Exploring the relationship between social accountability and competency-based medical education: A narrative review

Social accountability (SA), a quintessential goal of medical education, has been discussed as a precipitant for the transition toward competency-based medical education (CBME). However, the relationship between SA and CBME remains unclear. A narrative review was conducted to systematically explore the relationship between SA and CBME as described in the literature.

Electronic databases, select journals, and medical education organizations were systematically searched. 363 titles and abstracts were screened and 147 full texts were reviewed. The salient text was extracted from 36 records, which were then inductively coded before narrative synthesis and interpretation.

The relationship between SA and CBME was described in three manners: (1) CBME as a natural driver of SA where CBME was perceived to be inherently socially accountable, (2) CBME as an opportunistic mechanism for actively changing medical training to better meet standards of SA, and (3) CBME as a tool to measure SA relating to measurable outcomes data provided by CBME.

CBME has theoretical potential to assist programs in becoming more socially accountable if the communities they serve are considered key stakeholders in the design, implementation, and evaluation. A paucity of evidence remains which provides empirical evidence of SA within programs that have implemented CBME.