Abstract
BackgroundEffective clinical leadership is associated with better patient care. We implemented and evaluated a pilot clinical leadership course for second year internal medicine residents at a large United States Academic Medical Center that is part of a multi-hospital health system.MethodsThe course met weekly for two to three hours during July, 2013. Sessions included large group discussions and small group reflection meetings. Topics included leadership styles, emotional intelligence, and leading clinical teams. Course materials were designed internally and featured “business school style” case studies about everyday clinical medicine which explore how leadership skills impact care delivery. Participants evaluated the course’s impact and quality using a post-course survey. Questions were structured in five point likert scale and free text format. Likert scale responses were converted to a 1-5 scale (1 = strongly disagree; 3 = neither agree nor disagree; 5 = strongly agree), and means were compared to the value 3 using one-way T-tests. Responses to free text questions were analyzed using the constant comparative method.ResultsAll sixteen pilot course participants completed the survey. Participants overwhelmingly agreed that the course provided content and skills relevant to their clinical responsibilities and leadership roles. Most participants also acknowledged that taking the course improved their understanding of their strengths and weaknesses as leaders, different leadership styles, and how to manage interpersonal conflict on clinical teams. 88% also reported that the course increased their interest in pursuing additional leadership training.ConclusionsA clinical leadership course for internal medicine residents designed by colleagues, and utilizing case studies about clinical medicine, resulted in significant self-reported improvements in clinical leadership competencies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-014-0257-2) contains supplementary material, which is available to authorized users.
Highlights
Effective clinical leadership is associated with better patient care
Designing the leadership development course Course origins and participants in course design Three of this paper’s authors (DB, KB, and JB) undertook a year-long field study of leadership development in health care while students at Harvard Business School (HBS). This project, which was advised by an HBS Professor and the Medical Director of the Massachusetts General Hospital (MGH) Physician’s Organization (MGPO), produced a preliminary outline of the LDC
Choosing Educators While identifying potential teachers for the LDC, we considered a few questions, including: 1) Should we recruit facilitators from within the MGH (“internal”), from outside the MGH (“external”), or both?; and 2) Should all session leaders be practicing clinicians? While external leadership experts might have more experience with teaching leadership skills, internal facilitators, and practicing clinicians, would better understand the specific leadership challenges that residents face, and residents’ relative leadership deficits
Summary
We implemented and evaluated a pilot clinical leadership course for second year internal medicine residents at a large United States Academic Medical Center that is part of a multi-hospital health system. Junior residents take on many critical clinical leadership roles, including leading multidisciplinary clinical teams on general medical services and in the intensive care unit (ICU). Several U.S IM residency programs—including the Cleveland Clinic and the University of Washington—provide focused leadership training to help support residents through this transition. These interventions are associated with meaningful improvements in participants’ leadership skills and confidence in assuming clinical leadership roles [4,11].
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