Harvard Macy Institute Progrom for Leaders in Medical Education

The Program for Leaders in Medical Education is one of two programs offered by the Harvard Macy Institute. Both programs are designed to facilitate changes in medical education by empowering educators to lead change at their home institutions and by building an international community of scholars interested in promoting and sustaining such innovation. While the Program for Medical Educators (formerly the Program for Physician Educators) targets medical faculty who are interested in implementing changes in specific courses, the Program for Leaders in Medical Education is designed for those with responsibility for or significant roles in reshaping the curriculum at their institution. Medical Schools are encouraged to send teams of participants rather than individuals, but single participants are accepted.  The programs are conducted by the Harvard Medical School in conjunction with the Harvard Business School, and in collaboration with Harvard Medical International. Original funding for the programs came from the Josiah Macy Foundation. Since their inception in 1995, the programs have involved more than 900 educators from the United States and throughout the world. The majority of the participants have been deans, senior associate deans, curriculum committee chairs, or curriculum task force leaders at medical schools, but over the years nurses, social scientists, and other health science educators have participated. (I was the first, but hopefully not the last, librarian participant.)

The program lasts a week, and takes place at the Harvard Medical School. Each class is limited to no more than 50 participants. The classes meet daily in the Medical School’s case study room, patterned after similar rooms in the business school. Each day is a mixture of presentations, case studies, and small group work. There are background readings as well as the cases themselves to be prepared--in advance or as homework during the week. The program assumes the participants come with a thorough understanding of medical education in the United States–structure, content, laws, regulations, social and political environment–as well as knowledge of current issues and trends, and have been involved in discussions about the curriculum at their schools.

The case study method is patterned after the teaching method used in the Business School, and has many similarities to the problem-based learning methodology used in many medical schools. Each case presents a scenario, not necessarily from the world of education or medicine. The group as a whole, facilitated by the instructors, discusses the case, analyzes the underlying issues, shares relevant experiences, addresses specific questions, and extrapolates lessons learned to the world of medical education. The information extracted from the cases, combined with the readings and presentations, are the raw materials for the small group work each day.

While some of our cases presented specific experiences from health care or medical education, others were from manufacturing, engineering, government, and other fields. The Bay of Pigs and the Cuban Missile Crisis were case studies for decision making. Steel mills taught us disruptive technology and automobile manufacturing demonstrated the concept of “rules in use.” We studied the lessons of the space shuttle program when we discussed patient safety and quality improvement issues as drivers of curricular innovations. We also looked at cases around the current curriculum in medical schools from the student’s perspective and at cases specifically related to and illustrating management of curriculum change at medical schools.

The psychological and political aspects of change management were addressed as well. We had practical lessons in leading a task force, implementing pilot projects, developing faculty, and evaluating programs. We discussed building joint programs with business partners, and learned about individual and institutional assumptions that inhibit change and how to address them.

We had at least an hour each day for our small groups and individual work. A key component of the curriculum, the small groups of 8-10 students and two facilitators (themselves alumni of previous Institutes) met to discuss the effect of disruptive innovations, the current curricula at our schools, and possible alternative pathways for educating physicians. The small groups also provided feedback and support as we worked on our personal action plans for facilitating innovation. My small group included a medical school dean from Denmark and a curriculum dean from India who brought an outside perspective to many of the issues we were debating. In addition, lunches and a daily walk to class constituted informal small groups and the opportunity to discuss further and explore still other points of view.

I would recommend this course to others at academic medical libraries. It is an intense, demanding, and rewarding experience. Many of the lessons learned will be applicable to a wide range of issues, not just curriculum reform. If you are involved in evaluating or restructuring the curriculum at your school, or think you should be, this program will provide valuable information, insights, and experience.

Information about the Harvard Macy Institute and the Program for Leaders in Medical Education can be found on the Institute’s website. 

Submitted by
Jane Blumenthal, AHIP