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Translating medical school social missions to student experiences

journal contribution
posted on 06.03.2019, 00:00 by RH Ellaway, K Van Roy, Robyn Preston, J Greenhill, A Clithero, S Elsanousi, J Richards, C Labarda, L Graves, M Mammen
Context: There is a growing focus on the social missions of medical schools as a way of expressing an institutional commitment to service, responsibility and accountability. However, there has been little exploration of how a social mission translates to student experiences. Methods: This multicentre study explored how the social missions of eight medical schools (from Australia, Belgium, Canada, the Philippines, South Africa, Sudan and the USA) translated to their medical education programmes, and how their students perceived the mission. The study used a nested case study design involving interviews with final-year medical students. Constructivist grounded theory techniques were used to analyse the data. Cultural-historical activity theory concepts of externalisation and internalisation were used to structure the analyses. Results: The study identified substantial variation in the form, focus and depth of expression of each school's social mission, significant variation in how and to what extent the mission was externalised in the design of each school's undergraduate medical education programme, and significant variation in how students perceived the social mission and its translation to their training experiences. The translation of a social mission to educational outcomes depended on a cascade of externalisation and internalisation processes, each of which could alter or reinterpret the mission. Translation depended to a great extent on sensitising learners to the mission's values and issues and subsequently activating this knowledge in the context of direct clinical encounters that embodied the issues the mission was seeking to address. Conclusion: Whether a medical school's social mission is focused on equity of access to the medical profession or on its graduates serving particular community needs, the mission principles need to be translated into practice. This translation process involves a series of externalisation and internalisation steps, each of which determines how much and what aspects of the mission are translated. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education

Funding

Other

History

Volume

52

Issue

2

Start Page

171

End Page

181

Number of Pages

11

eISSN

1365-2923

ISSN

0308-0110

Publisher

Wiley-Blackwell Publishing, UK

Peer Reviewed

Yes

Open Access

No

Acceptance Date

11/07/2017

External Author Affiliations

University of New Mexico; University of Gezira, Sudan; University of the Philippines-Manila; Western Michigan University Homer Stryker MD School of Medicine; Walter Sisulu University, South Africa; Flinders University Rural Clinical School; Northern Ontario School of Medicine, Ghent University, Belgium; University of Calgary, Canada;

Era Eligible

Yes

Journal

Medical Education