A journey towards a more socially accountable healthcare system The integration of social accountability in medical education

This thesis is about educating our (future) healthcare professionals to be socially accountable. Because of the changes in the definition of health, social issues, and the healthcare system, societal accountability competencies become even more important than in the past. With this thesis, I aimed to answer two research questions: 1) How do educational staff members, medical students, and patients perceive the definition, competencies, and integration of social accountability in the medical curricula? 2) How can social accountability education be designed in an effective way? The findings of my studies showed that educational staff members, medical students, and patients have not yet formed a complete image of social accountability. They considered social accountability a multi-dimensional construct which is context-dependent. Important aspects of social accountability are: taking patient characteristics into account and tailoring care to the individual patient, taking the broader community and sustainability into account when making medical decisions, and being able to work interprofessionally. Several factors, such as organizational culture and common vision, affect the integration of social accountability. Flipped classroom, community-based education, and planetary health education are suitable approaches to teach students social accountability. Based on the findings of the studies in this thesis, we have formulated a roadmap and recommendations to integrate social accountability in the medical curriculum. Teaching future healthcare professionals social accountability competencies can better prepare them to face the current and upcoming challenges in the changing field of healthcare.