Development and evaluation of an online course about the social accountability of medical schools.

OBJECTIVES: The objective of this communication is to describe the development, implementation, and evaluation of a pioneering online course about the social accountability of medical schools intended to develop the skills of academic staff at medical schools in the eastern Mediterranean region. METHODS: This four-module course was developed using a six-step approach for curriculum development. Three faculty members with vast experience in social accountability delivered the course online through the MOODLE platform to participants. The content and appropriateness of the course were evaluated using Kirkpatrick's evaluation model, by offering a self-administered questionnaire that assesses the participants' opinions and feedback besides the analysis of the responses of the participants to the discussion points. RESULTS: Sixteen participants from four countries were admitted to the course. An overall 75% of the participants completed four modules. The mean number of online discussion threads was reported to be 36 responses per module. All participants regarded the course as having a clear take-home message. The majority agreed that the course introduced new concepts and corrected some of their misunderstandings about social accountability in medical schools. The main problems that participants experienced were time constraints and technical Internet problems. CONCLUSION: The application of the concept of social accountability in the day-to-day work of medical schools requires faculty to be informed and trained. The online course provides a flexible way to conduct faculty development programmes.

Time for action: key considerations for implementing social accountability in the education of health professionals.

Within health professional education around the world, there exists a growing awareness of the professional duty to be socially responsible, being attentive to the needs of all members of communities, regions, and nations, especially those who disproportionately suffer from the adverse influence of social determinants. However, much work still remains to progress beyond such good intentions. Moving from contemplation to action means embracing social accountability as a key guiding principle for change. Social accountability means that health institutions attend to improving the performance of individual practitioners and health systems by directing educational and practice interventions to promote the health of all the public and assessing the systemic effects of these interventions. In this Reflection, the authors (1) review the reasons why health professional schools and their governing bodies should codify, in both curricular and accreditation standards, norms of excellence in social accountability, (2) present four considerations crucial to successfully implementing this codification, and (3) discuss the challenges such changes might entail. The authors conclude by noting that in adopting socially accountable criteria, schools will need to expand their philosophical scope to recognize social accountability as a vitally important part of their institutional professional identity.

Coordinating medical education and health care systems: the power of the social accountability approach.

CONTEXT: As the purpose of medical education is to produce graduates able to most effectively address people's health concerns, there is general agreement that coordination with the health care system is essential. For too long, coordination has been dealt with in a subjective manner with only few landmarks to ensure objective and measurable achievements. Over the last 30 years, since the Edinburgh Declaration on medical education, progress has been made, namely with the concept of social accountability. METHODS: The social accountability approach provides a way to plan, deliver and assess medical education with the explicit aim to contribute to effective, equitable and sustainable health system development. It is based on a system-wide scope exploring issues from identification of people's and society's health needs to verification of the effects of medical education in meeting those needs. A wide international consultation among medical education leaders led to the adoption of the Global Consensus on Social Accountability of Medical Schools. EXPERIENCES: Benchmarks of social accountability are in the process of being conceived and tested, enabling medical schools to steer medical education in a more purposeful way in relation to determinants of health. A sample of schools using the social accountability approach claims to have had a positive influence on health care system performance and people's health status. CONCLUSION: Improved coordination of medical education and other key stakeholders in the health system is an important challenge for medical schools as well as for countries confronted with an urgent need for optimal use of their health workforce. There is growing interest worldwide in defining policies and strategies and supporting experiences in this regard.

Making a greater impact on society as a mark of excellence in the accreditation of medical schools / Conseguir un mayor impacto en la sociedad, como indicador de excelencia en la acreditación de las facultades de medicina

With challenges societies are facing to establish and maintain efficient, equitable and sustainable health care delivery systems, all key stakeholders are urged to question how they can best contribute. Likewise, academic institutions, medical schools particularly, must review the concept of excellence to include the capacity to make a more significant contribution to health system performance and people's health. The continuing adaptation of education, research and service delivery missions to respond to evolving health needs of society should be enhanced by the use of appropriate accreditation standards and mechanisms. Accreditation standards of the Liaison Committee for Medical Education (LCME), of the World Federation for Medical Education (WFME) and the Conférence Internationale des Doyens et des Facultés de Médecine d'Expression Française (CIDMEF) have been reviewed in this context. It is observed than they mainly concentrate on medical education content and processes. It is therefore recommended that their standards be revisited and new ones added to better reflect the concept of social accountability, which is illustrated by the three tier engagement: to identify present and future health needs of the population, including health determinants, to adapt missions accordingly and to the ensure anticipated effects have occurred on people's health status. To initiate change, a course of future actions is proposed (AU)

