'A drive to make change' - exploring the views and experiences of medical students engaging in advocacy: a qualitative study in a UK medical school.

Background: Advocacy is a recognised competency for medical graduates. Many medical students engage in advocacy, but research on this topic is limited. This study aimed to explore the views and experiences of medical student advocates.

Methods: Qualitative study using semi-structured interviews. Nine medical students from advocacy organisations were recruited by purposive sampling. Thematic analysis was used to generate codes and develop themes.

Results: There were five themes: triggers and enablers; barriers and disablers; knowledge, skills, and attributes; advocacy in the role of health professionals, and career aspirations; and teaching and assessment of advocacy. Triggers and enablers included internal drivers (e.g. experiencing injustice), and external drivers (e.g. role models). Obstacles included lack of institutional support, personal challenges, and discomfort around professionalism in advocacy. Student enhanced their knowledge of social issues and improved communication skills. Advocacy activities strongly influenced students' future plans. Most agreed that advocacy is an important topic in medical education, suggesting teaching it early in medical school via small-group tutorials and role-modelling. For assessment, a reflective approach was preferred over written exams.

Conclusion: Medical students' engagement in advocacy has complex facilitators and barriers, and the relationship between advocacy and professionalism requires clarity. Benefits of advocacy include fostering empathy and other transferable skills required of future doctors. Advocacy teaching was welcomed by students, with suggested approaches proposed. The optimal learning and assessment strategy remains uncertain, and further research is needed.