Myths of contestation in the medical education curriculum: A dialogical exploration

PURPOSE: In this paper, the authors use their collective experience as medical education scholars and change agents to engage in a dialogical approach examining five myths regarding the role of contestation in curricular change. In doing so, they argue that what is taught, how it is taught and what knowledge is valued in curricula is not a neutral decision; rather, it is the result of contestation, negotiation and compromise.

APPROACH: Five myths are contested: that curriculum planning is uncontested; that contestation is between two individuals; that curriculum is and should be the primary focus of contestation; that change is both necessary and desirable; and that consensus (or compromise) is valued over contestation. To challenge the myths, the author team engaged in a dialogic analysis prompted by a literature review on curriculum change and drawing on the authors' experiences as medical educators, which resulted in a suite of heuristics regarding how curriculum change can be both supported and opposed.

FINDINGS: Curriculum, whether it changes or not, is a site of ideological struggle. Participants should anticipate and strategically navigate disagreement. Compromise, rather than victory, is often the outcome. There is a need to go beyond the basics of what is taught, how much it is taught and when. Change should not always be the goal, not least because it can lead to superficial reforms, unintended consequences and a neglect of rigorous pedagogical evaluation. The pursuit of consensus and buy-in from all members can inadvertently (and sometimes deliberately) stifle diverse perspectives, leading to long-term resentment and disengagement.

IMPLICATIONS: Educators need to identify, understand and constructively engage with different forms of contestation in curriculum planning and management. By attending to processes for engaging in contestation, it is hoped that more educators will feel empowered to raise their concerns and negotiate with others in a professional manner.