Phases to Face in National Medical Leadership Development

2017 ◽  
Vol 2017 (1) ◽  
pp. 16102
Author(s):  
Wouter A. Keijser ◽  
Max B. Poorthuis ◽  
Judith Tweedie ◽  
Peter Lees ◽  
Graham Dickson
Keyword(s):  
Leadership Development ◽  
National Medical ◽  
Medical Leadership

scholarly journals Review of determinants of national medical leadership development

BMJ Leader ◽  
2017 ◽  
Vol 1 (4) ◽  
pp. 36-43 ◽  
Author(s):  
Wouter Keijser ◽  
Max Poorthuis ◽  
Judith Tweedie ◽  
Celeste Wilderom
Keyword(s):  
Leadership Development ◽  
Resistance To Change ◽  
Medical Profession ◽  
Data Extraction ◽  
National Level ◽  
National Development ◽  
National Medical ◽  
Physician Engagement ◽  
High Level ◽  
Medical Leadership

Increasingly, physician engagement in management, quality and innovation is being recognised as vital, requiring ‘medical leadership’ (ML) competencies. Besides numerous local institutional efforts and despite the high level of autonomy of the medical profession and the education of its members, in some countries, national level activities are focusing on developing ML competencies to guide physicians in more effectively engaging in these non-medical activities. Up to this date, little is known about effective strategies and tactics for developing ML on a national level. This study investigates existing literature on determinants and interventions for national ML development. We performed a scoping review and subsequent systematic literature review of published reviews, using PubMed, Scopus, Web of Science, Ovid MEDLINE and Science Direct in search for eligible papers between 2011 and 2016. Full-text versions of 43 papers were studied, and a snowballing method was deployed. Data extraction included grounded theory coding, and synthesis of data was done iteratively during data clinics. Analysis of the seven included papers resulted in five discrete categories of determinants of and 10 distinct interventions relevant to national development of ML approaches. None of the papers reported on any specific phasing of national ML development. Our data suggest that local and national level activities in ML development should consider multifaceted and multilevel approaches, taking into account resistance to change and redesign of institutionalised logics that accompany changing positions and reconstruction of professional identities of physicians.

Incorporating medical leadership into undergraduate curricula: a proposal for a spiral curriculum

2019 ◽  
Vol 32 (3) ◽  
pp. 435-444 ◽  
Author(s):  
Ross I. Lamont ◽  
Ann L.N. Chapman
Keyword(s):  
Leadership Development ◽  
Leadership Training ◽  
Learning Opportunities ◽  
Competency Framework ◽  
Medical Council ◽  
Undergraduate Level ◽  
Content Type ◽  
Leadership Competency ◽  
Spiral Curriculum ◽  
Medical Leadership

Purpose There is increasing recognition of the importance of incorporating medical leadership training into undergraduate medical curricula and this is now advocated by the General Medical Council (GMC) and supported through the development of the Undergraduate Medical Leadership Competency Framework (MLCF). However to date, few medical schools have done so in a systematic way and training/experience in medical leadership at undergraduate level is sporadic and often based on local enthusiasm. The purpose of this paper is to outline a theoretical curriculum to stimulate and support medical leadership development at undergraduate level. Design/methodology/approach This study describes a theoretical framework for incorporation of medical leadership training into undergraduate curricula using a spiral curriculum approach, linked to competences outlined in the Undergraduate Medical Leadership Competency Framework. The curriculum includes core training in medical leadership for all students within each year group with additional tiers of learning for students with a particular interest. Findings This curriculum includes theoretical and practical learning opportunities and it is designed to be deliverable within the existing teaching and National Health Service (NHS) structures. The engagement with local NHS organisations offers opportunities to broaden the university teaching faculty and also to streamline medical leadership development across undergraduate and postgraduate medical education. Originality/value This theoretical curriculum is generic and therefore adaptable to a variety of undergraduate medical courses. The combination of theoretical and practical learning opportunities within a leadership spiral curriculum is a novel and systematic approach to undergraduate medical leadership development.

