Medical Leadership Competency Research Articles

Critical route for development of medical student leadership competencies in 35 Pan American Health Organization member states: Ascoping review and thematic analysis.

The Pan American Health Organization has been committed to training physicians in leadership competencies since 2008. However, four reviews on teaching leadership using competency-based education in undergraduate medical education (UME) identified only two of 35 MS: Canada and the USA. Previous reviews did not use a systemic approach or qualitative methodology to explore factors influencing leadership education. Therefore, this review aims to identify facilitating and inhibiting factors in teaching leadership in UME using a scoping review and thematic analysis. Six databases containing grey and indexed literature in English, Spanish, and Portuguese were searched, including a hand search and authors' consultations. Forty-eight documents out of 7849 were selected based on eligibility criteria. Braun and Clarke's thematic analysis guide was used, identifying eight themes: curriculum, intended learning outcomes, teaching methods, assessment, addressing barriers, supporting organisational change, building networks, and developing expertise. Considering these themes, the authors propose a critical route for teaching leadership in UME in the Americas. First, institutional design should consider governance gaps, such as having national and international policies for leadership training in UME with inter-professional, trans-professional, and citizen-focused approaches. There is a pressing need to provide leadership training for physicians and other professionals from government, academia, non-governmental organisations, hospitals, and national and international organisations whose missions are related to health or education. Networking opportunities for stakeholders in leadership education and teacher training is also essential. Second, instructional design reveals knowledge-do gaps in member states (MS) when incorporating leadership into the medical curriculum. This includes using leadership frameworks, defining learning outcomes, and employing assessment and monitoring tools for leadership education. Mechanisms to reduce these gaps in MS include the Equator Network and Evidence-Informed Policy Networks fostering knowledge translation and governance.

Leadership in Undergraduate Medical Education: A Study of Pakistani Medical Students’ Perceptions, Attitudes, and Interest

Background: Despite calls for the much-needed involvement of physicians in leadership, very few medical colleges in Pakistan provide explicit training on the knowledge, skills, and attitudes necessary to be an effective physician leader. 
 Objective: To explored Pakistani medical students’ perceptions, attitudes, and interests regarding Leadership training in medical education.
 Methods:
 Participants were asked about their perceptions and attitudes towards medical leadership on a 5-point Likert scale. Students also self-rated their leadership competencies noted as per Medical Leadership Competency Framework. Survey also assessed the perceived need and topics for a leadership curriculum for physician leaders, the teaching format, and barriers to leadership training in medical schools. Data were analyzed using SPSS 26.
 Results:
 60.6% of the total 1204 respondents rated their leadership training in medical college as “very poor” or “poor” and 80.3% of them endorsed their interest and need for it. 77.4% of the participants agreed that clinicians should influence leadership decisions in a clinical setting. Only 25% of respondents were aware of the demands of a leadership rank in medicine. Leadership competencies endorsed for training included problem-solving, leading a team, confronting problematic employees, and communication skills with a multimodal teaching approach, including teaching methods like small group discussions. The main barriers to leadership training were identified as time constraints (66.1%), lack of available curriculum (69.0%), and disinterest by faculty (67.0%).
 Conclusion:
 Our study suggests that medical students in Pakistan appreciate the importance of leadership training in undergraduate education. There is a need for dedicated leadership teaching and study data to specify the possible content and delivery methods to serve as goals for an undergraduate leadership curriculum in Pakistan.

Next Generation Leaders Programme: A Multi-Methods Evaluation of a Leadership Development Programme for Biomedical Researchers.

