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.

CitationLarkins SL, Preston R, Matte MC, et al. Measuring social accountability in health professional education: development and international pilot testing of an evaluation framework. Med Teach. 2013;35(1):32-45. doi: 10.3109/0142159X.2012.731106. Epub 2012 Oct 26.

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Social Determinants of Health Inequalities

The gross inequalities in health that we see within and between countries present a challenge to the world. That there should be a spread of life expectancy of 48 years among countries and 20 years or more within countries is not inevitable. A burgeoning volume of research identifies social factors at the root of much of these inequalities in health. Social determinants are relevant to communicable and non-communicable disease alike. Health status, therefore, should be of concern to policy makers in every sector, not solely those involved in health policy. As a response to this global challenge, WHO is launching a Commission on Social Determinants of Health, which will review the evidence, raise societal debate, and recommend policies with the goal of improving health of the world’s most vulnerable people. A major thrust of the Commission is turning public-health knowledge into political action.

CitationMarmot M. Social determinants of health inequalities. Lancet. 2005;365(9464):1099-104.

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Service-learning Community-campus Partnerships for Health Professions Education

In 1995, the Health Professions Schools in Service to the Nation (HPSISN) program was launched under the auspices of the Pew Health Professions Commission as a national demonstration of an innovative form of community-based education called service-learning. The foundation of service-learning is a balanced partnership between communities and health professions schools and a balance between serving the community and meeting defined learning objectives. This article offers a definition of service-learning and an outline of its core concepts; it also describes how service-learning differs from traditional clinical education in the health professions. Further, the author discusses how service-learning programs may benefit students, faculty, communities, higher education institutions, and the relationships among all these stakeholders. The article concludes with brief descriptions of recommended resources for integrating service-learning into the medical school curriculum.

CitationSeifer SD. Service-learning: community-campus partnerships for health professions education. Acad Med. 1998;73(3):273-7.

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