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Demystifying the Op-Ed. A Novel Group Writing Workshop to Improve Upon Existing Pediatric Advocacy Training

Open AccessPublished:August 26, 2021DOI:https://doi.org/10.1016/j.acap.2021.08.017

      What's New

      An op-ed writing workshop utilizing a group compilation exercise increases participant self-reported comfort in writing op-eds and has led to published op-eds. An experiential op-ed writing workshop could be incorporated into advocacy curricula in pediatric residency programs.

      Keywords

      Background

      Pediatricians are uniquely qualified to advocate for public health solutions to problems affecting children
      • Plax K
      • Donnelly J
      • Federico SG
      • et al.
      An essential role for pediatricians: becoming child poverty change agents for a lifetime.
      . The Accreditation Council for Graduate Medical Education requires pediatric residency programs include child advocacy in their curriculum.

      ACGME program requirements for graduate medical education in pediatrics. Accreditation Council for Graduate Medical Education Available at: https://www.acgme.org/Portals/0/PDFs/Milestones/PediatricsMilestones.pdf?ver=2017-07-24-124802-340. Published 2017. Accessed March 3, 2020.

      An “Op-ed”, short for opposite-the-editorial (page), is a form of media advocacy in which the author publishes a commentary in lay press to communicate evidence directly to the public. Well written op-eds can influence policy by swaying public opinion, knowledge, and behaviors.
      • Sucharov M.
      Public Influence: A Guide to Op-Ed Writing and Social Media Engagement.
      ,
      • Coppock A
      • Ekins E
      • Kirby D.
      The long-lasting effects of newspaper op-eds on public opinion.
      Although some residency programs have included op-ed writing as a topic within their broader advocacy curriculum,
      • Majeed A
      • Newton H
      • Mahesan A
      • et al.
      Advancing advocacy: implementation of a child health advocacy curriculum in a pediatrics residency program.
      ,
      • Chung EK
      • Kahn SR
      • Altshuler M
      • et al.
      The JeffSTARS advocacy and community partnership elective: a closer look at child health advocacy in action.
      how to teach op-ed writing in pediatric training has not been described. We developed an op-ed writing workshop to improve self-reported comfort with writing op-eds, demonstrate writing feasibility with hands on practice and produce a publishable op-ed at workshop conclusion.

      Educational Approach and Innovation

      Curriculum Development

      The workshop was developed as one of three workshops in a larger physician media training curriculum covering op-eds, social media, and media interviews. We developed our op-ed writing workshop using situated learning theory as the conceptual framework.
      • McLellan H.
      Situated Learning Perspectives.
      Situated learning uses cognitive apprenticeship and coaching as well as opportunities for practice through problem-centered collaborative activities. We hypothesized that actively engaging participants in writing an op-ed during the workshop would increase comfort with writing op-eds and result in a submittable op-ed at workshop conclusion.

      Educational Innovation

      The op-ed workshop is a single 2-hour session. The first hour is a didactic on op-ed structure and organization, topic selection, framing, audience, timing, and pitching (Figure). The second hour engages participants in interactive writing. For efficiency, we preselect a topic and create a brief fact sheet for reference (available on request from the author). Participants are divided into 5 groups, covering each section of an op-ed
      • Sucharov M.
      Public Influence: A Guide to Op-Ed Writing and Social Media Engagement.
      ,
      • Monroe AH
      • Ehninger DJ
      : lede, main argument, supporting research, proposed solutions, and call to action. Each group consists of 4 to 5 participants. Each group is responsible for writing a short paragraph (Figure). The importance of framing in scientific communication is emphasized.

