What is the evidence base for leadership coaching for postgraduate medical doctors? A scoping review.

Clinical leadership training: a clinician's perspective

Purpose: The teachers are the pillars of strength and guiding force for creating and moulding their students to become better citizens of the future. They should be healthy and stress-free to become effective in their profession. This paper analyzes various challenges found in the subjective well-being of teachers and brings about better solutions for sustaining their subjective well-being by using the method of ‘rapid scoping review.’ Design/Methodology/Approach: Through the method of rapid scoping review, we aim to explore the various literature on subjective well-being, its key concepts and theories, sources of evidence, and gaps in the research under study. The researcher conducted a rapid Scoping review within a time duration of two months. This review mainly concentrated on the existing challenges and their solutions which influenced the subjective well-being of teachers. The data was collected by searching through internet servers like Google, Google Chrome, Google Scholar, etc. with general terms and key concepts like challenges of teachers, personal stress of teachers, professional stress, instructors' well-being, job stress and solutions, and subjective well-being, etc. The results found were descriptively summarized for a better outlook of the scoping review. Results/ Findings: The scoping review helped the researcher to understand the various sources of stress and their impacts on teachers' subjective well-being. The teachers’ daily personal and professional stress is very much influenced by the sources of stress found in the review. It has been discovered that factors like low incomes, high professional demands from the administration, parents and students, low morale, conflicting residential areas, etc., may raise more stress in teachers at work than those teachers with stable income, minimal demand, etc. These stress factors can directly or indirectly affect the teachers' subjective, personal, and professional lives and reduce their level of life satisfaction. Originality/Value: This review brings out the various challenges that propel stress in the life of teachers’ subjective well-being. These challenges make them partially ineffective in their personal and professional lives. To tackle those challenges, first, we analyzed subjective well-being in general and then moved to the prime challenges and concerns that cause and increase stress levels in teachers. Finally, we found evidence-based solutions which reduce stress levels and enhance the subjective wellbeing of the teachers. There is room for additional research to investigate the various factors based on the demographical, sociological, and religious background of the teachers which can cause by way of increasing or decreasing stress and life satisfaction. Type of Paper: An analytical type of paper with a rapid scoping review that studies challenges and solutions about the subjective well-being of teachers.

This study explores coaching during transition from medical school to residency through the perspectives of residents and faculty coaches participating in a coaching program from residency match through the first year of residency. From January to September 2020, 15 faculty coaches in internal medicine, obstetrics and gynecology, emergency medicine, orthopedics, and pathology participated in a synchronous, in-person coaching training course. All 94 postgraduate year 1 residents in these 5 training programs participated. Between November 2021 and March 2022, focus groups were held with interns from all residency programs participating in the program. Interviews were conducted with faculty coaches in February 2022. Faculty and residents discussed their experiences with and perceptions of coaching. De-identified transcripts were coded, and researchers organized these codes into broader categories, generated cross-cutting themes from the concepts described in both cohorts, and proposed a model for the potential of coaching to support the transition to residency. Descriptive themes were constructed and analytic themes developed by identifying concepts that crossed the data sets. Seven focus groups were held with 39 residents (42%). Residents discussed the goals of a coaching program, coach attributes, program factors, resident attributes, and the role of the coach. Coaches focused on productivity of coaching, coaching skills and approach, professional development, and scaffolding the coaching experience. Three analytic themes were created: (1) coaching as creating an explicit curriculum for growth through the transition to residency, (2) factors contributing to successful coaching, and (3) ways in which these factors confront graduate medical education norms. Learner and faculty perspectives on coaching through the transition to residency reveal the potential for coaching to make an explicit and modifiable curriculum for professional growth and development. Creating structures for coaching in graduate medical education may allow for individualized professional development, improved mindset, self-awareness, and self-directed learning.

