Background: Health advocacy is one of the competencies required by the Royal College of Physicians and Surgeons of Canada. Lack of curriculum and clarity around this competency are obstacles for effectively teaching health advocacy to neurology residents. The purpose of this study was to identify the top five neurological diseases suitable to form the core content of a Health Advocacy curriculum and to develop the detailed curricular content items on health advocacy based on these findings.
Methods: This is a cross-sectional study that includes a survey and Delphi procedure in two separate steps. In step one, neurologists and neurology residents were asked to rank 56 neurological diseases on a Likert scale based on how well the neurological disease lends itself to teaching the health advocacy aspects of neurology. In step two, curricular items were developed for the top five neurological diseases based on the mean Likert scale score, using a modified Delphi procedure. Cronbach’s alpha was used to determine the reliability of the survey instrument, and factor analysis was used for construct validity.
Results: 46 neurologists and 14 neurology residents were surveyed with total response rate of 88.33%. The top five neurological presentations that neurologists identified, which lend themselves easly to teaching health advocacy are: stroke/transient ischemic attacks, alcoholism, epilepsy, Alzheimer's disease and multiple sclerosis. The reliability of the survey instrument was 0.97. Exploratory factor analysis revealed four factors that can explain the variability in the survey instrument: chronic conditions affecting mobility and cognition, Paroxysmal or transient neurological conditions, conditions requiring cross-disciplinary specialist care, and Chronic conditions affecting cognition with potential improvement. Consensus on the curriculum content items was achieved using modified Delphi procedure.
Conclusion: Neurological presentations that suitable for a foundational curriculum for neurology health advocacy were identified. Consensus was achieved on curricular items for the top five neurological presentations that easily fit into a program of teaching health advocacy.