Social Accountability Building on Strengths Anne Durcan Department of Family Medicine and Community Health Sciences UGME SA Leader University of Manitoba
Social Accountability The obligation to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve. The priority health concerns are to be identified jointly by governments, health care organizations, health professionals and the public. 1995 World Health Organization
Social Accountability Framework Policy Makers Health Administrators Health System Based on People s Needs Health Professionals Communities Academic Institutions
As it pertains to my discipline and my personal reflection: 1. I know what social accountability means and can identify elements in my teaching 2. I know what SA is but need more information work it into my teaching 3. I have limited knowledge of what SA means and can t identify it in my teaching 4. I know what SA means but don t think it is relevant to my teaching 5. I know what SA means and know it is not relevant to my teaching (and also research and service)
FMEC recommendation #1 Address Individual and Community Needs Health care and health complex Diverse populations Asking who, why, where do they live, how to provide best care and work to improve outcomes
FMEC Moving Forward Patient, family, and community centred Consult with stakeholders in curriculum development Support relationships with communities Provide opportunities for students to work in low resource/underserved communities Link SA objectives with measureable health and health human resource outcomes
Relevance of Social Accountability Understand individuals in context of their environment in education, service Reflect on determinants of health Recognize importance of primary health care Health Equity Improve health for all
Diverse Populations Lower socioeconomic status Elderly community Refugee/new immigrants Gay/Lesbian/Bisexual/Transgendered Persons with physical & intellectual disabilities Persons with Addictions Northern/Rural Health Global Health Other communities?
Can Med spreadsheet UGME Knowledge Skills Attitudes Medical Expert Communicator Collaborator Health Advocate Manager Scholar History, challenges, SES, culture, barriers to health and health care Culture, language, values of own and patient/community Know patient/families priorities regarding health and treatment SDH, barriers to health care and health Services available to at risk groups, barriers, equity, costeffectiveness, quality of services, distribution resources Identify resources to serve communities in need Integrate knowledge into treatment plan, address social needs Empathy, respect, rapport for trust, listen Communicate information so understood, shared decision making Partner with community to advocate for change, health promotion/ disease prevention Apply knowledge to improve systems for at risk groups, strategies to navigate. Ability to engage with community to identify research priorities Identify strengths, flexible to patient s needs Recognize own and patient s world view/biases, power and privilege Patient as equal and expert in experience of health and illness Value input of stakeholders Pragmatic, able to partner to develop plan Facilitate work in community based participatory research, health equity research Professional Need to understand social determinants of health and health equity and root causes Critical self evaluation, highest quality of care Caring, compassion, openness, non judgmental, understand impact of racism and bias on health
What exists now Substantial Preclerkship curriculum - lecture and small group, community experiences block I &2 CHS, Medical Ethics, Communication skills, Human Development Addresses SDH, specific community needs Primarily lecture/tutorial Rural Week Rural Family Medicine clerkship
Existing Curricular Elements Optional Northern elective/optional core rotations in rural, northern, First Nation and Inuit communities Summer Work Program/SWEAT Program
Student initiated Projects Jacob Penner Park Program Global Connections Group local and global engagement Biomedical Youth Program Books with Wings In past students ran Health Advocate Program at Welcome Center WISH Clinic
Committee membership Anne Durcan Family Medicine, CHS Francis Amara Biochemistry and Medical Genetics Kim Clare Access Program RSW Karen Cook CHS Carrie Daymont Pediatrics Jeanette Edwards- Director Primary Care, WRHA Yvette Emerson Family Medicine, NMU Carla Ens - CHS Rick Lees RSW Mount Carmel Clinic Sharon Macdonald - CHS Deborah McPhail - CHS Yael Shrom Med II
How to teach Lecture 1 introductory session Longitudinal community service learning Tutorials Clinical reasoning Experiential learning with reflection in TTC Web based learning Reflective component throughout clerkship (logbook, portfolio) Clinical skills simulated patients with complex issues related to health
How to improve Identify leaders to support student led initiatives Increase community based early exposure experiences Experiences in key communities
Curricular enhancement Identify champions of different target groups Use social accountability framework to define learning needs Insert elements into existing curriculum or add parallel health equity elements to compliment existing curriculum
Outcomes Cognitive: Identify community/individual factors in health and integrate into clinical plan formulation Affective: Recognize own and patient s values, worldview, recognize power and privilege Psychomotor: Improved communication skills Outcome of Medical School : Better meet society s health care needs
Questions? Comments?