Evaluating professionalism, teamwork and leadership in medical undergraduates

Abstract

The complexity of healthcare is increasing due to new discoveries in the treatment of disease, the multiple pathologies of an ageing population and changes in working patterns and job roles. In addition, an increase in professional, regulatory and public scrutiny has led to revelations of poor care leading to preventable disability and death. Inquiries into sub-standard care have uncovered a number of professional lapses, in particular failures in teamwork and leadership. Medical undergraduates are future doctors. Their ability to work effectively within teams and to lead when necessary will therefore have a significant impact on the health of the population. In order to improve leadership and teamwork abilities we must be able to assess them. A literature review searching for a tool to assess teamwork and leadership in the medical undergraduate was carried out. As a consequence of an unsuccessful search, a tool was developed and evaluated, using data from existing tools and from a series of focus groups with medical undergraduates. The focus groups and an examination of the reasoning of assessment participants also informed a study on the justifications for failing to challenge poor performance by a more senior member of staff. The tool data showed adequate validity and reliability for formative assessments in a simulated environment. The focus groups and examination of reasoning highlighted the continued existence of the medical hierarchy, with steep authority gradients. This tool can be used in formative assessments, but further research is required before it is used outside the simulated environment and consideration must be given to psychometrics, feasibility and cost. The teaching and assessment of teamwork and leadership, should be given more time in the undergraduate curriculum and medical schools, regulatory bodies, deaneries and trusts should collaborate on minimising the unprofessional behaviours of senior healthcare personnel