Accelerating Change in Medical Education

Project gets underway to ensure sustainable med school innovations

How can a medical school completely change its curriculum in a smooth, efficient and sustainable way? By applying principles of business organizational change to medical schools, faculty at some of the schools participating in the AMA’s Accelerating Change in Education consortium are seeking to measure schools’ readiness for change and ways to ensure changes can be maintained over time.

The 11 schools that make up the consortium are planning and testing innovative education models, from competency-based assessment to team-based, interprofessional classes to electronic health records fully integrated into learning. But implementing such major transformations can’t happen overnight.

“You have to have some vision that you want to move toward,” said Kevin Souza, associate dean for medical education at the University of California San Francisco, one of the consortium schools. “You have to be able to articulate it very clearly and in a way that is compelling to others. Finally, you need to be able to communicate why it’s urgent.”

Souza heads the consortium’s organizational change group and is piloting a survey at his institution that will assess medical schools’ organizational readiness for change. Gathering data on a school’s willingness to change and areas that may present challenges will allow him to develop strategies around how to implement new curriculum.

After UC San Francisco tests the survey, all of the consortium schools will be able to use it to gauge their institutions’ readiness for change and where they may need to focus to ensure smooth and sustainable implementation.

“It lets us customize strategies and plans based off those results,” said Daniel Reimer, a curriculum specialist at UC San Francisco who is working with Souza on the project. “The strategies allow for schools to direct time and resources to address areas of concern so the school can address these areas and maximize their effectiveness.”

The group uses a business change model with a “top-down” approach as the basis of its own model, meaning the impetus for change comes from the higher levels of the organization.

“Medical education does not have a strong tradition of deliberate change management,” Souza said. “Changing curricula is always difficult, and the more comprehensive the change, the more difficult it is.”

For the consortium schools, the challenge likely will be getting faculty buy-in.

“Curricula in academic institutions are owned by the faculty and therefore must be changed by the faculty,” Souza said. “However, motivation to innovate in the curriculum often is the vision of academic leadership who are constantly monitoring the entire curriculum, its outcomes, trends and pressures external to the school and workforce needs. Therefore, the first big challenge is communicating the need for change and aligning faculty to the new vision.”