Persons living with obesity and experiencing infertility are counselled on healthy behaviours, such as increasing physical activity levels, to improve fertility-related outcomes. However, due to the known psychological burden of receiving an infertility diagnosis, there is an important need to consider the psychosocial impact of administering exercise programming for this population. This study aims to assess the psychosocial impact of exercise-based interventions on individuals with obesity and infertility through a rapid scoping review and a pilot study. The rapid scoping review was conducted in MedLine, Embase, and CINAHL. Studies involving exercise-based lifestyle interventions for people with obesity and infertility were included only if they measured a psychosocial outcome as a primary or secondary measure. Expanding upon evidence from our rapid review, a pre-experimental feasibility study (pre-test, post-test with one group) was conducted. The pilot study implemented a virtual exercise intervention for people with obesity and experiencing infertility. Questionnaires measuring anxiety and depression, quality of life (QoL), social support, fertility-related stress, and hopelessness were administered. Based on the nine articles from our rapid review, there is evidence that lifestyle interventions combining exercise, diet, and psychobehavioral components improve psychosocial outcomes like anxiety, depression, QoL, and self-esteem. In our pilot study, 11 participants (Age: 34 ± 3.7, BMI: 40.3 ± 4.54) engaged in the virtual exercise intervention, and seven completed the post-intervention questionnaires. The results of our pilot study showed improvements in depression, hopelessness, physical QoL, and fertility-related stress scores. However, we observed declines in anxiety, mental QoL, and perceived social support measures. Our mixed findings may be due to the unique context of our pilot study. The study took place during the COVID-19 pandemic, where increased stress, anxiety, and isolation, negatively impacted fertility patients. Additionally, the virtual intervention, required by restrictions, may have reduced social interaction and support, worsening one’s mental health.

Leadership Training Curriculum for Otolaryngology-Head and Neck Surgery Residents: A Scoping Review.

First year (freshman) engineering students often arrive on campus eager to begin designing engineered systems. Although their engineering design expertise is not nearly developed, the students themselves are often ready to begin. Some engineering student attrition can be attributed to students’ disappointment with typical first and second year curricula rich in math, science, and humanities course work, but featuring only a course or two with direct engineering emphasis. The Department of Civil Engineering at Rose-Hulman Institute of Technology offers a 10 week course in which teams of four students complete a real engineering design for external clients. Projects are solicited from the region, selected based on student capabilities and workload and mentored by the entire department faculty. The student teams interact directly with the client and produce a substantial final report comparable to a feasibility study and preliminary design. Example designs include bicycle trails, independent wastewater treatment systems, parks, athletic fields, and handicap access retrofits. ASCE Policy Statement 465 calls for leadership training of civil engineering students. First year students are well suited for leadership, teaming, and professionalism training. In the Department of Civil Engineering at Rose-Hulman, one aspect of leadership and teamwork training is Covey’s The Seven Habits of Highly Effective People (1989). Application of the Seven Habits infiltrates the curriculum in various courses. Growth of students along Covey’s maturity continuum is comparable to leadership development as the students are motivated to seek interdependence. Over the past three years, Covey’s Seven Habits have been incorporated into the weekly activities for student teams working on projects in this first year course. Student acceptance of the Seven Habits as a framework for self-improvement was mixed for the first few years. However, modification of the lessons to integrate application of the Habits to help the students with their client and group interaction has proven more successful. Assessment of perceived learning and development for this study through course surveys, course evaluations, and interviews indicates more students are embracing the Seven Habits as one tool to enhance their development as civil engineers. Even so, despite student acceptance of the Seven Habits as a useful framework, students reported they were not necessarily applying the principles to their lives. This leadership and teamwork training continues to evolve in the first year course. Future improvements will include learning modules designed to demonstrate application of the Seven Habits to engineering consulting and design. This paper summarizes only the freshman year component of leadership training being designed to infiltrate the curriculum in the department.

Psychologists are increasingly called upon to become more involved in academic health centers (AHCs) as leaders across a range of leadership roles in areas such as the clinical, teaching, and research missions, and in the administration thereof. Similarly, expansion of psychologists' service in national associations, boards, and other forums is increasing. This paper attempts to delineate the nature and extent of psychologists' involvement in leadership roles and their needs for professional leadership development to assist them in securing and succeeding in these positions. Members of the Association of Psychologists in Academic Health Centers (APAHC) were invited to complete a survey to identify current leadership roles and training needed to enhance leadership capabilities. Most (75%) of the respondents (total n = 105; 42% of APAHC full members; 70% female) were currently serving in leadership roles (range 1 to ≥ 10 positions). Years since degree conferred was positively associated with the number of leadership positions. Diversity of roles was delineated across AHC missions including psychology training (49.5%), clinical service (33.3%), and research (26.7%). An important subgroup (11.5%) served in upper-level administrative leadership positions. Leadership roles external to AHCs were common, particularly service ion committees (30.5%) and boards (27.6%) in state and national professional organizations. Half (51.4%) of survey respondents endorsed at least one leadership development need, with approximately 10% endorsing leadership development needs in all areas. The most common leadership development need was financial management skills, endorsed by nearly two-thirds of the sample. Early career respondents recognized more needs than advanced career respondents. AHC psychologists are expanding their leadership roles and distinguishing themselves as important contributors in AHCs. Despite this, many identified needs for further leadership training.

