Making Change in a Clinical Training Environment: A Checklist to Discuss the Process

Background & Need for Innovation: Effective change management is critical to the success of organizational change initiatives. Failure rates are estimated at approximately 70%. Change projects in clinical education are embedded in complex environments, where patient care has priority, professionals traditionally enjoy a high degree of autonomy, and multiple stakeholders are involved. Achieving successful change in such settings requires careful preparation by leaders. External consultancy support is costly, while gaining a comprehensive overview of the change management literature is time-consuming.

Goal of Innovation: A practical tool that prompts relevant questions tailored to clinical training settings.

Steps taken for Development and Implementation of Innovation: The checklist was developed using a developmental evaluation approach. Over several years, we applied a question-based tool grounded in key concepts from the change management literature. Initially consisting of twelve questions, the tool was iteratively expanded based on user experiences, identifying themes most relevant to clinical training contexts. Multiple-choice response options were developed to prevent unproductive discussions.

Outcomes of Innovation: The final product is a twenty-item checklist designed for discussion in small groups. Ideally, different stakeholder groups complete the checklist separately and subsequently compare perspectives on the change process. This approach facilitates a shared understanding of the risks of the change initiative and highlights unaddressed tasks. A game board, cards, and instructions are available for download and printing.

Critical Reflection on Our Process: This change management tool offers a structured journey through selected change management concepts, supporting leaders in clinical training environments and stimulating dialogue about change processes in clinical contexts.