How do medical students’ perspectives of socially accountable professionalism inform an integrated socioscience pedagogy?

Author: Kingsley Whittenbury

Whittenbury, Kingsley, 2021 How do medical students’ perspectives of socially accountable professionalism inform an integrated socioscience pedagogy?, Flinders University, College of Medicine and Public Health

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This mixed methods study sought South Australian medical students’ perceptions of social justice in health and health care in response to the obligation in for social accountability. A total of forty students from Adelaide and Flinders medical programs consented to an online demographic survey and audio-recorded semi-structured interview. Bourdieu’s theory of practice and Sen’s capability theory were combined to conceptualise participants’ capability to aspire to a preferred type of professionalism. Flinders belongs to a network of socially accountable medical schools and has a graduate entry program; Adelaide has a traditional secondary entry program. Only First and Final Year students were recruited, to evaluate dominant curriculum effects on perceptions. Participants’ diverse social equity identities was evaluated from demographic and interview data. Themes analysed from transcribed data were triangulated with demographic data in participant vignettes, to assist comparison of professional values and discourses. There was unanimous agreement about the most disadvantaged groups in the Australian population, and support for social accountability competencies in medical education. Similar to previous findings, more participants with single equity identities chose medical practice in areas of health need than those with intersectional identities. Contextual knowledge of social inequity and capability for critical argument followed a gradient of ‘knower gazes’ (Maton 2010) related to participants’ proximity to social injustices. Year level and School program were of minor significance. ‘Knowers’ born into disadvantaged societal contexts had the strongest sociological gazes, funds of knowledge, dialogical empathy, and critical insights to social health improvements. International participants had stronger insights to a mismatch between the Australian health system and Indigenous health needs. Weaker contextualisation of human health settings and relational knowledge of deprived populations observed in those with social, trained and cultured ‘knower gazes’ may oblige educators to apply deliberate coding in pedagogy; using Legitimation Code Theory (LCT) (Maton 2001). Critical reflexivity on human lifeworld diversity, global ecosocial change, and modifiable health determinants in clinical reasoning is proposed a key medical professional competence of social accountability and sustainability ethics.

Keywords: Social accountability, medical education, social justice, professionalism, equity identity, sociological gaze, critical reflexivity, equity of health outcomes, Legitimation Code Theory, sustainability.

Subject: Public Health thesis

Thesis type: Doctor of Philosophy
Completed: 2021
School: College of Medicine and Public Health
Supervisor: Paul Ward