Ellaway, Rachel, Van Roy, Kaatje, Preston, Robyn, Greenhill, Jennene, Clithero, Amy, Elsanousi, Salwa, Richards, Janet, Labarda, Charlie, Graves, Lisa, Mammen, Mary, Assayed, Abbas Abdalrahman, and Willems, Sara (2018) Translating medical school social missions to student experiences. Medical Education, 52 (2). pp. 171-181.

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Abstract

Introduction: 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 multi-centre study explored how the social missions of eight medical schools (from Australia, Belgium, Canada, the Philippines, South Africa, Sudan, and the United States) 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 at each school. Constructivist grounded theory techniques were used to analyse the data. Cultural-historical activity theory concepts of externalization and internalization 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 externalized 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 externalization and internalization processes, each of which could alter or reinterpret the mission. Translation depended to a great extent on sensitizing 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: There is substantial variation in the form, focus, and depth of expression of medical school social missions, significant variation in how and to what extent these missions are externalized in the design of their education programmes, and significant variation in how their students perceive the social mission and its translation to their training experiences

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