Social accountability: A face-lift or real change?
- Reflect on how we can ensure that social accountability fosters sustainable change in education and outcomes.
- Explore practical steps and mechanisms to evolve fit-for-purpose institutions and graduates.
Social accountability and community-engagement in health workforce education are gaining traction at global and regional policy levels and among education institutions and funding bodies. While this could represent a paradigm-shift in health workforce education—hopefully toward reducing health inequities—these concepts remain somewhat vague. They are often more aspirational than practical, perhaps somewhat simplistic. They barely address the core issue of power. Today, health education institutions and health professionals operate in complex systems that are more diverse, dynamic, resource-constrained, and interconnected than ever—and far less predictable. For social accountability to have the desired effect, new ways of operating, cooperating, co-creating, and enforcing are required. Institutions need to embrace heterogeneity; foster greater trust and reciprocity with communities and partners across sectors; and create feedback loops and adaptive mechanisms that are responsive to local dynamics.
Dr. Rachel Ellaway
Moral agency and scholarship in a time of social accountability
- Describe the principals of moral agency as applied to scholarship.
- Understand the challenges of scholarship-based moral agency in a socially accountable institution.
- Apply and challenge scholarly thinking and practice to be more engaged with principles of moral agency.
A moral agent recognizes their potential to do harm, and avoids doing harm—or at least minimizes the harm (and the impact of any harm) that flows from their actions or inaction. Although moral agency is arguably critical to the professional development and practice of medical education scholars, it is often omitted from their training and professional accountabilities. There is an inconsistency in physicians taking the Hippocratic Oath but not medical education scholars.
While scholarship may support or advance a school’s social mission, it should also hold the school, its mission, and its underlying ideologies to account. To paraphrase Bleakley, scholarship is (or should be) the primary systematic mechanism through which medical education programs are held to account, including acting as agents or advocates for the societies to which the broader sense of accountability is directed. As a result, a scholar may be their organization’s most committed champion, precisely by being its ideologies’ most ardent critic.
Drawing on the traditions of the public intellectual, this session explores the argument that scholars should strive to act as moral agents by directing their actions in reference to personal and professional codes and values. It also considers how the principles and practices of moral agency can and should respond to the social accountability missions and policies of their host institutions. Central to this thesis is that moral agency is not a matter of moral superiority, but the responsible and moral individual enactment of professional autonomy, particularly in the face of institutional ideologies.
Dr. Suwit Wibulpolprasert
His main interests are health policy and planning, and global health. He has been extensively involved in research and development in the areas of: human resources for health; health economics, health-care financing and universal health coverage; international trade and health; health promotion; health information; and pharmaceuticals. He has published more than 100 papers, reports, and books locally and internationally.
In Thailand, Dr. Suwit is the editor of a local journal for para-medical personnel and had produced radio and television programmes on health and social issues for more than 15 years. He was the elected member of the Thai Medical Council for 22 years, and also its Secretary General and Vice President. He was the first President of the Thailand National Health Assembly and is the current President of the Thailand Reform Assembly. At present, he is the Board Member of the National Science and Technology Board, the National Nanotechnology Centre, and Mahidol University Council. He founded and chairs the Thai Health Information Systems Network (THINK).
As part of his involvement in global health, Dr. Suwit represented Thailand in many international health forums and at the World Health Assembly. He represented Thailand and the South-east Asia Region as a Member and Vice Chair of the Governing Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria from 2001 to 2004. He chaired the Global Fund’s Policy and Strategy Committee from 2010 to 2011. In addition, he was the President of the Intergovernmental Forum on Chemical Safety from 2003 to 2006 and the Member and Vice Chair of the World Health Organization (WHO) Executive Board during 2004-2007.
At present, Dr. Suwit is the immediate past chair of the Connecting Organizations for Regional Disease Surveillance Networks (CORDS), senior member of the Organizing Committee of the annual international Prince Mahidol Award Conference, and member of the coordinating group for the five countries network on HRH education for the 21st century.
Dr. Suwit is currently the Vice Chair of the International Health Policy Program Foundation (IHPF) and the Health Intervention and Technology Assessment Foundation (HITAF), the Chair of the Institute for the Development of Human Research Protections Foundation (IHRPF), and the Chair of the Health and Society Creation Foundation. Prior to this position, he served the highest government official rank as a Senior Advisor in Disease Control to the Thai Ministry of Public Health during 2006-September 2013. In 2014-2015, he was appointed to be an adviser to the Health Minister on Global Health.
