Social accountability: A face-lift or real change?
- Reflect on how we can ensure that social accountability fosters sustainable change in education and outcomes.
- Explore practical steps and mechanisms to evolve fit-for-purpose institutions and graduates.
Social accountability and community-engagement in health workforce education are gaining traction at global and regional policy levels and among education institutions and funding bodies. While this could represent a paradigm-shift in health workforce education—hopefully toward reducing health inequities—these concepts remain somewhat vague. They are often more aspirational than practical, perhaps somewhat simplistic. They barely address the core issue of power. Today, health education institutions and health professionals operate in complex systems that are more diverse, dynamic, resource-constrained, and interconnected than ever—and far less predictable. For social accountability to have the desired effect, new ways of operating, cooperating, co-creating, and enforcing are required. Institutions need to embrace heterogeneity; foster greater trust and reciprocity with communities and partners across sectors; and create feedback loops and adaptive mechanisms that are responsive to local dynamics.
Dr. Rachel Ellaway
Moral agency and scholarship in a time of social accountability
- Describe the principals of moral agency as applied to scholarship.
- Understand the challenges of scholarship-based moral agency in a socially accountable institution.
- Apply and challenge scholarly thinking and practice to be more engaged with principles of moral agency.
A moral agent recognizes their potential to do harm, and avoids doing harm—or at least minimizes the harm (and the impact of any harm) that flows from their actions or inaction. Although moral agency is arguably critical to the professional development and practice of medical education scholars, it is often omitted from their training and professional accountabilities. There is an inconsistency in physicians taking the Hippocratic Oath but not medical education scholars.
While scholarship may support or advance a school’s social mission, it should also hold the school, its mission, and its underlying ideologies to account. To paraphrase Bleakley, scholarship is (or should be) the primary systematic mechanism through which medical education programs are held to account, including acting as agents or advocates for the societies to which the broader sense of accountability is directed. As a result, a scholar may be their organization’s most committed champion, precisely by being its ideologies’ most ardent critic.
Drawing on the traditions of the public intellectual, this session explores the argument that scholars should strive to act as moral agents by directing their actions in reference to personal and professional codes and values. It also considers how the principles and practices of moral agency can and should respond to the social accountability missions and policies of their host institutions. Central to this thesis is that moral agency is not a matter of moral superiority, but the responsible and moral individual enactment of professional autonomy, particularly in the face of institutional ideologies.
Dr. Cynthia Wesley-Esquimaux
Acknowledging our past
Dr. Cynthia Wesley-Esquimaux navigated the intergenerational storm so many Indigenous peoples found themselves with a firm conviction life could offer more. Out of respect for her parents, both Indian Residential School (IRS) survivors, she walked back into the annals of history and learned about the impacts of an unconscionable past. Inspired by this knowledge and with a new compassion, she forgave and moved into a life of learning, sharing, and service. Healing is a deliberate act, it takes courage, forgiveness, remembrance, and an acknowledgement we have all been touched in a multitude of ways by those who walked before. We must chose what we carry forward and what we put down, unnecessary burdens of pain and loss, not to be forgotten, but to lighten our steps towards a better future. The story of Indigenous peoples in Canada is a tapestry of broken hearts, despair, stifled rage, and an incredible survivance, but it also depicts love, hope, and an enduring reminder reconciliation and relationships cannot happen without acknowledgement of our past as individuals, as peoples, and as a country.
Dr. Sheldon Tobe
Perspectives from the NOSM-Heart and Stroke Foundation Chair in Aboriginal and Rural Health Research
- Describe the goals of the NOSM/HSF Chair in Aboriginal and Rural Health Research with respect to research with Aboriginal communities.
- List some of the barriers, challenges, and potential pitfalls of promoting more research activities between NOSM and the communities.
- Describe some of the early outcomes and experiences resulting from efforts to achieve the research goals.
According to the Aboriginal and Rural Health Research Chair job description, the Chair is responsible for developing scientific advancement in the field of cardio and cerebrovascular disease in Aboriginal and rural communities. The Chair is also expected to integrate with Aboriginal and rural research units to establish mentorship and networking, as well as to work collaboratively with students, residents, faculty, university and hospital administrators, government officials, Aboriginal organizations, and the public.
To achieve this, a Chair’s Advisory Committee was struck and over 100 meetings organized with faculty, stakeholders, students, community members, and the public. A pilot program was developed to bring students together with Aboriginal communities interested in conducting their own research, mentored by the Research Chair and others. There was one student/community pair in the summer of 2014, three in 2015, and three more planned for 2016. These projects will be described to provide examples of how community-based participatory research can lead to greater trust, to capacity development, and provide learners with positive research experiences.
Dr. Aurel Schofield
Titre de la conférence principale
L’accès aux services de santé des francophones en situation minoritaire : survol du passé, présent et vision future
L’apport des francophones dans l’histoire de la province, du pays jusqu’à date a peu été célébrer. Dans toutes les provinces et territoires du Canada les francophones vivants en milieu minoritaire ont travaillé à arrache pied entre autre à se doter de services de santé adapté à leur langue et leur culture. Au cours des années beaucoup de gains ont été réalisés mais beaucoup reste à faire. Présentement plusieurs forces provinciales et nationales se sont ralliées vers une vision unifiée pour la santé des francophones minoritaires. Des actions concrètes nationales menées entre autre par la Société santé en français le Consortium national de formation en santé et l’Association des facultés de médecine du Canada dont le projet Franco Doc ainsi que par les facultés de médecine elles-mêmes, auront un impact majeur sur l’accès services de santé en français. Le futur s’annonce très prometteur mais son réel succès va être possible seulement grâce à un effort concerté et continu des individus et des communautés engagées vers un but et une vision commune.
Accessing French-language health services in a minority setting: overview of the past, present and the vision for the future
The contribution of Francophones in the history of the province, and the country has not been recognized much to date. In all provinces and territories of Canada, Francophones living in minority settings have toiled to ensure they obtain services that are adapted to their language and culture. Throughout the years, there have been many positive outcomes but there is still much to do. Currently, a number of provincial and national organizations have rallied together towards a common vision for the health and benefit of minority Francophones. Concrete actions at the national level lead, among others, by la Société Santé en français, le Consortium national de formation en santé and the Association of Faculties of Medicine of Canada, specifically the Franco Doc project, as well as all faculties of medicine themselves will have a major impact of accessing French-language health services. The future is looking bright but the ultimate success is only possible with concerted and continued efforts by committed individuals and communities to a common goal and vision.