This study described the instructional practices of selected clinical medical school faculty. It addressed the following questions: - how do medical and surgical clinical faculty select/design and combine instructional methods and media in teaching clinical content? - what influences clinical faculty use of a particular method or medium for clinical teaching? The primary purpose of this research was to investigate how clinical medical school faculty make pedagogical decisions and carry out their instruction in clinical patient care settings. The research described the clinical faculty members' instructional practices with medical students and how the medical apprenticeship system is used for their clinical instruction. The research involved two medical schools and a sample of four clinical faculty representing surgical and medical practice. A general method of descriptive research was employed including the data-gathering techniques of participant observation, interviewing, and collection of documents. Strategies developed by Spradley (1980) and Erickson (1986) were used for data analysis. Findings indicated that the sample clinical faculty do not use an instructional planning process such as described by Gagne and Briggs (1979) or Wildman and Burton (1981). Instead, they select instructional methods and media intuitively, carefully monitoring the medical students' reactions to their instruction. The data show the instructional techniques that include the human element -- defined here as personcentered methods -- are selected most often. / Ed. D.

In the early 1990s, Oregon Health and Science University leadership examined the political and economic landscape and determined it needed a new operational model to survive and thrive. In 1995 OHSU separated from the state higher education system and became a public corporation, with goals of increased efficiency, customer-focus, ability to attract world-class researchers and physicians, and salaries commensurate with an urban academic health center. This research examines the internal impacts when universities undergo significant change, using OHSU's governance change as a case study. Central is the question: what effect(s) did OHSU's decision to become a unique public corporation have on specific employee groups? This study looks at two groups and their perceptions of the change: faculty, and union-represented staff. The author interviewed the leadership team who led the transition, reviewed historical and organizational documents and archives, and examined quantitative data such as tuition, state funding, research, and salaries. Interviews were then conducted with longtime and former employees to obtain employee perceptions. Finally, the study compares employee perceptions about process, culture, and job satisfaction, to the goals established by the leadership. The results of this study reveal that, while there were internal and external challenges, the transition to a public corporation was successful according to the perceptions of most employees when compared to the goals. After the transition, OHSU did become more efficient and more nimble for a time, able to recruit world-class employees and pay competitive salaries. Staff felt empowered and some faculty felt it made OHSU a better institution. However, some faculty felt that OHSU's transition to the public corporation eventually led to increased bureaucracy, as well as to the loss of shared governance, tenure practices, and other cultural norms inherent to academic institutions. By examining OHSU's transition and the impacts on employee groups, this study provides insight to other universities contemplating this type of change. While each institution is unique, understanding the impacts to these key stakeholders can help universities plan for and implement significant governance change.