Paradigm shift of medical education to support UHC
Dr. Cynthia Wesley-Esquimaux
Cynthia is a Board Member for Healthy Minds Canada and the newly formed Teach for Canada Non-Profit. She is a member of the Governing Circle of the National Centre for Truth and Reconciliation at the University of Manitoba and was inducted as a “Honourary Witness” by the Truth and Reconciliation Commission of Canada.
Interested in environmental and humanitarian causes she is actively engaged in a variety of initiatives across Canada and is an active and engaging media representative. Cynthia is a member of the Chippewa of Georgina Island First Nation in Lake Simcoe, Ontario and has dedicated her life to building bridges of understanding between people. She sees endless merit in bringing people from diverse cultures, ages, and backgrounds together to engage in practical dialogue and applied research initiatives, and is deeply committed to public education and active youth engagement.
Cynthia co-founded and chairs a youth project called Canadian Roots Exchange, supported by the University of Toronto, the University of Saskatchewan and Lakehead University.
Acknowledging our past
Dr. Cynthia Wesley-Esquimaux navigated the intergenerational storm so many Indigenous peoples found themselves with a firm conviction life could offer more. Out of respect for her parents, both Indian Residential School (IRS) survivors, she walked back into the annals of history and learned about the impacts of an unconscionable past. Inspired by this knowledge and with a new compassion, she forgave and moved into a life of learning, sharing, and service. Healing is a deliberate act, it takes courage, forgiveness, remembrance, and an acknowledgement we have all been touched in a multitude of ways by those who walked before. We must chose what we carry forward and what we put down, unnecessary burdens of pain and loss, not to be forgotten, but to lighten our steps towards a better future. The story of Indigenous peoples in Canada is a tapestry of broken hearts, despair, stifled rage, and an incredible survivance, but it also depicts love, hope, and an enduring reminder reconciliation and relationships cannot happen without acknowledgement of our past as individuals, as peoples, and as a country.
Dr. Marie Wilson
As a journalist, Dr. Wilson worked in print, radio, and television as a regional and national reporter, and later as the Canadian Broadcasting Corporation’s senior manager for northern Quebec and the three northern Territories. She was the first television program host of northern Canada’s flagship weekly information program, Focus North. Her reports tackled complex issues, from the Quebec sovereignty referendum and national unity debates to the national Constitutional talks of the 1980s; from the settlement of historic aboriginal rights agreements to the state of health in First Nations and Inuit communities; from Papal visits to centennial celebrations of the Riel Rebellion.
As a Regional Director for the Canadian Broadcasting Corporation, Dr. Wilson was a pioneer. She launched the first Daily Television News service for northern Canada, against a back-drop of four time zones and ten languages: English, French, and eight indigenous. She developed the Arctic Winter Games and True North Concert series to showcase northern performing artists and traditional indigenous sports for audiences in southern Canada. She fought for the recruitment and development of aboriginal staff and their on-air reflection. She acknowledged staff excellence with the CBC North Awards. She acknowledged the community with program initiatives to support and promote literacy.
A career highlight was to deliver training through the South African Broadcasting Corporation as part of that country’s transition to democracy, coinciding with the start-up of South Africa’s own Truth and Reconciliation Commission. For several years, she served as an associate board member of what was to become the Aboriginal Peoples Television Network (APTN). Over the years, she has worked with various other boards and agencies committed to social justice; journalism and civic engagement; community, spiritual and international development; and the well-being of children and youth.
Dr. Wilson is the recipient of a CBC North Award for Lifetime Achievement, the Northerner of the Year Award, and various awards and recognitions for journalism, writing excellence, and work-place safety initiatives. In May 2012, she was awarded an honourary Doctor of Laws degree by St. Thomas University of Fredricton, New Brunswick, in recognition of a professional career “marked by public service and social justice.” Dr. Wilson speaks English and French, with some knowledge of Spanish and Sahtu Dene. She and her husband, Stephen Kakfwi, are the proud parents of Kyla, Daylyn and Keenan, and are blessed with four grand-children.
