Theory/model/ framework citation	Search strategy identification	NOSM Useability	NOSM Testability	NOSM Applicability	NOSM Acceptability
1	Conceptualization, Production, Useability (CPU)33	Narrative review; keyword search	Boelen’s World Health Organization Definition (from which this framework emerges) is currently the definition of social accountability used by NOSM.	No clear, explanatory pathways between constructs. Example indicators are identified.	Challenging to populate given current data availability/accessibility, somewhat of a checkbox approach, more appropriate for accreditation (across school comparisons)	Definition and interpretations accepted by NOSM faculty and staff.
2	THENet framework10	Narrative review; keyword search	NOSM is looking to align with existing data collection and strategic plan.	Pilot testing of framework was conducted at NOSM to assess feasibility and acceptability of framework.	The framework requires collection of new data specifically for this purpose including qualitative and quantitative data, which requires significant resources.	NOSM participated in the pilot testing of this framework and is an active participant with THENet community.
3	ASPIRE criteria9	Keyword search	Narrative examples of social accountability are useful to support reporting, but are not sufficient for evaluation or quality improvement.	Framework is narrative, which supports contextualization, but challenging for NOSM to compare itself over time or between institutions.	Narrative approach and high-level interpretation of social accountability make it hard to use as assessment tool due to subjectivity.	NOSM stakeholders are familiar with ASPIRE from an individual physician, faculty member, or program perspective, but would not consider it an evaluation or improvement mechanism.
4	CARE model11	Environmental scan	This framework outlines types of approaches that different sub-committees need to consider (clinical activity, advocacy, research, and education) within a faculty of medicine, but doesn’t specify constructs specific to accountability in action.	Not clear how model could be testable, although authors note that this structural approach could be compared to other institutions.	The CARE model identifies an approach to implementing social accountability (through sub-committee structures) which is relevant for medical schools and organization levels, but not other socio-ecological levels.	The University of Saskatchewan has a similar population, geographic context and training focus as NOSM, and the types of activities (clinical activity, advocacy, research, and education) are important when evaluating social accountability at NOSM. Probably not specific enough for ongoing evaluation.
5	Collaborative E2 framework38	Environmental scan	Social accountability lenses provide in-depth insight into constructs that are important for discussing and evaluating impacts.	Authors of framework describe five implementation steps to integrate social accountability lenses at a department/school level, but do not elaborate on how the lenses relate to each other to demonstrate social accountability.	NOSM identified a need for a framework that includes indicators of social accountability that can be tracked over time (for continuous improvement), at multiple levels (e.g., individual, school, system), and leveraging existing data, which is not be defined in Collaborative E2 framework.	The engagement approach and different “lenses” for social accountability might be transferrable for NOSM. Specifically, the model might help with program assessment or the development of new structures at the school.
6	EPIS framework34	Keyword search	EPIS is useful for capturing multiple levels of how context can affect the implementation of a new program/intervention, and identifying interactions and feedback that influence the effectiveness. This framework does not describe constructs or ideas specific to social accountability in health professional education.	These categories can guide a “systems approach” to a NOSM social accountability framework, but further specification is needed to examine how and in what ways health professional education communicates with health systems, and how to measure or characterize this.	This framework offers specific process and outcome indicators, and clear relationships between concepts. This framework can provide important considerations for contextualizing social accountability at NOSM, across time, but needs to be adapted to health professional education context.	An implementation science framework is not familiar to administrators or staff at NOSM, although concepts might be.
7	AIDER framework14	Environmental scan	Important concepts are included in this model, has built upon Boelen’s CPU framework and THENet, though not described in relationship to evaluating impacts. Case studies describe how framework applied by different stakeholders in different settings.	Case studies offer examples of framework in practice, though what outcomes the framework aims to achieve are not clear. Description of how the concepts relate to each other is helpful, could be tested in research.	Emphasis on systems thinking and identifying priority health concerns of underserved communities is important for NOSM framework. Examples of the framework in action are provided through project cases, which doesn’t include specific evaluation goals or measures.	The concepts and the frameworks that informed AIDER development are well-known and accepted at NOSM, but not the specific framework itself.
8	Learning Health System36	Environmental scan	This framework describes relevant constructs/concepts for social accountability and feedback loops/system. Different from other frameworks in that social (shared) accountability is a pillar, not an outcome.	The diagram and narrative describe the values, pillars, processes, and outcomes of the framework, which could be tested, but not clear in terms of implementation process. Additionally, the lack of health professional education would mean adaptation.	The values, pillars, enablers/accelerators, learning cycles, and outcomes resonate with current priorities and directions of Northern Ontario (and provincial/national) health systems. There is no explicit consideration of health professional education, which means specific process and outcome measures would need to be defined separately.	Framework is well-known among health system partners, though not clear how and in what ways to position health professional education as upstream concept (or pillar, processes or outcome)
9	Integrated health care performance measurement framework37	Environmental scan	Similar to learning health systems, this particular framework represents a specific interpretation of how different perspectives (patients, clinical, system) outcomes relate to overall health system goals of equity and access. Provides in-depth conceptual clarity, though does not identify health professional education processes or outcomes in framework.	This framework depicts clear relationships between concepts, which are likely testable. The purpose of the framework is to support performance measurement, quality improvement, and policy, though does not include health professional education as upstream determinant.	This framework aligns with health system evaluation frameworks used by Northern Ontario health system stakeholders in performance measurement. Because authors indicate they are describing a measurement system, it’s unclear who is responsible for implementing the framework.	While there are a variety of performance measurement frameworks available in the Ontario context, this example reflects integrated whole-system outcomes and measures. Many of the example indicators do not include context-specific measures, and might be better suited for country-level comparisons, instead of smaller health systems.
10	Realist framework of social accountability in health services31	Keyword search	This particular review developed a realist framework that identified the contexts, mechanisms, and outcomes that promoted health provider response to social accountability interventions. This framework provided specific details about “downstream health outcomes” that could be relevant for medical education, but no explicit mention of education.	The realist perspective aims to produce testable context-mechanism-outcome configurations. This framework identifies three groups of outcomes (receptivity, responsiveness, relations) and hypothesizes the circumstances and mechanisms that could lead to these outcomes.	This framework suggests multiple types of data collection that could be used in the evaluation of context-mechanism-outcome at multiple levels. Without explicit recognition of health professional education contexts in these configurations, adaptations to this framework and further testing needed.	The complexity of this framework might be implementation at NOSM more resource-intensive. The testability and specific configurations proposed are helpful for understanding how social accountability concepts relate to create impacts.
11	Realist framework of the relationships between communities and medical education32	Keyword search	By identifying contexts, mechanisms, and outcomes for community engaged education, this framework provides detailed insight into the “downstream” impacts of medical education, while also considering the determinants of such outcomes. This framework clearly alludes to NOSM’s model of community engaged education, a	Similar to the previous realist framework, configurations are intended to be testable. This framework list specific mechanisms and outcomes, and depicts contexts of health professional education and community relationships, the specific configurations and tests would need to be further defined by NOSM.	Although this framework does not explicitly reference social accountability and accountability processes and outcomes, NOSM had several stakeholders involved in the framework development. How data is collected to use the metrics identified in the framework is not clear.	The concepts and relationships specified in this framework are familiar to NOSM stakeholders (given their role in the development of it, and community-engaged education model at NOSM), though the implementation of this framework would likely be resource-intensive.