title: A qualitative study of enablers and barriers influencing the incorporation of social accountability values into organisational culture: a perspective from two medical schools.
abstract: BACKGROUND
  Definitions of social accountability describe the obligation of medical schools to direct education, research and service activities towards addressing the priority health concerns of the population they serve. While such statements give some direction as to how the goal might be reached, it does not identify what factors might facilitate or hinder its achievement. This study set out to identify and explore enablers and barriers influencing the incorporation of social accountability values into medical schools.
  
  
  METHODS
  Semi structured interviews of fourteen senior staff in Bar Ilan and Leeds medical schools were undertaken following a literature review. Participants were recruited by purposive sampling in order to identify factors perceived to play a part in the workings of each institution.
  
  
  RESULTS
  Academic prestige was seen as a key barrier that was dependent on research priorities and student selection. The role of champions was considered to be vital to tackle staff perceptions and facilitate progress. Including practical community experience for students was felt to be a relevant way in which the curriculum could be designed through engagement with local partners.
  
  
  CONCLUSIONS
  Successful adoption of social accountability values requires addressing concerns around potential negative impacts on academic prestige and standards. Identifying and supporting credible social accountability champions to disseminate the values throughout research and education departments in medical and other faculties is also necessary, including mapping onto existing work streams and research agendas. Demonstrating the contribution the institution can make to local health improvement and regional development by a consideration of its economic footprint may also be valuable.
authors.affiliation: Division of Primary Care and Public Health, Leeds Institute of Health Sciences, Faculty of Medicine and Health, Leeds University, Charles Thackrah Building, 101 Clarendon Road, Leeds, LS2 9LJ UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Leigh-Hunt
authors.affiliation: Division of Primary Care and Public Health, Leeds Institute of Health Sciences, Faculty of Medicine and Health, Leeds University, Charles Thackrah Building, 101 Clarendon Road, Leeds, LS2 9LJ UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Stroud
authors.affiliation: The Medical School, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Murdoch Eaton
authors.affiliation: Faculty of Medicine in the Galilee, Bar Ilan University, Ramat Gan, 5290002 Israel.
authors.forename: Mary
authors.initials: M
authors.lastname: Rudolf
keywords: Barriers; Enablers; Medical school; Organisational change; Social accountability; Social mission; Social responsibility