Dr. Sheldon Tobe
Dr. Tobe’s research in the 1990s focused on dialysis research, but by the end of the decade, his focus shifted to blood pressure management to help keep patients off dialysis.
Dr. Tobe’s significant contributions have been recognized by awards such as Blood Pressure Canada’s Certificate of Excellence (2008), the HSF Ontario’s Award for Volunteer Excellence (2010), and many teaching awards. As former chair of the Canadian Hypertension Education Program (CHEP), his knowledge translation efforts have contributed to the dramatic improvement in hypertension awareness treatment and control in Canada over the past 20 years and the associated improvement in mortality from heart failure, stroke and heart attack. Dr. Tobe is also Co-Chair of the Canadian Cardiovascular Harmonized National Guidelines Endeavour (C-CHANGE) guidelines that have been endorsed by the Council of Federation’s Healthcare Innovations Working Group in 2012 for implementation in primary care across Canada.
As the HSF/NOSM Chair of Rural and Aboriginal Health, Dr. Tobe brings his experience working with Aboriginal communities including The Diabetes Risk Evaluation and Microalbuminuria (DREAM) studies and the Aboriginal Hypertension Management Program (AHMP). His Hypertension Management Program (HMP) and AHMP study has resulted in improved treatment and control of hypertension in Ontario. He is co-PI of the CIHR/GACD funded DREAM-GLOBAL study (Diagnosing hypertension- Engaging Action and Management in Getting Lower Blood Pressure in Aboriginal and LMIC). A recognized leader in his field, Dr. Tobe’s effective collaborations with researchers, clinicians, policy-makers and Aboriginal people have had significant impact in Canada.
In his new role, Dr. Tobe works closely with the Centre for Rural and Northern Health Research (CRaNHR) and has initiated pilot projects to increase the awareness and appreciation for research among Northern health-care providers. These projects include:
- Research Quality Assurance Program
- Community Engagement Through Research Program
- Northern PEARLS program (Peer Education to Facilitate Clinical Practice Guidelines implementation with Health Care Providers)
- Chair’s Advisory Council
Perspectives from the NOSM-Heart and Stroke Foundation Chair in Aboriginal and Rural Health Research
- Describe the goals of the NOSM/HSF Chair in Aboriginal and Rural Health Research with respect to research with Aboriginal communities.
- List some of the barriers, challenges, and potential pitfalls of promoting more research activities between NOSM and the communities.
- Describe some of the early outcomes and experiences resulting from efforts to achieve the research goals.
According to the Aboriginal and Rural Health Research Chair job description, the Chair is responsible for developing scientific advancement in the field of cardio and cerebrovascular disease in Aboriginal and rural communities. The Chair is also expected to integrate with Aboriginal and rural research units to establish mentorship and networking, as well as to work collaboratively with students, residents, faculty, university and hospital administrators, government officials, Aboriginal organizations, and the public.
To achieve this, a Chair’s Advisory Committee was struck and over 100 meetings organized with faculty, stakeholders, students, community members, and the public. A pilot program was developed to bring students together with Aboriginal communities interested in conducting their own research, mentored by the Research Chair and others. There was one student/community pair in the summer of 2014, three in 2015, and three more planned for 2016. These projects will be described to provide examples of how community-based participatory research can lead to greater trust, to capacity development, and provide learners with positive research experiences.
Dr. Frank Sullivan
Dr. Sullivan is a chief investigator on thee large family practice trials in earlier diagnosis of lung cancer (ECLS), tonsillectomy for adults (NATTINA) and management of childhood eczema (CREAM) as well as the Scottish Research Register (SHARE). He is also a principal investigator on twelve other studies including two large European Union-funded informatics projects.
Dr. Sullivan has published 222 papers in peer-reviewed journals and his NEJM paper of a trial of steroids and antivirals for Bell’s palsy won the 2009 BMA research paper of the year award. He was elected a Fellow of the Royal Society of Edinburgh in 2011.
Early diagnosis of Lung Cancer (The challenge and early results from a 12,000 patient trial in Scotland.)
