Specialty Training’s Organizational Readiness for curriculum Change (STORC): development of a questionnaire in a Delphi study

BMC Medical Education

Fedde Scheele⁴  Albert Scherpbier²  Corry den Rooyen¹  Scheltus van Luijk²  Mariëlle Jippes³  Lindsay Bank⁵ 

[1] Royal Dutch Medical Association (KNMG), Mercatorlaan 1200, Utrecht, 3528 BL, Netherlands;Maastricht UMC+, Maastricht, 6202 AZ, Netherlands;Diakonessenhuis Utrecht, Bosboomstraat 1, Utrecht, 3582 KE, Netherlands;Athena Institute for Transdisciplinary Research, De Boelelaan 1081, Amsterdam, 1081 HV, Netherlands;Sint Lucas Andreas Hospital, Jan Tooropstraat 164, Amsterdam, 1061 AE, Netherlands

关键词: Questionnaire;    Delphi study;    Curriculum change;    Postgraduate medical education;    Organizational readiness for change;   

Others  :  1224505
DOI  :  10.1186/s12909-015-0408-0

 received in 2015-05-18, accepted in 2015-07-07,  发布年份 2015

【 摘 要 】

Background

In postgraduate medical education (PGME), programs have been restructured according to competency-based frameworks. The scale and implications of these adjustments justify a comprehensive implementation plan. Organizational Readiness for Change (ORC) is seen as a critical precursor for a successful implementation of change initiatives. Though, ORC in health care settings is mostly assessed in small scale settings and in relation to new policies and practices rather than educational change. Therefore our aim with this work was to develop an instrument to asses Specialty Training’s Organizational Readiness for curriculum Change (STORC).

Methods

A Delphi procedure was conducted to examine the applicability of a preliminary questionnaire in PGME, which was based on existing instruments designed for business and health care organizations. The 41 panellists (19 trainees and 22 supervisors from 6 specialties) from four different countries who were confronted with an apparent curriculum change, or would be in the near future, were asked to rate the relevance of a 89-item web-based questionnaire with regard to changes in specialty training on a 5-point Likert scale. Furthermore, they were invited to make qualitative comments on the items.

Results

In two rounds the 89-item preliminary questionnaire was reduced to 44 items. Items were either removed, kept, adapted or added based on individual item scores and qualitative comments. In the absence of a gold standard, this Delphi procedure was considered complete when the overall questionnaire rating exceeded 4.0 (scale 0–5). The overall item score reached 4.1 in the second round, meeting our criteria for completion of this Delphi procedure.

Conclusions

This Delphi study describes the initial validating step in the development of an instrument to asses Specialty Training’s Organisational Readiness for curriculum Change (STORC). Since ORC is measured on various subscales and presented as such, its strength lies in analysing these subscales. The latter makes it possible for educational leaders to identify and anticipate on hurdles in the implementation process and subsequently optimize efforts for successful curriculum change.

