Table 3.

Illustrative Examples of Changes at IUSM Observed by Members of the RCCI Steering and Discovery Teams and Attributed (at least in part) to the RCCI

Observed Changes
New Meeting Formats and Practices
• New meeting practices to “humanize” meetings of the standing committees of IUSM (e.g., checking-in, noticing successes and appreciative debriefings) are spreading.
• The use of paired interviewing, reflective narratives and appreciative inquiry is spreading (e.g., chief resident orientation, resident workshops on professionalism, and elements of new NIH-funded Behavioral and Social Sciences Integrated Curriculum.
• Staff members in the Office of Medical Education and Curricular Affairs created and implemented a plan to be mindful of every personal interaction and to manifest a relationship-centered culture in all of their work.
• The competency directors and coordinators transformed themselves into a “relationship-centered learning community” seeking to live the values of the competency curriculum as a way of disseminating them across the school and the state.
• Methods from the RCCI are now being adapted to quality and service improvement initiatives in facilities across the health system.
New Institutional Procedures and Programs
• The Dean includes rigorous data on the work environment in performance reviews for department chairs and conducts these reviews in a relationship-centered manner.
• A major school-wide initiative in mission-based management was designed and implemented with the explicit intention of fostering partnership, engagement, shared decision-making and trust.
• The Admissions Committee developed new criteria and new interviewing methods to select relationally oriented applicants.
• The Academic Standards Committee changed its approach to reporting and addressing poor ratings on student course evaluations from a form letter (known as the “ding letter”) to a more personal and collaborative conversation.
• A fifty-hour career development course has been created for newly hired faculty that incorporates relationship-centered principles and emphasizes the importance of mentorship.
• Two leadership development programs (a year-long series of quarterly retreats called The Courage to Lead and a 15 hour Internal Change Agent Program) have been added to the roster of faculty development activities. Originally conducted by the external consultants, these are now internally planned and facilitated.
• Students requested and received approval for a permanent Dean-appointed student leadership position intended to promote the RCCI and to foster mindfulness of relationship in campus activities.
• After protesting reduced library hours, students responded successfully to an invitation to develop an alternative plan that met necessary financial constraints.
Communication about Culture
• The School’s weekly newsletter, Scope, now includes a column entitled “Mindfulness in Medicine” that uses stories of actual faculty and trainee experiences to focus attention on relationships and professionalism.
• Students created a special Bulletin Board in the student center devoted to promoting student interest in the activities and events of the RCCI.
• A group of students published a book of students’ stories about professionalism that was presented to incoming students at the White Coat Ceremony. In each of the subsequent two years, students created and published similar books presenting art, stories, and poems by IUSM faculty, residents, and students reflecting humanistic aspects of doctoring.