Social accountability - The missing link in dental education

Social accountability - The missing link in dental education ISSN: 2394-0026 (P)Review Article ISSN: 2394-0034 (O)Social accountability - The missing link in dental educationManu Batra1*, Aasim Farooq Shah2, Subha Soumya Dany3, Prashant Rajput3, Jasbir Mehar41Senior Lecturer, Department of Public Health Dentistry, Surendera Dental College and Research Institute, Rajasthan, India2Registrar, Department of Community Dentistry, Government Dental College and Hospital, Srinagar, Kashmir, Jammu and Kashmir, India3Post graduate student, Department of Public Health Dentistry, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India4Post graduate student, Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India *Corresponding author email: [email protected] to cite this article: Manu Batra, Aasim Farooq Shah, Subha Soumya Dany, Prashant Rajput,Jasbir Mehar. Social accountability - The missing link in dental education. IAIM, 2015; 2(1): 137-140. Available online at www.iaimjournal.comReceived on: 15-12-2014 Accepted on: 22-12-2014AbstractIn this century, dental colleges will be gauged by their capacity to anticipate the kind of doctorsrequired by evolving health systems. They will need to consider the challenges these systems face asthey grapple with critical health concerns in society. The roots of ill health lie in poverty,discrimination, lack of education, misdistribution and misuse of often scarce resources; and in anygiven country, those who identify health issues, act on health determinants, decide on the use ofresources, deliver health services, or train health manpower are usually different groups that maynot share the same value system and priorities. Thus, fragmentation is a serious threat to theefficiency and effectiveness of health systems everywhere. Meeting requirements of socialaccountability is a real challenge for dental colleges as it is for the dental health professions, healthservice organizations, health insurance schemes, and health policy leaders. So this article tries toevaluate the need for social accountability in the dental education system.Key wordsSocial accountability, Dental education, Health professionals.International Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 137Copy right © 2015, IAIM, All Rights Reserved.

Social accountability - The missing link in dental education ISSN: 2394-0026 (P)Introduction ISSN: 2394-0034 (O) costly. Subsequently many cases go untreated, snow balling the burden of dental diseases.Today we are facing widening disparities in India Hence, when conceiving a perception likein health status and access to basic health care. “service learning\" both ends of the sword are inCatastrophic health expenditure is causing the favour of the community: disease burden issignificant indebtedness. There is an acute dwindling, providing experience to thehealth manpower shortage, particularly in rural professionals.areas. Four values of social accountability are:The social accountability of medical schools has relevance, quality, cost effectiveness and equity,been defined as “their obligation to direct as they pertain to the activities of medicaleducation, research and service activities schools, namely education, research and servicetowards addressing the priority health concerns [4]. As governments, health care organisations,of the community, region and/or nation that health professionals and the public jointlythey have a mandate to serve” [1]. According to identify health concerns, two features of socialits definition, the principle of social accountability emerge: altruism and integration.accountability can be applied to all the health Altruism focuses primarily on society’s well-professions, dentistry being one among all. being and integration is an integral part of the social canvas. Humanistic principles: relative to“Service learning,” by which students people’s protection, and systemic principles:experience rigorously planned and evaluated relative to the relationship of the institutionlearning activities while providing direct with the health care system; serves as frames ofcommunity service, is the concept of community references [5].based education [2]. The rigour of this Integration of medical education into healthcommunity based education and research must service delivery system plays an important roleequal that traditionally expected in an academic to community health promotion andsetting. Although methodological standards may improvement of medical schools in all aspects ofneed to be adjusted to fit a community context, social accountability.applying different standards does not meanapplying lower ones. If, for example, a An educational institution that aspires toqualitative analysis is used to assess patients’ excellence in the production of health careexperiences of the transition from hospital to professionals should be granted that status notambulatory care, the standards established by only when its graduates possess all of thepeer review in that methodology must be met. competencies desirable to improve the health ofMethods of student assessment may also need citizens and society, but when they are able tomodification; for example, residents assigned to use them in their professional practice. Althoughremote sites could be examined via electronic medical schools are not presently held tomedia, but such examinations would have to be account for the ways in which their graduatesequivalent to those given at the home are used, and serve, their societies, such aninstitution [3]. In a dental setup community accounting may be required in the future.based learning can be of particular use, as Educational institutions are increasinglybecause in a developing country like India requested to be more explicit about theirpeople don’t consider dental problems to be lifethreating, and cogitate the treatments to beInternational Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 138Copy right © 2015, IAIM, All Rights Reserved.

