Board affiliate pilot: leadership and innovation—creating new opportunities to deliver better patient care

BackgroundLeadership and management have become a key facet of medical training. However, there remains enormous variation in the quality and effectiveness of medical leadership training. This article describes an innovative pilot programme that aimed to prove a new method of developing clinical leaders.MethodsWe undertook a 12-month pilot integrating a doctor in training onto our trust board in a role called the ‘board affiliate’. We collected qualitative and quantitative data throughout our pilot programme.ResultsQualitative data demonstrated a clear positive impact of this role on senior management and clinical staff. Our staff survey results increased from 47.4% to 50.3%. The pilot programme has had such an impact on our organisation that we have expanded the single pilot role into two positions.ConclusionThis pilot programme has demonstrated a new and effective method of developing clinical leaders.

Evaluating the impact of a national strategic leader development programme for UK doctors: myth-busting, mind-changing, mood-enhancing

BackgroundThe drive towards engaging UK doctors in clinical leadership and management has involved many initiatives at various levels.MethodsThis paper reports on the findings of an in-depth evaluation of a national medical leadership programme for doctors in the late stages of specialty or general practitioner (GP) training or have just become consultants or GPs.ResultsThe evaluation clearly demonstrates the impact of this programme and the benefits for the individuals and organisations involved, particularly around stimulating a shift in mood and a major mindset shift in what medical leadership is (and is not) and what they can achieve as medical leaders. The programme structure and activities allowed participants to learn from a range of senior decision-makers about policy and strategic developments and processes. However, the evaluation also highlighted that some pervasive myths still exist around medical leadership and management which, if not addressed, will hamper efforts to fully engage doctors in taking on strategic leadership roles.ConclusionClinical leadership programmes are valuable, but must be carefully managed to extract the full value from them.

Mind the gap: thoughts on intergenerational relations in medical leadership

Numerous models categorize, characterize, and explain differences among generations in society. Currently, four distinct generations are engaged in the physician pipeline from early training to late career. The distinct differences in how they view the world, their self-perceptions, and how they conduct relationships create real and imagined tensions. However, the significance of these differences is debated, as variability among those within a generation is likely larger than that between generations. Nevertheless, medical leaders and educators will be wise to develop an appreciation for generational differences to ensure that everyone may live up to their full potential. Opportunities exist to gain greater appreciation for how generational differences manifest in day-to-day interactions, adopt new approaches to interacting with those of different generations, and identify points of leverage across generations to optimize relationships and outcomes.

How full is the glass? A perspective on women in medical leadership in Canada

What do we really know about the representation of female physicians in medical leadership in Canada? Female representation on the current boards of the Canadian Medical Association and provincial/territorial medical associations is 23% and 40%, respectively. Identified barriers to female medical leadership include gendered organizational and workplace culture, gender bias, inflexible work practices, unequal childcare and domestic responsibilities, and biased performance assessment criteria and recruitment practices. Identified enablers include flexible tenure policies, systematic parental leave policies, greater inclusivity in the workplace, and formal mentorship structures. More has been written about the costs of leadership for female physicians rather than the benefits.

Evidence-based Medical Leadership Development: A Systematic Review

1Alexander Mafi, 2Oscar Lyons, 3Robynne George, 4Joao Galante, 5Thomas Fordwoh, 6Jan Frich,7Jaason Geerts 1University of Oxford, UK, 2University of Oxford, UK, 3Royal United Hospital Bath NHS Trust,4Oxford University Hospitals NHS Trust, UK, 5University of Oxford, UK, 6University of Oslo,Norway, 7Canadian College of Health Leaders, Ottawa, Canada Health systems invest significant resources in leadership development for physicians and other health professionals. Competent leadership is considered vital for maintaining and improving quality and patient safety. We carried out this systematic review to synthesise new empirical evidence regarding medical leadership development programme factors which are associated with outcomes at the clinical and organisational levels. 117 studies were included in this systematic review. 28 studies met criteria for higher reliability studies. The median critical appraisal score according to the Medical Education Research Study Quality Instrument for quantitative studies was 8.5/18 and the median critical appraisal score according to the Jonna Briggs Institute checklist for qualitative studies was 3/10. There were recurring causes of low study quality scores related to study design, data analysis and reporting. There was considerable heterogeneity in intervention design and evaluation design. Programmes with internal or mixed faculty were significantly more likely to report organisational outcomes than programmes with external faculty only (p=0.049). Project work and mentoring increased the likelihood of organisational outcomes. No leadership development content area was particularly associated with organisational outcomes. In leadership development programmes in healthcare, external faculty should be used to supplement in-house faculty and not be a replacement for in-house expertise. To facilitate organisational outcomes, interventions should include project work and mentoring. Educational methods appear to be more important for organisational outcomes than specific curriculum content. Improving evaluation design will allow educators and evaluators to more effectively understand factors which are reliably associated with organisational outcomes of leadership development.