scholarly journals Development of a national medical leadership competency framework: the Dutch approach

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wouter A. Keijser ◽  
Henricus J. M. Handgraaf ◽  
Liz M. Isfordink ◽  
Vincent T. Janmaat ◽  
Pieter-Paul A. Vergroesen ◽  
...  
Keyword(s):  
Community Of Practice ◽  
Competency Framework ◽  
Research Approach ◽  
Multiple Sources ◽  
Voluntary Work ◽  
Medical Practitioners ◽  
Quality Healthcare ◽  
National Medical ◽  
Similar Work ◽  
Medical Leadership

Abstract Background The concept of medical leadership (ML) can enhance physicians’ inclusion in efforts for higher quality healthcare. Despite ML’s spiking popularity, only a few countries have built a national taxonomy to facilitate ML competency education and training. In this paper we discuss the development of the Dutch ML competency framework with two objectives: to account for the framework’s making and to complement to known approaches of developing such frameworks. Methods We designed a research approach and analyzed data from multiple sources based on Grounded Theory. Facilitated by the Royal Dutch Medical Association, a group of 14 volunteer researchers met over a period of 2.5 years to perform: 1) literature review; 2) individual interviews; 3) focus groups; 4) online surveys; 5) international framework comparison; and 6) comprehensive data synthesis. Results The developmental processes that led to the framework provided a taxonomic depiction of ML in Dutch perspective. It can be seen as a canonical ‘knowledge artefact’ created by a community of practice and comprises of a contemporary definition of ML and 12 domains, each entailing four distinct ML competencies. Conclusions This paper demonstrates how a new language for ML can be created in a healthcare system. The success of our approach to capture insights, expectations and demands relating leadership by Dutch physicians depended on close involvement of the Dutch national medical associations and a nationally active community of practice; voluntary work of diverse researchers and medical practitioners and an appropriate research design that used multiple methods and strategies to circumvent reverberation of established opinions and conventionalisms. Implications The experiences reported here may provide inspiration and guidance for those anticipating similar work in other countries to develop a tailored approach to create a ML framework.

scholarly journals Motivating doctors into leadership and management: a cross-sectional survey

BMJ Leader ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 196-200
Author(s):  
Agnes Bäker ◽  
Mickael Bech ◽  
Jaason Geerts ◽  
Susanne Maigaard Axelsen ◽  
Henrik Ullum ◽  
...  
Keyword(s):  
Leadership Development ◽  
Health Systems ◽  
Leadership Training ◽  
Cross Sectional Survey ◽  
Motivation To Lead ◽  
Cross Sectional ◽  
Leadership And Management ◽  
Leadership Pipeline ◽  
Medical Leadership ◽  
Motivation To Participate

PurposeCalls for doctors to enter management are louder as the benefits of medical leadership become clearer. However, supply is not meeting demand. This study asks doctors (physicians): what might encourage you to go into leadership, and what are the disincentives? The same was asked about leadership training. First, the paper tries to understand doctors’ motivation to lead, specifically, to explore the job characteristics that act as incentives and disincentives. Second, the study points to organisational obstacles that further shrink the medical leadership pipeline.MethodDoctors were surveyed through the Organization of Danish Medical Societies. Our key variables included: (1) the incentives and disincentives for doctors of going into leadership and management and (2) the motivation to participate in leadership training. Our sample of 3534 doctors (17% response) is representative of the population of doctors in Denmark.FindingsThe main reason why doctors are motivated towards leadership is to make a difference. They are put off by fears of extra administration, longer hours, burnout, lack of resources and by organisational cultures resistant to change. However, doctors are aware of their need for leadership development prior to entering management.Practical implicationsTo improve succession planning, health systems should adapt to reflect the incentives of their potential medical leaders. Leadership training is also essential. These changes are especially important now; medical leaders are linked positively to organisational and patient outcomes and have been central in responding to COVID-19, stress and burnout among clinical staff continues to rise, and health systems face recruitment and retention challenges.

Developing medical leadership in India: A mission impossible?

