Students as catalysts for curricular innovation: A change management framework

Abstract

Introduction: The role of medical students in catalyzing and leading curricular change in US medical schools is not well described. Here, American Medical Association student and physician leaders in the Accelerating Change in Medical Education initiative use qualitative methods to better define student leadership in curricular change.

Methods: The authors developed case studies describing student leadership in curricular change efforts. Case studies were presented at a national medical education workshop; participants provided worksheet reflections and were surveyed, and responses were transcribed. Kotter’s change management framework was used to categorize reported student roles in curricular change. Thematic analysis was used to identify barriers to student engagement and activators to overcome these barriers.

Results: Student roles spanned all eight steps of Kotter’s change management framework. Barriers to student engagement were related to faculty (e.g. view student roles narrowly), students (e.g. fear change or expect faculty-led curricula), or both (e.g. lack leadership training). Activators were: (1) recruiting collaborative faculty, staff, and students; (2) broadening student leadership roles; (3) empowering student leaders; and (4) recognizing student successes.

Conclusions: By applying these activators, medical schools can build robust student–faculty partnerships that maximize collaboration, moving students beyond passive educational consumption to change agency and curricular co-creation.

Keywords:

• Medical students
• leadership
• curriculum change
• undergraduate medical education

Acknowledgements

The authors thank the American Medical Association for their financial support of the Accelerating Change in Medical Education Initiative, which supported the institutional educational change efforts described herein and the transcription of handwritten session notes used as data in this article. They also thank the many participants who took the time to complete session surveys and worksheets.

Ethical approval: The data collection at the 2015 AAMC Learn Serve Lead national meeting was reviewed and received exempt status from the Penn State College of Medicine Institutional Review Board.

Previous presentations: The case studies in this article were presented in significantly abbreviated form during the AAMC Learn Serve Lead meeting, Baltimore, MD, November 2015.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article. SE Skochelak is an employee of the AMA.

Glossary

Change management: A structured approach to moving an organisation from the current state to the desired future state. Association for Project Management. Available at https://www.apm.org.uk/body-of-knowledge/delivery/scope-management/change-management/

Additional information

Notes on contributors

Jesse Burk-Rafel

Jesse Burk-Rafel, MD, MRes, is an Internal Medicine resident at NYU Langone Health, New York, NY. He was formerly a medical student and curriculum representative, University of Michigan Medical School, Ann Arbor, MI.

Kevin B. Harris

Kevin B. Harris, MD, is an Internal Medicine resident at the Cleveland Clinic, Cleveland, OH. He was formerly a medical student and curriculum representative, Brody School of Medicine at East Carolina University, Greenville, NC.

Jacqueline Heath

Jacqueline Heath, MD, is an Internal Medicine resident at NYU Langone Health, New York, NY. She was formerly a medical student and curriculum representative, Penn State College of Medicine, Hershey, PA.

Alyssa Milliron

Alyssa Milliron, MD, is an Internal Medicine resident at UC Davis, Sacramento, CA, where she was formerly a medical student and curriculum representative.

David J. Savage

David J. Savage, MD, PhD, is an Internal Medicine resident at the Cleveland Clinic, Cleveland, OH, where he is in the Clinician-Educator Track. He was formerly a medical student, University of Texas McGovern Medical School, Houston, TX.

Susan E. Skochelak

Susan E. Skochelak, MD, MPH, is group vice president, Medical Education, American Medical Association, Chicago, IL.