SERVICE LEARNING: AN INSTITUTIONAL LOGICS APPROACH

Abstract

The medical profession is in a state of social transformation. Medical education must follow suit to continue to produce physicians who can meet the demands of the ever-changing field of medicine and of the public it serves. In this study, an institutional logic framework is used in examining how the implementation of transformative pedagogy in medical education may be impeded by competing institutional logics, thereby disrupting the change process. This study proposed three questions aimed at examining and understanding the perceptions of social actors as it relates to transformational change in medical education: 1) What is the impact of institutional logics on the implementation of transformative pedagogy in medical education? 2) What are the institutional logics in medical education that may impact change, and are there any conflicts between them? 3) Is there any evidence that these conflicts, if they exist, act as a barrier or disincentive to pedagogical reform when diversity, equity, and inclusion measures are introduced? A mixed method approach involving a two-step method of data collection and analysis was used in this study. Information from websites were used to create interview guidelines for interviews with faculty, administrators, and students at two US-based urban medical schools. By analyzing data from the websites of two US-based urban medical schools and comparing those findings to that of the perceived notions retrieved from interviews of the impact logics have on service learning, this research has shown that understanding institutional logics aid in the implementation of transformative pedagogy by better understanding the role of competing logics. This researcher provides three recommendations for medical schools to consider when using an institutional logics framework to enact transformational pedagogy. The first recommendation is change on the micro level (i.e., on the program level). The second recommendation relates to change on the macro level (i.e., relationship with governing bodies). And the third recommendation is related to the influence on diversity, equity, and inclusion (DEI) practices on the change process. I end with providing reasons for how examining the perceptions of the role of transformative pedagogy as a change agent in medical education can advance the field of medical sociology.