Medical Leadership Development Research Articles

Striving for equity: exploring gender-inclusive medical leadership in India

IntroductionThere is a notable gap in studies examining the impact of gender within sociocultural norms in non-western professional settings, especially concerning the well-being of women physicians.MethodsUsing purposive sampling and thematic...

Tailoring a specific medical leadership development program for faculty members: the Lyon-Ottawa experience

ABSTRACT The development of leadership skills has been the topic of several position statements over recent decades, and the need of medical leaders for a specific training was emphasized during the COVID-19 crisis, to enable them to adequately collaborate with governments, populations, civic society, organizations, and universities. However, differences persist as to the way such skills are taught, at which step of training, and to whom. From these observations and building on previous experience at the University of Ottawa, a team of medical professors from Lyon (France), Ottawa, and Montreal (Canada) universities decided to develop a specific medical leadership training program dedicated to faculty members taking on leadership responsibilities. This pilot training program was based on a holistic vision of a transformation model for leadership development, the underlying principle of which is that leaders are trained by leaders. All contributors were eminent French and Canadian stakeholders. The model was adapted to French faculty members, following an inner and outer analysis of their specific needs, both contextual and related to their time constraints. This pilot program, which included 10 faculty members from Lyon, was selected to favor interactivity and confidence in older to favor long-term collaborations between them and contribute to institutional changes from the inner; it combined several educational methods mixing interactive plenary sessions and simulation exercises during onescholar year. All the participants completed the program and expressed global satisfaction with it, validating its acceptability by the target. Future work will aim to develop the program, integrate evaluation criteria, and transform it into a graduating training.

Contextual importance of leadership and management training in undergraduate medical education: Literature review

Leadership is recently known to be necessary at all levels within an organization, causing it to be extremely important for new graduates to understand what leadership is and to be familiar with different key leadership and management competencies. Leadership is also an integral part of medical practice. However, at present several medical colleges do not have a leadership and management curriculum, and thus, our medical college is not preparing its undergraduates in such skills as effective communication, conflict resolution, and time management. The search terms used were undergraduate medical leadership and management programs, undergraduate medical student leadership development programs, student leadership, and management training, clinical leadership, challenges of leadership and management programs in medical colleges, and skills needed for leadership and management course development. The review has shed light on skills needed for proposing a program on leadership and management for students at medical universities. The review also provided a rich combination of definitions of leadership, challenges to the type of leadership as well as how other medical organizations approach leadership and management. The theories suggest approaching competencies for leadership rather than building on pure theoretical knowledge of leadership. Furthermore, the research suggests differentiating the leadership training for undergraduate students based on how to add value to their career/study progressions, standardization, and organizational contribution. The literature further revealed the different challenges and barriers to developing leadership and management programs in medical colleges.

The Eighth Annual Academic International Medicine Congress and Scientific Forum, July 14–16, 2023: Thinking Globally, Acting Locally

The first in-person Academic International Medicine Congress (AIM 2023) since the beginning of the COVID-19 Pandemic took place at Rutgers University in New Brunswick, NJ, almost exactly 4 years after a meeting at the same location had to be canceled due to the global calamity. Featuring 3 days packed with high quality continuing medical education content and leadership development sessions, AIM 2023 set several important records for our organization. Among the most important sessions was the half-day strategic leadership retreat, with a goal of charting ACAIM’s path for the next 3-5 years. The main program featured more than 35 speakers and panelists, and offered more than 20 hours of continuing medical education credits. The scientific program included more than 30 abstracts and interesting case presentations. The AIM 2023 Gala and Awards Ceremonies were among the most attended attractions. This report includes a summary of key events and sessions from the AIM 2023 Congress, inclusive of published abstracts from the meeting. The following core competencies are addressed in this article: Interpersonal and communication skills, Professionalism, Practice-based learning and improvement, Systems based practice.

Leadership for Medical Students: Lessons Learned From a Relationship-Centered Leadership Curriculum.

