Unpacking educational approaches for social accountability in health professions education: a scoping review

Health systems worldwide continue to face health inequities rooted in social, political, and economic structures. In response, health professions education (HPE) programs are increasingly aiming to prepare learners for socially accountable practice. Despite this growing attention, social accountability remains ambiguously defined and inconsistently taught, assessed, and enacted across curricula. The aim of this scoping review was to map the breadth and depth of educational approaches within HPE that promote social accountability. A scoping review was conducted following Arksey and O'Malley's six-stage framework and the Joanna Briggs Institute methodology. MEDLINE, EMBASE, CINAHL, ERIC, APA PsycINFO, and Education Source were searched for articles published from January 2000 to May 2020, with an updated search in 2024. Screening involved a calibration exercise at both title/abstract and full-text stages. Descriptive numerical analysis and reflexive thematic analysis were employed, supported by knowledge user consultation. Most articles originated in North America (n = 179; 82%) and focused on undergraduate medical education (n = 157; 71.7%), especially among future physicians (n = 122; 55.7%). Common strategies included reflection-based learning (n = 90; 41.1%), small group learning (n = 82; 37.4%), and didactic lectures (n = 80; 36.5%). Many studies described using multimodal approaches (n = 85; 38.8%). Educational approaches emphasized experiential, reflective, and community-engaged learning and were grouped into ten overarching categories. These were organized using the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET). By synthesizing how educational approaches to social accountability are reported, this review offers a basis for reflection, dialogue, and further inquiry into their development, delivery, and integration in HPE curricula.