In the wake of the Bologna process, many European universities are undergoing comprehensive educational reform. Our attention in this paper is focused on how a medical university came to terms with the challenges presented therein. We wished to explore how educators identify, understand and deal with opportunities for change at a medical university. To accomplish this, we devised meetings between the respondents and colleagues at the university and examined the reported results of these meetings. Our results suggest that there may be substantial educational crosstalk taking place, whereby people are experiencing a communicative mismatch in terms of negotiating the meaning of change initiatives. This can act as a hindrance for implementation of educational reforms. We acknowledge that educational developers and people in leadership need to consider different ways of creating opportunities for peer review and dialogue around educational issues in order to fully embrace opportunities for change.