Curriculum change is inevitably a part of postgraduate medical education (PGME) due to a necessity to rapidly adapt to changes in societal needs, educational philosophy and technological advances. Initiating, adopting as well as sustaining successful change can be very challenging especially in complex and time-constrained environments such as healthcare and PGME. Indeed, research has shown that educational changes do not always lead to the desired adjustments in practice. Surprisingly, implementation processes in healthcare and, more particularly, those in medical education are rarely supported by change management principles despite the scale and implications of curriculum reforms that justify guidance of such implementation processes. Insights from a change management perspective could help to smoothen the transition from theory to practice by guiding implementation processes and provide support in routinizing innovations in standard practice. A thorough description about change from an educational as well as a change management perspective is made, followed by the experiences with introducing change management principles into PGME. Lastly, the potential of change management principles for future changes in medical education, and their practical implications, is presented.
Part of the book: Medical and Surgical Education
Patients are becoming more involved in healthcare, however, their involvement in postgraduate medical education (PGME) is often less prominent. We provide insight into patients’ and residents’ perspectives regarding possible topics for patient feedback, to increase its use and effectiveness in PGME. Semi-structured interviews with 20 purposefully sampled patients were done and 15 residents filled out a fully qualitative questionnaire. The sample size was not calculated as we aimed for data sufficiency. Content analysis was inspired by grounded theory. Topics mentioned by patients and residents were communication skills and communication of medical knowledge. While patients find organizational matters and personal aspects important topics, residents do not. Patients intend to provide feedback on task-, process-, and self-level, whereas residents do not wish to receive feedback on self-level. Topics mentioned by patients corresponded with various CanMEDS roles, that is, communicator, collaborator, professional, and leader. Feedback directed on task- and process-level would be of residents’ interest, including feedback on the physician-patient relationship and communication of medical knowledge. Patient feedback should not only focus on communication skills but also on other CanMEDS roles. To provide effective feedback and ensure that it remains at the level that enhances residents’ learning, patients should avoid giving feedback on self-level.
Part of the book: Health and Educational Success