Exploring the relationship between social accountability and competency-based medical education: A narrative review

Abstract

Background

Social accountability (SA), a quintessential goal of medical education, has been discussed as a precipitant for the transition toward competency-based medical education (CBME). However, the relationship between SA and CBME remains unclear. A narrative review was conducted to systematically explore the relationship between SA and CBME as described in the literature.

Methods

Electronic databases, select journals, and medical education organizations were systematically searched. 363 titles and abstracts were screened and 147 full texts were reviewed. The salient text was extracted from 36 records, which were then inductively coded before narrative synthesis and interpretation.

Results

The relationship between SA and CBME was described in three manners: (1) CBME as a natural driver of SA where CBME was perceived to be inherently socially accountable, (2) CBME as an opportunistic mechanism for actively changing medical training to better meet standards of SA, and (3) CBME as a tool to measure SA relating to measurable outcomes data provided by CBME.

Conclusion

CBME has theoretical potential to assist programs in becoming more socially accountable if the communities they serve are considered key stakeholders in the design, implementation, and evaluation. A paucity of evidence remains which provides empirical evidence of SA within programs that have implemented CBME.

Keywords:

• Competency-based medical education
• social accountability
• narrative review

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Competency-based medical education (CBME): An outcomes-based approach to the design, implementation, assessment, and evaluation of medical education programs, using an organizing framework of competencies (Frank et al. 2010).

Social responsibility: Medical education that is committed to what faculty intuitively considers the welfare of society where the intention to produce good practitioners is based on an implicit identification of society’s health needs (Boelen et al. 2012).

Social responsiveness: Medical education that responds to society’s welfare by directing education, research, and service activities towards explicitly identified health priorities in society (Boelen et al. 2012).

Additional information

Notes on contributors

Angela R. Schneider

Angela Schneider, MD MSc, is an Internal Medicine resident at the University of Calgary. She completed her MD at the University of Calgary in 2020 and her MSc in Applied Sciences at McGill University in 2017.

Tejeswin Sharma

Tejeswin Sharma, MPH, is a third-year medical student at the University of Calgary. He completed his MPH at the University of Saskatchewan in 2019.

Anindita Bhattacharya

Anindita Bhattacharya, BHSc, is a third-year medical student at the University of Calgary. She completed her BHSc at the University of Calgary in 2019.

Allison Brown

Allison Brown, PhD, is an Assistant Professor at the Cumming School of Medicine in the Department of Medicine and Department of Community Health Sciences. She completed a PhD in Community Health Sciences at the University of Calgary (specializing in Medical Education) in 2020 and an MSc in Health Research Methods at McMaster University in 2017.