Bank Lindsay, Jippes Mariëlle, Leppink Jimmie, Scherpbier Albert Jja, den Rooyen Corry, van Luijk Scheltus J, Scheele Fedde
Department of Healthcare Education, OLVG Hospital.
Faculty of Earth and Life Sciences, Athena Institute for Transdisciplinary Research, VU University, Amsterdam.
Adv Med Educ Pract. 2017 Dec 14;8:807-815. doi: 10.2147/AMEP.S146021. eCollection 2017.
Curriculum change and innovation are inevitable parts of progress in postgraduate medical education (PGME). Although implementing change is known to be challenging, change management principles are rarely looked at for support. Change experts contend that organizational readiness for change (ORC) is a critical precursor for the successful implementation of change initiatives. Therefore, this study explores whether assessing ORC in clinical teaching teams could help to understand how curriculum change takes place in PGME.
Clinical teaching teams in hospitals in the Netherlands were requested to complete the Specialty Training's Organizational Readiness for curriculum Change, a questionnaire to measure ORC in clinical teaching teams. In addition, change-related behavior was measured by using the "behavioral support-for-change" measure. A two-way analysis of variance was performed for all response variables of interest.
In total, 836 clinical teaching team members were included in this study: 288 (34.4%) trainees, 307 (36.7%) clinical staff members, and 241 (28.8%) program directors. Overall, items regarding whether the program director has the authority to lead scored higher compared with the other items. At the other end, the subscales "management support and leadership," "project resources," and "implementation plan" had the lowest scores in all groups.
The study brought to light that program directors are clearly in the lead when it comes to the implementation of educational innovation. Clinical teaching teams tend to work together as a team, sharing responsibilities in the implementation process. However, the results also reinforce the need for change management support in change processes in PGME.
课程变革与创新是研究生医学教育(PGME)进步不可避免的组成部分。尽管实施变革具有挑战性,但很少有人寻求变革管理原则的支持。变革专家认为,组织变革准备度(ORC)是成功实施变革举措的关键前提。因此,本研究探讨评估临床教学团队的ORC是否有助于理解PGME中的课程变革是如何发生的。
要求荷兰医院的临床教学团队完成《专科培训课程变革的组织准备度》,这是一份用于测量临床教学团队ORC的问卷。此外,通过使用“变革行为支持”测量方法来衡量与变革相关的行为。对所有感兴趣的响应变量进行双向方差分析。
本研究共纳入836名临床教学团队成员:288名(34.4%)学员、307名(36.7%)临床工作人员和241名(28.8%)项目主任。总体而言,与其他项目相比,关于项目主任是否有权领导的项目得分更高。另一方面,“管理支持与领导”“项目资源”和“实施计划”子量表在所有组中的得分最低。
该研究揭示,在教育创新实施方面,项目主任显然处于领先地位。临床教学团队倾向于作为一个团队共同工作,在实施过程中分担责任。然而,研究结果也强化了PGME变革过程中对变革管理支持的需求。