Management of Social Accountability in Medical Education at Tabriz University of Medical Sciences

© 2015 The Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, as long as the original authors and source are cited. No permission is required from the authors or the publishers. Article History: Received: 21 Feb 2015 Accepted: 24 June 2015 ePublished: 4 July 2015


Introduction
Social accountability in medical education is defined as an education that responds to the requirements and expectations of the society.Answering to the most important community problems, needs and expectations is a reasonable, continuing and stable demand.The first and most important step is the integration of medical sciences education and health care services.4] Therefore, meeting the society's expectations of the education system depends on a close collaboration between the educational and delivery systems. 5nother important point is that the disease-centered educational system should be replaced by a health-centered system.Physicians and other health professionals should address health-related issues in a way that depends on the collaboration of the educational and care systems. 6onsidering that the main responsibility of the health care system is maintaining and enhancing the community health, an evolution in health care systems should be followed by an improvement in the educational system. 7earning and education are inseparable contexts 8 ; in other words, the learning environment dictates the content, method, time and place of learning.Therefore, the education system is a requirement to train professionals in the field of community service systems. 9arious fields of health care systems provide a real/ typical learning environment for graduates who will enter the health care system in the future.1] The close relationship between medical education, health services, and the requirements and expectations of the community is confirmed by the context and history of education and health systems; the extensive scientific literature indicates this close relationship as well; therefore it is obvious that social accountability is in line with the mission and philosophy of the medical education.The main objective of this study was to assess the status of management of social accountability in medical education at Tabriz University of Medical Sciences.

Materials and Methods
This cross -sectional study was conducted in two phases in 2013-2014: The first phase was carried out using a librarian study by direct observation and the second phase by documenting the activities and programs of the Tabriz University of Medical Sciences using the convenience and purposive sampling method, which included:

University of Medical Sciences Ethical Considerations
There is no need for ethical clearance or any issues pertaining to same as long as statistics from governmental database or related information are not being used.Study also does not deal with any sensitive information pertaining to human, invasive procedures, informed consent.

Discussion and Conclusions
The main objectives of the health care system are health promotion in the community, distribution of health, an increase in the accountability of the health system to the legitimate demands of the population and sharing financial resources fairly.Due to its mission, the Ministry of Health of Iran has tried to be more responsive to the health and medical requirements of the society by training specialists.If the mission of medical education is considered to be the overall concept of health, then focusing on the individuals as the objective of medical education should be replaced by focusing on comprehensive health.Therefore, medical education should have a comprehensive view to all aspects of health.One of the philosophical approaches to higher education is accountability and commitment, which focuses mostly on the social accountability of universities to serve the community.Accountability and social commitment in medical education should be met in all aspects of education.According to the findings of the present study, the following positive points can be inferred regarding to the Tabriz University of Medical Sciences' performance toward social accountability,: • Tabriz University has training programs based on the requirements of society (education in society, training in non-hospital settings) and social accountability in curriculum, as well as educational goals tailored to the needs of society.The findings F11 and F12 showed that this university attempts to create relevant hospital and non-hospital fields to educate medical, pharmacy, dentistry and other medical sub-disciplines.WORLEY and colleagues had also given attention to the subject of education in appropriate field. 8,12 Based on the F13 finding, this university has emphasized on conducting research on the quality of education-related fields. 11-10F15 and F16 implied that the university makes efforts to plan and implement workshops related to new methods of teaching and learning, student assessment and program evaluation based on the needs assessment survey from the basic science and clinical faculty members.These workshops have led to increased educational knowledge of the academic members and implementation of these methods in classes, workshops, hospitals and other medical fields.] • Based on F17, skilled manpower training has been considered as one of the top-priority goals of the university.Through this training, it would be possible for medical experts to serve the most deprived and isolated parts of the country.This mission is consistent with the mission of many other universities around the world. 15 Establishment of the Head Council of Accountable Education in Tabriz University of Medical Sciences (F2), which is responsible for macro-level policy setting, is one of the university efforts.Although the council is the highest authority to decide on this issue, it seems that, like the strategic plan of the Iran's Ministry of Health for social accountability in medical education, the council has mainly focused on training in the field.In other words, the fields, indexes and indicators of accountability in education have not yet been defined.Therefore, it appears that defining the fields, indexes and indicators of social accountability in medical education will clarify the academic performance.
• Based on F6 and F7, regional priorities in health and disease  have been set and announced to educational departments. Altough the departments' performance outcome implied that these concepts are addressed and presented during the training period in accordance with the curriculum, specification and greater emphasis on these topics have not been noticed.Priority setting is consistent with some previous studies by other investigators.[16][17] Overall, Tabriz University of Medical Sciences has made great efforts to construct a link between health care decision-makers, health provision, university and the society.Using appropriate methods and educational technology and student assessment appropriate to their future career, including students' responsiveness to the community, faculty members' accountability to the community, educational environment and community responsiveness, educational administration and accountability to society should evolve at an accelerating pace.So, the performance of Tabriz University of Medical Sciences in regard to its educational mission can be outlined as follows: 1. Training experts and skilled manpower according to the requirements of the community 2. Providing various services to promote public health 3. Utilization, conversion and transfer of knowledge according to the requirements of the community 4. Continuous effort to develop a comprehensive collaboration with health-focused NGOs 5. Focusing on promoting the quality of communityoriented and social accountability education 6.Four principles of social accountability, including proportion with the community's needs, equity, costeffectiveness and quality, have been the basis of all of the Tabriz University of Medical Sciences' programs, although they have not been fully evaluated yet 7. Trying to plan a family physician program as part of the main principles of accountability Although the mission of social accountability in medical education has been partly conducted by the university, based on the findings of this study, it seems that the indicators of social accountability in medical education lack definition.
Sciences proceedings in the field of social accountability in medical education: F (finding) F1: Creating "accountable education" unit as the main coordinator in Medical Education Development Center F2: Establishing the Head Council of Accountable Education for policy setting F3: Setting the indicators of social accountability in medical education F4: Integration of health and medical education system F5: Setting the priorities of Health and Disease in East Azerbaijan by the Deputy of Health of Tabriz Medical University, including: • Environmental health • Nutrition promotion • Occupational health • Family health • School health • Health education • Oral and dental health • Drug and laboratory problems F6: Notifying the health and disease priorities to the educational departments for including in their educational curriculum F7: Faculty members' participation in health-based NGOs and patient education through providing brochures and books F8: Presenting educational health and patient care programs in media F9: Reviewing all curriculum and lesson plans to develop field education F10: Creating the appropriate hospital and non-hospital training fields for medical students F11: Creating a model pharmacy in the Faculty of Pharmacy to train students F12: Performing research projects related to "field education quality improvement" F13: Establishing the "Faculty members empowering unit" in the Medical Education Development Center F14: Designing "academic skills" courses and "core skills" courses to empower faculty members in the related fields, including: 1. Principles of learning and teaching in medical sciences 2. Needs assessment and planning in medical education 3. Learning and teaching methods in medical sciences: • Training in large groups • Training in small groups • Training in the clinical field and the community • Computer training and the application of multimedia in teaching • Methods of continuing education and professional advancement 4. Methods of evaluation of students in medical sciences: • A written test based on multiple choice questions • Evaluation of clinical and practical learning 5. Evaluation and accreditation of programs and institutions 6. Educational management 7. Principles and methods of research in medical sciences 8. Research methods in education 9. Evidence-based education 10.Article writing 11.Communication and advice on learning 12. Academic and professional ethics 13.The use of portfolio learning in medical education 14.Creating the Medical Education Research Center F15: Specialist training based on community health requirements