How To Get Your Clinical Teaching Team Ready For Curriculum Change: A Practical Guide

Figures & data

Table 1 Overview Of The Elements Of Readiness For Change, Their Possible Hurdles And Recommended Solutions

Subscale Of STORC Element Of Readiness	Possible Hurdles: Team Members	Recommended Solutions
Pressure to change	… are unwilling to adapt old routines and express discontent about top-down pressure	Resistance is a form of feedback. Listen and use it. Show best practices from other teams to reduce the perceived complexity of the innovation. Provide sufficient information about the innovation and how it will affect your team.
Appropriateness	… express doubts whether the proposed change will be an appropriate solution for the intended improvement of practice	Define, within the team, what the intended meaning of the innovation is. Show the relative advantage of the innovation, eg, by means of best practices. Let team members adapt and refine the innovation on a limited basis to let it suit their own needs and local context.
Necessity to change	… feel no urgency to change	Provide information about the need for change – what changes in the health care system push this innovation? Make the benefits of the innovation clearly visible – eg, what is its relevance for a trainee’s performance? Define the long-term gains. Use strong leadership to help create a receptive context for change.
Management support and leadership	… feel insufficient management support	Show that goals of the innovation align with the goals of the local educational/faculty board or committee. Provide a platform for sharing experiences and best practices. Provide outcome measures at an institutional level.
Staff culture	… show limited commitment or shared responsibility within the team	Link the innovation to the existing knowledge and skills base of the team members. Create short-term goals with and relevant for the team members. Define your team’s social network and use it.
The formal leader	… do not know who has the final authority to make decisions regarding the change	Define clear roles and responsibilities for all team members. Identify different leadership roles and systematically harness the efforts of these leaders. Train leaders to lead.
Involvement	… express that they feel like their opinion is not taken into account	Provide accurate and timely information about the innovation and the implementation process. Listen to the crowd, use both formal and informal communication channels. Seek input, respond and continue to do so during the entire change process.
Project resources	… express a sense of insecurity about whether they have the ability/skills to implement the change	Build on existing expertise. Provide sufficient faculty development – related to the innovation (eg, teaching skills) and the implementation process (eg, giving feedback). Provide support on task issues (eg, how to incorporate the innovation in daily work).
Clarity of mission and goals	… miss a clear vision on where the change will lead them	Look for a purposeful construction of a shared vision. Get feedback and adjust if necessary. Keep it short and inspiring. Create clear indicators of successful change and discuss them in regular team meetings.
The implementation plan	… do not know when the change should be implemented and what consecutive actions to take	Break the innovation down in manageable parts. Provide clear timelines. Monitor and evaluate the impact of the innovation. Adapt if necessary.