Social accountability - The missing link in dental education ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)outputs of professional practitioners and the production–usability (CPU) model and theimpact of their presence on social well-being [5]. health system if there are not enough job opportunities for health professionals educatedExpressions of social accountability to respond to the public interest. A sustainable series of partnerships is necessary if feedbackSocial accountability requires that the actions of loops of CPU activities are to be built. Sociala medical school begin and be grounded in the accountability cannot be entirely fulfilled if all ofidentification of societal needs. The meeting of the main actors do not share a common set ofthose needs is the desired end. We suggest that values and an effective, although complex,the beginning and end of this complex process system through which to express those commonare connected through a cascade of three values [5].specific, although interdependent, domains This model is such a sweeping concept, that itconcerning the health professionals they can be very well amended according to theproduce: conceptualisation, production and dental institutions also. In Indian scenario whereusability. the Dental Council of India, is trying its best toThe domain of conceptualisation involves the give the Department of Public Health Dentistrycollaborative design of the kind of professional its merited status, by including it as an subject ofneeded and the system that will utilise his or her final professional year and 3 months ofskills. The domain of production involves the compulsory posting during internship. So babymain components of training and learning. The steps towards social accountability alreadydomain of usability involves initiatives taken by taken need to be polished by well versedthe institution to ensure that its trained professionals with their scholarly thoughts.professionals are put to their highest and bestuse. ConclusionThe term ‘usability’ is preferred to the terms Accreditation systems, properly designed and‘utilisation’ or ‘usefulness’. Graduates may mandated, can be powerful forces for qualityindeed be utilised and useful as soon as they are and change in any complex system. This isemployed in any health care structure, even if particularly true of the institutions of medicalthey only partially apply the spectrum of education. Accreditation can support countriescompetencies in which they have been trained. in their regulatory obligation to institutionaliseBy contrast, the notion of usability refers to the quality assurance approaches and guidedegree of concordance between their acquired individual institutions in their development.competencies and their opportunities to Therefore, it is very important to pay closepractise them. Therefore, the domain of attention to developments in this area. There isusability should reflect processes initiated by the an urgent need to foster the adaptation ofinstitution to ensure that the profile of a health accreditation standards and norms that reflectprofessional on which the training was based is social accountability. Only then can educationalproperly valued in the future working institutions be measured and rewarded for theirenvironment. real capacity to meet the pressing health care needs of society.There may be a mismatch between aninstitution applying this conceptualisation–International Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 139Copy right © 2015, IAIM, All Rights Reserved.

Social accountability - The missing link in dental education ISSN: 2394-0026 (P)Not only medical professions but also dental ISSN: 2394-0034 (O) 2. Health Professions Schools in Service toprofessions are liable to this social accountability the Nation survey. San Francisco: Centreas they also need to direct education, research for the Health Professions at theand service activities to meet the needs of the University of California, San Francisco,community. This will help in providing quality 1996.affordable, accessible & sustainable oral health 3. Brian H. Demonstrating socialcare to the destitute by the institutions along accountability in medical education. Canwith learning experience to the dental students Med Assoc J, 1997; 156(3): 365-67.in a real life situation. All these will for definite 4. Rourke J. Social Accountability in Theorymake them a more confident practitioner with a and Practice. Ann Fam Med, 2006;humanitarian touch. 4(Suppl 1): S45-S48. 5. Charles B, Bob W. Social accountabilityReferences an accreditation: A new frontier for educational institutions. Med1. Boelen C, Heck JE. Defining and Educ., 2009; 43(9): 887-94.measuring the social accountability ofmedical schools. Geneva: World HealthOrganization; 1995. WHO documentWHO/ HRH/95.7.Source of support: Nil Conflict of interest: None declared.International Archives of Integrated Medicine, Vol. 2, Issue 1, January, 2015. Page 140Copy right © 2015, IAIM, All Rights Reserved.