Abstract
The concept of quality culture has gained increased attention in health professions education, drawing on insights that quality management processes and positive work-related attitudes of staff in synergy lead to continuous improvement. However, the directions that guide institutions from quality culture theory to educational practice have been missing so far. A prospective qualitative case study of three health professions education programmes was conducted to explore how a quality culture can be enhanced according to the experiences and perspectives of educational leaders. The data collection was structured by an appreciative inquiry approach, supported with vignette-based interviews. A total of 25 participants (a selection of course coordinators, bachelor coordinators and directors of education) reflected on quality culture themes to learn about the best of what is (Discover), envision positive future developments (Dream), identify actions to reach the desired future (Design), and determine how to support and sustain improvement actions (Destiny) within their own educational setting. The results are presented as themes subsumed under these four phases. The experiences and perspectives of educational leaders reveal that peer learning in teams and communities, attention to professional development, and embedding support- and innovation networks, are at the heart of quality culture enhancement. An emphasis on human resources, (inter)relations and contextual awareness of leaders stood out as quality culture catalysts. Educational leaders are therefore encouraged to especially fuel their networking, communication, coalition building, and reflection competencies.
Highlights
Many schools for health professions education (HPE) nowadays face the challenges of increasing student numbers, rapidly evolving educational approaches and technologies, a volatile financial environment and increased accountability pressures (Frenk et al 2010)
Based upon the qualitative analysis, twelve themes were identified which are structured under the four phases of appreciative inquiry: (1) Discover: stimulating expertise based selection and creativity, reinforce multidisciplinary learning, collect and act upon multisource feedback, (2) Dream: foster external perspectives for curriculum alignment, establish staff learning communities with and without students, enhance teacher appreciation and identity building, (3) Design: Implement longitudinal education roles, encourage peer coaching and interactive education, pay attention to quality of work experience, and (4) Destiny: intertwine departmental and educational human resources management (HRM) policies, invest in support and innovation networks, further educational leadership expertise
It should be noted that themes described under the Dream and Design phases might already be present in the current situation, yet interviewees reported that these aspects should receive more emphasis to enhance the quality culture
Summary
Many schools for health professions education (HPE) nowadays face the challenges of increasing student numbers, rapidly evolving educational approaches and technologies, a volatile financial environment and increased accountability pressures (Frenk et al 2010). Since the 1990′s, educational quality enhancement methods have been carried forward by waves of research on organisational culture and performance, total quality management, and an integration of both into the more topical concept of ‘quality culture’ (Harvey and Williams 2010; EUA 2012) The latter concept is commonly used in higher education and originates from insights that quality management and control approaches are too technocratic and top-down and fail or even have adverse effects (Newton 2000; Lomas 2004). There is a growing consensus that an organisational culture for quality requires a more holistic approach in which quality systems and instruments, competencies, and individual as well as collective values are not seen as separate entities but are combined into one overarching concept—the concept of quality culture (Ehlers 2009).
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