Shifts in the interpretation of health advocacy: a textual analysis.

Context Health advocacy is widely accepted as a key element of competency-based education. We examined shifts in the language and description of the role of the health advocate and what these reveal about its interpretation and enactment within the context of medical education. Methods We conducted...

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Publicado en:Medical Education Vol. 48; no. 12; pp. 1235 - 1244
Autores principales: Hubinette, Maria, Dobson, Sarah, Towle, Angela, Whitehead, Cynthia
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2014
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Shifts in the interpretation of health advocacy: a textual analysis.
      aug:
        au:
          Hubinette, Maria
          Dobson, Sarah
          Towle, Angela
          Whitehead, Cynthia
        affil: Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia; Department of Family Practice, Faculty of Medicine, University of British Columbia
      sug:
        subj:
          Education, Medical
          Patient Advocacy
          Professional Competence
          Health Promotion
          Physician's Role
          Human
          Ontario
          Conceptual Framework
          Health Policy
          Schools, Medical Ontario
          Print Materials
      ab: Context Health advocacy is widely accepted as a key element of competency-based education. We examined shifts in the language and description of the role of the health advocate and what these reveal about its interpretation and enactment within the context of medical education. Methods We conducted a textual analysis of three key documents that provide sequential depictions of the role of the health advocate in medical education frameworks: Educating Future Physicians for Ontario (1993), Can MEDS 2000 and Can MEDS 2005. We used a series of questions to examine shifts in the emphasis, focus and application of the role between documents. Theoretically, we drew upon Carlisle's conceptual framework to identify different approaches to advocacy. Results We identified three major shifts in the language associated with the role of health advocate across our textual documents. Firstly, activities and behaviours that were initially positioned as being the responsibility of the profession as a whole came to be described instead as competencies required of every physician. Secondly, the initial focus on health advocacy as representing collective action towards public policy and systems-level change was altered to a primary focus on individual patients and doctors. Thirdly, we observed a progression away from descriptions of concrete actions and behaviours. Conclusions This study uncovers shifts in the language of physician advocacy that affect the discourse of health advocacy and expectations placed on physicians and trainees. Being explicit about expectations of the medical profession and individual practitioners may require renewed examination of societal needs. Although this study uses the Can MEDS role of Health Advocate as a specific example, it has implications for the conceptualisation of health advocacy in medicine and medical education globally.
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    language: English
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