The challenges of educational change: cultural and psychological inertia

In this issue of the CMEJ we showcase several studies of successful innovations, a commentary calling for more and better research into curriculum delivery models to eventually improve the choices available to curriculum planners, and a suggestion that a recent change in resident work hours was ill advised. Applied research, which is much of what currently happens in medical education, by its very nature, recommends, suggests, and offers a new direction which then implies change for someone. On a regular basis we seem to blithely toss out ideas for improvement with little regard for the very real challenges of successfully adopting, implementing, and embedding 1 new ways into often reluctant organizations. Though we know much about the march of progress as a whole 1 we know little and use less of what is going on inside individuals and organizations.