Table 4.

Negative Comments about RCCI Organizational Change at IUSM Taken from Steering and Discovery Team Minutes, Personal Interviews, Formal Reports, and Articles, Grouped By Theme

Comments
Initial Skepticism Regarding the RCCI Likelihood of Success
• “When initially briefed on RCCI, my first reflex was that this was too “warm and fuzzy” and that people would trivialize it no matter how well-intentioned the program. ...To my surprise, we experienced an outpouring of truly remarkable stories that created a groundswell of pride and inspiration among participants.”
•IUSM Dean
•Academic Medicine, 2007; 82:1094–1097
• “What I honestly thought might be a “noble failure” when I accepted this assignment, has amazed me with its power and, yes, its unique form of rigor. It has truly engendered the hope that this “experiment” might lead to long needed changes in medical education and patient care.
•RCCI External Evaluator
•2004 Report to the Fetzer Institute
• Trusting others did not become my strong suit. At the outset of the Relationship-Centered Care Initiative, I was solidly in this career-long orientation. .... To my surprise, people in high-risk environments were just as likely to take positive steps as others, perhaps because the felt need resided there.
In spite of being one of the principal leaders for RCCI, the weight of responsibility for designing project plans and was not upon my shoulders. I would take my initiatives within my own environment but expect that institutional ‘emergence’ would serve as the optimal intelligence for program activities institution-wide.
•President and CEO, Regenstrief Institute
•Interview with RCCI external consultants, 2006
•Skepticism Regarding the Personal Impact of RCCI Activities
•I participated in the RCCI when I could, but got nothing out of it.
•IUSM Faculty
•Response to RCCI survey on faculty vitality, 2007
• When I was asked to participate in the RCCI Courage to Lead program, I was totally unaware of what the program was about and what it entailed. The first session was very difficult for me to find a comfort level in the group. I had never participated in such a discussion group with people I barely knew and some I didn’t know. As the year progressed, I realized that I was looking forward to the retreats and found it much easier to express myself and join in the group. I found the sessions ... helped me to reflect on my feelings and look at how I was not attending to my own needs. ... I will always remember the sessions and continue to try and incorporate the ideas of the sessions in my life and career.
•Clinician, Co-Chair of key IUSM administrative committee
•Response to RCCI survey on faculty vitality, 2007
Skepticism Regarding the Methods of the RCCI
• At each [Discovery Team] meeting the consultants asked us what changes we were noticing in the IUSM culture, and what we were trying. I wasn’t sure that any positive elements of the IUSM culture that I was noticing were the direct results of the RCCI, or just my decision to consciously attend to the positive. I was also not sure what new “things” I should be trying. I had always tried to be friendly and helpful to my colleagues, but I knew this wasn’t enough. What else was I supposed to be doing?
•Medical Education Staff, currently a core member of the RCCI Leadership Team
•From written description of experience with the RCCI, 2006
Skepticism Regarding Ability of the RCCI to Transform All Aspects of IUSM Culture
• Recorded in the Discovery Team minutes, 2005:
•Another DT member expressed appreciation for the DT environment but is feeling unsuccessful helping it to spread elsewhere. There is not a widespread perception that communication and relationship are important. The working environment seems to be better in community hospitals than academic ones, but there’s less teaching taking place in those settings. It’s validating to see others who care about this.
• Recorded in the Discovery Team minutes, 2006:
•Two DT members shared some frustration with their inability to fully engage physicians (most notably more experienced staff physicians) in their recent departmental and organizational change efforts. Potential reasons for a lack of engagement include time constraints, a lack of highly scientific quantitative evidence regarding potential benefits to patients and a lack of understanding of how this approach might benefit their practice. The group discussed ...potential approaches.