Conceptualising social accountability as an attribute of medical education

BACKGROUND: Health professionals need to be both person- and community oriented to improve population health. For educators to create socially accountable physicians, they must move learners from understanding social accountability as an expectation to embracing and incorporating it as an aspect of professional identity that informs medical practice. AIM: The aim of this article was to assess the degree to which medical students, preceptors and community mentors understand the concept of social accountability. SETTING: The setting is the KwaZulu-Natal Province in Durban, South Africa. METHODS: Using an observational design, we surveyed 332 participants, including the first- and sixth-year medical students, physician preceptors and community mentors. RESULTS: Whilst most respondents understood social accountability as requiring an action or set of actions, it was defined by some as simply the awareness one must have about the needs of their patients, community or society at large. Some respondents defined social accountability as multi-dimensional, but these definitions were the exception, not the rule. Finally, most respondents did not identify to whom the accountable party should answer. CONCLUSION: Whilst the development of professional identity is seen as a process of ‘becoming’, the ability to define and understand what it means to be socially accountable is not a linear process. Assessment of this progress may start with comprehending how social accountability is understood by students when they begin their education and when they are graduating, as well as in knowing how their educators, both clinical and community, define it.