COVID-19 fosters social accountability in medical education.

The COVID-19 pandemic has highlighted embedded inequities and fragmentation in our health systems. Traditionally, structural issues with health professional education perpetuate these. COVID-19 has highlighted inequities, but may also be a disruptor, allowing positive responses and system redesign. Examples from health professional schools in high and low- and middle-income countries illustrate pro-equity interventions of current relevance. We recommend that health professional schools and planners consider educational redesign to produce a health workforce well equipped to respond to pandemics and meet future need.

Training for impact: the socio-economic impact of a fit for purpose health workforce on communities.

Across the globe, a "fit for purpose" health professional workforce is needed to meet health needs and challenges while capitalizing on existing resources and strengths of communities. However, the socio-economic impact of educating and deploying a fit for purpose health workforce can be challenging to evaluate. In this paper, we provide a brief overview of six promising strategies and interventions that provide context-relevant health professional education within the health system. The strategies focused on in the paper are:1. Distributed community-engaged learning: Education occurs in or near underserved communities using a variety of educational modalities including distance learning. Communities served provide input into and actively participate in the education process.2. Curriculum aligned with health needs: The health and social needs of targeted communities guide education, research and service programmes.3. Fit for purpose workers: Education and career tracks are designed to meet the needs of the communities served. This includes cadres such as community health workers, accelerated medically trained clinicians and extended generalists.4. Gender and social empowerment: Ensuring a diverse workforce that includes women having equal opportunity in education and are supported in their delivery of health services.5. Interprofessional training: Teaching the knowledge, skills and attitudes for working in effective teams across professions.6. South-south and north-south partnerships: Sharing of best practices and resources within and between countries.In sum, the sharing of resources, the development of a diverse and interprofessional workforce, the advancement of primary care and a strong community focus all contribute to a world where transformational education improves community health and maximizes the social and economic return on investment.

The training for health equity network evaluation framework: a pilot study at five health professional schools.

BACKGROUND: The Training for Health Equity Network (THEnet), a group of diverse health professional schools aspiring toward social accountability, developed and pilot tested a comprehensive evaluation framework to assess progress toward socially accountable health professions education. The evaluation framework provides criteria for schools to assess their level of social accountability within their organization and planning; education, research and service delivery; and the direct and indirect impacts of the school and its graduates, on the community and health system. This paper describes the pilot implementation of testing the evaluation framework across five THEnet schools, and examines whether the evaluation framework was practical and feasible across contexts for the purposes of critical reflection and continuous improvement in terms of progress towards social accountability. METHODS: In this pilot study, schools utilized the evaluation framework using a mixed method approach of data collection comprising of workshops, qualitative interviews and focus group discussions, document review and collation and analysis of existing quantitative data. RESULTS: The evaluation framework allowed each school to contextually gather evidence on how it was meeting the aspirational goals of social accountability across a range of school activities, and to identify strengths and areas for improvement and development. DISCUSSION: The evaluation framework pilot study demonstrated how social accountability can be assessed through a critically reflective and comprehensive process. As social accountability focuses on the relationship between health professions schools and health system and health population outcomes, each school was able to demonstrate to students, health professionals, governments, accrediting bodies, communities and other stakeholders how current and future health care needs of populations are addressed in terms of education, research, and service learning.

Measuring social accountability in health professional education: development and international pilot testing of an evaluation framework.

BACKGROUND: Health professional schools are responsible for producing graduates with competencies and attitudes to address health inequities and respond to priority health needs. Health professional schools striving towards social accountability founded the Training for Health Equity Network (THEnet). AIM: This article describes the development of THEnet evaluation framework for socially accountable health professional education, presents the framework to be used as a tool by other schools and discusses the findings of pilot implementation at five schools. METHODS: The framework was designed collaboratively and built on Boelen and Woollard's conceptualization, production and usability model. It includes key components, linked to aspirational statements, indicators and suggested measurement tools. Five schools completed pilot implementation, involving workshops, document/data review and focus group discussions with faculty, students and community members. RESULTS: Three sections of the framework consider: How does our school work?; What do we do? and What difference do we make? Pilot testing proved that the evaluation framework was acceptable and feasible across contexts and produced findings useful at school level and to compare schools. The framework is designed as a formative exercise to help schools take a critical look at their performance and progress towards social accountability. Initiatives to implement the framework more widely are underway. The framework effectively aids in identifying strengths, weaknesses and gaps, with a view to schools striving for continuous self-improvement. CONCLUSION: THEnet evaluation framework is applicable and useful across contexts. It is possible and desirable to assess progress towards social accountability in health professional schools and this is an important step in producing health professionals with knowledge, attitudes, and skills to meet the challenges of priority health needs of underserved populations.

Global health: networking innovative academic institutions.

Medically underserved communities suffer a high burden of morbidity and mortality, increasing with remoteness where access to health services is limited. Major challenges are the overall shortage and maldistribution of the health workforce. There is a lack of understanding of how academic institutions can best contribute to addressing these health inequities. A new international collaborative of health professions schools, Training for Health Equity Network, is developing and disseminating evidence, challenging assumptions, and developing tools that support health profession institutions striving to meet the health and health workforce needs of underserved communities.

A roundtable of innovative leaders in medical education.

In 2008, the Global Health Education Consortium (GHEC) created the Training for Health Equity Network (THEnet), bringing together schools in different parts of the world that share a core mission: to recruit students from, and produce physicians for, underserved communities. In determining the competencies such physicians will need, these schools also share an approach to medical education that looks beyond the traditional curriculum and seeks the involvement of communities and other stakeholders. Their input helps define the knowledge, skills, and attitudes around which new curriculum is built, and helps guide the selection of educational methodologies, taking into account context and resource constraints. The nascent THEnet now has a nucleus of eight member schools, each dedicated to fulfilling a strong social accountability mandate. The network is designed to assist them by providing a collaborative platform conducive to experimentation; dialogue; and creation and sharing of tools, experiences and evidence. It will also support systematic outcome evaluations, innovation, and joint research to strengthen the knowledge base on successful strategies for increasing the number and quality of doctors in neglected communities. By bringing these schools together, developing synergy among them and publishing their results, THEnet hopes to more broadly promote the transformation of medical education and medical practice into more socially accountable endeavors that improve health system equity and performance. Leaders from six of these innovative medical schools spoke with the Guest Editors of this issue of MEDICC Review, a conversation we bring you below. They are: Dr Juan Carrizo, Rector of the Latin American Medical School (ELAM), Cuba; Dr Fortunato L. Cristobal, founding Dean of the School of Medicine at Ateneo de Zamboanga University (AZU), the Philippines; Dr Pedro D�az, member of the National Academic Coordinating Committee of the National Training Program for Comprehensive Community Physicians (NTPCCP), Venezuela; Dr Richard Murray, Dean and Head of the School of Medicine and Dentistry, James Cook University (JCU), Australia; Dr Roger Strasser, founding Dean of Northern Ontario School of Medicine (NOSM), Canada; and Dr Paul Worley, Dean of Flinders University School of Medicine (FUSM), Australia. Erratum Neusy, AJ, Palsdottir, B. A Roundtable of Innovative Leaders in Medical Education. MEDICC Review. 2008;10(4):20-24. The correct website for the Ateneo de Zamboanga University School of Medicine in the Philippines is: http://som.adzu.edu.ph.