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Abstract

Introduction: Leadership is vitally important to the delivery of high quality health care and is especially important in the critical care environment. Intensivists must develop leadership skills during training, but a validated methodology for teaching and assessment of leadership does not exist. Most importantly, there is no consensus as to what leadership skills are essential within pediatric critical care (PCC). We hypothesized that practitioners in critical care would identify specific skills and attributes most important for leadership in the PCC environment Methods: The Education in Pediatric Intensive Care (E.P.I.C). research collaborative used the modified Delphi technique to develop a 59-item list of leadership behaviors and skills based on an extensive literature search and characteristics identified in various published leadership models. The items were then randomized in a 5-point Likert survey and administered anonymously online to PCC providers in the United States. Items scored 4 or 5 (which both had the stem ‘needed by all PCC specialists’) by >90% of respondents were considered essential. Attributes scored 4 or 5 by 75% to 89% of individuals were considered important but not crucial and those scored <75% were deemed not critical Results: To date, 201 individuals have completed the survey (88 attending physicians, 36 fellows, 67 nurses, 9 nurse practitioners, and 1 physician assistant). 97% of respondents have held a leadership role, with 54% holding more than one. Three items met the definition of essential (displays honesty and integrity, remains effective even when situations become stressful, and is able to work and think without the guidance of others). Thirty-two items met the definition of important, including many skills in the areas of self-management, team building and task management. Twenty four items were categorized as not critical. Non critical items included those related to the role of the intensivist in the organization as an innovator and change agent Conclusions: These data suggest that experienced critical care providers identify a specific subset of leadership skills that are essential for all critical care providers to learn during training. Future directions include a plan to develop leadership curricula and an assessment tool based on these data