The document discusses curriculum change and innovation. It defines curriculum change as making alterations to a curriculum's philosophy, aims, objectives, content, methods, or evaluation procedures. Curriculum innovation involves any planned or unplanned changes to a curriculum. There are several reasons for curriculum change, including restructuring according to learner and societal needs, introducing new teaching methods and content, and adjusting clinical instruction hours. The document also outlines different types of curriculum change, such as substitution, alteration, restructuring, and perturbations.