Goal Coupling and Innovation in Medical Schools

Medical educators should spend more energy setting goals and priorities for competing goals, and articulating innovation goals with higher-order goals, to help ensure the implementation and success of innovations.

Abstract

In this article, the authors report their study of how the degrees of "coupling"-orfit between parallel institutional goals and between institutional and lesser-order goals of organizations affect the implementation and success of innovations. Using a qualitative research design, the authors studiedfour medical schools that attempted to integrate the instruction of basic medical sciences into either organ-system or problem-solving curricula. The authors'findings lead them to hypothesize that the closer the innovation's goals are to institutional goals, the more targeted and limited the institutional goals, the tighter the coupling across institutional goals and with lesser-order goals, and the more linear and rational the goal-setting processes, the more likely an innovation is to survive. They conclude that medical educators-and other organization leaders-should spend more energy setting goals and priorities for competing goals, and articulating innovation goals with higher-order goals.