Biomedical scientists have become de facto leaders for their research teams. Theories of expert leadership suggest that the specialist knowledge and credibility these researcher-leaders bring to their roles can lead to improved performance. Formal leadership development for biomedical researchers remains uncommon, and it is unclear whether existing leadership development programmes achieve improved individual and organisational outcomes. Our study evaluates the effectiveness of a single centre leadership development programme for biomedical researchers using a mixed-methods approach. 26 biomedical researchers participated in an 8 month single centre multidisciplinary leadership development programme. Participants completed prospective pre-test, retrospective then-test and traditional post-test self-assessments using the Primary Colours Questionnaire (PCQ) and Medical Leadership Competency Framework Self-Assessment Tool (MLCFQ). Pre-post pairs and then-post pairs were analysed for changes using Wilcoxon signed-rank tests and compared with a parallel mixed-methods evaluation organised by Kirkpatrick levels. There were significant increases in 3/7 domains and 1/5 tasks of leadership in the PCQ, in both pre-post and then-post paired assessments. There were statistically significant but small increases in 2/7 domains of the MLCFQ. The mixed-methods data showed positive outcomes at all Kirkpatrick levels.Participants said the programme was relevant, interesting and well-organised, with 63% reporting increased confidence and motivation. Participants had a significant change in behaviour, spending 1-2 hours per week on group projects, which were successfully implemented locally. 42% of participants expected these projects to continue beyond the programme. This study demonstrates a local leadership programme can have positive impact within a biomedical research centre despite time and financial constraints. We encourage future studies to utilise a mixed-methods approach to evaluating the impact of leadership development programmes.

Redeveloping Leadership Training for Higher Trainees in the West Midlands

AimsMany of the competencies that trainees in psychiatry are required to achieve can be linked to leadership in the broadest sense, yet specific training is not often systematically provided. The West Midlands Psychiatry Leadership Development Programme aims to support the acquisition of important leadership skills already set out in the curriculum through provision of high-quality specialist leadership content within the existing programme. Here we present the findings of a scoping exercise exploring the views and attitudes towards leadership training held by higher trainees in psychiatry within the West Midlands.MethodsAll psychiatry higher trainees within West Midlands Deanery were invited to complete an anonymous online survey using Survey Monkey in November 2021. This survey incorporated questions about their preferred learning styles, confidence in their leadership skills and barriers to accessing leadership opportunities, generating both quantitative and qualitative data.ResultsKey results included: •37 responses were received. All subspeciality training programmes were represented. Almost half of respondents (46%) were ST6 or above and most were in training full time (84%).•Trainees expressed a preference for experiential learning about leadership (87%) as well as small group teaching (62%) and interactive workshop style content (62%).•Awareness of leadership opportunities was typically via their peer group (81%) or clinical supervisor (60%). Only 52% of trainees were aware of leadership opportunities within the Deanery.•Only 54% felt that existing leadership training met their curriculum requirements. Less than half of trainees (46%) felt confident to evidence their leadership experience within their training portfolio.•One-fifth of trainees (21%) reported experiencing barriers to leadership development. These included: inadequate awareness of opportunities, lack of senior support, time constraints and difficulty matching interests with available opportunities.ConclusionTrainees expressed interest in the redevelopment of a regional leadership training programme which would support them to achieve their curriculum competencies and prepare them for life as a consultant psychiatrist. The new multi-faceted regional leadership programme will offer resources in a variety of formats including webinars, podcasts, optional interactive workshops and action learning sets. It is hoped that this flexible programme, linked to the Medical Leadership Competency Framework, will better meet the needs of higher trainees as they pursue their own personal leadership journeys.

Leadership Development in U.S. Undergraduate Medical Education: A Scoping Review of Curricular Content and Competency Frameworks.

To inform research on developing or adopting leadership competency frameworks for use in U.S. undergraduate medical education (UME), this scoping review describes the content of U.S. UME leadership curricula, associated competency frameworks, and content delivery. The authors searched PubMed, Embase, and ERIC databases on June 22, 2020. They included English-language studies that described U.S. UME curricula in which the primary end goal was leadership development. They excluded studies published before January 1, 2000. Data were extracted on leadership competency frameworks and curricular content, audience, duration, electivity, selectivity, learning pedagogies, and outcome measures. The curricular content was coded and categorized within the Medical Leadership Competency Framework (MLCF) using the constant comparative method. A repeated search of the literature on May 14, 2021, did not yield any additional studies. Of 1,094 unique studies, 25 studies reporting on 25 curricula met inclusion criteria. The course content of the curricula was organized into 91 distinct themes, most of which could be organized into the first 2 competencies of the MLCF: Demonstrating Personal Qualities and Working With Others. Thirteen curricula (52%) aligned with leadership competency frameworks, and 12 (48%) did not appear to use a framework. Number of participants and target learner level varied widely, as did curricula duration, with fewer than half (n = 12, 48%) spanning more than 1 semester. Most curricula (n = 14, 56%) were elective, and many (n = 16, 64%) offered experiential learning. Most studies (n = 16, 64%) reported outcomes as student perception data. The authors found wide variation in content of U.S. UME leadership development curricula, and few curricula aligned with an established leadership competency framework. The lack of professional consensus on the scope of medical leadership and how it should be taught thwarts effective incorporation of medical leadership training within UME.

