Doctors as change agents: Transformative learning within the boundaries of the Learning Communities of Groningen Medicine curriculum G2020

Contact person

Joke Fleer. j.fleer umcg.nl

Summary

One of the aims of G2020 is to train students to become change agents. This is achieved through a learning process known as ‘transformative learning’, in which students develop the leadership qualities that they will need to play a leading role in the continuous change processes in demand-oriented care in their future professional careers. The foundations for this transformative learning are partly laid by the development of CanMEDS competences. However, the ability to approach an issue from an interdisciplinary perspective, look beyond one’s own discipline and share knowledge and expertise between LCs are also necessary elements that contribute to the development of leadership skills. G2020 started in 2014, but the transformative learning process has not yet achieved a structural position in the curriculum.

This project aims to integrate transformative learning in the Bachelor’s phase of the Groningen Medicine curriculum G2020. ‘Transformative weeks ‘ will be developed, implemented and evaluated to this end, which will focus on the development of leadership skills and on two recurring elements:

1. An explicit aim for interaction among the four LCs to teach students to look beyond the boundaries of their own LCs, which is a prerequisite for the development of leadership skills
2. The Medical Humanities will play a central role during these weeks. This means that, within the context of medical knowledge acquisition, topics from the liberal arts will be used to stimulate students to develop leadership skills (i.e. a wide view, interdisciplinarity, creativity).

The transformative weeks are expected to help students learn to approach issues from a perspective broader than their own personal and medical points of view. Awareness of one’s own ideas and opinions and understanding other views are prerequisites for the development of leadership skills.

Best Practices

One of the goals of the new medical curriculum (G2020) is to integrate transformative learning into the bachelor of medicine. Transformative learning refers to the development of leaderschip attributes, needed to become a medical leader, i.e. someone who can make change happen in health care. A change agent does not have to be a person in authority, but (s)he does have to have a clear vision and be able to communicate that vision clearly with others. Developing a vision requires that a person (a) knows the context of medicine, i.e. how it organized and how it is influenced by politics, economy, history, technology etc, and (b) knows him/her self, i.e. his/her norms and values, strengths and weaknesses, what (s)he wants and what (s)he finds important.

The pilot project aimed to implement transformative learning into the bachelor of medicine by developing and implementing nine Medicine in Context (MiC) weeks throughout the first five semesters of the bachelor of medicine. The focus of these weeks was to help students develop a broader perspective on medicine than the personal or medical perspective. To cultivate this broader perspective, we strived for interaction between the four learning communities (LCs) in every MiC week, providing an opportunity to learn from each other's LC perspectives. Furthermore, in every week we aimed to make use of the Medical Humanities, i.e. art, philosophy, history, to create awareness and understanding of other points of view.

What went well: the MiC weeks are implemented as planned, including the interaction between LCs and the Medical Humanities. Students evaluate the weeks positively. Points for improvement: the interaction between LCs is currently rather passive, we can make more out of it. Furthermore, we struggle with finding a way to test transformative learning. Currently it is tested in the written exam, but transformative learning is about personal development, or Bildung, for which testing is probably not opportune.