Klaus Puschel1, Arnoldo Riquelme2,3, Jaime Sapag1, Philippa Moore1, Luis A Díaz2, Eduardo Fuentes-López3, William Burdick4,5, John Norcini4, Jorge Jiménez de la Jara6, Henry Campos7, Jorge E Valdez8, María Paola Llosa9, Francisco Lamus-Lemus10, Horacio Yulitta11, Marcela Grez12. 1. Department of Family Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. 2. Department of Gastroenterology, Pontificia Universidad Católica de Chile, Santiago, Chile. 3. Department of Health Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile. 4. Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, PA, USA. 5. Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA, USA. 6. Department of Public Health, Pontificia Universidad Católica de Chile, Santiago, Chile. 7. Rector, Universidade Federal do Ceará, Fortaleza, Brazil. 8. School of Medicine, Tecnológico de Monterrey, Monterrey Nuevo Leon, Mexico. 9. School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. 10. Department of Medical Education, Universidad de La Sabana, Cundinamarca, Colombia. 11. Evaluation Professional Board, Argentinean Paediatrics Society, Buenos Aires, Argentina. 12. Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Abstract
Context: Social accountability of medical schools has emerged as a standard of excellence in medical education during the last decade. However, the lack of valid and reliable instruments to estimate social accountability has limited the possibility of measuring the impact that medical schools have in society. Our aim was to develop an instrument and validate its use for assessing social accountability in Latin American countries. Methods: We used a three-phase mixed methods research design to develop, validate and estimate social accountability in a diverse convenient sample of 49 medical schools from 16 Latin American countries. We used a qualitative framework approach and a Delphi consensus method to design an instrument with high content validity. Finally, we assessed the psychometric properties of the instrument. Results: The Social Accountability Instrument for Latin America (SAIL) contained 21 items in four domains: mission and quality improvement, public policy, community engagement, and professional integrity. Its reliability index, estimated using Cronbach's alpha, was very high (0.96). Most of the medical schools that had ranked over the 80th percentile on traditional national academic estimates did not reach the 80th percentile using SAIL.Conclusions: There are validity arguments (content and reliability) to support the measurement of social accountability using the SAIL instrument. Its application showed that it provides a complementary dimension to that traditionally obtained when estimating quality in medical schools.
Context: Social accountability of medical schools has emerged as a standard of excellence in medical education during the last decade. However, the lack of valid and reliable instruments to estimate social accountability has limited the possibility of measuring the impact that medical schools have in society. Our aim was to develop an instrument and validate its use for assessing social accountability in Latin American countries. Methods: We used a three-phase mixed methods research design to develop, validate and estimate social accountability in a diverse convenient sample of 49 medical schools from 16 Latin American countries. We used a qualitative framework approach and a Delphi consensus method to design an instrument with high content validity. Finally, we assessed the psychometric properties of the instrument. Results: The Social Accountability Instrument for Latin America (SAIL) contained 21 items in four domains: mission and quality improvement, public policy, community engagement, and professional integrity. Its reliability index, estimated using Cronbach's alpha, was very high (0.96). Most of the medical schools that had ranked over the 80th percentile on traditional national academic estimates did not reach the 80th percentile using SAIL.Conclusions: There are validity arguments (content and reliability) to support the measurement of social accountability using the SAIL instrument. Its application showed that it provides a complementary dimension to that traditionally obtained when estimating quality in medical schools.