Análise de subgrupo de participantes brasileiros de um instrumento de competências de liderança médica: um estudo de pesquisa transversal do Latin American Cooperative Oncology Group (LACOG) e da Academy of Leadership Sciences Switzerland (ALSS)

INTRODUCTION: We previously published the results of a medical leadership (ML) competencies instrument applied to Latin-American (LA) physicians with a leadership position, which disclosed meaningful differences in the valuation of specific ML competencies by LA physicians as compared to a similar survey applied to healthcare professionals from North America and Europe (NA/EU). Because the most pronounced differences in the responses were in terms of country of medical practice, we felt that an analysis focused on the Brazilian participants (a culturally more homogeneous population) could provide further insights into understanding other subgroup differences. OBJECTIVES: We aimed to: 1) compare the responses from the Brazilian participants with those of the NA/EU survey and 2) perform subgroup analyses within the Brazilian participants. DESIGN AND SETTING: Cross-sectional survey study applied only once. MATERIAL AND METHODS: Between November 13th and December 12th, 2018, we collected 217 responses. Results: There were (n=135/63%) Brazilian participants. The valuation of a set of ML competencies by Brazilian physician-leaders roughly match those of the main study (task management remaining the most valued set of competencies versus 3rd in the NA/EU survey). However, significant differences in the responses were seen in some subgroups, especially in terms of the impact of seniority (which no longer appears to affect the responses) and gender (with women no longer placing a higher value on innovation competencies). CONCLUSION: This analysis reinforces the existence of significant cultural differences within the LA participants, and that these cultural variations can significantly affect the valuation of specific ML competencies.

Skills, Determinants and Attitudes towards Leadership among Undergraduates in Medicine

Background: Good leadership is fundamental for providing a better healthcare. The objective of this study was to evaluate the leadership skills, determinants and attitudes in medical undergraduates. 
 
 Methods: Self and Rater versions of the Authentic Leadership Questionnaire (ALQ) and a formulated questionnaire based on Medical Leadership Competency Framework (MLCF) were distributed among first year students who were followed up in the final year with the same assessments. Skills were evaluated with an average ALQ score, under four domains; transparency (TR), ethical skills (ES), balanced processing (BP) and self-awareness (SA). Determinants of leadership skills were assessed by a self-administered questionnaire.
 
 Results: Students in the first year (n=115; females=64, males=51), had lower leadership skills score (2.74±0.38; mean ± SD) than in the final year (n=101; females=52, males=49; 3.05±0.43p

Community Medical Leadership Workshop: An Introduction to Physician Leadership for Resident Physicians.

ObjectiveThe Community Medical Leadership Workshop (CMLW) aims to prepare residents to become effective physician leaders through medical leadership lectures and case scenario discussions. By the end of the CMLW, participants will be able to define leadership in medicine, employ strategies to manage conflict and differences of opinions in the workplace, demonstrate effective communication skills while working with others, and describe the role of power in effective leadership.MethodsA total of 32 resident physicians participated in our workshop that is based on the leadership practice inventory (LPI) and the Medical Leadership Competency Framework (MLCF). Our evaluation assessed communication strength, conflict resolution, time management, negotiation, delegation, teamwork, and community service.ResultsMost participants were satisfied with the course. They rated the workshop's contents the highest. In addition, over 90% of learners would recommend this workshop to others. We found a statistically significant increase in learners’ ability to provide opportunities to include patients in quality improvements.ConclusionOur workshop was designed and tailored for resident physicians to introduce them to physician leadership. The workshop was well received and could serve as a model to promote qualities in residents that define effective physician leaders.

