Abstract
Primary Subject area
Medical Education
Background
Effective clinical leadership is known to improve clinical outcomes, health service delivery, effective resource allocation, and patient and staff satisfaction rates. Although it is well known that leadership skills can be taught and are necessary for all physicians, there are very few described residency-level structured leadership-training curricula. Yet, pediatric residency programs' Competence-By-Design (CBD) includes 19 stage-specific, leadership-focused Milestones, spanning 10 Entrustable Professional Activities (EPAs) that will need to be assessed.
Objectives
The purpose of this study was to map how leadership is formally taught in Canadian pediatric residency programs and to explore how leader-specific milestones and EPA are incorporated into programs’ training.
Design/Methods
Program Directors from all Canadian pediatric residency programs were invited to complete an online, anonymous survey, which was developed using the AMEE Seven-Step Survey Development guidelines. The survey explored demographics, teaching structure, teaching content and methods, assessment, and participants’ perspectives. Descriptive and thematic analyses were performed.
Results
Ten of the 17 pediatric programs directors responded to the survey. All program directors (n=10), stated that there is a need for mandatory, formal leadership teaching and formal leadership skills assessment for pediatric residents. Yet, half of respondents (n=5) reported no formal leadership teaching and residents' leadership skills are not formally assessed in three (of 10) pediatric residency programs. Additionally, none of the programs offers stage-specific leadership teaching.
Of the programs that offer formal leadership teaching, four programs’ teachings are stand-alone courses, while one program has a longitudinal leadership curriculum. Only one program offers formal teachings on leader-related CBD EPAs and/ or Milestones. Seven programs formally assess residents’ leadership skills. Of these, four programs use a formal assessment tool, while three programs do not use any assessment tool. None of the programs utilizes a validated or published leadership skills assessment tool.
Thematic analyses revealed that the common barriers to introducing a formal leadership curriculum include limited available time in residents’ teaching curriculum, lack of expertise and resources to teach leadership, and difficulty in assessing leadership skills.
Conclusion
Although residency programs identify leadership teaching and assessment as necessary, most pediatric residency programs lack formal leadership teaching and assessment. Additionally, no such teaching is stage-specific. Understanding the current state of programs’ leadership teaching will help better prepare programs for the integration of leadership milestones/ EPAs in the curriculum.