Dr. Aurel Schofield
Il a été le directeur fondateur du Centre de formation médicale du Nouveau-Brunswick, doyen associé pour le Nouveau-Brunswick de la Faculté de médecine et des sciences de la santé de l’Université de Sherbrooke et doyen associé pour la formation médicale de l’Université de Moncton. Il est le premier médecin du Nouveau-Brunswick a avoir été nommé professeur titulaire de cette faculté de médecine et oeuvrant entièrement au Nouveau-Brunswick. Il a récemment été élu président de la Société Santé en français du Canada en plus de coprésider le comité de direction des soins de santé primaires pour la province du Nouveau-Brunswick depuis sa mise en place il y a six ans.
Il a été membre de plusieurs comités dans la communauté traitant de la violence familiale, de l’abus des enfants, du suicide chez les adolescents et des survivants adultes d’abus sexuel.
Il a présenté de nombreux exposés et ateliers sur ces questions ainsi que sur l’enseignement médical à divers regroupements locaux, nationaux (CMFC et RCPSC) et internationaux (WONCA, Vers l’unité pour la santé).
En 1999, Dr Schofield a coprésidé la Conférence Acadie-Sherbrooke, la première conférence internationale sous le thème « La pratique et l’éducation médicale des professionnels de la santé en réponse aux besoins des individus et des communautés ». Cette conférence a contribué à mettre à l’avant-scène la problématique des services de santé en français à l’échelle canadienne. Ses travaux ont été sélectionnés pour la conférence d’ouverture pour le lancement de la stratégie de « Vers l’Unité pour la santé » de l’Organisation mondiale de la santé.
Il a reçu plusieurs reconnaissances prestigieuses tant sur la scène locale, provinciale et nationale pour sa contribution exceptionnelle en éducation médicale et pour sa profession; dont l’Ordre du mérite de la Societé médicale du Nouveau-Brunswick, Médecin de cœur et d’action, et le prix Delphis Brochu de l’Association des médecins de langue française du Canada, le premier récipiendaire du prix Montfort Santé octroyé par le Gouvernement du Canada, le prix Jean Pierre Despins du Collège des médecins de famille du Canada, l’Ordre du mérite de la Faculté de médecine et des sciences de la santé de l’Université de Sherbrooke ainsi qu’une reconnaissance pour la qualité de l’enseignement catégorie « équipe d’enseignement » de l’Université de Sherbrooke. Il a également été récipiendaire du prix le Prisme, ancien de l’année de la Faculté des sciences de l’Université de Moncton, le prix Acadie-Québec ainsi que l’Ordre des francophones d’Amérique présenté par le Gouvernement du Québec. Il reçu le Prix Paul Harris, fellowship du club rotary Dieppe. Il fut également élu personnalité de l’année de Radio-Canada/L’Acadie Nouvelle en 2011.
En novembre 2012, il recevait le prix 2012 Group of Regional Medical Campus (GRMC), Shining Star of Community Achievement de l’Association of American Medical Colleges (AAMC) lors de la réunion annuelle tenue à San Francisco, Californie. Ce prix est octroyé à un site de formation médicale délocalisée parmi les quatre vingt douze sites américains et les huits sites canadiens.
En mai dernier, il a reçu l’Ordre du Canada pour sa contribution exceptionnelle à la formation médicale et à l’amélioration des services de santé en français. En octobre 2014, il a reçu le Prix Ovation des anciens et amis de l’Université de Moncton. En avril 2015, il a reçu le Prix de la présidente de l’Association des facultés de médecine du Canada (AFMC) pour leadership exemplaire en médecine universitaire à l’échelle nationale pour son travail et sa contribution exceptionnelle en éducation médicale. Tout récemment, en octobre 2015, il a reçu le prix de l’Ambassadeur du français octroyé par Médecins francophones du Canada.
Il est présentement président de la Société santé en français pour un deuxième mandat et chef du projet Franco Doc de l’AFMC
Titre de la conférence principale
L’accès aux services de santé des francophones en situation minoritaire : survol du passé, présent et vision future
L’apport des francophones dans l’histoire de la province, du pays jusqu’à date a peu été célébrer. Dans toutes les provinces et territoires du Canada les francophones vivants en milieu minoritaire ont travaillé à arrache pied entre autre à se doter de services de santé adapté à leur langue et leur culture. Au cours des années beaucoup de gains ont été réalisés mais beaucoup reste à faire. Présentement plusieurs forces provinciales et nationales se sont ralliées vers une vision unifiée pour la santé des francophones minoritaires. Des actions concrètes nationales menées entre autre par la Société santé en français le Consortium national de formation en santé et l’Association des facultés de médecine du Canada dont le projet Franco Doc ainsi que par les facultés de médecine elles-mêmes, auront un impact majeur sur l’accès services de santé en français. Le futur s’annonce très prometteur mais son réel succès va être possible seulement grâce à un effort concerté et continu des individus et des communautés engagées vers un but et une vision commune.
