Implementation of curriculum by family medicine fellows: what factors help and what factors hinder?

BACKGROUND AND OBJECTIVES The need for change in medical curricula is increasing, due partially to tougher curriculum and evaluation standards. Participants in our academic medicine fellowship learn to develop curricula, but not all are successful at fully implementing them. This study looked for facilitators of and barriers to curriculum implementation by individual fellows. A literature review uncovered studies identifying institutional variables relating to successful curriculum innovation but little that identified variables pertaining to the individual curriculum developer. METHODS We interviewed alumni of the curriculum development track of the Primary Care Faculty Development Fellowship at Michigan State University, asking what promoted or hindered their curriculum implementation. We analyzed interview notes to identify themes according to a theoretical framework. RESULTS Common facilitators were (1) having a strong advocate, (2) perception of need for the curriculum by both fellow and institution, and (3) having a curriculum plan. Common barriers were (1) no time slot for curriculum, (2) fellow had left job, and (3) curriculum was too large or complex. CONCLUSION Successful curriculum developers have powerful advocates of well-designed curriculum plans that address recognized institutional needs.