Dados los retos a los que se enfrenta la sociedad de establecer y mantener sistemas de prestación de servicios de salud eficientes, equitativos y sostenibles, se debe instar a todos los agentes implicados a preguntarse cómo pueden contribuir mejor a ello. También las instituciones académicas, y las facultades de medicina en particular, deben revisar el concepto de excelencia para incluir la capacidad de contribuir de forma más significativa al funcionamiento del sistema de salud y a la salud de las personas. La adaptación continua de las misiones de la educación, la investigación y la prestación de servicios para responder a las necesidades de salud en evolución de la sociedad debería reforzarse mediante el uso de estándares y mecanismos de acreditación adecuados. Los estándares de acreditación del Liaison Committee for Medical Education (LCME), de la World Federation for Medical Education (WFME) y de la Conférence Internationale des Doyens et des Facultés de Médecine d'Expression Française (CIDMEF) han sido revisadas en este contexto. Se observa que se concentran principalmente en los contenidos y los procesos de la educación médica. Por lo tanto, se recomienda revisar estos estándares y que se añadan estándares nuevos que reflejen mejor el concepto de responsabilidad social, que se ilustra mediante el compromiso en tres niveles: identificar las necesidades en salud de la población actual y futura, incluidos los determinantes de la salud; consecuentemente, adaptar las misiones y asegurarse si los efectos anticipados se han producido en el estado de salud de las personas. Para iniciar el cambio, se propone una serie de acciones futuras (AU)

Producing a socially accountable medical school: AMEE Guide No. 109.

Health systems worldwide are confronted with challenges due to increased demand from their citizens, an aging population, a variety of health risks and limited resources. Key health stakeholders, including academic institutions and medical schools, are urged to develop a common vision for a more efficient and equitable health sector. It is in this environment that Boelen and Heck defined the concept of the "Social Accountability of Medical Schools" - a concept that encourages schools to produce not just highly competent professionals, but professionals who are equipped to respond to the changing challenges of healthcare through re-orientation of their education, research and service commitments, and be capable of demonstrating a positive effect upon the communities they serve. Social Accountability calls on the academic institution to demonstrate an impact on the communities served and thus make a contribution for a just and efficient health service, through mutually beneficial partnerships with other healthcare stakeholders. The purpose of this Guide is to explore the concept of Social Accountability, to explain it in more detail through examples and to identify ways to overcome obstacles to its development. Although in the Guide reference is frequently made to medical schools, the concept is equally applicable to all forms of education allied to healthcare.

Why should social accountability be a benchmark for excellence in medical education? / ¿Por qué es la responsabilidad social un punto de referencia para la excelencia en la educación médica?

A mong the several criteria to recognize excellence in medical education, social accountability is probably one of the most important ones. Social accountability is the capacity to respond to society's priority health needs and health system challenges to meet such needs. It emphasizes the potential of medical schools to partner with key stakeholders in the health sector and organize medical education in a way that it has the greatest chances to yield most relevant outcomes and highest impact on people's health

Entre los diferentes criterios de reconocimiento de la excelencia en la educación médica la responsabilidad social es probablemente uno de los más importantes. La responsabilidad social es la capacidad de responder a las necesidades prioritarias de salud de la sociedad y a los retos del sistema sanitario para atender tales necesidades. Se pone de relieve el potencial que tienen las facultades de medicina para colaborar con las principales partes interesadas en el sector de la salud y para organizar una educación médica que disponga de las mejores opciones para producir resultados más relevantes y el mayor impacto en la salud de las personas

Is our medical school socially accountable? The case of Faculty of Medicine, Suez Canal University.

BACKGROUND: Faculty of Medicine, Suez Canal University (FOM/SCU) was established as community oriented school with innovative educational strategies. Social accountability represents the commitment of the medical school towards the community it serves. AIMS: To assess FOM/SCU compliance to social accountability using the "Conceptualization, Production, Usability" (CPU) model. METHODS: FOM/SCU's practice was reviewed against CPU model parameters. CPU consists of three domains, 11 sections and 31 parameters. Data were collected through unstructured interviews with the main stakeholders and documents review since 2005 to 2013. RESULTS: FOM/SCU shows general compliance to the three domains of the CPU. Very good compliance was shown to the "P" domain of the model through FOM/SCU's innovative educational system, students and faculty members. More work is needed on the "C" and "U" domains. CONCLUSION: FOM/SCU complies with many parameters of the CPU model; however, more work should be accomplished to comply with some items in the C and U domains so that FOM/SCU can be recognized as a proactive socially accountable school.