      FrameWorks Institute. (2018). “Framing and policy making: how does framing help advance our public policy goals.” [Article]. Washington, DC. Available at: https://www.frameworksinstitute.org/article/framing-and-policy-making/. Accessed May 25, 2021

      Participants with relevant patient experiences to illustrate the topic are placed in the lede group. Sensitivity to patient confidentiality is emphasized. After the lede group completes the introductory paragraph with the patient story, they read the paragraph aloud so other groups can weave the story into the remainder of the op-ed. After all groups complete their paragraph, each group reads their paragraph aloud sequentially to reveal the completed op-ed. The final op-ed draft is reviewed and finalized by 1 to 2 participants with the goal of submitting the final product for publication.
      Figure
      FigureSituated learning model for op-ed writing.

      Evaluation

      We surveyed all pediatric residents and workshop participants prior to the workshop and 6 months postworkshop. Respondents self-reported comfort “writing an article, letter to the editor, or op-ed to promote health education or health policy,” using a 5-point Likert scale (strongly disagree, somewhat disagree, neither agree nor disagree, somewhat agree, strongly agree.) The post-workshop survey asked respondents if they had participated in 1 or more of the media training workshops.
      Change in self-reported comfort writing op-eds was compared using odds ratios with 95% confidence intervals.
      The University of California Davis Institutional Review Board classified the study as exempt.

      Results

      Fifty-six medical students, residents and faculty returned preparticipation surveys (89%; 56/63). Twenty-one residents (n = 16), faculty (n = 3), and medical students (n = 2) participated in the op-ed workshop. Of participants who attended at least one media workshop and all pediatric residents, 44% (24/55) completed the post participation survey.
      Respondents who participated in at least 1 workshop were almost 9 times more likely (odds ratio = 8.83; 95% confidence interval, 1.58–49.35) to strongly/somewhat agree they were comfortable writing an op-ed than those who did not participate.
      The completed op-ed produced at the workshop was published in The Sacramento Bee which has an average daily readership of 654,100.

      Rothstein L, Gambill L. Pot brownies can kill toddlers. It's time for childproof cannabis packaging law. The Sacramento Bee. 2019.

      Discussion and Next Steps

      Our op-ed workshop increased comfort with writing op-eds and resulted in a published op-ed.
      We adapted the op-ed workshop to different settings, including pediatric grand rounds, an advocacy interest group, a pediatric hospital medicine conference, and our residency community health and advocacy rotation, including as a virtual workshop during the COVID-19 pandemic. Adaptations included shortening the workshop to 1 hour (30 minutes for didactic and 30 minutes for writing) and, for small groups, having participants each write one paragraph of the op-ed. Despite the modifications in the workshop, subsequent workshops have resulted in 4 additional op-eds submitted for publication; one rejection, one publication, one publication in press, and one that qualified as a finalist for an academic journal essay competition.
      Our study has several limitations. Our small sample size and single site limits generalizability. However, repeated op-ed workshops to varied audiences and venues were well received and resulted in additional op-ed publications. We had a low response rate for the postworkshop survey. Unfortunately, we are unable to determine whether post-participation respondents participated in the op-ed workshop or one of the other 2 media workshops offered in the series. However, neither of the 2 other workshops covered op-ed writing, so our results may be an underestimation of improvement in self-reported comfort as it is possible that respondents who did not participate in the op-ed workshop were included in the intervention arm.
      Next steps include gathering qualitative data about how and why this op-ed worship was effective and individual participants op-ed publication rates postworkshop.
      Pediatricians are ideal advocates for children. Op-eds allow pediatricians an avenue to advocate for children by influencing public opinion and shaping policy.
      • Coppock A
      • Ekins E
      • Kirby D.
      The long-lasting effects of newspaper op-eds on public opinion.
      While previous pediatric advocacy curricula mention op-eds as an important aspect in advocacy training, our innovative workshop is the first to detail the situated learning framework as a model for writing op-eds in pediatric residency training, demonstrate increased participant comfort with writing op-eds, and include a product which can be submitted for publication at workshop conclusion. We believe that our workshop model has the potential to help other pediatric residency programs effectively and efficiently incorporate op-ed writing within their own curriculum and provide another avenue to advocate for child health.

      Acknowledgments

      Funding statement: American Academy of Pediatrics Community Pediatrics Training Initiative.

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