Seven ways to get a grip on implementing Competency-Based Medical Education at the program level

Dagnone, Jeffrey Damon; McEwen, Laura April; Taylor, David; Acker, Amy; Bouchard, Mary; DeJong, Peggy; Chamberlain, Susan; Dos-Santos, Andrew; Fleming, Melinda; Hall, Andrew K.; Jaeger, Melanie; Mann, Steve; Trier, Jessica

doi:10.36834/cmej.68221

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…We thus implemented a well-known change management strategy developed by John P. Kotter and known as Kotter's 8-Step Change Model, 4,5 which has been successfully applied to many industries, including health care. 6,7 GME programs have used this model to address the transition to competency-based medical education, 8 didactics redesign, 9 and trainee wellness, 10 but we are not aware of previous descriptions applying it to recruitment. The objective of our article is to describe the application of Kotter's framework in our redesign efforts, describe our interventions, and report on the outcomes, including feasibility and acceptability of using the framework to guide change and the interventions themselves.…”

Section: Introductionmentioning

confidence: 99%

Using Kotter's Change Management Framework to Redesign Departmental GME Recruitment

Miles

Richardson

Wolfe

et al. 2023

Journal of Graduate Medical Education

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Background In light of the COVID-19 pandemic, dramatic change in the graduate medical education (GME) trainee recruitment process was required. Kotter's 8-Step Change Model is a change management framework that has been successfully applied to a variety of GME initiatives but not for recruitment redesign. Objective To implement major change in program recruitment during the COVID-19 pandemic while maintaining Match outcomes and a high-quality candidate experience. Methods In 2020, we applied Kotter's 8 steps to implement major changes to program recruitment for a department of internal medicine including 15 GME programs (1 internal medicine residency and 14 subspecialty fellowships). We collected each program's Match fill rates and used Google Analytics to collect monthly website traffic for the year prior to our change process and the subsequent 2 years. Standardized post-interview survey questions were created, and these results were reviewed for descriptive analysis. Results We successfully used Kotter's 8 steps to change recruitment to a virtual format. Program fill rates remained high after implementation. Website engagement improved with peak monthly page rates doubling over previous values. During the highest traffic month, the average time on site increased for 7 programs, while the bounce rate decreased by more than half for 10 programs. Candidate descriptive feedback was positive. Conclusions The application of Kotter's 8 steps guided major changes to GME recruitment for 15 programs and was associated with maintained Match fill rates and increased website engagement.

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Section: Introductionmentioning

confidence: 99%

Using Kotter's Change Management Framework to Redesign Departmental GME Recruitment

Miles

Richardson

Wolfe

et al. 2023

Journal of Graduate Medical Education

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Laying train tracks en route: How institutional education leaders navigate complexity during mandated curriculum change

Tam,

Scott

2024

Medical Education

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IntroductionInstitutional education leaders serve key roles in leading major curricular change within residency education, yet little is known about how they accomplish these goals on the ground. Change management principles have predominantly been developed and described in the hierarchical context of management science and corporate settings. However, the non‐hierarchical, complex and adaptive features of health professions education may render these traditional change management models inadequate. We explored how institutional educational leaders navigate the complex residency education system in implementing a major curricular change.MethodsUsing constructivist grounded theory, we conducted and iteratively analysed semi‐structured interviews with 11 institutional education leaders from across Canada who were responsible for leading the nationally mandated curricular change to competency‐based residency education. Thematic analysis was performed iteratively using constant comparison.ResultsLeaders managing the change process focused on two priorities: steering the direction of the change process as it evolved and maintaining the momentum amongst stakeholders to move forward steadily. Four common threats and opportunities impacted the focus on direction and momentum: multiplicity of contexts, innovation, resistance and distractions. In response, leaders utilised various tactics and harnessed diverse leadership styles to manage these challenges accordingly.ConclusionsWe identified a change framework that offers a more contextually nuanced understanding of curricular change in residency education that has not been described in the change management literature generated by the management sector. Institutional education leaders focused on maintaining the direction and momentum, while constantly assessing and adapting to evolving, uncertain and complex conditions. Our findings provide a simple and practical foundation to support leadership education in curricular change as well as researchers in developing further change theories in complex adaptive health professions education systems.

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Seven ways to get a grip on implementing Competency-Based Medical Education at the program level

Cited by 2 publications

References 10 publications

Using Kotter's Change Management Framework to Redesign Departmental GME Recruitment

Using Kotter's Change Management Framework to Redesign Departmental GME Recruitment

Laying train tracks en route: How institutional education leaders navigate complexity during mandated curriculum change

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