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

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

Identifying leadership in medical trainees: evaluation of a competency-based approach

BackgroundAs medical professional roles diversify, it is essential to understand what makes effective medical leaders. This study develops and validates a medical leadership competency framework that can be used to...

Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy.

Background:There is an ongoing call for leadership development in academic health care and medical students desire more training in this area. Although many schools offer combined MD/MBA programs or leadership training in targeted areas, these programs do not often align with medical school leadership competencies and are limited in reaching a large number of students.Methods:The Leadership Initiative (LI) was a program created by a partnership between a School of Medicine (SOM) and Business School with a learning model that emphasized the progression from principles to practice, and the competencies of self-awareness, communication, and collaboration/teamwork. Through offerings across a medical school curriculum, the LI introduced leadership principles and provided an opportunity to apply them in an interactive activity or simulation. We utilized the existing SOM evaluation platform to collect data on program outcomes that included satisfaction, fidelity to the learning model, and impact.Results:From 2017 to 2020, over 70% of first-year medical students participated in LI course offerings while a smaller percentage of fourth-year students engaged in the curriculum. Most students had no prior awareness of LI course material and were equivocal about their ability to apply lessons learned to their medical school experience. Students reported that the LI offerings provided opportunities to practice the skills and competencies of self-awareness, communication, and collaboration/teamwork.Discussion:Adding new activities to an already crowded medical curriculum was the greatest logistical challenge. The LI was successful in introducing leadership principles but faced obstacles in having participants apply and practice these principles. Most students reported that the LI offerings were aligned with the foundational competencies.

Developing medical leadership in India: A mission impossible?

PurposeGlobally, there have been calls to enhance medical leadership in healthcare, although we know little about how this objective has been pursued in low-income middle-income contexts such as India. This...

Development of a national medical leadership competency framework: the Dutch approach

BackgroundThe concept of medical leadership (ML) can enhance physicians’ inclusion in efforts for higher quality healthcare. Despite ML’s spiking popularity, only a few countries have built a national taxonomy to facilitate ML competency education and training. In this paper we discuss the development of the Dutch ML competency framework with two objectives: to account for the framework’s making and to complement to known approaches of developing such frameworks.MethodsWe designed a research approach and analyzed data from multiple sources based on Grounded Theory. Facilitated by the Royal Dutch Medical Association, a group of 14 volunteer researchers met over a period of 2.5 years to perform: 1) literature review; 2) individual interviews; 3) focus groups; 4) online surveys; 5) international framework comparison; and 6) comprehensive data synthesis.ResultsThe developmental processes that led to the framework provided a taxonomic depiction of ML in Dutch perspective. It can be seen as a canonical ‘knowledge artefact’ created by a community of practice and comprises of a contemporary definition of ML and 12 domains, each entailing four distinct ML competencies.ConclusionsThis paper demonstrates how a new language for ML can be created in a healthcare system. The success of our approach to capture insights, expectations and demands relating leadership by Dutch physicians depended on close involvement of the Dutch national medical associations and a nationally active community of practice; voluntary work of diverse researchers and medical practitioners and an appropriate research design that used multiple methods and strategies to circumvent reverberation of established opinions and conventionalisms.ImplicationsThe experiences reported here may provide inspiration and guidance for those anticipating similar work in other countries to develop a tailored approach to create a ML framework.