Despite the need for and relevance of leadership skills to the success of medical trainees and healthcare professionals, few medical schools offer formal leadership training during the preclinical years. Where such curricula exist, we have found few schools that intentionally incorporate key principles of lifestyle medicine critical to short- and long-term career development. We describe a novel relationship-centered leadership curriculum, grounded in a conceptual framework of emotional intelligence and incorporating key principles of lifestyle medicine, first piloted in 2019 and now in its fourth year of existence. In comparing pre- and post-course self-evaluations on a 5-point Likert scale, students (n = 19) reported increased competencies in Self (3.12 vs 4.20, P < .001), Teams (3.06 vs 4.00, P < .001), and System (2.55 vs 3.55, P < .001) domains. Qualitative responses demonstrated that a vital strength of the course was its direct relevance and immediate applicability to students' personal and professional roles and goals. Results provide encouraging support for using a relationship-centered leadership framework that incorporates core elements of lifestyle medicine and emotional intelligence to facilitate medical students' leadership development, as related to leading oneself and in dynamic relationships with others (e.g., with leaders, colleagues, patients, and within communities, teams, and systems).

Evidence-based Medical Leadership Development: A Systematic Review

1Alexander Mafi, 2Oscar Lyons, 3Robynne George, 4Joao Galante, 5Thomas Fordwoh, 6Jan Frich,7Jaason Geerts&#x0D; 1University of Oxford, UK, 2University of Oxford, UK, 3Royal United Hospital Bath NHS Trust,4Oxford University Hospitals NHS Trust, UK, 5University of Oxford, UK, 6University of Oslo,Norway, 7Canadian College of Health Leaders, Ottawa, Canada&#x0D;  &#x0D; Health systems invest significant resources in leadership development for physicians and other health professionals. Competent leadership is considered vital for maintaining and improving quality and patient safety. We carried out this systematic review to synthesise new empirical evidence regarding medical leadership development programme factors which are associated with outcomes at the clinical and organisational levels.&#x0D; 117 studies were included in this systematic review. 28 studies met criteria for higher reliability studies. The median critical appraisal score according to the Medical Education Research Study Quality Instrument for quantitative studies was 8.5/18 and the median critical appraisal score according to the Jonna Briggs Institute checklist for qualitative studies was 3/10. There were recurring causes of low study quality scores related to study design, data analysis and reporting. There was considerable heterogeneity in intervention design and evaluation design. Programmes with internal or mixed faculty were significantly more likely to report organisational outcomes than programmes with external faculty only (p=0.049). Project work and mentoring increased the likelihood of organisational outcomes. No leadership development content area was particularly associated with organisational outcomes.&#x0D; In leadership development programmes in healthcare, external faculty should be used to supplement in-house faculty and not be a replacement for in-house expertise. To facilitate organisational outcomes, interventions should include project work and mentoring. Educational methods appear to be more important for organisational outcomes than specific curriculum content. Improving evaluation design will allow educators and evaluators to more effectively understand factors which are reliably associated with organisational outcomes of leadership development.

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

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

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.

A Call for Leadership and Management Competency Development for Directors of Medical Services-Evidence from the Chinese Public Hospital System.

Background: A competent medical leadership and management workforce is key to the effectiveness and efficiency of health service provision and to leading and managing the health system reform agenda in China. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentive for competency development and improvement. Methods: A three-component survey including the use of a validated management competency assessment tool was conducted with Directors of Medical Services (n = 143) and Deputy Directors of Medical Services (n = 152) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey identified the inadequacy of formal and informal management training received by hospital medical leaders before commencing their management positions and confirms that the low self-perceived competency level across two medical management level and three hospitals was beyond acceptable. The study also indicates that the informal and formal education provided to Chinese medical leaders have not been effective in developing the required management competencies. Conclusions: The study suggests two system level approaches (health and higher education systems) and one organization level approach to formulate overall medical leadership and management workforce development strategies to encourages continuous management competency development and self-improvement among clinical leaders in China.

A Proposed Shared Vision for Leadership Development for all Medical Students: A Call from a Coalition of Diverse Medical Schools

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.

