Using medical education as a tool to train doctors as social innovators

Abstract

IntroductionCurrent medical education prepares doctors to diagnose, assess and treat individual patients yet lacks the expectation to be responsible for the care of the wider community. Learning the skills to recognise and redress the social determinants of health are increasingly being recognised as an essential part of medical education.ObjectivesThe goal of this research was (1) to investigate how medical education can be leveraged to reduce health inequalities through the role and practice of doctors and (2) to elucidate how key innovations in medical education are a necessity that can support doctors as ‘change agents.’MethodsTwo international multidisciplinary roundtable focus groups with 23 healthcare leaders from various backgrounds were facilitated. The discussions were audiorecorded, transcribed and then thematically analysed with the qualitative analysis software QDA Miner.ResultsEight themes emerged: (1) Social innovation training in medical education; (2) Linking community working with social innovation; (3) Future curricula development; (4) Settings, context, environment and leaving the classroom; (5) Developing links with third sector organisations and community, including low-income and middle-income countries; (6) Including learners’ perspectives and lived experience; (7) Medical roles are political and need political support and (8) The need to address power imbalances and impact of discrimination.ConclusionsMedical education needs to fundamentally widen its focus from the individual doctor–patient relationship to the doctor–community relationship. Doctors’ training needs to help them become social innovators who can balance interventions with prevention, promote good health on a community and societal scale and tailor their treatments to the individuals’ contexts.

The experiences of medical and pharmacy students participating in a Collaborative Online International Learning on social accountability and Global Health: a qualitative study

“…These programs are often optional and not considered in the validation of the curriculum. Community-based and international learning have the potential to promote a new educational paradigm that produces socially innovative medical practitioners [25].…”

“…The objective of educational programs, such as SOLID'AIRS, is to raise awareness of the realities of other healthcare systems and to train professionals capable of nding a useful place for themselves in a complex healthcare system. Therefore, it is critical to assess the impact of these study programs on students and the social determinants of health [9,[23][24][25]. Regarding the impact of the SOLID'AIRS program, students reported professional bene ts, including improved group work skills.…”

“…A meta-analysis of socio-demographic and educational factors among medical students revealed that participation in experimental community learning had a positive impact on their interest in social accountability and outreach to disadvantaged populations [9]. Another systematic review of 47 studies also reported that service-learning is effective in fostering signi cant improvement in students' social justice beliefs, stimulating signi cant changes in their attitudes towards developing altruistic behaviours and their commitment to social justice, and increasing their critical understanding by sparking questioning processes related to personal assumptions of inequalities [23]. Based on a recent meta-synthesis, it is recommended that the core medical school curriculum should include mandatory training to enable students to identify and address adverse social factors that are medically relevant [24].…”

Fragmentation, dehumanization, commodification: crisis of medicine

“…In addition, the framework of medical diagnosis is only one of several lenses through which we view a person's individual situation and experience. No matter how much it is perfected, it cannot fully describe and respond to illness or health ( 15 ). It follows that doctors do not have exclusivity in illness and health, a state of affairs that represents a change in the decades-old paradigm.…”

AMA Code of Medical Ethics’ Opinions Related to Critical Pedagogy in the Health Professions

“…1,2,3 The need for critical pedagogy and health justice studies in medical education has been recognized in the literature as important to supporting trainees' capacities to respond with care to structural biases in the health sector. 2,3,4,5,6 Critical pedagogy in medical education requires teaching and learning about social, political, cultural, and environmental determinants of human health. 3 Although there are examples of academic boundaries of medical education being pushed to provide more comprehensive and justice-driven service-learning experiences for medical trainees, 7,8 this approach is certainly not standard in training programs.…”