Leading the way into advocacy

Mentoring program gives students the ability to get involved early

Amy Hewko - 4 December 2013

Many medical students dream about changing the world. A budding program at the U of A is helping to make that happen.

The Health Advocacy and Leadership program (HAL) is designed to help students bridge the gap between medical education and patient advocacy. Students work with a mentor on a project to address a community-based problem, attend a seminar series and brainstorm as a group during sessions called "idea incubators."

HAL is facilitated by Kinga Kowalewska-Grochowska, a professor in the Department of Medical Microbiology & Immunology (MMI) and the director of the MMI residency program. She first encountered the program in 2009 as a student proposal in need of faculty support. Inspired by the idea, she provided the initial support, continues to recruit mentors and acts as a liaison between the students and the mentors.

"When you leave medical school, you're going to know your medicine no matter what," Lisa Kibria, MD class of 2015 and HAL committee member, said of the skills taught by the program. "You also have to know how to use your knowledge wisely, where to use it and which aspects of medicine you're more interested in."

Selecting the right people

With a maximum enrolment rate of only six medical students per intake, the HAL committee is very selective on who is admitted. Students apply through a questionnaire and an interview and the committee (a two-tier system composed of seven medical students and Kowalewska-Grochowska) selects participants based on the information they provided. Kowalewska-Grochowska commented that one student joked that applying for HAL was like applying to medical school all over again.

Despite the rigorous application process, it seems to be a popular option among students: nearly 20 per cent of the 2017 class applied.

"I got really excited," Emeka Nzekwu, MD class of 2015 and HAL committee member, said of the first time he heard of the program. "I've always enjoyed working with people, helping my community and getting involved in meaningful projects."

One of HAL's biggest attractions is the one-on-one relationships it allows students with their mentors, providing a closer bond and the feeling of equality in project planning. Because of that, matching the students to the right mentor is an important and difficult task. Mentors and mentees complete paper profiles and rate their interactions when they meet face-to-face in the "speed dating" sessions that allow them to discuss common interest and project ideas. The HAL committee cross-references both results for the best possible level of compatibility. There have been no unsuccessful matches so far.

Kowalewska-Grochowska, who recruits the mentors herself, estimates that more than 95 per cent of professionals she has asked eagerly participate in the program. She approaches health-care leaders, such as Louis Francescutti, former president of the Royal College of Physicians and Surgeons of Canada and the current president of the Canadian Medical Association.

"A lot of [the mentors] wanted to change the world as medical students … but nobody gave us any tools to make that change happen," Kowalewska-Grochowska said. "What we did was fumble through it through trial and error. At the end of it, with all the bruises life gave us, we actually came up with a path: why not share this experience? How about shortening this process and giving [medical students] some tools at the onset?"

Projects for the community

Collaboration is a huge part of the HAL program. Mentors guide students through the pitfalls of early-stage advocacy and help them connect with the right people. Students take leading roles while consulting their mentors about the direction and focus of their projects. Beyond each mentorship pairing, all of the projects also come together at the "idea incubator" sessions. These are large-scale brainstorming sessions when all HAL students and mentors come together to share ideas. They help address any concerns between mentors and mentee and provide fresh insights.

"We brainstorm ideas and help students angle their projects toward the right way. We try to focus them and help with any problems or concerns regarding their project," Kibria said, noting that she hopes these sessions can one day be open to all medical students with personal projects.

Kibria focused her project on a topic close to the heart of many a Canadian mother: concussion education in minor hockey. With the help of her mentor, Anne Fanning, she designed an education program teaching 11 to 12 year-old players about the causes, symptoms and long-term effects of concussions.

"I talked about anatomy a little bit and why you get the symptoms. They loved it!" Kibria said of her course. She is still in the debriefing stage of her project to identify the effectiveness of the program.

Nzekwu, MD candidate in the class of 2015, chose to reconsider medical education. He noticed that curriculums rarely design coursework around community engagement. Through a concept called productive curricula, he is proposing a way to use coursework (assignments, projects and even exams) to benefit the community.

"What most courses do is give you a bunch of assignments, projects and tests with the sole purpose of evaluating your knowledge, all of which goes into the garbage thereafter," Nzekwu said of his project. "The intention of productive curricula is to both evaluate the student and simultaneously create something to benefit future students, your school or community in some way."

To implement his project Nzekwu collaborated with several people including Rabia Bana (MD Class 2015), Dominic Allain (Department of Pediatrics), Roxanne Felix-Mah (School of Public Health) and Yvonne Chiu (co-founder of Multicultural Health Brokers Co-Operative), to name a few. With the help of his team, he applied a curriculum based on refugee and immigrant health to INTD410, an interdisciplinary course that teaches students from different areas of health care to come together in professional settings. After meeting with community partners, students created project proposals to address some of the challenges or needs identified by the organizations. These projects were broken down into small steps for future classes to build upon.

Future of advocacy

HAL may be a small program but Kowalewska-Grochowska and committee have big aspirations. It is popular, produces intriguing projects and has virtually unlimited potential for improving Edmonton and Alberta communities. The challenge now lies in growing the program without losing either the quality of the mentors or their relationships with the students.

"I hope to remain involved in the development of this program beyond my years as a medical student," Nzekwu noted, indicating he would love to be a mentor one day if the opportunity presents itself. "I fully support the HAL program and the idea behind it."

"It's exhausting but I love it," Kowalewska-Grochowska noted. "I feel so lucky to be surrounded by people who give so much of themselves."