581 Basecamp: Burn Efficiency Care Pathway

Abstract Introduction Standardizing care has shown in the literature to be a means to improving the culture of safety in any field. Aligning burn surgeons, staff and ancillary services in the Burn ICU, Burn Acute Care floor, Burn Clinic who all have varying ideas, and plans of care creates toxic variation and communication challenges for bedside staff. While attending a medical center leadership development session, Burn Center Leadership collaborated on a project regarding burn center standardization. Methods A multidisciplinary Burn Center retreat in September 2017, launched the effort with a special emphasis on patient and family participation.We elicited feedback on what we did well and areas we could improve on. Using crowdsourcing methodology, the group selected 5 core QI/PI areas: resuscitation, wound care, pain/anxiety/delirium, physical mobility and psychosocial needs.Each multidisciplinary group, led by a non-physician chair and a Physician liaison established assigned tasks, rules of engagement and time frames. Work groups met weekly and reported progress to the Burn center QI committee.The project concluded with dissemination of the work products to staff. Patients and families were updated on the progress made to ensure we were still in alignment with our original goals. Results Burn Center orientation materials, standard operating practice documents and a Burn Center Standard of Care packet was developed. Documents were uploaded to a commonly accessible Burn Center Sharepoint website so there was one central source of information. The final BasECamP output was a daily checklist packet started on all BICU admits, that addressed key QI indicators and directives for care goals; 24 hr resuscitation guidelines, time to TF vs PO within 4 hrs of admit, daily weights, IV vs PO medication for wound care, time to first active mobility and a review of ICU and Hospital LOS per %TBSA. 71 adult burn patients &amp;gt;18 years admitted to the BICU between November 2018 and May 2019 were started on the pathway. Of the 71, 58 were admitted with a burn injury, 4 with TEN, 6 were burn post-ops and there were 3 deaths. The 58 new burn admits are reviewed below. Conclusions The BaSeCamP packet is turned in and reviewed with the team. Data shows significant improvement in knowledge of standard operating procedures, expectations and resource availability. With improved communication across the burn team, staff more clearly understand patient-specific expectations in burn care and are more easily able to educate patients and families about the plan. Applicability of Research to Practice This Process improvement project responds to patient and family feedback that burn teams must coordinate communication and eliminate variability in delivery of care.

The Importance of Leadership Development in Medical Curricula: A UK Perspective (Stars are Aligning).

“Medical leadership and management” describes the engagement of doctors in the leadership and management of both individual patient care and of the departments, organizations and systems within which they work. Around the world, doctors are generally accepted as the leaders of clinical teams, holding ultimate accountability for individual patient care. However, the role of doctors as organizational and system leaders within healthcare, despite evidence of benefit, shows considerable variation. In this article, we briefly explore the history of leadership development for doctors, and then, taking a UK perspective on recent developments in undergraduate education and postgraduate training, consider the opportunities and challenges for medical schools, educators and doctors in implementing these. The future of medical leadership and management development is promising although there is still a lack of evidence on the longer-term outcomes and impact on patients of current interventions. It is clear, however, that faculty need to be skilled in holding effective developmental conversations and structuring formative experiences for those they educate, and that leadership development must be integrated longitudinally throughout a doctor’s career, with undergraduate development being a critical stage for helping medical students recognize and understand their wider responsibility to the system, as well as the patient in front of them.

Graduating With Honors in Resilience: Creating a Whole New Doctor.

BackgroundAlthough coaching programs have become a prominent piece of graduate medical education, they have yet to become an integral part of undergraduate medical education. A handful of medical schools have utilized longitudinal coaching experiences as a method for professional identity formation, developing emotional intelligence and leadership.ObjectiveWe developed A Whole New Doctor (AWND), a medical student leadership development and coaching program at Georgetown University, with the aim of fostering resilience, leadership, and emotional intelligence at the nascent stage of physician training. To our knowledge, ours is the only program that is largely student-managed and uses certified executive coaches in the medical student population.MethodsCohort 1 of AWND started in October 2016. For each cohort, we hold a kickoff workshop that is highly interactive, fast-paced and covers coaching, complex thinking, reflective writing, and a coaching panel for Q&A. Following the workshop, students work with coaches individually to address self-identified weaknesses, tensions, and areas of conflict. We believe the program’s student-driven nature provides a new structural approach to professional development and leadership programs, offering students a simultaneously reflective and growth-oriented opportunity to develop essential non-technical skills for physician leaders.ResultsOf the 132 students in the program, 107 have worked with one of our coaches (81%). Student testimonials have been uniformly positive with students remarking on an increased sense of presence, improvements in communication, and more specific direction in their careers.ConclusionOur pilot coaching program has received positive feedback from students early in their medical training. It will be important to further scale the program to reach an increasing number of students and quantitatively evaluate participants for the long-term effects of our interventions.

