title: Family physician preceptors' conceptualizations of health advocacy: implications for medical education.
abstract: OBJECTIVE
  Despite its official acceptance as an important physician responsibility, health advocacy remains difficult to define, teach, role model, and assess. The aim of the current study was to explore physicians' conceptions of health advocacy based on their experience with health-advocacy-related activities.
  
  
  METHODS
  In 2012, the authors conducted 11 semistructured interviews with family physician clinical preceptors and analyzed the interviews in the tradition of phenomenography.
  
  
  RESULTS
  The authors identified three distinct but related ways of understanding health advocacy: (1) Clinical: Health advocacy as support of individual patients in addressing health care needs related to the immediate clinical problem within the health care system, (2) Paraclinical: Health advocacy as support of individual patients in addressing needs that the physician preceptors viewed as peripheral yet parallel to both the health care system and the immediate clinical problem, and (3) Supraclinical: Health advocacy as population-based activities aimed at practice- and system-level changes that address the social determinants of health.
  
  
  CONCLUSIONS
  The qualitatively different understandings of health advocacy shed light on why current approaches to defining, teaching, role modeling, and assessing health advocacy competencies in medical education appear idiosyncratic. The authors suggest the development of an inclusive and extensive conceptual framework that may allow the medical education community to imagine novel ways of understanding and engaging in health advocacy.
authors.affiliation: Dr. Hubinette is clinical assistant professor, Centre for Health Education Scholarship and Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Dr. Ajjawi is senior lecturer, Centre for Medical Education, University of Dundee, Dundee, Scotland. Dr. Dharamsi is associate professor, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Hubinette
authors.forename: Rola
authors.initials: R
authors.lastname: Ajjawi
authors.forename: Shafik
authors.initials: S
authors.lastname: Dharamsi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001955:British Columbia; D004503:Education, Medical, Graduate / Q000379:methods*; D005194:Family Practice / Q000379:methods; D005260:Female; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010344:Patient Advocacy; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research