Recognizing Change in Post-Graduate Medical Education Using the Organizational Knowledge Creation Model

摘要

Context: Université de Montréal medical school implemented Competen cy-based medical education, an important organizational change. Recognizing a nd reporting progress towards change is critical for success. Yet, in formative frameworks that allow educators to track progress aren’t available. We used the Organizational Knowledge Creation Model for such a purpose. Purpose: This paper reports on how we used the Organizational Knowledge Creation Model to recognize change towards Competency-based Medical Education implementation. Method: Because Organizational Knowledge Creation Model focuses on the relationships between individuals and social structures, we selected an embedded case study approach. Diverse case sampling was used to select three academic departments: internal medicine, surgery and psychiatry. Data collection was conducted at two intervals, two years apart. Semi-structured interviews (individual and group) were conducted with Department Heads and Educators. Thematic analysis was conducted on the 15 interview transcripts and coded according to the four Organizational Know ledge Creation Model stages. Results: As implementation begins, selected and trained Educators critically revisit teaching routines and develop com mon conception of Competency-based medical education. This enables communication with wider audiences and intervene within existing working groups where Competency-based medical education is “broken down” into pra c tical concepts. Educators’ roles evolved from “expert” who disseminates knowl edge about Competency-based medical education, to responsive and pra gm atic tutors who develop practical tools with peers and program director s. Conclusion: The Organizational Knowledge Creation Model framework provided a deep understanding of ongoing change. Study participants, interviewed twice, described their perception of change as it progressed as well as insights into the underlying dynamics. As medical schools evolve, Organizational Knowled ge Creation Model may be a valuable conceptual tool to track progress and describe tangible changes.