Academic excellence in Latin America: Social accountability of medical schools

Abstract

Context: Social accountability of medical schools has emerged as a standard of excellence in medical education during the last decade. However, the lack of valid and reliable instruments to estimate social accountability has limited the possibility of measuring the impact that medical schools have in society. Our aim was to develop an instrument and validate its use for assessing social accountability in Latin American countries.

Methods: We used a three–phase mixed methods research design to develop, validate and estimate social accountability in a diverse convenient sample of 49 medical schools from 16 Latin American countries. We used a qualitative framework approach and a Delphi consensus method to design an instrument with high content validity. Finally, we assessed the psychometric properties of the instrument.

Results: The Social Accountability Instrument for Latin America (SAIL) contained 21 items in four domains: mission and quality improvement, public policy, community engagement, and professional integrity. Its reliability index, estimated using Cronbach’s alpha, was very high (0.96). Most of the medical schools that had ranked over the 80th percentile on traditional national academic estimates did not reach the 80th percentile using SAIL.

Conclusions: There are validity arguments (content and reliability) to support the measurement of social accountability using the SAIL instrument. Its application showed that it provides a complementary dimension to that traditionally obtained when estimating quality in medical schools.

Keywords:

• Ethics/attitudes
• general
• undergraduate
• postgraduate
• institutional accreditation

Ethical approval

Ethics Committee at the Faculty of Medicine, Pontificia Universidad Católica de Chile (ID14–518).

Acknowledgments

The authors wish to thank to Mauricio Bouey (Toronto, Canada) for the proofreading of the manuscript.

Disclosure statement

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

Additional information

Funding

This work was supported by School of Medicine Pontificia Universidad Católica de Chile [Grant funding 14–518].

Notes on contributors

Klaus Puschel

Klaus Püschel, MD, MPH, MSc, is a full professor and Director of The Centre for Medical Education and Health Sciences at Pontificia Universidad Católica de Chile. He was the former Director of the School of Medicine until 2018 at the same institution. He is a specialist in Family Medicine and holds a Master degree in Public Health (University of Washington) and a Master in Bioethics (University of Lovain). He has large experience in community based learning education, and health advocacy applied to medical education.

Arnoldo Riquelme

Arnoldo Riquelme, MD, MEd, is a full professor and a specialist in Internal Medicine and Gastroenterology. He holds a Master degree in Medical Education (University of Dundee). He is a clinician and professor at the Department of Gastroenterology and at the Centre for Medical Education, School of Medicine, Pontificia Universidad Católica de Chile. He is currently the Director of the Department of Health Sciences, Faculty of Medicine, at the same institution.

Jaime Sapag

Jaime C. Sapag, MD, MPH., Ph.D, is an associate professor at the Division of Public Health and Family Medicine, Pontificia Universidad Católica de Chile (PUC). He completed a Master degree in Public health at Harvard University and a PhD Program at the University of Toronto. He has strong experience in Global Health and community medicine.

Philippa Moore

Philippa Moore, MD, is an associate professor and a clinician at the Department of Family Medicine, Pontificia Universidad Catolica de Chile (PUC). She was trained at the University of Cambridge and at the University of Oxford in communication and evidence based health care. She has large experience in team based learning and communication. She developed the Unit of Health Professional Communication at PUC.

Luis A. Díaz

Luis Antonio Díaz, MD, is a specialist in Internal Medicine and resident of Gastroenterology, Pontificia Universidad Católica de Chile. He is working in equity health policies at the Chilean national health care system and in the development of assessment instruments for medical education.

Eduardo Fuentes–López

Eduardo Fuentes-López, PhD, is an academic at the Department of Health Sciences, Faculty of Medicine, Pontificia Universidad Católica de Chile. He holds a Doctor of Philosophy degree in Public Health, Universidad de Chile. He has large experience in statistical and psycometric analysis applied to medical education.

William Burdick

William P. Burdick, MD, M.S.Ed., is Associate Vice President for Education at the Foundation for Advancement of International Medical Education and Research (FAIMER), and Co-Director of the FAIMER Institute. He is Clinical Professor of Emergency Medicine at Drexel University College of Medicine.

John Norcini

John J. Norcini, MD, PhD, has been President and CEO of FAIMER since May 2002. For the previous 25 years, he held a number of different senior positions at the American Board of Internal Medicine. Dr Norcini’s has a vast experience in medical education and in particular in the area of assessing physician´s performance.

Jorge Jiménez de la Jara

Jorge Jiménez de la Jara, MD, MPH, is a specialist in Paediatrics and full professor, Division of Public Health and Family Medicine, Pontificia Universidad Católica de Chile. He has been trained in Chile, England and USA. He was Minister of Health (Chile) between 1990-1992 and president of the Executive Committee of the World health Organization in 2000.

Henry Campos

Henry de Holanda Campos, MD, PhD, is a full professor and President of the Universidade Federal do Ceará (Ceará, Brasil). Dr. Campos is a specialist in Nephrology, has made major contributions in public health policies in the area of organ transplants. He has worked in collaboration with the Brazilian Minister of Education and Health promoting a national strategy for faculty development.

Jorge E. Valdez

Jorge E. Valdez García, M.D., PhD, is a full professor and Dean at the School of Medicine, Tecnológico de Monterrey (México). He is a specialist in ophthalmology and holds a Master degree in Arts and Medical Science from Boston University, as well as a PhD at the University of Oviedo. Dr. Valdez has made major contributions in innovation and medical education applied to health care in Mexico.

María Paola Llosa

María Paola Llosa, MD, PhD, is a specialist in Internal Medicine and Hematology. She was the former Dean at the Faculty of Medicine, Universidad Peruana Cayetano Heredia (2011-2017). She has made large contributions targeted to enhance medical education and community based learning initiatives in Perú.

Francisco Lamus-Lemus

Francisco Lamus-Lemus, MD, is an associate professor and Director of the Medical Education Department, School of Medicine, Universidad de La Sabana (Colombia). Dr. Lamus completed a Master Program in interdisciplinary studies at Tulane University and a fellowship program at the FAIMER Institute in Philadelphia. He has been very active in promoting medical education and in the development of community based education projects at the primary care level in Colombia.

Horacio Yulitta

Horacio Yulitta, M.D., is President of Evaluation Profesional Board, Argentinean Paediatrics Society. Staff Department of Pediatrics Germany Hospital Buenos Aires. General Coordinator Paediatrics Trainee, Minister of Health Ciudad Autonoma de Buenos Aires.

Marcela Grez

Marcela Grez, Ps, Ph.D, is a psychologist and completed a PhD program Eberhard Karls Universität Tübingen. She has large experience in assessment and accreditation programs in postgraduate medical education at the School of Medicine, Pontificia Universidad Católica de Chile.