P015: Leadership and administration: a novel elective rotation for emergency medicine residency training

Abstract

Introduction/Innovation Concept: In 2015, the Royal College of Physicians and Surgeons of Canada set out to redefine the CanMEDS roles including replacement of the “manager” role to that of the “leader”. This was to highlight the fact that skills in leadership are crucially important as ongoing health care improvement occurs. This educational innovation was born out of a need for formal education in leadership and administration in post graduate emergency medicine training. Methods: Few post graduate emergency medicine training programs in Canada have leadership and administrative curricula involving either longitudinal or discrete 4 week rotations. We sought to create an evidence based leadership and administrative experience based on the CanMEDS roles. We adapted components of pre-existing rotations from other universities and selected competencies from Thoma et al in order to compile a list of objectives. This was coupled with a reading list, various departmental, hospital, and regional meetings, a physician leadership training seminar, a departmental presentation, and a leadership project. Curriculum, Tool, or Material: The curriculum involved 4 weeks combining 8 emergency department (ED) clinical shifts with a leadership and administration component. The latter involved clinical interdepartmental meetings, a hospital medical advisory council (MAC) meeting, a provincial medical directors meeting, a health authority MAC meeting, and taking part in planning for an ED quality improvement initiative focused on triage. Attendance at a 2-day physician administrator leadership training seminar was also included. The reading list included books on leadership and references to ED quality improvement. In addition, exposure to a B.C. Ministry of Health document entitled, “Setting Priorities for the Health Care System,” the KGH Medical Staff Rules, and the B.C. Health Quality Matrix occurred. A summary presentation to the full ED on change management and leadership in residency occurred at completion. Conclusion: This innovative leadership and administration elective was the culmination of a need to see more formal post graduate leadership training in residency. The rotation was based on the CanMEDS framework, particularly the “leader” competency, and was based on recent evidence regarding leadership and administration competencies in emergency medicine. We hope this serves as a potential model for other rotation based electives or core rotations that desire to blend leadership competencies with clinical emergency medicine.