Bolander Laksov et al. (2022) designed a program “to support teams of clinical teachers to build capacity to lead educational change based on educational research in their clinical environments” to run over a year with 8 half-day workshops that each included preparatory tasks. Three years later, three of the five projects are still going strong, so let’s read about how they did that!

For the first meeting, teams prepared by figuring out what challenges they wanted to solve. During the meeting, beside an introduction, the focus was on fine-tuning the aims and expectations, as well as potential challenges.

To prepare for the second meeting, a journal club, participants read four articles per team that were relevant to the challenge they wanted to address (according to what they decided in the first meeting).

In the third meeting, there was input on project management models, e.g. Meyer & Stensaker (2006), who stress that change isn’t an isolated event as assumed in some theories of change (for example when we unfreeze-change-refreeze), but an ever ongoing and dynamic process with, in fact, many different changes starting and ending and changing at the same time. For an organisation to be able to deal with this, they need to have the capability to implement a single change, to implement changes subsequently, and at the same time to maintain daily operations. Organizations can foster these capacities by focussing on

• framing, i.e. how things are being communicated through symbols or metaphors, so that all involved have a similar understanding of what needs to happen, why, and how it is going to impact them, in order to motivate their support for the change. If a crisis is used to motivate change, this can potentially paralyse people, and this can also not be used repeatedly (like crying wolf…)
• participation, i.e. involving everybody concerned with the change in both decision-making and implementation. This generally improves the solutions, but it can also create frustration if participants feel that they are being asked for input but not being listened to, and it can also take away capacity from the ongoing daily work if people get too involved
• pacing and sequencing; how slowly or quickly changes are implemented (either have advantages or disadvantages related to change being able to evolve organically, loosing momentum, taking time to find good solutions, disrupting the day job, change fatigue, …) and in what order steps are being taken
• routinising, i.e. having routines and processes in place to deal with the change
• recruiting, i.e. bringing in consultants or extra staff to support the change process or to take regular workload off staff who are very much involved in the change process

The fourth meeting was distributed, such that each team got their own meeting with facilitators in their own context, to produce tools for change.

The fifth meeting used the”Mirror exercise: Each team identified their objectives, the tools that would help them achieve those objectives and signs of achievement in relation to past, present and the future. This helped them to design the process of implementation.” I’ve done quite some digging to figure out more about this activity to understand it enough to potentially be able to implement it myself, but so far that has been unsuccessful. I hope to follow up on this with a new blogpost soon! Anyway, this fifth meeting is centered about implementing the change and planning evaluations.

To prepare for the sixth meeting, participants described experiences with change initiatives, both successful and not, which they shared in distributed meetings, one per each team, in order to build a strong community.

In the seventh meeting, evaluations were either prepared or results discussed and reflected upon.

In the last, eighth meeting, all projects were presented to the public and especially invited colleagues in key positions.

One success factor the authors identify is that they gave participants the opportunity to choose, rather than prescribing process (too much), literature, and type of artefact. They reflect that it helps to “make explicit from the very start that participants create the content of the course, not a course where they ‘consume’ course content”. And I agree that this is always very important!

Another one is that the program was designed around creating and maintaining supportive teams, which helped in the process itself but also when it was challenged from the outside. Changes to the team do take time, according to Tuckman’s stages of group development, and also in the case described here. Having a mentor can help reaching a performing state faster after disturbances.

Ultimately, sharing ownership in a team (rather than individuals feeling ownerships for aspects and then fighting against other ideas / attempts / …) is making innovation easier and more sustainable.

Lastly, it was important to “obtain legitimacy” from testing ideas from research in practice; theoretical ideas do need to be convincing in practice to overcome scepticism. For this, it helped to invite the bosses to at least visit the process and observe.

It also helped that the project provided “protected time” to participants to focus on their educational development. What I think is important here is that the participants actually spent substantive amounts of time together in their teams, both in the eight half-day meetings, and over almost a full year. This is something that I can maybe try to implement more in my own courses.

So yeah, this is it! Many of the points they make resonate with me and my practice. I also quite like the input on how change works in the third meeting, and to consider all these aspects. For the course that I had at the back of my mind when reading this this might not be as important, as they will all be working towards fixed (not by me, by the university’s routines) deadlines, but it is an interesting thought to keep in mind in the future!

Featured image: The “phases of team development” slide that I drew when I was still working at TUHH (you might recognize the Bachelor project’s remote-controlled helium balloons in the “performing” phase!) Also funny how it the “forming” phase, people are staring out of the window or into their newspaper. That was definitely NOT pre mobile phone, but maybe we still used them in a different way back then?

Bolander Laksov, K., Elmberger, A., Liljedahl, M., & Björck, E. (2022). Shifting to team-based faculty development: a programme designed to facilitate change in medical education. Higher Education Research & Development, 41(2), 269-283.

Meyer, C. B., & Stensaker, I. G. (2006). Developing capacity for change. Journal of change management, 6(2), 217-231.