effect on resident evaluations. IRB exemption was obtained. Paired testing (Wilcoxon Rank Sum & McNemar) were utilized for statistical analysis. Funding for this project was provided by the Community Pediatrics Training Initiative Advocacy Training Grant.

Discussion: Survey data demonstrated overall positive results. The majority of our participants didn’t have any prior formal legislative training (84%, n=16). There was significant improvement between pre- and post- workshop responses to whether residency programs should train residents in legislative advocacy (p= 0.03) and to the idea that pediatricians should participate in career-long legislative advocacy (p= 0.07). Regarding barriers to participating in legislative advocacy, post workshop surveys showed a significant decrease in identifying the following barriers: “I do not understand the legislative process” (p= 0.04) and “I am intimidated by the legislative process” (p= 0.04). Post survey responses also showed an improvement in our participant’s understanding of how a bill becomes a law (p= 0.002), how to use online resources to find information about their representatives (p= 0.001) and their level of comfort in communicating to representatives about healthcare issues (p < 0.001).

Conclusion: In a population of pediatric residents with little to no previous experience with legislative advocacy, we found that the initiation of legislative curriculum was significantly beneficial. The framework we created can be utilized by other residency programs to design similar curricula to educate and empower residents to work with lawmakers. By increasing a pediatricians’ comfort level and willingness to advocate for informed policymaking, we see the potential to improve the health and wellness of the communities we serve.