Peter Boedeker
Nadia Ismail and Nancy Moreno 

Background
Medical and health professions programs invest heavily in curriculum-renewal. Programmatic assessment often aims at endpoint measures rather than the implementation process and individuals involved. Knowing individuals' concerns can inform continuous quality improvement (CQI) and ultimately impact return on investment. The Concerns-Based Adoption Model, a framework for understanding adoption of innovative educational practices (1),positsthatfacultytransitionthroughsevenStagesofConcern(SoC). Eachincreasingstage indicates a greater level of comfort and skill with the innovation (2). The SoC Questionnaire helps leaders identify, address, and track faculty concerns over time. At Baylor College of Medicine, we are using the SoC Questionnaire to inform CQI efforts as we implement a new curriculum. 

Summary of work
We administered the 35-item SoC Questionnaire to 143 individuals implementing the curriculum. Open-ended items captured concerns and solutions. 

Results
Of those surveyed, 42 (29.4%) responded; 18 (42.9% of respondents) were at the lowest SoC (stage 0). The next highest concern was equally stage 1 and stage 5. Most faculty are at a low stage of concern and may be passively engaging with the new curriculum. Suggestions for improvement included regular meetings between implementers, opportunities for advance preparation, and improved logistics. 

Discussion and Conclusions
Reponses to the SoC Questionnaire provided valuable insights. The low SoC of many faculty respondents was anticipated given the recent introduction of the new curriculum. Faculty suggestions for addressing concerns will inform CQI efforts with the ultimate goal of increasing faculty's comfort and skill with implementing the new curriculum, evidenced by an increase in their SoC. 

Take-home/further research
Focusing on the concerns of those tasked with implementing an innovation can inform CQI efforts and increase program fidelity. The SoC Questionnaire is one tool for collecting this information. Future work includes re-distribution of the survey to evaluate change in concern over time. 

References (maximum three) 

(1) Hord S, Rutherford W, Huling L, Hall G. (2014). Taking Charge of Change. Austin, TX USA: SEDL. 

(2) George, A. A., Hall, G. E., & Stiegelbauer, S. M. (2006). Measuring implementation in schools: The stages of concern questionnaire. Southwest Educational Development Laboratory.