Wollard RF.. Caring for a common future: Medical schools’ social accountability

Department of Family Practice, University of British Columbia, Canada.
Medical Education (Impact Factor: 3.2). 05/2006; 40(4):301-13. DOI: 10.1111/j.1365-2929.2006.02416.x
Source: PubMed


ORIGINS AND CONTEXT: The concept of 'the social accountability of medical schools' is moving from the peripheral preoccupation of a few to a more central concern of medical schools themselves. Born of concerns about the professionalism and relevance of both the institutions and their graduates, it is seen increasingly as an urgent call to focus the considerable social resources vested in academic health science institutions on addressing the priority health concerns of the societies they serve. For a profession embedded in an ethos of service, this would seem an obvious transition. However, as with any movement towards transformative change, it runs the risk of being more mantra and rhetoric than mandate and responsibility. NEEDED RESPONSE: Proceeding from the assumption that good intentions alone are not enough, this paper seeks to outline the historical development and some current expression of the concept throughout the world. The sadly divergent wealth and health status of modern societies calls for very different actions by medical schools across the spectrum from the least endowed to the wealthiest of schools. In a profession claiming centuries of cohesive commitment to the welfare of others, it is increasingly urgent that the current generation of medical educators converge on a relevant set of principles and coherent activities. TOOLS FOR THE TASK: While recognising that they are closely intertwined, the paper outlines the difference between the social accountability of the institutions themselves and the social accountability of the graduates they produce. It outlines both individual examples and the international initiatives that are fostering and facilitating institutional collaborations to bring both progress and optimism to this daunting task. It provides connections to practical resources for those who are committed to that task. Other papers in this series add further practical insights into the central role that medical educators must play if we are to fulfil the responsibilities we carry with the privilege of our profession.

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Available from: Robert Woollard, Jan 03, 2014
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    • "Since the lack of integration in health and sustainability issues is a form of knowledge deficit in its own right—this integration of knowledge also offers a critical opportunity to know more. Furthermore, Table 3 summarises how both projects generated a different type of knowledge that would have been achieved in isolation, consistent with what Woollard (2006) describes as the scholarship of integration, application and engagement (see also Table 1). "
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    ABSTRACT: E-BOOK: Available on Google books: (Chapter 7) FREE-SAMPLE: HARD-COPY: Available at: ABSTRACT: The title of this chapter offers several insights into its origins and intent. While the instruction to “Just Add Water” is often associated with convenience (mixing “instant soup” for example), the metaphor of interest is the “magic” of combining ingredients in a way that reveals something new. The chapter aims to reveal and combine a range of considerations that are often overlooked when we address converging health, environment and community concerns. The focus here is the interrelated themes of integration, participation and collaboration. Drawing on the author’s background in medicine, human ecology and the emerging field of ecohealth and the literatures on transdisciplinarity, participatory processes and organisational change, the water that we add to this mix includes working together in the particular social-ecological context of a research project in a rural New Zealand catchment (or watershed). Beyond its scholarly origins, the chapter is a reflection on boundary-crossing and change - as taught by a river and those whose livelihoods, lifestyles and living systems depend on it.
    Ecosystems, Society and Health: Pathways through Diversity, Convergence and Integration, Edited by Lars K Hallstrom, Nicholas Guelstorf, Margot W Parkes, 05/2015: chapter ‘Just Add Water’: Dissolving Barriers to Collaboration and Learning for Health, Ecosystems and Equity.; McGill-Queens University Press., ISBN: 978-0-7735-4479-6
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    • "High student satisfaction rates and sustained student enthusiasm, strong faculty commitment, university support, and good acceptance by community health actors have allowed the community immersion clerkship program to become a highlight of the Geneva problem-based medical curriculum over the past 15 years. The community immersion clerkship program has also strengthened ties between community health institutions and the Medical School, contributing to the latter’s social accountability, as discussed in the literature.24 "
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    ABSTRACT: Significant changes in medical education have occurred in recent decades because of new challenges in the health sector and new learning theories and practices. This might have contributed to the decision of medical schools throughout the world to adopt community-based learning activities. The community-based learning approach has been promoted and supported by the World Health Organization and has emerged as an efficient learning strategy. The aim of the present paper is to describe the characteristics of a community immersion clerkship for third-year undergraduate medical students, its evolution over 15 years, and an evaluation of its outcomes. A review of the literature and consensus meetings with a multidisciplinary group of health professionals were used to define learning objectives and an educational approach when developing the program. Evaluation of the program addressed students' perception, achievement of learning objectives, interactions between students and the community, and educational innovations over the years. The program and the main learning objectives were defined by consensus meetings among teaching staff and community health workers, which strengthened the community immersion clerkship. Satisfaction, as monitored by a self-administered questionnaire in successive cohorts of students, showed a mean of 4.4 on a five-point scale. Students also mentioned community immersion clerkship as a unique community experience. The learning objectives were reached by a vast majority of students. Behavior evaluation was not assessed per se, but specific testimonies show that students have been marked by their community experience. The evaluation also assessed outcomes such as educational innovations (eg, students teaching other students), new developments in the curriculum (eg, partnership with the University of Applied Health Sciences), and interaction between students and the community (eg, student development of a website for a community health institution). The community immersion clerkship trains future doctors to respond to the health problems of individuals in their complexity, and strengthens their ability to work with the community.
    04/2013; 4:69-76. DOI:10.2147/AMEP.S41090
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    • "Such goals suggest a need to teach and value emotional knowledge and understandings , to include into undergraduate medical curriculum ways of perceiving the world that do not rest solely on bioscientific or objective orientations. We wonder what this might look like, and how we might arrive at a place where emotional knowledges and understandings can be safely taught and learned as part of the aspirations of, and attention, to social accountability within medical schools (Woollard, 2006; GCSAMS, 2010; Boelen and Woollard, 2011). We are also conscious that demanding BOTH social accountability and biomedical fluency in undergraduate medical students e who are not being formally schooled in how to deal with the stresses and tensions they encounter as learners e can make pedagogical landscapes even more fraught, even more ruinous and emotionally difficult. "
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    ABSTRACT: This paper engages our struggles with the discipline of medicine. Specifically, and sometimes from very personal perspectives, we question if the geographies in which undergraduate medical education unfolds are healthy. As three women broadly trained as geographers who are emotionally, politically, personally, and professionally tied to the discipline of medicine, we wonder if undergraduate medical curriculum is meeting the competencies to which is aspires. Anchored in broader literatures about medical education and the potential of medical humanities, and in our own and others’ observations and experiences about medicine being – at least to some degree – a discipline in crisis and in some state of ruin and disrepair, we reflect in this paper on two things. First, we consider how undergraduate medical education disciplines its students and scholars in specific ways that often sublimates emotional knowledge. Second, we reflect on how the discipline’s undergraduate curricular structures might improve through creative interventions that encourage non-linear, creative, possibly emotive, ways of knowing and understanding.
    Emotion Space and Society 01/2013; 11. DOI:10.1016/j.emospa.2013.11.006
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