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

Context: Universite de Montreal medical school implemented\r\nCompetency-based medical education, an important\r\norganizational change. Recognizing and\r\nreporting progress towards change is critical for success. Yet, informative\r\nframeworks that allow educators to track progress aren’t available. We used the\r\nOrganizational Knowledge Creation Model for such a purpose. Purpose: This paper reports on how we used the Organizational Knowledge Creation Model to recognize change towards\r\nCompetency-based Medical Education implementation. Method: Because Organizational Knowledge Creation Model focuses on the\r\nrelationships between individuals and social structures, we selected an\r\nembedded case study approach. Diverse case sampling was used to select three academic departments: internal medicine,\r\nsurgery and psychiatry. Data collection was conducted at two intervals,\r\ntwo years apart. Semi-structured interviews (individual and group) were\r\nconducted with Department Heads and Educators. Thematic analysis was conducted\r\non the 15 interview transcripts and coded according to the four Organizational\r\nKnowledge Creation Model stages. Results: As implementation begins, selected and trained Educators critically revisit\r\nteaching routines and develop common\r\nconception of Competency-based medical education. This enables communication\r\nwith wider audiences and intervene within existing working groups where Competency-based medical education is “broken\r\ndown” into practical concepts. Educators’ roles evolved from\r\n“expert” who disseminates knowledge\r\nabout Competency-based medical education, to responsive and pragmatic tutors who develop practical tools with peers\r\nand program directors. Conclusion: The Organizational Knowledge Creation Model\r\nframework provided a deep understanding of ongoing change. Study participants,\r\ninterviewed twice, described their perception of change as it\r\nprogressed as well as insights into the\r\nunderlying dynamics. As medical schools evolve, Organizational Knowledge\r\nCreation Model may be a valuable conceptual tool to track progress and describe\r\ntangible changes.