In training for a career in clinical practice or research, leadership and management skills are becoming increasingly necessary for physicians-in-training. To stay ahead of the curve, institutions have begun implementing leadership training in their graduate medical education (GME) programs. With the increased interest in leadership training, some of our GME leaders published a systematic review in BMC Medical Education examining different approaches. In the study, Bharat Kumar, MD, MME, associate director of the Rheumatology Fellowship Program; Manish Suneja, MD, Vice Chair for Education; and Melissa L. Swee, MD, MME, clinical assistant professor in Nephrology, analyzed leadership development courses in the United States and Canada, finding some limitations in these programs.
“In an era in which the demands of leadership increasingly fall upon the weary shoulders of physicians, a key question must be answered: how should we train residents to become leaders?” Kumar said.
The team reviewed fifteen studies, assessing the learning process of 639 residents, chief residents, and fellows. Within the fifteen studies, there was a variety of different formats for each study, but many emphasized conflict management, interpersonal skills, and stress management. Seven used before and after surveys to monitor the course’s impact while another seven used course evaluations. For their systematic review, the researchers used the Medical Education Research Study Quality Instrument (MERSQI) to measure the quality of each of the methods.
The MERSQI tool assesses a quantitative study’s design, sampling, type of data, validity, data analysis and outcomes, assigning a score between 5 and 18. Kumar and colleagues’ survey revealed that most of the studies earned a MERSQI score between 6 and 9.
The team believes their study serves as a guide to future leadership training courses. With limitations such as validity and student outcomes, the researchers found most of the studies focused on satisfaction and attitudes of the students rather than their knowledge and skills acquisition as a result of the course.
“Teaching leadership skills is very tricky,” Kumar said. “A lot of programs focus on getting trainees to know what effective leadership is. What we need are programs that take it one step beyond and teach GME trainees how to become effective leaders in their own right. That’s why we rigorously assessed the validity of studies—to see which ones are actually leading to changes in the world.”
[Previously: Kumar, Suneja, and Swee analyzed the characteristics of effective training program directors.]