The integration of social accountability in the medical curriculum: a qualitative study to the change process as perceived by educational staff and students

Abstract Background. In addition to (pre)clinical skills and knowledge there is more and more attention for social accountability within the medical curriculum. The integration of social accountability into the medical curriculum requires an organizational change process, which is affected by many factors. This study aims to investigate; the reaction of educational staff and students to this change; the perceived consequences resulting from this potential change; and the change antecedents that affect the reaction to change and change outcomes. Methods. This study used a qualitative design in which semi-structured individual interviews were conducted with 28 educational staff members and 16 students at a medical school in the Netherlands, in 2021. The grounded theory method was used to qualitatively analyze the interviews. Results. Most participants were in favour of more attention for social accountability within the medical curriculum but their reaction depended on their career stage, perceived autonomy, level of focus on either solutions or problems, their degree of participation in the change process, and their perceived expertise. Participants perceived several potential consequences of the change, such as a higher workload, reduction of organizational commitment, and withdrawal from the change. Examples of important antecedents of change were resources such as finances and time, a common vision, and principal support. Conclusions. The reaction of educational staff and students to the integration of social accountability in the medical curriculum and their perceived consequences resulting from this change can be positively stimulated by taking the involved antecedents into account during the organizational change process.