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The Cardiff Lecture 2009



Professor Richard M. Frankel

Indiana University School of Medicine, USA

Topic: Changing the Organisational Culture of Medical Education: It's the Relationship that Counts

Date: 25 June 2009

Time: 6.45pm for 7pm

Venue: Julian Hodge Building, Colum Drive, Cardiff

Members of the general public as well as members of staff, students, health and social care professionals and service providers are welcome.

Please register your interest to attend by contacting Aileen Doyle, Health Communication Research Centre (tel: 029 2087 6154;
fax: 029 2087 4901; email


Recent scholarship in medical education has concentrated on describing the so-called informal or “hidden” curriculum of medical education and identifying its effect(s) on learners.  The literature suggests that medical trainees learn as much by observing physicians in action as they do by mastering content in the classroom.  Medical education is more than rote memorization of facts; it involves many complex social relationships and day to day communication about the experience of being a trainee.  We now know that to fully understand the process of learning to become a physician it is necessary to have deep knowledge of the organizational culture in which medical education takes place.

Over the past five years the Indiana University School of Medicine, the second largest in North America, has been engaged in an organizational culture change initiative to bring into better alignment elements of the formal and informal curriculum. We have also enlisted the schools of nursing, pharmacy and allied health as partners in an interprofessional learning collaborative involving 20 other schools. Imagining our organization as a series of conversations that take place in a complex web of relationships, we have used concepts like emergent design, positive deviance, and appreciative meeting practices to effect culture change. I will present several examples of our efforts and the evidence to suggest that these efforts have been successful. 

Richard M. Frankel     

Richard M. Frankel, Ph.D., is Professor of Medicine and Geriatrics and a Senior Research Scientist at the Regenstrief Institute, Indiana University School of Medicine (IUSM). He is also a research sociologist in the Center on Implementing Evidence-Based Practice at the Richard L. Roudebush Veteran’s Administration Medical Center (VAMC). In addition to his research, he has been a medical educator for nearly three decades and is currently the statewide professionalism competency director at IUSM and leads the patient safety fellowship at the VAMC. Dr Frankel has held Visiting Professorships in many countries and was the 1999-2000 recipient of the George Engel Award for outstanding contributions to teaching about the medical encounter and the 2006-2007 Lynn Payer Award for outstanding contributions to the literature, both given by the American Academy on Communication in Healthcare. Dr Frankel is the co-author of The Four Habits of Highly Effective Clinicians, which has been taught to more than 10,000 physicians at Kaiser Permanente. He has published more than 160 research papers about clinician-patient communication.