Presented By: Heather Fedesco, The American Association of Veterinary Medical Colleges
Co-Authors: Jessica Brodsky, The American Association of Veterinary Medical Colleges
Julie Noyes, The American Association of Veterinary Medical Colleges

Purpose 
The veterinary profession is increasingly concerned about access to care. A strategy to address this issue is practicing across the spectrum of care (SOC). This entails providing a wide range of care options to socioeconomically diverse clients. The American Association of Veterinary Medical Colleges (AAVMC) launched the SOC Initiative to support veterinary education programs in making curricular and cultural changes to prepare SOC practitioners. We report on the initiative's piloting of the 'Ecosystem Model of Systemic Change Leadership' to structure our approach for guiding change in these complex programs. 

Methods 
We focused on four key leader moves from the Ecosystem Model. 'Developing Strategy and Resources' involves creating equitable plans for success, encompassing the necessary revenue, infrastructure, and personnel. 'Leading People and Teams' requires forming a skilled and diverse team aligned with change goals and engaging stakeholders. 'Creating Vision' involves developing shared expectations by drawing from stakeholders and articulating goals, outcomes, and timing. 'Sensemaking and Learning' entails using data to understand perceptions, raise consciousness, and bridge knowledge gaps for robust organizational learning and development. 

Results 
The AAVMC activated the 'Developing Strategy' move by securing funding to hire dedicated staff, which ensured momentum in the initiative's first two years. Leveraging the 'Leading People' move involved forming a task force of diverse stakeholders, which created buy-in for the initiative across the profession. The task force activated the 'Vision' move by defining the SOC competencies of new veterinarians, which provided programs with a clear outcome to guide changes. Leveraging the 'Sensemaking' move entailed introducing a curriculum mapping process for programs to assess their alignment with the competencies, resulting in concrete evidence to direct internal change efforts. 

Conclusion 
The AAVMC's use of the Ecosystem Model illustrates how this model offers a roadmap for guiding change across complex medical education programs.