Navigating medical education reform: charting a course through changing landscapes of technology, pedagogy, and content

Abstract

BACKGROUND: Less than two decades into the 21st century, U.S. medical schools are experiencing substantial curricular reform affecting multiple aspects of teaching and learning. The pace of change is rapid when compared to that of the previous century. Little changed in medical education for 100 years after Abraham Flexner’s 1910 recommendations from his evaluation of North American medical schools. Using a case-study approach to examine a single medical school, this dissertation study explores pre-clerkship faculty perspectives of select curricular changes over a ten-year span at Boston University School of Medicine (BUSM). These changes include the adoption of educational technologies and student-centered pedagogical approaches, as well as curricular content integration designed for foundational science courses. PURPOSE: This study seeks to understand and document faculty experiences with change, factors influencing change, effective and challenging aspects of change, and recommendations for successful future changes. It also explores faculty change adoption tendencies and change leadership styles for those who led groups through a newly integrated curriculum. METHODS: This is a mixed-methods study using qualitative and quantitative inquiry in three phases of data collection with two subject sets. In the first phase, qualitative data was collected from interviews with a subset of 12 subjects to inform creation of a researcher-designed survey, which was used in the second phase collecting responses from a larger pool of 55 subjects. The third phase collected quantitative data from an externally-validated instrument, Change Intelligence (CQ) (Trautlein, 2013), which assessed change leadership styles of the subset of 12 subjects who experienced all changes studied. RESULTS: BUSM faculty members are motivated towards continuous improvement of the curriculum to foster students’ success. Faculty are challenged by compressed time to plan and implement change and when change is mandated without opportunity for pre-decision input. BUSM faculty adopt changes at higher rates than the normal curve defined in Diffusion of Innovations (Rogers, 2003). The subset of 12 subjects assessed for change leadership styles focus on people and process when leading change. CONCLUSION: Medical education change studies on the faculty perspective are limited. This study provides insight and recommendations for future study and successful change