Experts suggest that leadership education should begin during medical school. However, little information exists on preferences of medical students on leadership development and particularly of those who want to work with underserved communities. This student-led study surveyed medical students on leadership development skills and perceptions on curricular needs. We conducted a cross-sectional study using a 26-question survey with Likert scales, multiple choice, and open-ended questions. We anonymously surveyed 83 students (medical school years 1 through 4) at the Keck School of Medicine of University of Southern California and conducted a one-time focus group with six students to assess leadership aspirations and training needs. We compared student responses based their desire to serve in underserved communities in their careers. Medical student desire to practice in underserved communities was greatest among respondents in their first 2 years (62% and 67%), compared to 36% and 53% for respondents in third and fourth year, respectively. Students interested in underserved communities were statistically more likely (t test 2.07, P=.04) to indicate "My well-being may need to be sacrificed in order to serve as a leader," based on the survey. The survey showed similar top-five leader characteristics (competent, dependable, honest, inspiring, supportive) were valued among all respondents. Optional leadership modules were selected to enhance medical education by the most respondents and could potentially meet their curricular needs. Our findings show that medical students welcome leadership training opportunities and prefer optional longitudinal modules. Students who plan to practice in underserved communities have similar preferences on training but may need additional support related to maintaining their well-being.

This article was migrated. The article was marked as recommended. Background: Canadian family medicine residency programs have the challenge of training in a wide breadth of topics and competencies within a two-year program, including training residents to be effective teachers. There has been a gap in knowledge with regards to the most effective method to train residents to teach. We developed, implemented, and evaluated a novel multi-level resident-as-teacher (RAT) coaching curriculum to provide training and authentic experiences for family medicine residents in teaching medical students. Methods: A curriculum centred around multi-level coaching was designed where family medicine faculty members directly observed and provided feedback to family medicine residents teaching small group clinical skills to first and second year medical students. Family medicine residents received didactic training on how to provide effective feedback to students and manage small group dynamics, after reviewing the learning objectives that students were to achieve. This was followed by the authentic small group teaching experiences. A survey was sent out by email to all residents and faculty members who had participated in the RAT curriculum at the end of the 2013-2014 and 2014-2015 academic years. Quantitative survey data were analyzed using descriptive statistics (frequencies, percentages, correlation coefficients (Spearman's rho)). Qualitative analysis was completed through thematic analysis of respondents' written comments to open-ended survey questions. Results: 80% of 127 residents strongly agreed (26%) or agreed (54%) that the RAT program effectively developed their teaching skills. 57% either strongly agreed (17%) or agreed (40%) that the direct observation and feedback from faculty coaches helped to improve their teaching skills. There was a significant positive correlation between residents' perceptions of the usefulness of the feedback from faculty coaches and residents' perceptions of the overall RAT program's effectiveness in developing their teaching skills (r=0.42; p=0.001). Qualitative analysis revealed that residents perceived the RAT program to have solidified their own knowledge base for the content covered in the sessions. Residents also perceived a benefit of near-peer teaching for the medical students and an elevated family physicians' profile as teachers. They found the active learning experience increased their self-awareness of their teaching skills. Time away from clinical rotations and preparation time were derived as a potential drawback of the program. All faculty coaches agreed or strongly agreed that the RAT curriculum improved the teaching skills of family medicine residents. Thematic analysis of the faculty coaches' comments revealed that participating as coaches allowed for their own professional development in that their feedback and coaching skills improved. Conclusions: Our experiences and program evaluation of a novel multi-level resident-as-teacher coaching curriculum show that direct observation with feedback of authentic teaching activities is highly valued, and appears to be effective in developing resident teaching skills while fostering interest in future teaching.

