Final-year students' perspectives on socially responsive curricula in medical education: A qualitative case study

There is urgency for health professionals to be better prepared to tackle health inequities. Transitioning to responsive and contextually relevant curricula is an important strategy to equip students to be both clinically competent and critically conscious of the contexts in which they provide health care. Although the literature suggests reframing medical education to be responsive, student engagement in this process remains limited. Little is known about how students understand and experience social responsiveness, or their involvement in reframing medical curricula to be more responsive. This paper, therefore, aims to explore how a medical curriculum has influenced undergraduate final-year medical students to become socially responsive.

This was a qualitative exploratory case study positioned within a constructivist paradigm. Data were generated through focus group discussions and individual interviews. Rich picture drawings served as reflective prompts. Initially, 27 students participated. Three withdrew across the course of the study. Data were coded inductively and analysed using reflexive thematic analysis. All relevant ethical and institutional approvals were granted.

The findings revealed that becoming socially responsive is a complex endeavour. Four intersecting themes were identified: (i) applying a socially responsive approach to health care; (ii) the culture and traditions of medicine; (iii) shattering of mindsets and (iv) the value of the student voice in the curriculum. The students expressed that the curriculum provided opportunities to engage with concepts related to social responsiveness. However, these opportunities were less frequent and were considered less valuable when compared to biomedical knowledge. Furthermore, the cultures and traditions of medicine were seen to create conditions that position students as consumers of the curriculum.

This paper argues that although the curriculum is an important aspect in developing social responsiveness in students, other aspects, such as the health system and what the student brings should also be considered. Additionally, the students should be considered co-constructors of their learning and key role players in transforming curricula to be socially responsive and contextually relevant.