【 授权许可】

   
2015 Bank et al.

【 参考文献 】

• [1]ACGME Common Program Requirements. Accreditation Council for Graduate Medical Education 9-6-2013;Available from:. http://www. acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs2013.pdf webcite
• [2]Billet S. Constituting the workplace curriculum. J Curriculum Stud. 2006; 38:31-48.
• [3]Chou S, Cole G, McLaughlin K, Lockyer J. CanMEDS evaluation in Canadian postgraduate training programmes: tools used and programme director satisfaction. Med Educ. 2008; 42:879-86.
• [4]Cole MS, Harris SG, Bernerth JB. Exploring the implications of vision, appropriateness, and execution of organizational change. Leadership Org Dev J. 2006; 27:352-67.
• [5]Coomarasamy A, Khan KS. What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. BMJ. 2004; 329:1017.
• [6]Fleuren M, Wiefferink K, Paulussen T. Determinants of innovation within health care organizations: literature review and Delphi study. Int J Qual Health Care. 2004; 16:107-23.
• [7]Frank JR. The CanMEDS 2005 physician competency framework : better standards, better physicians, better care. Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario; 2005.
• [8]Griffiths S. The role of the postgraduate medical education and training board. Arch Dis Child. 2006; 91:195-7.
• [9]Helfrich CD, Li YF, Sharp ND, Sales AE. Organizational readiness to change assessment (ORCA): development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework. Implement Sci. 2009; 4:38. BioMed Central Full Text
• [10]Holey EA, Feeley JL, Dixon J, Whittaker VJ. An exploration of the use of simple statistics to measure consensus and stability in Delphi studies. BMC Med Res Methodol. 2007; 7:52. BioMed Central Full Text
• [11]Holt D, Armenakis A, Feild H, Harris S. Readiness for organizational change. J Appl Behav Sci. 2007; 43:232-55.
• [12]Holt DT, Armenakis AA, Harris SG, Field HS. Towards a comprehensive definition of readiness for change: a review of research and instrumentation. In: Research in organizational change and development. Elsevier, Oxford; 2007: p.289-336.
• [13]Holt DT, Helfrich CD, Hall CG, Weiner BJ. Are you ready? How health professionals can comprehensively conceptualize readiness for change. J Gen Intern Med. 2010; 25:50-5.
• [14]Ingersoll GL, Kirsch JC, Merk SE, Lightfoot J. Relationship of organizational culture and readiness for change to employee commitment to the organization. J Nurs Adm. 2000; 30:11-20.
• [15]Jippes M, Driessen EW, Broers NJ, Majoor GD, Gijselaers WH, van der Vleuten CP. A medical school’s organizational readiness for curriculum change (MORC): development and validation of a questionnaire. Acad Med. 2013; 88:1346-56.
• [16]Jippes E, van Engelen JM, Brand PL, Oudkerk M. Competency-based (CanMEDS) residency training programme in radiology: systematic design procedure, curriculum and success factors. Eur Radiol. 2010; 20:967-77.
• [17]Jippes E, Van Luijk SJ, Pols J, Achterkamp MC, Brand PL, van Engelen JM. Facilitators and barriers to a nationwide implementation of competency-based postgraduate medical curricula: a qualitative study. Med Teach. 2012; 34:e589-602.
• [18]Jones R, Higgs R, de Angelis C, Prideaux D. Changing face of medical curricula. Lancet. 2001; 357:699-703.
• [19]Jones RA, Jimmieson NL, Griffiths A. The impact of organizational culture and reshaping capabilities on change implementation success: the mediating role of readiness for change. J Manage Stud. 2005; 42:361-86.
• [20]Keeney S, Hasson F, McKenna HP. A critical review of the Delphi technique as a research methodology for nursing. Int J Nurs Stud. 2001; 38:195-200.
• [21]Kuper A, D’Eon M. Rethinking the basis of medical knowledge. Med Educ. 2011; 45:36-43.
• [22]Lehman WE, Greener JM, Simpson DD. Assessing organizational readiness for change. J Subst Abuse Treat. 2002; 22:197-209.
• [23]Lillevang G, Bugge L, Beck H, Joost-Rethans J, Ringsted C. Evaluation of a national process of reforming curricula in postgraduate medical education. Med Teach. 2009; 31:e260-6.
• [24]Malau-Aduli BS, Zimitat C, Malau-Aduli AEO. Quality assured assessment processes evaluating staff response to change. Higher Educ Manage Policy. 2011; 23:1-24.
• [25]Mortensen L, Malling B, Ringsted C, Rubak S. What is the impact of a national postgraduate medical specialist education reform on the daily clinical training 3.5 years after implementation? A questionnaire survey. BMC Med Educ. 2010; 10:46. BioMed Central Full Text
• [26]Okoli C, Pawlowski SD. The Delphi method as a research tool: an example, design considerations and applications. Inf Manage. 2004; 42:15-29.
• [27]Scheele F, Novak Z, Vetter K, Caccia N, Goverde A. Obstetrics and gynaecology training in Europe needs a next step. Eur J Obstet Gynecol Reprod Biol. 2014; 180:130-2.
• [28]Scheele F, Teunissen P, Van LS, Heineman E, Fluit L, Mulder H et al.. Introducing competency-based postgraduate medical education in the Netherlands. Med Teach. 2008; 30:248-53.
• [29]Scheele F, Van LS, Mulder H, Baane C, Rooyen CD, De Hoog M et al.. Is the modernisation of postgraduate medical training in the Netherlands successful? Views of the NVMO Special Interest Group on Postgraduate Medical Education. Med Teach. 2014; 36:116-20.
• [30]Shea CM, Jacobs SR, Esserman DA, Bruce K, Weiner BJ. Organizational readiness for implementing change: a psychometric assessment of a new measure. Implement Sci. 2014; 9:7. BioMed Central Full Text
• [31]Tidd J. Managing innovation : Integrating technological market and organizational change. John Wiley & Sons, Chichester, West Sussex; 2005.
• [32]van Zolingen SJ, Klaassen CA. Selection processes in a Delphi study about key qualifications in Senior Secondary Vocational Education. Technological Forecasting Soc Change. 2003; 70:317-40.
• [33]Verdonschot S, Keursten P. Learning with the intention of innovating: eleven design principles for knowledge productivity. In: Supporting workplace learning: towards evidence-based practice. Poell RF, Woerkom M, editors. Springer, London; 2011: p.183-203.
• [34]von der Gracht HA. Consensus measurement in Delphi studies. Technological Forecasting Soc Change. 2012; 79:1525-36.
• [35]Weiner BJ. A theory of organizational readiness for change. Implement Sci. 2009; 4:67. BioMed Central Full Text
• [36]Weiner BJ, Amick H, Lee SY. Conceptualization and measurement of organizational readiness for change: a review of the literature in health services research and other fields. Med Care Res Rev. 2008; 65:379-436.