Curricular change in medical schools: How to succeed

Society's changing needs, advancing knowledge, and innovations in education require constant changes of medical school curricula. But successful curri cular change occurs only through the dedicated efforts of effective change agents. This study systematically searched and synthesized the literature o n educational curricular change (at all levels of instruction), as well as organizational change, to provide guidance for those who direct curricular change initiatives in medical schools. The focus was on the process of plan ning, implementing, and institutionalizing curricular change efforts; thus, only those articles that dealt with examining the change process and artic ulating the factors that promote or inhibit change efforts were included, In spite of the highly diverse literature reviewed, a consistent set of cha racteristics emerged as being associated with successful curricular change. The frequent reappearance of the same characteristics in the varied fields and settings suggests they are robust contributors to successful change. S pecifically, the characteristics are in the areas of the organization's mis sion and goals, history of change in the organization, politics (internal n etworking, resource allocation, relationship with the external environment) , organizational structure, need for change, scope and complexity of the in novation, cooperative climate, participation by the organization's members, communication, human resource development (training, incorporating new mem bers, reward structure), evaluation, performance dip (i.e,, the temporary d ecrease in an organization's performance as a new program is implemented), and leadership. These characteristics are discussed in detail and related s pecifically to curricular change in medical school settings.