Organizational change, learning and culture: A mixed methods case study on creating a culture of quality via accreditation CQI reforms
Balascuta, Iuliana A
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https://hdl.handle.net/2142/115672
Description
Title
Organizational change, learning and culture: A mixed methods case study on creating a culture of quality via accreditation CQI reforms
Author(s)
Balascuta, Iuliana A
Issue Date
2022-03-31
Director of Research (if dissertation) or Advisor (if thesis)
At its core, the purpose of the accreditation process is to support, increase and sustain the quality of higher education programs. However, since accreditation is externally enforced, it creates two understandings of accreditation: one that paints accreditation as compliance and the other as enhancing quality. Using the Liaison Committee on Medical Education (LCME) Continuous Quality Improvement (CQI) accreditation requirement introduced in 2015, this case study explores the process through which externally mandated change reforms contribute to shifts in the organizational culture of medical schools aligned with organizational learning or learning organization. Informed by organizational change and culture theory and supported by a mixed methods research design, quantitative and qualitative data was collected for both a national sample and at a single institution. To triangulate data, this research employed a survey, interviews, document collection, as well as the researcher’s direct observations and analytic memo.
The results of the study were that there are variable levels of engagement in quality improvement across the nation and that at most institutions, the CQI accreditation requirement created a new bureaucratic system. Although there is limited empirical evidence regarding the efficacy of the CQI process to monitor compliance with accreditation standards (Boulet et al., 2014; Norcini, 2010; van Zanten et al., 2008), this research demonstrates that the CQI reform has the potential to shift the organizational culture from compliance to improvement and towards organizational learning. Whether LCME accreditation is leading to a quality of education that is sustainable is debatable. However, in this research it was found that at the single institution of study, shifting from a more process-oriented view to a more cultural view where change initiatives are not only encouraged but embedded in the cultural fabric of the institution, the LCME accreditation can serve as a quality improvement tool via the CQI process. At the single institution of research, CQI has been more easily adopted because the organizational culture was characterized by a mindset of growth, and stakeholders were actively involved in the development of institution’s mission, values, expectations, and commitment regarding quality. Whether quality in medical education can be explained as a result of the LCME CQI requirement of creating a well-defined institutional CQI process or whether it is a result of the organizational culture that is dedicated to holistic quality improvement is another issue that is debatable.
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