BACKGROUND AND OBJECTIVES: Academic institutions are typically resistant to change. Redefining scholarship is an important issue for academic health care institutions. This study examines the change process at institutions that have attempted to change the definition of scholarship. METHODS: Five medical schools were identified that had recently redesigned their promotion and tenure systems based on expanded definitions of scholarship. Interviews were conducted with a key leader in this effort. The interviews were designed to identify the forces and barriers involved in change, activities designed to secure faculty "buyin," factors needed to sustain change, and advice that would help others who might be considering such an effort at their academic health centers. We organized the results of the interviews within a change leadership and management model. RESULTS: The responses to the survey questions fit well into the change model. Many of the responses were felt to be applicable to multiple stages of the change model. CONCLUSIONS: The leaders of change from the study institutions, either by intention or intuition, identified key factors of their change process that fit well with the study model. Change leaders should include plans that follow an established model for institutional change in their strategy to change the definition of scholarship at their institution.
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