Dealing with resistance and negative attitudes as barriers to the implementation of a longitudinal communication curriculum - a field report

• Published in: GMS journal for medical education Vol. 38; no. 3; p. Doc51
• Main Authors: Hollinderbäumer, Anke, Hinding, B, Buggenhagen, H, Jünger, J
• Format: Journal Article
• Language: English
• Published: Germany German Medical Science GMS Publishing House 01-01-2021
• Subjects: communication curriculum; implemention barriers; negativ attitude; resistance; communication curriculum; negativ attitude; implemention barriers; resistance
• ISSN: 2366-5017; 2366-5017
• DOI: 10.3205/zma001447

The aim of the project "Communicative Competences of Physicians" (BMG) was the pilot implementation of a longitudinal model communication curriculum. For the Mainz project location, the task was to integrate courses offered in the clinical subjects into a communication curriculum and to expand it longitudinally. In this process, which was both content-related and social, resistance and negative attitudes regarding the continued development of the communication curriculum became apparent at an early stage. How these manifested and which measures were taken to overcome them is laid out in this reflective field report.
At the beginning of the project, a SWOT analysis was used to identify the strengths and weaknesses that the faculty presented for the continued development of the communication curriculum. This assessment by the project staff included, among other things, an evaluation of the motivation levels of the faculty's lecturers and senior teaching staff. The subsequent specific, strategic and content-related planning of the further implementation steps in accordance with change-management concepts made it possible to take this aspect into account. For a more reliable assessment of the situation, the project was first presented to the faculty's teaching committee. In this situation it was possible to identify individuals with favourable and unfavourable attitudes. With the insight that was gained, the following course of action was decided upon: Contact advocates to gain their support. Contact the individuals with negative attitudes with the aim of building a relationship and arranging a personal meeting. Identify resistances and negative attitudes in one-on-one meetings and employ targeted countermeasures.Develop an action plan with a particular focus on gaining the cooperation of those who are essential to the success of integrating communication-related content into the major clinical disciplines.
In one-on-one meetings, it was possible to first clarify which learning objectives of communication training are already covered in the respective subject and which expertise is therefore available. Furthermore, it was possible to clarify which areas that were still absent in the overall communication curriculum should be taught in this clinical subject in particular. It became possible to involve the lecturers in the development in the spirit of participatory design. In accordance with the action plan, offers to support the development and organisation of as-yet absent portions of the curriculum were presented to the affected departments.
Resistance and negative attitudes often do not represent a rejection of communicative competences - they rather express that teachers fear they do not have the expertise and resources to teach them. With the selected approach of outreach, personal conversation, and action plan, it was possible to provide the individuals in question with goal-oriented support.