A Systematic Review of Social
Accountability in Medical Education:
Robert Stempel College of Public Health and Social Work
Herbert Wertheim College of Medicine
Florida International University
Alan Wells, PhD, MPH; Presenter
Gilbert Ramirez, DrPH; Principal Investigator
Collaborators
• Shafik Dharmsi, PhD
• Lauri Andress, PhD
University of British Columbia
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 Grid
Values
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 themes
theme
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/enterprise
Social
justice/obligation/perspective/response
Altruism, 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
• Principles
• Issues
• Groups
• Practices
Values/ Goals
• Principles
• Issues
• Groups
• Practices
Vision
Mission
Analytic Framework
• 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