Leadership Training in Graduate Medical Education: Time for a Requirement?

INTRODUCTION: The need for all physicians to function as leaders in their various roles is becoming more widely recognized. There are increasing opportunities for physicians at all levels including Graduate Medical Education (GME) to gain leadership skills, but most of these opportunities are only for those interested. Although not an Accreditation Council for Graduate Medical Education (ACGME) requirement, some US graduate medical education programs have incorporated leadership training into their curricula. Interestingly, the Royal College of Physicians and Surgeons of Canada adopted the Leader role in its 2015 CanMEDS physician training model and requires leadership training. We sought to understand the value of a leadership training program in residency in our institution. MATERIALS AND METHODS: Our 2017 pilot leadership training program for senior military internal medicine residents consisted of four one-hour sessions of mini-lectures, self-assessments, case discussions, and small group activities. The themes were: Introduction to Leadership, Emotional Intelligence, Teambuilding, and Conflict Management. Participants were given an 18-question survey (14 Likert scale multiple-choice questions and 4 open-ended response questions) to provide feedback about the course. The Brooke Army Medical Center Institutional Review Board approved this project as a Quality Improvement effort. RESULTS: The survey response rate was 48.1% (26 of 54). The majority of respondents (84.6%) agreed the leadership training sessions were helpful and relevant. Following the sessions, 80.8% saw a greater role for physicians to function as leaders. Most (88.4%) agreed that these sessions helped them understand the importance of their roles as leaders, with 80.8% feeling more empowered to be leaders in their areas, 76.9% gaining a better understanding of their own strengths and weaknesses as leaders, and 80.8% feeling better prepared to meet challenges in the future. After exposure to leadership training, 73.1% indicated a plan to pursue additional leadership development opportunities. All respondents agreed that internists should be able to lead and manage a clinical team, and every respondent agreed that leadership principles should be taught in residency. CONCLUSIONS: This pilot project supports the premise that leadership training should be integrated into GME. Initial results suggest training can improve leadership skills and inspire trainees to seek additional leadership education. Moreover, much like the published literature, residents believe they should learn about leadership during residency. While more effort is needed to determine the best approach to deliver and evaluate this content, it appears even small interventions can make a difference. Next steps for this program include developing assessment tools for observation of leadership behaviors during routine GME activities, which would allow for reinforcement of the principles being taught. Additionally, our experience has led our institution to make leadership training a requirement in all of our GME programs, and we look forward to reporting future progress. Finally, an ACGME requirement to incorporate leadership training into GME programs nationwide would prove useful, as doing so would reinforce its importance, accelerate implementation, and expand knowledge of best approaches on a national level

LEAD 2.0: An Interprofessional Leadership Curriculum

Purpose: To develop knowledge, skills, and attitudes about leadership for graduate medical education trainees, junior nurses, and allied health trainees. Background: Many graduate medical education (GME) trainees, junior nurses, and allied health professionals complete training with exceptional clinical skills, but are not equipped to assume leadership roles or work well within teams. The goal of LEAD 2.0 is fill the gap for those assuming leadership positions, and to enhance the leadership skills of all trainees. Intervention: Walter Reed National Military Medical Center’s Department of GME developed an interprofessional leadership curriculum called LEAD 2.0 in 2016. The curriculum of LEAD 2.0 was derived from a systematic review of existing leadership curricula as well as a local needs assessment focusing on content, format, barriers, and logistics. The curriculum is composed of 8 core topics, each with well-defined goals and objectives: leadership fundamentals (leadership styles, definitions, etc.), mentoring and coaching, emotional intelligence, conflict resolution, feedback, managing effectively, building an effective team, and implementing change). Teaching methods are interactive and based on the Kolb Learning Cycle and Adult Learning Theory. LEAD 2.0 sessions are 1.5 hours long and occur monthly. Preliminary Results: Four sessions have been completed with 106 interprofessionals attending at least one session. Survey results suggest that sessions are useful and leading to changes in leadership behaviors among participants. Ninety percent (18/20) of those attending Leadership 101 (n=53) who responded to a post-class survey said the session was useful and 95% (19/20) said they were inspired to learn more about leadership. Recommendations: 1. Participants want materials that allow for interactive teaching sessions to include personal leadership inventories and case studies. 2. Speakers should be a mix of local speakers and outside experts if possible. 3. Logistics and timing should be coordinated with all stakeholders well in advance to allow for maximal participation. Learning Objectives: Determine the key elements of a successful interprofessional leadership curriculum. Demonstrate potential teaching strategies for leadership development. Recognize optimal methods for evaluating a leadership curriculum

Atypical Q Fever in US Soldiers

Q fever is an emerging infectious disease among US soldiers serving in Iraq. Three patients have had atypical manifestations, including 2 patients with acute cholecystitis and 1 patient with acute respiratory distress syndrome. Providers must be aware of Q fever’s signs and symptoms to avoid delays in treatment

Cutaneous and Presumed Visceral Leishmaniasis in a Soldier Deployed to Afghanistan

Leishmaniasis has been frequently diagnosed in US military personnel returning from duty in Southwest Asia. The majority of cases have demonstrated cutaneous disease, although a few cases of visceral disease have been documented. We present the case of an immunocompetent, HIV-negative, US Army soldier who suffered both visceral and cutaneous manifestations of leishmaniasis after returning from deployment in Afghanistan. Overlap of cutaneous and visceral involvement is rare and has not been reported in our cohort. Latent Plasmodium vivax infection may have been an exacerbating cofactor. We discuss this case and present a review of the literature

sj-pdf-2-mde-10.1177_23821205231164837 - Supplemental material for Read to Lead: Developing a Leadership Book Club Curriculum for Graduate Medical Education

Supplemental material, sj-pdf-2-mde-10.1177_23821205231164837 for Read to Lead: Developing a Leadership Book Club Curriculum for Graduate Medical Education by Sarah B. Schulte, William Rainey Johnson, Anthony J. Greco, John G. Blickle, Thomas R. Brooke, Melanie L. Wiseman and Joshua D. Hartzell in Journal of Medical Education and Curricular Development</p

sj-pdf-3-mde-10.1177_23821205231164837 - Supplemental material for Read to Lead: Developing a Leadership Book Club Curriculum for Graduate Medical Education

Supplemental material, sj-pdf-3-mde-10.1177_23821205231164837 for Read to Lead: Developing a Leadership Book Club Curriculum for Graduate Medical Education by Sarah B. Schulte, William Rainey Johnson, Anthony J. Greco, John G. Blickle, Thomas R. Brooke, Melanie L. Wiseman and Joshua D. Hartzell in Journal of Medical Education and Curricular Development</p