title: Are Canadian postgraduate training programs meeting the health advocacy needs of obstetrics and gynaecology residents?
abstract: OBJECTIVE
  Health advocacy (HA) is a core competency in Canadian obstetrics and gynaecology postgraduate programs. Our objectives were to assess awareness and understanding of the health advocate role among trainees, their current HA training and exposure, and the desire and needs for future HA training.
  
  
  METHODS
  An anonymous, cross-sectional, Internet-based, self-reported health advocacy questionnaire was distributed to Canadian obstetrics and gynaecology trainees. Descriptive analysis was conducted for all study variables. Chi-square tests, Cochran-Armitage trend test, and Fisher exact test were performed where appropriate.
  
  
  RESULTS
  Most trainees (93.9% of respondents) were aware of the CanMEDS HA role and that it is a training objective (92.9%). Only 52.4% had clear objectives while 58.4% understood the role requirements. Most trainees (95.1% of respondents) felt HA was important to address during training. Only 30.4% had HA training, and just 36.3% felt their training needs were addressed. Training included teaching sessions (11.9%), clinical teaching (4.7%), and role modelling (4.7%). Although 82.9% of respondents had HA opportunities with patients, there were fewer opportunities at community (45.1%) and societal (30.0%) levels. Awareness of community groups and activities was low (28.6%), and few (20.0%) had participated in community advocacy programs during their residency. Incorporating advocacy activities into training was valued (80.0%). Many residents supported mandatory HA training (60.0%), more training time on HA experiences (66.3%), and HA experiences during protected time (71.3%).
  
  
  CONCLUSIONS
  Awareness of and interest in the HA role is high, but clear objectives and training are lacking or inadequate. A standardized curriculum would ensure health advocacy exposure and emphasize active participation in community and societal activities. Trainees support this training during protected time.
authors.affiliation: Department of Obstetrics, Gynecology, and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON.
authors.forename: Julie
authors.initials: J
authors.lastname: Hakim
authors.affiliation: Department of Obstetrics, Gynecology, and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON; Division of Pediatric and Adolescent Gynecology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON.
authors.forename: Amanda
authors.initials: A
authors.lastname: Black
authors.affiliation: Department of Obstetrics, Gynecology, and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON.
authors.forename: Andrée
authors.initials: A
authors.lastname: Gruslin
authors.affiliation: Department of Obstetrics, Gynecology, and Newborn Care, The Ottawa Hospital, University of Ottawa, Ottawa ON; Division of Pediatric and Adolescent Gynecology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fleming
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000592:standards*; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D009774:Obstetrics / Q000193:education*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: curriculum; health advocacy; obstetrics and gynaecology; postgraduate medical education