Leading from within: shaping a resident-driven leadership curriculum for surgical trainees using a qualitative needs assessment

Abstract

Although leadership competency is a requirement of the Accreditation Council for Graduate Medical Education, few surgical residency programs have successfully implemented structured leadership training founded on trainees’ learning needs and experiences. We modeled a qualitative needs assessment to explore surgical trainee attitudes and perceptions regarding leadership and dedicated leadership training within surgical residency to inform development of a future leadership curriculum for trainees. Fifteen general surgery residents voluntarily participated in focus groups divided into two sessions of mixed trainee level to explore leadership definitions, leadership experiences and challenges, and curriculum preferences. Transcripts were inductively coded and categorized through consensus discussions from which representative themes were drawn. Six major themes were identified through thematic analysis and organized within the following framing questions: how do residents define surgeon leadership, why is dedicated leadership training important to residents, and how should we approach leadership training for residents? Six themes emerged including (1) contextualization of surgeon leadership; (2) characteristics, skills, and styles of surgeon leaders; (3) impact on team dynamics and outcomes; (4) relevance within surgical hierarchy; (5) learner-centered strategies and implementation; and (6) need for feedback and evaluation. Surgery residents defined the need for dedicated leadership training to promote career advancement within academic surgery as well as to impact clinical team dynamics and outcomes. Skills and styles required of surgeon leaders are varied and best promoted through self-reflection, peer discussion, and feedback strategies at all trainee levels. These results will be used to guide leadership curriculum development, and the approach can serve as a model for other programs.