Changing the way we do things: a qualitative exploration of culture change in clinical care and education before and during the COVID-19 pandemic in an academic health center.

Purpose: This study investigated the necessity of culture change in clinical care and medical education within a US academic hospital before and during the COVID-19 pandemic. It explored how the syndemics of COVID-19, racism, and the mental health crisis magnified the urgency of culture change in healthcare and aimed to understand the impact of these syndemics on healthcare and educational culture.

Method: An 11-item survey with 8 open-ended questions was distributed to healthcare teams and trainees at a large academic medical center before (Dec 2019 to March 2020) and during the pandemic (Feb 2021 to April 2021). The survey examined need for culture change, where it has worked well, and factors contributing to successful culture change. Responses were analyzed and themes were generated by qualitative analysis.

Results: The study revealed a strong focus on person-centered care before the pandemic with an emphasis on interdisciplinary care, communication, and safety. Within the pandemic, the focus shifted to COVID-19 safety, increased staffing and support, addressing health disparities and racism in healthcare, and use of telemedicine. As the pandemic evolved, burnout and mental health concerns became more prominent raising questions about the sustainability of culture changes..

Conclusion: The study highlighted cultural shifts within healthcare and medical education magnified by syndemics. There is a growing emphasis on anti-racism, respect, and psychological safety. It emphasized the importance of understanding cultural shifts within institutions to drive effective culture change. Future research should explore different healthcare settings and post-pandemic culture changes. This study provided valuable insight into the landscape of culture change, clinical care, and education, especially in response to COVID-19 pandemic challenges.

Supplementary information: The online version contains supplementary material available at 10.1007/s44250-025-00241-7.