e-Prescribing is designed to assist in facilitating safe and appropriate prescriptions for patients. Currently, it is unknown to what extent e-prescribing for opioids influences experiences and outcomes. To address this gap, a rapid scoping review was conducted. This rapid scoping review aims to (1) explore how e-prescribing has been used clinically; (2) examine the effects of e-prescribing on clinical outcomes, the patient or clinician experience, service delivery, and policy; and (3) identify current gaps in the present literature to inform future studies and recommendations. A rapid scoping review was conducted following the guidance of the JBI 2020 scoping review methodology and the World Health Organization guide to rapid reviews. A comprehensive literature search was completed by an expert librarian from inception until November 16, 2022. Three databases were electronically searched: MEDLINE (Ovid), Embase (Ovid), and Scopus (Elsevier). The search criteria were as follows: (1) e-prescribing programs targeted to the use or misuse of opioids, including those that were complemented or accompanied by clinically focused initiatives, and (2) a primary research study of experimental, quasi-experimental, observational, qualitative, or mixed methods design. An additional criterion of an ambulatory component of e-prescribing (eg, e-prescribing occurred upon discharge from acute care) was added at the full-text stage. No language limitations or filters were applied. All articles were double screened by trained reviewers. Gray literature was manually searched by a single reviewer. Data were synthesized using a descriptive approach. Upon completing screening, 34 articles met the inclusion criteria: 32 (94%) peer-reviewed studies and 2 (6%) gray literature documents (1 thesis study and 1 report). All 33 studies had a quantitative component, with most highlighting e-prescribing from acute care settings to community settings (n=12, 36%). Only 1 (3%) of the 34 articles provided evidence on e-prescribing in a primary care setting. Minimal prescriber, pharmacist, and clinical population characteristics were reported. The main outcomes identified were related to opioid prescribing rates, alerts (eg, adverse drug events and drug-drug interactions), the quantity and duration of opioid prescriptions, the adoption of e-prescribing technology, attitudes toward e-prescribing, and potential challenges with the implementation of e-prescribing into clinical practice. e-Prescribing, including key features such as alerts and dose order sets, may reduce prescribing errors. This rapid scoping review highlights initial promising results with e-prescribing and opioid therapy management. It is important that future work explores the experience of prescribers, pharmacists, and patients using e-prescribing for opioid therapy management with an emphasis on prescribers in the community and primary care. Developing a common set of quality indicators for e-prescribing of opioids will help build a stronger evidence base. Understanding implementation considerations will be of importance as the technology is integrated into clinical practice and health systems.

Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included “leading a team” (98% of residents), “confronting problem employees” (93%), “coaching and developing others” (93%), and “resolving interpersonal conflict” (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pre-graduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees.

Issue: Despite clear relevance, need, descriptive literature, and student interest, few schools offer required curriculum to develop leadership skills. This paper outlines a proposed shared vision for leadership development drawn from a coalition of diverse medical schools. We advocate that leadership development is about self (looking inward), teams (not hierarchy), and change (looking outward). We propose that leadership development is for all medical students, not for a subset, and we believe that leadership curricula and programs must be experiential and applied. Evidence: This paper also draws on the current literature and the experience of medical schools participating in the American Medical Association’s (AMA) Accelerating Change in Medical Education Consortium, confronts the common arguments against leadership training in medical education, and provides three cross-cutting principles that we believe must each be incorporated in all medical student-centered leadership development programs as they emerge and evolve at medical schools. Implications: By confronting common arguments against leadership training and providing a framework for such training, we give medical educators important tools and insights into developing leadership training for all students at their institutions.

A Call to Develop More Anesthesiologist Physician Leaders of Healthcare Organizations

Advancing leadership in medical radiation sciences: Incorporating systematic leadership education in pre-registration curricula

Police, firefighters, and emergency medical technicians and paramedics are frequently exposed to potentially traumatic events (PTE) in their work as public safety personnel (PSP). PTE are a risk factor for posttraumatic stress disorder, depression, anxiety, substance abuse, and suicidal ideation. This systematic rapid scoping review summarizes evaluation research on psychosocial interventions to reduce the negative consequences of exposure to work-related PTE on the mental health of PSP. Articles were identified using PubMed and PsycInfo. Publications from January 1, 2013, to December 1, 2020, were retained because the research published before 2013 was covered by other reviews. We identified 601 unique documents; 30 met preliminary eligibility criteria; and 18 were retained. Most studies were limited to police officers and firefighters. Participants exposed to prevention measures reported improvements of symptoms of depression, burnout, anxiety, sleep problems, and well-being. Most articles identified factors that may hinder or facilitate the use of program components. Studies on ways to support PSP recently affected by a PTE are lacking. There are little data on the efficacy of prevention programs in reducing the prevalence of mental disorders associated with PTE. More studies should focus on identifying participant characteristics and intervention components that influence program use, adherence, and efficacy. Realistic evaluations combined with participatory research could help address important knowledge gaps. (PsycInfo Database Record (c) 2024 APA, all rights reserved).