He was the Founding Director at the Centre de formation médicale du Nouveau-Brunswick, Associate Dean for New Brunswick for the Faculty of Medicine and Health Sciences, Université de Sherbrooke as well as Associate Dean for medical education at the Université de Moncton. He is the first physician in New Brunswick to obtain the status of tenured professor. He was recently elected the President of la Société Santé en français du Canada. He also co-chairs the Primary Health Care Steering Committee for the Province of New Brunswick since its creation six years ago. He was a member of several committees in the community dealing with family violence, child abuse, suicide among adolescents, and adult survivors of sexual abuse.
Dr. Schofield has made numerous presentations and given several workshops on these issues as well as medical education at various local groups, national groups (College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada) as well as international groups (WONCA, Towards Unity for Health).
In 1999, Dr. Schofield co-chaired the Conference Acadie-Sherbrooke, the first international conference on the theme “The practice and medical education of health professionals to meet the needs of individuals and communities.” This conference helped bring the issue of health services in French across Canada to the forefront. His work was selected as the keynote conference for the launch of the World Health Organization’s strategy “Towards Unity for Health.”
He has received several prestigious awards at the local, provincial, and national level for his outstanding contributions in medical education and his profession, including the Order of Merit of the New Brunswick Medical Society, Médecins de coeur et d’action (Doctor of heart and action) as well as the Delphis Brochu Award from the Association des médecins de langue française du Canada. He was also the first recipient of the Montfort Health Award granted by the Government of Canada, the Jean Pierre Despins Award from the College of Family Physicians of Canada, the Order of Merit from the Faculty of Medicine and Health Sciences, Université de Sherbrooke. He received recognition of the quality of medical education in the “teaching team” category of the Université of Sherbrooke. He also won the Alumni Prism Award from the Université de Moncton, the Prix Acadie-Québec and the “Ordre des francophones d’Amérique” presented by the Government of Quebec. He received the Paul Harris Award, a fellowship awarded by the Dieppe Rotary Club, and was named personality of the year in 2011 by Radio-Canada/L’Acadie Nouvelle.
In November 2012, he received the 2012 Group of Regional campus (GRMC), Shining Star of Community Achievement Award at the annual meeting of the Association of American Medical Colleges (AAMC) held in San Francisco, California. This prize is given to one of the ninety-two American and eight Canadian distributed medical education sites.
Last May, he was awarded the Order of Canada for his exceptional contribution to medical education and improving health services in French. In October 2014, he received the Prix Ovation des anciens et amis de l’Université de Moncton. In April 2015, he was the recipient of the Association of Faculties of Medicine of Canada (AFMC) President’s Award for Exemplary National Leadership in Academic Medicine for his work and contribution to medical education. In October 2015, he was named Ambassadeur du français by Médecins francophones du Canada.
He presently is Chair of la Société santé en français for a second term and Project Director for the Franco Doc project of the AFMC.
Accessing French-language health services in a minority setting: overview of the past, present and the vision for the future
The contribution of Francophones in the history of the province, and the country has not been recognized much to date. In all provinces and territories of Canada, Francophones living in minority settings have toiled to ensure they obtain services that are adapted to their language and culture. Throughout the years, there have been many positive outcomes but there is still much to do. Currently, a number of provincial and national organizations have rallied together towards a common vision for the health and benefit of minority Francophones. Concrete actions at the national level lead, among others, by la Société Santé en français, le Consortium national de formation en santé and the Association of Faculties of Medicine of Canada, specifically the Franco Doc project, as well as all faculties of medicine themselves will have a major impact of accessing French-language health services. The future is looking bright but the ultimate success is only possible with concerted and continued efforts by committed individuals and communities to a common goal and vision.