Seeking impact of medical schools on health: meeting the challenges of social accountability.

CONTEXT: The acquisition of sums of knowledge and mastery of sophisticated technologies by medical graduates is insufficient for their responsibilities to recognise and adapt to people's evolving needs. RESPONSE: A Global Consensus on Social Accountability for Medical Schools brought together 130 organisations and individuals from around the world with responsibility for health education, professional regulation and policy making to participate for 8 months in a three-round Delphi process leading to a 3-day consensus development conference which included weighted representation from all regions of the world. The resulting Consensus reflects agreement on 10 strategic directions to enable a medical school to be socially accountable. RESULTS: The list of 10 directions embraces a system-wide scope from identification of health needs to verification of the effects of medical schools on those needs, all driven by the quest for positive impact on peoples' health status. This includes an understanding of the social context, an identification of health challenges and needs and the creation of relationships to act efficiently (directions 1 and 2). Within the spectrum of the health workforce required to address health needs, the anticipated role and competences of the doctor are described (direction 3) serving as a guide to the education strategy (direction 4), which the medical school is called to implement along with consistent research and service strategies (direction 5). Standards are required to steer the institution towards a high level of excellence (directions 6 and 7), which national authorities need to recognise (direction 8). While social accountability is a universal value (direction 9), local societies will be the ultimate appraisers of the achievements of the school and its graduates (direction 10).

The social accountability of medical schools and its indicators.

CONTEXT: There is growing interest worldwide in social accountability for medical and other health professional schools. Attempts have been made to apply the concept primarily to educational reform initiatives with limited concern towards transforming an entire institution to commit and assess its education, research and service delivery missions to better meet priority health needs in society for an efficient, equitable an sustainable health system. METHODS: In this paper, we clarify the concept of social accountability in relation to responsibility and responsiveness by providing practical examples of its application; and we expand on a previously described conceptual model of social accountability (the CPU model), by further delineating the parameters composing the model and providing examples on how to translate them into meaningful indicators. DISCUSSION: The clarification of concepts of social responsibility, responsiveness and accountability and the examples provided in designing indicators may help medical schools and other health professional schools in crafting their own benchmarks to assess progress towards social accountability within the context of their particular environment.

[Global consensus on social accountability of medical schools]. / Consensus Mondial sur la Responsabilité Sociale des Facultés de Médecine.

A collaborative research project on the social accountability of medical schools based on the Delphi method was conducted by an international reference group composed of 130 representatives of the main associations of medical schools and medical education organizations throughout the world, in addition to experts invited to take part in a personal capacity. The project ended with a conference held in South Africa overseen by an independent adjudicator who was not an expert in the field. The event resulted in the unanimous adoption of a document entitled ?Global consensus on social accountability of medical schools'. The document emphases the importance of improving the capacity of medical schools to respond to the needs and challenges of health care for citizens and society in general, in line with the core values of quality, equity, relevance and effectiveness. The implications for reconsidering quality practices and for reviewing accreditation and evaluation criteria are presented.

Social accountability: the extra leap to excellence for educational institutions.

More than ever are we facing the challenge of providing evidence that what we do responds to priority health needs and challenges of the ones we intend to serve: patients, citizens, families, communities and the nation at large. Which are those health needs and challenges? Who defines them? How do medical schools organize themselves to address them through their education, research and service delivery functions? Principles of social accountability call for an explicit three-tier engagement: identification of current and prospective social needs and challenges, adaptation of school's programmes to meet them and verification that anticipated effects have benefited society. Measurement tools need to be designed and tested to steer development in this direction, particularly to establish a meaningful relationship between inputs, processes, outputs and impact on health. The Global Consensus on Social Accountability of Medical Schools provides a unique opportunity to foster collaborative research and development in an area of great significance for the future of medical education.

Medical schools in sub-Saharan Africa.

Small numbers of graduates from few medical schools, and emigration of graduates to other countries, contribute to low physician presence in sub-Saharan Africa. The Sub-Saharan African Medical School Study examined the challenges, innovations, and emerging trends in medical education in the region. We identified 168 medical schools; of the 146 surveyed, 105 (72%) responded. Findings from the study showed that countries are prioritising medical education scale-up as part of health-system strengthening, and we identified many innovations in premedical preparation, team-based education, and creative use of scarce research support. The study also drew attention to ubiquitous faculty shortages in basic and clinical sciences, weak physical infrastructure, and little use of external accreditation. Patterns recorded include the growth of private medical schools, community-based education, and international partnerships, and the benefit of research for faculty development. Ten recommendations provide guidance for efforts to strengthen medical education in sub-Saharan Africa.