BMJ Leader ◽  
2020 ◽  
pp. leader-2020-000217
Author(s):  
Kamal Gulati ◽  
Ian Kirkpatrick
Keyword(s):  
Leadership Development ◽  
Public Sector ◽  
Low Income ◽  
Health Management ◽  
Grey Literature ◽  
Healthcare Management ◽  
Indian Government ◽  
The Public ◽  
Resource Governance ◽  
Medical Leadership

PurposeGlobally, there have been calls to enhance medical leadership in healthcare, although we know little about how this objective has been pursued in low-income middle-income contexts such as India. This paper highlights the opportunities to strengthen leadership in this context, while also considering the obstacles to this change and how they might be overcome.MethodsThe paper draws on a review of available secondary sources including published journal articles in the academic and grey literature, reports published by the Indian government and transnational organisations. The search focused specifically on medical leadership, clinical leadership, management and governance in the Indian healthcare system.FindingsIndia is currently in the throes of the world’s biggest experiment in universal healthcare popularly known as ‘Modicare’. However, these reforms have been criticised with regard to the lack of solid healthcare management framework in the country. The current National Health Policy highlights the need for specialised ‘public health management cadre, human resource governance and leadership development’. Nevertheless, the available research highlights a gap in the research on this topic, specifically about the development of medical leadership competencies. Our findings highlight not only the opportunities to develop medical leadership but also the obstacles to this process. Inadequate training and education, spiralling workloads, low salaries in the public sector and a growing culture of kickbacks have all stifled attempts to engage more doctors in leadership roles.ConclusionsWhile the Indian government is now focusing more on the need to strengthen medical leadership, there are significant barriers to change. In future, building leadership capabilities will require deeper reforms in training, regulation and remuneration of doctors to generate sufficient incentives especially in the public sector.

scholarly journals Self-determining medical leadership needs of occupational health physicians

2017 ◽  
Vol 30 (4) ◽  
pp. 394-410 ◽  
Author(s):  
Prosenjit Giri ◽  
Jill Aylott ◽  
Karen Kilner
Keyword(s):  
Health Care ◽  
Leadership Development ◽  
Leadership Roles ◽  
Leadership Qualities ◽  
Leadership Academy ◽  
Self Assessment ◽  
Leadership And Management ◽  
Content Type ◽  
Management Experience ◽  
Medical Leadership

Purpose The purpose of this study was to explore which factors motivate doctors to engage in leadership roles and to frame an inquiry of self-assessment within Self-Determination Theory (SDT) to identify the extent to which a group of occupational health physicians (OHPs) was able to self-determine their leadership needs, using a National Health Service (NHS) England competency approach promoted by the NHS England Leadership Academy as a self-assessment leadership diagnostic. Medical leadership is seen as crucial to the transformation of health-care services, yet leadership programmes are often designed with a top-down and centrally commissioned “one-size-fits-all” approach. In the UK, the Smith Review (2015) concluded that more decentralised and locally designed leadership development programmes were needed to meet the health-care challenges of the future. However, there is an absence of empirical research to inform the design of effective strategies that will engage and motivate doctors to take up leadership roles, while at the same time, health-care organisations continue to develop formal leadership roles as a way to secure medical leadership engagement. The problem is further compounded by a lack of validated leadership qualities assessment instruments which support researching this problem. Design/Methodology/approach The analysis draws on a sample of about 25 per cent of the total population size of the Faculty of Occupational Medicine (n = 1,000). The questionnaire used was the Leadership Qualities Framework tool as a form of online self-assessment (NHS Leadership Academy, 2012). The data were analysed using descriptive statistics and simple inferential methods. Findings OHPs are open about reporting their leadership strengths and leadership development needs and recognise leadership learning as an ongoing development need regardless of their level of personal competence. This study found that the single most important factor to affect a doctor’s confidence in leadership is their experience in a management role. In multivariate regression, management experience accounted for the usefulness of leadership training, suggesting that doctors learn best through applied “leadership learning” as opposed to theory-driven programmes. Drawing on SDT (Deci and Ryan, 1985; 2000; Ryan and Deci, 2000), this article provides a theoretical framework that helps to understand those doctors who are likely to engage in leadership and management activities in the organisation. More choice and self-determination of medical leadership programmes are likely to result in more relevant leadership learning that builds on doctors’ previous experience in this area. Research limitations/implications While this study benefitted from a large sample size, it was limited to the use of purely quantitative methods. Future studies would benefit from the application of a mixed methodology to combine quantitative data with one-to-one interviews or a focus group. Practical implications This study suggests that doctors are able to determine their own learning needs reliably and that they are more likely to increase their confidence in leadership and management if they are exposed to leadership and management experience. Originality/value This is the first large-scale study of this kind with a large sample within a single medical specialty. The study is considered as insider research, as the first author is an OHP with knowledge of how to engage OHPs in this work.

