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Medical education is undergoing one of its most intense reassessments in a quarter of a century. The current reassessments often have focused on reevaluation of the manner in which basic science and clinical education are provided. This paper aims to identify and illustrate the processes by which members of "MWCOM" (a pseudonym), a medical educational institution, make sense of the pedagogical innovation taking place. The paper provides a descriptive/thematic analysis that lays the foundation for future work which directs attention to the complex and shifting power relationships embedded within the MWCOM culture during the implementation period of this particular innovation diffusion process. Discussing the data from an ethnographic study--a collection of interviews with 18 administrators and faculty members at MWCOM--the paper notes a dramatic emergence of the use of metaphor in the organizational members' narratives and the subsequent use of metaphoric analysis to consider the data. According to the paper, the primary metaphor to emerge from the interview transcripts was "family," with the two strong subthemes of "double bind" and "entropy." The paper discusses in detail these themes and their application by MWCOM members. The paper concludes that it is only by studying how the MWCOM members construct their perceptions of organizational life that the "critical next step" can be taken toward forging a more meaningful look at the often politically charged meaning systems that stifle some organizational members while privileging others. (Contains 65 references. Appendix A provides the interview schedule, and Appendix B presents "Foucault's Ideas on the Micro Processes of Discipline." (NKA)

A study explored some of the ways that the members of a medical educational institution make sense out of the radical pedagogical innovation taking place in their school. Interviews and focus groups were conducted with members at "MWCOM" (a pseudonym), then data were analyzed according to three primary themes which revolve around how organizational members make sense of the problem-based learning (PBL) program and the PBL students. First, how organizational members expressed their view that those enrolled in the PBL curriculum were afforded more organizational resources was explored. Then, organizational members' perceptions that the PBL students enjoyed a more positive quality of life than did their traditionally educated counterparts was examined. Finally, how organizational members related their perceptions that the PBL students were undergoing a positive role socialization with respect to their chosen profession was focused on. An aim of the study is to enrich understanding of the establishment of innovation within one of the most traditional educational institutions--medical education organizations. This study is situated squarely within the context of medical education, an institution which has few rivals in the system of social discourse which privileges medical knowledge above most other forms of knowledge. It is hoped that by providing a "real life," day-to-day picture of the exigencies inherent in accomplishing the PBL diffusion, this study can be of use to educators who wish to introduce innovative programs into educational systems with similar concerns. (Contains 34 references. An appendix gives the location and describes the population, support staff, faculty, and administration of "MWCOM.") (NKA)