Leadership development programs for surgical residents: A narrative review of the literature

Abstract

• Narrative review of the literature on leadership programs for surgical residents. • Nine eligible papers, with heterogeneous results, limited effectiveness, and quality. • LDPs should be grounded in leadership theory and accreditation competencies. • This is necessary to prepare today's residents into tomorrow's surgeon-leaders. While North American accreditation bodies have included leadership as a core competency for all clinicians, there remains a general lack of strategy and evidence on how surgical residents are expected to achieve that objective. This paper aimed to systematically review the current body of literature on leadership development programs (LDPs) for surgical residents. Articles pertaining to LDPs for surgical residents were identified through an electronic database search including Medline and EMBASE. Each LDP was stratified by setting, frequency, content, teaching methods, outcomes, and cross-referenced against national accreditation competencies. The Kirkpatrick model and Best Evidence Medical Education (BEME) scale were used to assess curriculum effectiveness and quality, respectively. Nine articles were selected for final review. Despite significant content variability, the most common topics included leadership theory (89%), and team building/ management (56%). Reported learning outcomes, measured primarily via surveys, included an improvement in understanding leadership ( n = 4), communication skills ( n = 3), and team building/management skills ( n = 3). The overall effectiveness of each program was low, with 67% having a Kirkpatrick effectiveness score of 1, indicating only a change in learners’ attitudes. The highest BEME score, achieved by 56% of programs, was 3/5 (i.e., conclusions can probably be based on the results). Only 33% of studies ( n = 3) framed outcomes in the context of national accreditation competencies. The current body of literature on leadership curricula for surgical residents is heterogeneous and limited in effectiveness and quality. Future programs should be rooted in leadership theory and national accreditation competencies.