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

2019 ◽  
Vol 42 (2) ◽  
pp. 359-378 ◽  
Author(s):  
Mathilde A. Berghout ◽  
Lieke Oldenhof ◽  
Wilma K. Scheer ◽  
Carina G. J. M. Hilders
Keyword(s):  
Leadership Development ◽  
Professional Identity ◽  
Development Programme ◽  
Medical Leadership

scholarly journals Mixed-methods evaluation of a leadership development programme for higher specialist trainees

2012 ◽  
Vol 36 (10) ◽  
pp. 386-390
Author(s):  
Christine Healey ◽  
David Fearnley ◽  
Mandy Chivers ◽  
Ovais Wadoo ◽  
Peter Kinderman
Keyword(s):  
Leadership Development ◽  
Qualitative Interviews ◽  
Action Learning ◽  
Development Programme ◽  
Consultant Psychiatrist ◽  
Mixed Methods Evaluation ◽  
Maximum Variance ◽  
Raising Awareness ◽  
Medical Leadership ◽  
The Impact

Aims and methodNewly appointed consultant psychiatrists have reported that management and leadership is an area for which they are unprepared. Our aim was to evaluate the impact of a leadership development programme based on the principles of ‘action learning’ for higher trainees. A questionnaire survey was sent to 54 trainees and consultants who had attended the programme. Qualitative interviews were conducted with 15 participants using the concept of maximum variance sampling.ResultsThe relevance of the topics covered, the opportunity for free discussion and increased understanding of National Health Service policy were rated highest. At the end of a thematic analysis, themes were organised into four major categories: (a) lack of engagement with management during training; (b) the lasting impact of the leadership development programme; (c) understanding the larger organisational context; and (d) transition to consultant psychiatrist.Clinical implicationsThe findings suggest that programmes such as this can be successful in raising awareness and increasing engagement in medical leadership and management.

Evaluating leadership development in postgraduate medical education

2014 ◽  
Vol 27 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Stavros Bekas
Keyword(s):  
Medical Education ◽  
Leadership Development ◽  
Postgraduate Medical Education ◽  
Empirical Literature ◽  
Content Type ◽  
Pedagogical Content ◽  
Leadership Initiatives ◽  
The Uk ◽  
Quality In Healthcare ◽  
Medical Leadership

Purpose – Medical leadership has attracted significant attention over the recent years as one of the factors that could potentially improve quality in healthcare. In response, various stakeholders in UK medical education have been looking into the most efficient ways of developing leadership among trainee doctors and invested in various courses and programmes. This paper aims to briefly set the theoretical basis for evaluating leadership development in postgraduate medical education. Design/methodology/approach – Critical review of available theoretical and empirical literature and review of the content of a number of leadership and management development programmes available to postgraduate trainee doctors in the UK. Findings – This review suggests that programme evaluation can be approached through four different “frames”: their pedagogical content, the conceptualisation and achievement of leadership, the contribution in quality improvement and the consideration of practical aspects that increase engagement and participation. On this basis empirical methodologies of evaluation can be developed. Originality/value – The evaluation of leadership initiatives for medical trainees is an important task that has not been adequately addressed in the literature. This paper provides a theoretical approach to developing more robust methodologies of evaluation.

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