Social responsiveness: The key ingredient to achieve social accountability in education and health care.

While social accountability (SA) is regarded as an obligation or mandate for medical school administration, it runs the danger of becoming a bureaucratic checkbox. Compassion which leads to social responsiveness (SR), in contrast, is often recognized as an individual characteristic, detached from the public domain. The two, however, complement each other in practice. Institutions must be truly socially accountable, which is possible if there is spontaneous SR to the needs, and is fueled by compassion. Compassion in this article is defined as a "feeling for other people's sufferings, and the desire to act to relieve the suffering." Compassion has a long history, whereas SA is more recently described concept that follows the historical development of social justice. SR is the moral or ethical duty of an individual to behave in a way that benefits society. Not everyone feels the need to do something for others. Even if the need is felt, there may be a lack of will to act for the needs or to act effectively to fulfill the needs of society. The reasons are many, some visible and others not. SR provides the basis for being compassionate; hence, medical schools need to include SR as a criterion in their admissions process for student recruitment and inculcate compassion in health professions education and health care. By fostering SR and engaging compassion and self-compassion to achieve SA, we can humanize medical education systems and health care.

Teaching compassion for social accountability: A parallaxic investigation.

BACKGROUND: In an arts integrated interdisciplinary study set to investigate ways to improve social accountability (SA) in medical education, our research team has established a renewed understanding of compassion in the current SA movement. AIM: This paper explores the co-evolution of compassion and SA. METHODS: The study used an arts integrated approach to investigate people's perceptions of SA in four medical schools across Australia, Canada, and the USA. Each school engaged approximately 25 participants who partook in workshops and in-depth interviews. RESULTS: We began with a study of SA and the topic of compassion emerged out of our qualitative data and biweekly meetings within the research team. Content analysis of the data and pedagogical discussion brought us to realize the importance of compassion in the practice of SA. CONCLUSIONS: The cultivation of compassion needs to play a significant role in a socially accountable medical educational system. Medical schools as educational institutions may operate themselves with compassion as a driving force in engaging partnership with students and communities. Social accountability without compassion is not SA; compassion humanizes institutional policy by engaging sympathy and care.

Exploring rural medical education: a study of Canadian key informants.

INTRODUCTION: Recruiting and retaining primary healthcare professionals is a global healthcare problem. Some countries have been using medical education as a strategy to aid in the recruitment and retention of these healthcare professionals. The purpose of this study is to engage with key informants and explore the learning processes that support medical students to prepare for a rural career. METHODS: Seven key informants with extensive experience in rural medical education participated in semi-structured interviews. The interviews were audio-recorded and professionally transcribed. Transcripts were analyzed using thematic analysis. RESULTS: Four key themes were identified. Respondents discussed the different ways they conceptualized 'rural'. Informants suggested that relationships could either be barriers or facilitators to rural practice and that certain educational strategies were necessary to help train students for rural careers. Finally, informants discussed different characteristics that rural physicians need. CONCLUSION: The finding of this study suggests that preparing students for rural practice requires a multifaceted approach. Specifically, using certain educational strategies, pre-selecting or developing certain characteristics in students, and helping students develop relationships that attach them to a community or support working in a rural community are warranted.

Community engagement: A central feature of NOSM's socially accountable distributed medical education.

BACKGROUND: Northern Ontario School of Medicine (NOSM) serves as the Faculty of Medicine of Lakehead and Laurentian Universities, and views the entire geography of Northern Ontario as its campus. This paper explores how community engagement contributes to achieving social accountability in over 90 sites through NOSM's distinctive model, Distributed Community Engaged Learning (DCEL). METHODS: Studies involving qualitative and quantitative methods contribute to this paper, which draws on administrative data from NOSM and external sources, as well as surveys and interviews of students, graduates and other informants including the joint NOSM-CRaNHR (Centre for Rural and Northern Health Research) tracking and impact studies. RESULTS: Community engagement contributes throughout the lifecycle stages of preadmission, admission, and undergraduate medical education. High school students from 70 Northern Ontario communities participate in NOSM's week-long Health Sciences Summer Camps. The MD admissions process involves approximately 128 volunteers assessing written applications and over 100 volunteer interviewers. Thirty-six Indigenous communities host first year students and third-year students learn their core clinical medicine in 15 communities, throughout Northern Ontario. In general, learners and communities report net benefits from participation in NOSM programs. CONCLUSION: Community engagement makes a key contribution to the success of NOSM's socially accountable distributed medical education.

Needs of the many: Northern Ontario School of Medicine students' experience of generalism and rural practice.

OBJECTIVE: To explore the Northern Ontario School of Medicine (NOSM) student and graduate experience of generalism in rural practice, in the context of a growing discourse on generalism. DESIGN: Qualitative analysis. SETTING: Northern Ontario School of Medicine in multiple sites across northern Ontario, which is the NOSM campus. PARTICIPANTS: A total of 37 graduating medical students and 9 practising NOSM graduates. METHODS: The Centre for Rural and Northern Health Research and NOSM tracking studies use mixed methods drawing on data from various sources. This paper reports on an arts-based study using semistructured interviews. MAIN FINDINGS: Key themes from student observations include an affinity for the northern Ontario environment and a recognition that rural medicine involves a broad scope of practice. Students from NOSM consider generalist care to be a comprehensive service with a strong focus on responding to the health needs of the communities they serve. Beyond primary care, a rural medicine "true generalist" is viewed as a complete package-a physician who provides care ranging from promoting prevention to performing specialist tasks. CONCLUSION: Rural practitioners, particularly in family medicine, are extended generalists with a broad scope of practice guided by the health needs of the communities they serve. The NOSM students' and graduates' experience of rural generalism is positive and highly influential in determining their career directions, including specialty, scope, and location of practice. The generalist approach of NOSM might be effective beyond rural applications and an advantageous approach for foundational medical education. Students and graduates report that NOSM's distributed community-engaged learning prepares them well for rural generalist practice.