Key drivers of social accountability in nine Canadian medical schools.

A social accountability mandate for Canadian medical schools formally emerged in Canada with changes to accreditation standards in 2015. However, how social accountability is defined and operationalized within medical schools has transpired independently. Key enablers of social accountability in Canadian medical schools have been largely unexplored. This paper is the first of a two part series that seeks to explore drivers of social accountability in a sample of Canadian medical schools. Nine key drivers of social accountability emerged from the data including a unified vision, committed leadership, accreditation standards, champions of social accountability, authentic community engagement, community-based learning opportunities, a supportive organizational and governance structure, diversity within medical schools, and measurement of progress and outcomes. This is the first study of its kind to examine what is driving social accountability across Canadian medical schools. An appreciative inquiry approach highlights areas of progress for future work to focus and build upon. This paper presents the findings from part one of the study - exploring the themes emerging from key informant interviews with senior leaders. A second paper will dive into the broader perspectives of faculty, staff and students, to explore more fully the varying perspectives of social accountability within colleges.

Exploring social accountability in Canadian medical schools: broader perspectives.

This article was migrated. The article was marked as recommended. This article is the second of a two-part series in a study that explores key drivers of social accountability in Canada's medical schools and offers examples of social accountability in action. The study gathered perspectives from medical school staff, students and faculty through focus group discussions, using an appreciative inquiry approach. Drivers of social accountability emerging from the focus groups largely corroborate what was discovered in the first part of the series during key informant interviews with senior leaders. These include the importance of accreditation, leadership, vision and mandate, and community engagement among others, and highlight the key role champions play in driving social accountability. This study builds on the first article in the series by recognizing leadership as an important driver for social accountability, but highlighting how leadership alone is not enough. The broader range of perspectives gathered through the focus group discussions uncovered the importance of social accountability 'champions' at all levels: formal leadership, faculty, student and staff. Focus group discussions also uncovered an additional key driver that was not found in key informant interviews - cultural humility, with participants noting that action towards social accountability requires shifts not only in organizational structure, but also organizational culture, to foster real, lasting change. This study demonstrates the utility of an appreciative inquiry approach for understanding how complex systems like medical education institutions are innovatively tackling challenges around health equity. The richness of the themes that emerged consistently across focus group sessions and key informant interviews support the utility of the approach in furthering our understanding as to what is working to drive social accountability in some Canadian medical schools.