Educators' experiences with governance in curriculum change processes; a qualitative study using rich pictures

Abstract

In the midst of continuous health professions curriculum reforms, critical questions arise about the extent to which conceptual ideas are actually put into practice. Curricula are often not implemented as intended. An under-explored aspect that might play a role is governance. In light of major curriculum changes, we explored educators' perspectives of the role of governance in the process of translating curriculum goals and concepts into institutionalized curriculum change at micro-level (teacher-student). In three Dutch medical schools, 19 educators with a dual role (teacher and coordinator) were interviewed between March and May 2018, using the rich pictures method. We employed qualitative content analysis with inductive coding. Data collection occurred concurrently with data analysis. Different governance processes were mentioned, each with its own effects on the curriculum and organizational responses. In Institute 1, participants described an unclear governance structure, resulting in implementation chaos in which an abstract educational concept could not be fully realized. In Institute 2, participants described a top-down and strict governance structure contributing to relatively successful implementation of the educational concept. However it also led to demotivation of educators, who started rebelling to recover their perceived loss of freedom. In Institute 3, participants described a relatively fragmentized process granting a lot of freedom, which contributed to contentment and motivation but did not fully produce the intended changes. Our paper empirically illustrates the importance of governance in curriculum change. To advance curriculum change processes and improve their desired outcomes it seems important to define and explicate both hard and soft governance processes.

Keywords: Educators; Governance; Implementation; Medical schools; Undergraduate medical curriculum change.

Fig. 1

Decision making drawn and explained as ‘a great pile of shit.’ (P11)

Fig. 2

Having the Board of Directors on the right, represented as screaming with a big mouth to the curriculum committee members about what should be done, while dreaming to be number one in the rankings, and having little brains and small ears, expressing that they were not perceived to have the brains to know what should be done, and being bad listeners. On the left the representation of implementation chaos in the curriculum committee as a dirty plate of spaghetti. (P9)

Fig. 3

In the tower of the educational institute, the head of the curriculum is screaming and throwing bags, which are represented to be the assignments for the organization about what they should do regarding the development of the new curriculum. The person receiving the bags is not happy, as is expressed by the sad face, and is trying to covey the messages to others with whom he/she is working but that does not work, as everybody is already overloaded and too busy with their own parts, represented as the wall that stand between them with red crosses, representing no connection. (P8)

Fig. 4

Below, students are represented to be swimming between different educational materials/tools (the blocks), not knowing where to go to, with a teacher who wants to help them, however is also uncertain him/herself about what to do and what is expected of this new curriculum. The big red hand on the left represents a stop sign of the department that was responsible for the logistics and scheduling of the new curriculum. They were explained to be at some point so entirely overloaded (outside this snapshot; people crying really hard) that they were not approachable anymore, having negative consequences for the continuation and implementation of the change process. (P8). (Color fiogure online)

Fig. 5

the Blueprint represented as Bible in a church. (P5)

Fig. 6

The educational scientist represented with the holy grail in his left hand, pointing at the outlines of the curriculum on the board on the right. (P2)

Fig. 7

The curriculum director represented as a king on the thrown. (P2)

Fig. 8

The representation of people worshipping the external Oracle that was listened to by curriculum leaders instead of to the ideas of faculty. (P1)