Impact of a leadership development programme for physicians in India

Purpose The purpose of this study was to evaluate the impact of leadership development programme on enhancing leadership competencies of physicians in India. Assessment of leadership competencies of physicians is critical for designing suitable leadership development programmes. The previous studies of authors have revealed significant gaps in leadership competencies among physicians in India. Hence, authors have designed a programme incorporating various facets of health-care leadership and evaluated its impact on improvement of leadership competencies of top- and mid-career level professionals. Design/methodology/approach A six-day offsite residential programme incorporating a three-day component of leadership development was organized, in which 96 physicians participated. A mix of pedagogical approaches was used. A pre- and post-assessment of 30 medical leadership competencies was done using a self-administered questionnaire. Findings Majority of participants (69%) scored their competencies at Level 3 and Level 4 (Average to Good) with a mean score ranging from 3.20 ± 0.85 to 4.12 ± 0.71 in the pre-assessment group. In contrast, in post-assessment, this shifted to Level 4 and Level 5 (Good to Very good) in 72% with mean scores ranging from 3.8 to 4.24. Statistically significant differentiation was noted in pre- and post-assessment mean scores for all 30 competencies. The maximum improvement was noted in Competency 29 “Information management system planning and implementation”, whereas the least improvement was noted in Competency 12 “Holding self and others accountable and responsible for organizational goal attainment”. Originality/value The authors believe that this is the first study from India to assess effectiveness of leadership development programmes on enhancing medical leadership competencies demonstrating positive outcome. The findings of this study can provide a roadmap for designing of future medical leadership development programmes for physicians in India.

Leadership development in New Zealand and Australian medical schools: needs analysis

BackgroundLeadership is a core competency of doctors. However, specific learning outcomes for leadership are often not well defined in medical school curricula. This article uses New Zealand (NZ) and Australian...

Assessment of medical leadership competencies and development needs: First comprehensive study from India

ABSTRACT Purpose: To assess medical leadership competencies of physicians in India, to analyse the competency gaps, and suggest measures for medical leadership development. Methods: A survey questionnaire was developed to assess 30 medical leadership competencies at ‘Self-assessed proficiency’ levels (1 very poor to 5 very good), ‘Perceived importance of competency’ levels (1 not important to 5 very important) amongst physicians and perceived need for medical leadership development programmes (MLDPs) to which 540 doctors responded (54%). Findings: Majority (70%) self-assessed their competencies between ‘Average to Good’. Self-assessed competency levels fell significantly short of the perceived importance of each of the competencies across all demographic variables. Thus, the study demonstrated existence of significant ‘Medical leadership competency gap’. The competencies, which were consistently deficient were in the NHS-MLCF domains of Setting directions, Working with others, and Managing services, with the lowest rated competency being ‘Knowledge of HR, procurement, financial and contracts management’. The variables, which were observed to have significant influence on competency levels included: Formal management training, Speciality and Duration of management/leadership experience. Majority (94.8%) of physicians indicated need for MLDPs at all levels. Conclusions: This is the first study from India highlights leadership competency gaps amongst physicians and confirms need for MLDPs.

Foundation forum: developing leadership skills among foundation trainees.

Foundation forums have been adopted over the last few years to provide representation for newly qualified doctors, but they do not develop essential leadership, management and quality improvement skills for those recruited - key attributes that have been formally identified by General Medical Council (2012) guidance. A foundation forum was set up across three Oxford deanery hospitals. Forum members were assigned classical forum roles, but were also tasked to complete quality improvement projects, organize a national quality improvement conference, and undergo formal leadership and management training. Members were surveyed before and after completion of training, revealing statistically significant increases in confidence in leadership, management and quality improvement skills. All members revealed an eagerness to continue formal leadership and management training. The foundation forum proved a successful initiative to improve overall trainee experience and involvement, while providing a platform for leadership and management training to satisfy key domains within the Medical Leadership Competency Framework.

Enhancing engagement in medical leadership through structured quality improvement teaching

To evaluate the impact of an integrated clinical quality improvement module within undergraduate medical and nursing training on leadership skills development using the domains of the Medical Leadership Competency Framework (MLCF). The quality improvement module initially comprised formal methodology lectures and supervised projects in an acute hospital setting. The 10-week module was interdisciplinary; mixed small groups of undergraduate third-year medical and nursing students worked alongside clinical fellows. Following completion of one Plan, Do, Study, Act cycle, the …

View from the top: a thematic analysis of interviews with top healthcare leaders in the UK about leadership and how UK GPs should prepare for it

IntroductionLeadership is often quoted as being a solution to future work force problems . This study looks at the views of leaders within the NHS to find out what they...

Physicians as leaders: are we trying to fit square pegs into round holes?

The purpose of medical education has changed over the last 70 years. The modern doctor is expected to be a leader who will be skilled in people management, team working...