The transformative power of a change laboratory: Experiences from an assessment re-design project in Oman.

Introduction: Research on educational change consistently shows that the success of any implementation process depends on the involvement of stakeholders. The Change Laboratory (CL) is a method that involves stakeholders in co-creating their work practice. Its application in medical education has been proven to result in improvement of learning environments. The aim of this study is to explore participants' perceptions on how the use of the CL impacts their commitment to change.

Methods: We conducted a qualitative study to explore participants' experiences with a CL intervention focused on redesigning a workplace-based assessment program in postgraduate medical training in Oman. Semi-structured interviews with nine participants (residents, faculty and administrators) were conducted to examine how the CL process influenced their commitment to change, focusing on learning and agency. Data collection and analysis followed an iterative process. We used a reflexive thematic analysis approach and constructed a model of how the CL intervention resulted in transformative changes at the individual, team and organization levels.

Results: Participants' intrinsic motivation to actively engage in assessment re-design was driven by perceptions of a shared understanding of tensions in the assessment system and the realization that, as a group, they would be able to initiate meaningful change. Three shifts experienced by participants while progressing through the CL were identified: from individual learning to collective competence; from individual responsibility to collective agency; and, from collective agency to organizational learning, reflecting engagement in change processes beyond participants' residency training program.

Conclusion: By illustrating how a CL intervention fosters transformative shifts in learning and agency, at individual, collective and organizational levels, this study extends prior work on participatory design in medical education. It provides empirical evidence that co-creation supports both personal and professional development, fostering stakeholders' competencies to collaboratively navigate and lead educational change processes.