A medical humanities program emphasizing clinically oriented training is described. The four-year required curriculum, in which students accompany attending physicians on rounds, is taught by faculty representing a wide range of medical and non-medical disciplines. The approach is seen to challenge good teachers and evoke humanities themes from…

Development of a comprehensive medical ethics teaching program for four years and residency, and of an ethics consultation service, are described. Potentials and significant difficulties in program establishment and maintenance are discussed, including long-term funding, negative faculty and student attitudes, and instructional approaches.…

Gives an overview of the decisions, activities, events, and issues that influenced the process of change at eight medical schools participating in a large-scale medical curriculum development project. Focus is on three stages of the change process: planning and creating the climate for change, making the change, and reinforcing the new model.…

Discusses the role of organizational communication in the process of curricular reform at eight medical schools participating in a large-scale medical curriculum development project, particularly during four stages of change: recognizing the need for change; planning; implementation; institutionalization. Communication strategies for promoting a…

A study evaluated the impact of the reorganization of the academic Sepulveda (California) Veterans' Administration medical center toward primary and ambulatory care. Surveys of several thousand patients were linked to computerized utilization and mortality data and related to the center's strategic plan and goals. Substantial improvement in…

The process of change at the academic Sepulveda (California) Veterans' Administration hospital during implementation of a new ambulatory primary care program was examined through individual or focus group interviews with 63 managers, house officers, and patients. Major problems included administrative integration of in- and outpatient services;…