Table 1.

An outline of the continuum of decision-making levels in health professions education with examples of the scope and drivers for decision-making processes at different levels

Decision-making level	Decision-making types	Decision-making covers	Drivers of decision-making
Individual teachers	Individual	Primarily instruction, with limited ability to influence content, timing etc	Individual autonomy, responses to necessity and curiosity
Teaching colleagues	Social, discursive	Assign teaching duties, debate teaching approaches, and provide colleagues feedback	Social discussions and influences, developing shared responsibility, group norms and consensus
Course (i.e. theme, unit)	Tactical, limited governance	Operational details (e.g. logistical and human relations) within the parameters of the defined curriculum	Day-to-day management, responding to problems and challenges from instructors and learners, implementing policies and procedures from program and institutional
Program	Strategic, substantial governance	Maintaining and/or changing curriculum, syllabus, and policies and procedures; and responding to extra-program oversight	Curriculum committees, working groups, and senior managers scrutinize and set policies and procedures, and respond to program-level accountabilities (e.g. accreditation)
Organization (school, university, hospital)	Managerial	Setting, managing, and maintaining budgets, human resources, facilities, infrastructure, contracts, labour relations, broad policy, extramural relations	Senior leadership: education-related decisions balanced with other organizational functions and responsibilities (e.g. research, clinical, etc.)
Regulators and funders	Regulatory	Legitimacy and authority of programs, and broad oversight of their strategic resources and accountabilities	High-level policy (government, healthcare, professional)
Society	Sociopolitical	General principles, values and expectations that shape healthcare, medicine, and health professions education	Societal processes, including the media, community relations, political parties and lobby groups, donors, societal engagement, funding priorities