Shiraz E-Med J. 2021 March; 22(3):e97422. Published online 2020 September 1. doi: 10.5812/semj.97422. Research Article Challenges and Motivational Facilitators of Social Accountability in Medical Students of Shiraz University of Medical Sciences: A Qualitative Study Mahbobeh Mohammadi 1 , Mehdi Bagheri 1, * , Parivash Jafari 2 and Leila Bazrafkan 3 1 Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran 2 Science and Research Branch, Islamic Azad University, Tehran, Iran 3 Shiraz University of Medical Sciences, Shiraz, Iran * Corresponding author: Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran. Email: mbagheri.sbu@gmail.com Received 2019 September 28; Revised 2020 May 06; Accepted 2020 May 07. Abstract Background: Accountability in the community is one of the main missions of the medical school. Objectives: The current study aimed at explaining the motivational facilitators and challenges in medical students of Shiraz Uni- versity of Medical Sciences, Shiraz, Iran, for social accountability based on their experiences. Methods: The current study using semi-structured interviews was conducted on 28 individuals, 16 of whom were students and 12 professors and managers of the medical school. Purposeful sampling was used up to saturation. Data were analyzed using the content analysis method. First, conceptual codes were extracted and then grouped into several main themes. Selected concepts or main themes included facilitators, inhibitors, or challengers. Results: Selected concepts or main themes included facilitating factors and educational challenges for the social accountability of the students. The facilitators included informed choice, personality and moral commitment, content and process of motivation, promotion of community-based learning in the university, and the role of professors in motivation. The inhibitors or challenges included traditional routines, ineffective evaluations, manners of meeting the students’ needs, the lack of educational facilities, and the impact of the increased number of students on the quality of education. Conclusions: According to the current study findings, the conditions and facilities should be shared among medical education programs to provide a supportive environment for the students, and take a positive and effective step toward motivating them to improve their accountability. Keywords: Social Accountability, Medical Student, Motivation, Challenge, Strategy 1. Background One of the most challenging aspects of medical educa- tion is to learn how to motivate students in a long period of studying. Responsiveness in the community is one of the main missions of the medical school. In this regard, the World Health Organization, in its definition of social ac- countability, requires educational institutions to direct all the services, educations, and research activities to address the concerns and health priorities of the community (1, 2). Scholars consider social accountability a new paradigm for medical education and a kind of cultural change, and one of the four major missions of medical universities, which needs to be addressed in order to examine and compre- hend the concept deeper (3). In all countries, one of the problems of the medical education system is the inabil- ity of medical graduates to respond to the growing needs of the community (4). Several studies on newly gradu- ated physicians in the United Kingdom pointed to a lack of skills (5, 6). Heaton et al. (6), noted that many undergrad- uate medical students did not have sufficient knowledge and skills in the field of prescription, and they believed that the teaching and learning methods were not efficient enough. The social accountability problems of the gen- eral medicine curriculum are the lack of knowledge, atti- tudes, and skills of physicians corresponding to the needs of society. However, the lack of attention paid to social accountability in the training of physicians provides the ground for inducing inability in them to serve the commu- nity, thereby self-confidence is reduced, and anxiety is in- creased in the early years of practice (6-8). Motivation in students depends on a variety of fac- Copyright © 2020, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.