Norwich Medical School, University of East Anglia, Norwich, UK.
Med Teach. 2011;33(8):673-6. doi: 10.3109/0142159X.2011.590253.
Social accountability as an outcome must be measured at institutional (evaluation) and individual (assessment) level. The definitions used in the measurement will be dependent on the social setting of the medical school being scrutinised. A formal framework is needed so that comparisons can be made and progress measured. The World Health Organisation suggests that there are four principles that delineate social accountability--relevance, quality, cost-effectiveness and equity. Medical schools are evaluated according to their planning, doing and impact in relation to these principles. Boelen and Woollard have clarified the ideas of planning, doing and impact into Conceptualisation, Production and Usability. THEnet group of medical schools use a shortened version of Boelen and Woollard's framework with 20 criteria to evaluate their programmes. At the individual level, there is considerable overlap between the concepts of 'social accountability' and 'professionalism'. Attempts are being made to define and measure professionalism, however, if the behaviour and attitudes of individual graduates is a significant component in defining social responsibility new methods of assessment need to be developed. Factors such as the available resources and the structure of the health services have a very large effect on doctors' attitudes and behaviour. As a result, the task of evaluating and assessing the extent to which medical schools are socially accountable is complex. Judgments on how well a school is meeting the standards will have to make allowance for the local political and economic environment.
社会问责制作为一种结果，必须在机构（评估）和个人（评估）层面进行衡量。衡量中使用的定义将取决于被审查医学院的社会背景。需要一个正式的框架，以便进行比较和衡量进展。世界卫生组织（World Health Organization）建议，有四项原则可以划定社会问责制——相关性、质量、成本效益和公平性。医学院校根据其在这些原则方面的规划、实施和影响进行评估。Boelen 和 Woollard 将规划、实施和影响的理念澄清为概念化、生产和可用性。THEnet 医学院校使用 Boelen 和 Woollard 框架的简化版，有 20 项标准来评估其课程。在个人层面上，“社会问责制”和“职业道德”的概念之间存在很大的重叠。人们正在努力定义和衡量职业道德，但是，如果个体毕业生的行为和态度是定义社会责任的重要组成部分，则需要开发新的评估方法。可用资源和卫生服务结构等因素对医生的态度和行为有很大影响。因此，评估和评估医学院在多大程度上承担社会责任的任务非常复杂。对学校满足标准的程度的判断必须考虑到当地的政治和经济环境。
