Purpose
Multi-faceted educational innovations present significant implementation challenges. Those who are responsible for applying the innovations daily often have the best understanding of what works and what doesn’t. The Concerns-Based Adoption Model (CBAM) is an implementer-focused framework for examining the fidelity and quality of new programs. Using elements of CBAM, the first-year implementation of a new medical school curriculum was evaluated, specifically identifying implementation challenges and potential solutions from the perspective of course directors.

Methods
Focus groups (key element of CBAM), were conducted with course directors. The focus group protocol was developed based on identified areas of concern: (1) experiences of the course directors in preparation for and while leading courses, (2) quality of communication with curriculum leadership, and (3) challenges or suggestions identified while working with instructors and learners. Multiple focus groups/interviews were conducted to ensure all course directors had opportunities to contribute. Immediately following each focus group or interview, notes were reviewed and specific challenges and suggestions for improvement identified.

Results
In total, 26 faculty from 7 courses participated in 11 focus groups/interviews. The groups ranged in size from 1 to 4. Course directors identified key areas for improvement: technology coordination to ensure seamless hybrid teaching across two campuses; refinement of educator development workshops to focus on active facilitation; changes in frequency and length of communications from leadership; and clarity of pre-work requirements for learners. Actionable solutions to these challenges were suggested.

Conclusion
Providing implementers with opportunities to give honest perspectives on challenges and their potential solutions is essential for iterative improvement. Our process uncovered specific areas that needed to be improved and informed prioritization of curriculum modifications. Other institutions implementing innovative programs are encouraged to consider implementer feedback when engaging in quality improvement.