Cultural metamorphosis: Better doctors through better rel...( INDIANAPOLIS Change can be difficul...),Health

INDIANAPOLIS Change can be difficult. It also can be rewarding. In the case of a medical school culture, change can have important consequences for what students learn and what type of physicians they ultimately become. Successfully altering an institutions culture can be accomplished without massive amounts of funding or strict administrative edicts, say researchers at the Indiana University School of Medicine.

A study published in an advanced online issue of the Journal of General Internal Medicine reports that dramatic change in the organizational culture of the nations second largest medical school is being achieved through a process called relationship-centered care.

Organizational culture is like the weather everyone complains about it, but unlike the weather you can do something about it. We found that organizational culture at our medical school, and we believe at others, is subject to intentional change, so long as you use appropriate methods, said the studys senior author, Thomas Inui, M.D., associate dean for health services research at the IU School of Medicine and president and CEO of the Regenstrief Institute, Inc.

The momentum to change the organizational culture or informal curriculum of the IU School of Medicine began a decade earlier with the initiation of a curriculum expanded to include nine key competencies that IUSM medical students must achieve before graduation. These include clinical skills; self-awareness, self care and personal growth; professionalism and role recognition; social and community contexts of health care; and moral reasoning and ethical judgment.

As we developed the competency curriculum, we realized that in addition to teaching these abilities, we needed to change the organizational and interpersonal environment of the school the hidden curriculum so our schools informal curriculum and culture supported the values promoted by new curriculum. Unless we did this, we were sending a
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