Medical Leadership Development (MLD): the need of change and the way to approach it

Medical Leadership Development (MLD): the need of change and the way to approach it

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...

From context to contexting: professional identity un/doing in a medical leadership development programme.

Physicians are known for safeguarding their professional identities against organisational influences. However, this study shows how a medical leadership programme enables the reconstruction of professional identities that work with rather than against organisational and institutional contexts to improve quality and efficiency of care. Based on an ethnographic study, the results illustrate how physicians initially construct conflicting leadership narratives – heroic (pioneer), clinical (patient's guardian) and collaborative (linking pin) leader – in reaction to changing organisational and clinical demands. Each narrative contains a particular relational‐agentic view of physicians regarding the contexts of hospitals: respectively as individually shapeable; disconnected or collectively adjustable. Interactions between teachers, participants, group discussions and in‐hospital experiences led to the gradual deconstruction of the heroic –and clinical leader narrative. Collaborative leadership emerged as the desirable new professional identity. We contribute to the professional identity literature by illustrating how physicians make a gradual transition from viewing organisational and institutional contexts as pre‐given to contexting, that is, continuously adjusting the context with others. When engaged in contexting, physicians increasingly consider managers and directors as necessary partners and colleague‐physicians who do not wish to change as the new ‘anti‐identity’.

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.

Engaging Medical Students in Leadership Development.

Leadership development plays a critical role in preparing collaborative, systems-based physicians. Medical schools across the globe have dedicated significant effort towards programming for medical student leadership development. Students report a variety of existing leadership opportunities, ranging from formal didactics to leadership positions within the community. Students identify lack of time, funding, and the hierarchy of medicine as significant barriers for engaging in leadership opportunities. Students favor a formal leadership curriculum coupled with hands-on opportunities to practice leadership skills. In order to train medical students to be engaged physician leaders, it is imperative to foster practical opportunities for leadership development.

Is postgraduate leadership education amatch for the wicked problems of health systems leadership? A critical systematic review.

PurposeThere have been a growing number of leadership education programs for physicians. However, debates about the value and efficacy of leadership education in medicine persist, and there are calls for systematic and critical perspectives on medical leadership development. Here, we review evidence on postgraduate leadership education and discuss findings in relation to contemporary evidence on leadership education and practice.MethodWe searched multiple databases for papers on postgraduate leadership development programs, published in English between 2007 and 2017. We identified 4,691 papers; 31 papers met the full inclusion criteria. Data regarding curricular content and design, learner demographics, instructional methods, and learning outcomes were abstracted and synthesized.ResultsThere was modest evidence for effectiveness of programs in influencing knowledge and skills gains in select domains. However, the conceptual underpinnings of the ‘leadership’ training delivered were often unclear. Contemporary theory and evidence on leadership practice was not widely incorporated in program design. Programs were almost exclusively uni-professional, focused on discrete skill development, and did not address systems-level leadership issues. Broader leadership capacity building strategies were underutilized. A new wave of longitudinal, integrated clinical and leadership programming is observed.ConclusionsOur findings raise questions about persistent preparation-practice gaps in leadership education in medicine. Leadership education needs to evolve to incorporate broader collective capacity building, as well as evidence-informed strategies for leadership development. Barriers to educational reform need to be identified and addressed as educators work to re-orientate education programs to better prepare budding physician leaders for the challenges of health system leadership.Electronic supplementary materialThe online version of this article (10.1007/s40037-019-0517-2) contains supplementary material, which is available to authorized users.