Abstract
Background: Leadership training is of growing importance in medical education. The COVID-19 pandemic provides unique insight into the qualities and characteristics medical students value in leaders. Little standard information exists regarding best practices, competency-based leadership models or frameworks to guide leadership program development in undergraduate medical education. This study aims to determine what students value in leadership during a pandemic and what implicit leadership framework students use in order to inform medical education curricula.
 Methods: We developed a survey instrument aimed to uncover student perceptions of effective and ineffective leadership qualities and examples, both during the current COVID-19 pandemic and during crises in general.
 Results: Students identified the overarching themes of Communication, Other-Orientation, Personal Characteristics, Decisive Action, and Use of Information. These five themes were then built into the model of Pandemic Leadership within the context of complexity leadership theory and collective leadership theory. 
 Conclusion: This study is unique in its focus on student perceptions of leadership qualities both in general, and during a time of challenge that can serve as a real-world laboratory for leadership. We hope that this information, along with the pandemic leadership model, can serve as the first step to useful and relevant leadership training programs in undergraduate medical education.
Highlights
Today’s medical school graduates face a rapidly changing practice environment
The objective of this study is to determine, through qualitative survey, the values that medical students at the University of Michigan Medical School hold for leadership during a pandemic, in order to inform the further development of medical education curricula
Of approximately 640 eligible students attending the University of Michigan Medical School, 162 students participated in the survey
Summary
Today’s medical school graduates face a rapidly changing practice environment. From decreasing physician autonomy, to increasing interprofessional collaborative care, to unprecedented public health challenges like the COVID-19 pandemic, the challenges of practicing physicians continue to grow.[1]. Within these frameworks, leadership is seen as a complex system of interaction agents with unpredictable feedback networks which, in turn, output responsive results such as information-sharing, invention, and continued evolution to change.[11,12,13] Complexity and Shared Leadership provide an ideal framework for the interdependent relationships and dynamism of the medical field. We identified themes of Communication, Other-Orientation, Personal Characteristics, Decisive Action, and Use of Information These five themes were built into the model of Pandemic Leadership within the context of complexity leadership theory and collective leadership theory. Conclusion: This study is unique in its focus on student perceptions of leadership qualities during a real-world laboratory for leadership We hope that this information, along with the pandemic leadership model, can serve as the first step toward relevant leadership training programs in medical education. Leadership training programs in medical education would likely benefit from grounding in the student values identified by this study
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