Getting off the carousel: Exploring the wicked problem of curriculum reform

Lorraine Hawick*, Jennifer Cleland, Simon Kitto

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)
14 Downloads (Pure)


INTRODUCTION: Making substantial changes to the form and delivery of medical education is challenging. One reason for this may be misalignment between existing conceptualizations of curricula and curriculum reform in medical education, with the former perceived as 'complex' yet the latter as linear. Reframing curriculum reform as a process-driven, complex entity may enhance the possibility of change. To explore the utility of this approach, we carried out an exploratory case study of curriculum reform in a real-life context.

METHODS: We used a qualitative case study approach. Data were collected from 17 interviews with senior faculty involved in curriculum reform in one medical school plus document analysis of approximately 50 documents and files, to provide background, context, and aid triangulation.

RESULTS: Data coding and analysis was initially inductive, using thematic analysis. After themes were identified, we applied the 'wicked problem' framework to highlight aspects of the data. This paper focuses on two main analytic themes. First, that multiple players hold different views and values in relation to curriculum reform, resulting in various influences on the process and outcomes of reform. Second, 'solutions' generate consequences which go beyond the anticipated advantages of curriculum reform.

DISCUSSION: This is the first empirical study of curriculum reform in medical education which uses the wicked problem framework to conceptually illuminate the complex processes which occur in relation to reform. Those involved in reform must be reflective and attentive to the possibility that persistent and emerging challenges may be a result of wicked problems.

Original languageEnglish
Pages (from-to)337-343
Number of pages7
JournalPerspectives on medical education
Issue number5
Early online date26 Sept 2017
Publication statusPublished - Oct 2017

Bibliographical note

The authors wish to thank all participants in this study. Our thanks to the School of Medicine where this study was undertaken for supporting LH’s doctoral research program. Our thanks to Alan Bleakley for his advice and guidance when planning the interview component of this study.


  • Wicked Problem
  • Curriculum Reform
  • Case Study
  • Undergraduate Medical Education


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