A Systematic Review of Social Accountability in Medical Education:

Robert Stempel College of Public Health and Social WorkHerbert Wertheim College of Medicine

Florida International University

Alan Wells, PhD, MPH; PresenterGilbert Ramirez, DrPH; Principal Investigator

Collaborators

• Shafik Dharmsi, PhD University of British Columbia

• Lauri Andress, PhD Independent Researcher, Consultant

• Luther Brewster, PhD Herbert Wertheim College of Medicine (HWCOM), Florida International University (FIU)

• David Brown, MD, HWCOM-FIU

• Alnecia Rumphs, Epi Doctoral Student FIU School of Public Health

Social Accountability Concepts

• “[Medical Schools have] the obligation to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve”

• WHO 1995

Social Accountability GridValues Education

Relevance What is the best role for doctors?

Quality Collaborating to address the Social Determinants of Health

Equity Minority recruitment and placing graduates in health professional shortage areas

Cost-effectiveness Promote a primary health care model

Boelen C, Woollard B., (2009). Social accountability and accreditation: A new frontier for educational institutions. Medical Education (43) 887-894

FIU data base

• Medical School Mission Statements • n=159

Content analysis of Social Accountability in Mission Statement

Word analysis looking at

Presence ↔ dichotomous (no, yes; 0,1)

• Intensity ↔ how often

• Consistency ↔ levels in mission, vision, values, goals

• But we haven’t analyzed all of this yet

Major themestheme description

Population A key group that must be included within the realm of care and concern or a group not historically trained that must be educated as providers

Principle A key standard, aspiration or believe that must be incorporated into education and curriculum and practice

Issue A subject, topic or concern that should be addressed

Practice A type of approach to providing care

Analytic categories and indicator words

Categories Words/Phrases

Principles/ Overarching Perspective Moral obligation/enterpriseSocial justice/obligation/perspective/responseAltruism, social contract

Issues/Needs Societal challenges and needs, cultural and social background

Groups/Populations Rural, poor, underserved, minority

Practice/Approach Partnership, integration, community engagement, community based

Analytic FrameworkM

issi

on • Principles• Issues• Groups• Practices

Visi

on • Principles• Issues• Groups• Practices

Valu

es/

Goa

ls • Principles• Issues• Groups• Practices

Next Steps?

Discussion

How should we measure/define social accountability outcomes?

Should we focus on analyses of medical curriculum?

Correspondence and Thank you• Alan L. Wells, HWCOM, FIU• alwells@fiu.edu• 305-348-6197