Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital Traci N. Fraser, MD, Daniel M. Blumenthal, MD, MBA, Kenneth Bernard, MD, MBA, and Christiana Iyasere, MD, MBA
Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising secondyear IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents’ gender or previous leadership training and experience. Commonly cited leadership skill needs included “leading a team” (98% of residents), “confronting problem employees” (93%), “coaching and developing others” (93%), and “resolving interpersonal conflict” (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees.
E
ffective clinical leadership is critical to the success of cost control and quality improvement efforts (1). Although no universal definition of leadership exists, effective leaders articulate and build consensus around a vision and empower their team members (2). For physicians in the modern interdisciplinary practice environment, clinical leadership is crucial to health care quality and organizational performance (2). Evidence suggests that leadership training can improve leadership quality (3–5). However, medical schools and residency programs do not emphasize leadership training (2, 6). Moreover, we know little about the leadership development needs of internal medicine (IM) residents, and a paucity of quantitative data exists to guide the development of leadership training programs for them. We report the results of a leadership needs assessment survey of IM residents at an academic medical center.
Proc (Bayl Univ Med Cent) 2015;28(3):317–320
METHODS The Massachusetts General Hospital is a 1057-bed teaching hospital affiliated with Harvard Medical School. The Department of Medicine residency program at Massachusetts General Hospital includes approximately 55 categorical, primary care, and medicine-pediatrics residents in each residency class. A Leadership Needs Assessment Survey (LNAS) was designed by IM residents at Massachusetts General Hospital to characterize residents’ need for and preferences regarding leadership training. Several survey questions were adapted from a previously published needs assessment survey of Dutch IM residents (7). Answers to LNAS questions were structured on a 5-point Likert scale, yes/no, “choose all that apply,” “choose only one,” or free-text format. The LNAS was reviewed by Dr. Eric Campbell, a professor of medicine at Harvard Medical School and an expert in survey design, for face and content validity and by two IM residents for clarity. The LNAS contained questions about resident demographics and leadership experience, perceived need for leadership training, and content and format of desired leadership training. In May 2013 and 2014, we administered surveys to rising junior residents in the categorical, primary care, and combined medicine-pediatrics programs. Participants were given 2 months to respond to the survey, and e-mail reminders were sent bimonthly. To motivate survey participation, participants received a $5 gift card for completing the LNAS. Survey responses were deidentified. We administered all surveys through RED Cap, a secure online data repository (REDCap; Vanderbilt University, Nashville, TN). Data were analyzed using JMP Pro 11 (SAS Inc.; Cary, NC) and Microsoft Excel (Microsoft Inc.; Redmond, WA). We summarized data by count and percentage for categorical outcomes and used the Fisher’s exact test to compare the perceived need for leadership training among subgroups of residents. This study was deemed exempt by our institution’s institutional review board. From the Department of Medicine (Fraser, Blumenthal, Iyasere), Division of Cardiology (Blumenthal), and Department of Emergency Medicine (Bernard), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Corresponding author: Traci Fraser, MD, Massachusetts General Hospital, 55 Fruit Street, GRB 740, Boston, MA 02114 (e-mail: [email protected]).
317
Table 1. Characteristics of 55 survey participants at Massachusetts General Hospital in 2013 and 2014 Characteristic Gender Male Female Residency program Primary care Categorical Medicine-pediatrics Marital status Single Married Time offa Advanced degree MBA or MPH MPP PhD Military training Prior leadership trainingb Through employer During medical school Through college Through extracurricular organization Prior leadership experienceb During medical school During college Led a team Career plansc Basic science Clinical research Clinical fellowship General medical fellowship Health care administration Health policy fellowship Hospitalist Primary care Private industry Translational research Undecided
2013–14 2014–15 interns interns
Total Characteristic
13 (48%) 16 (57%) 29 (53%) 14 (52%) 12 (43%) 26 (47%)
I have a need for training in leadership competencies.
2013–14 interns
2014–15 interns
Total
22 (81%)
22 (79%)
44 (80%)
I would like training in the following competencies: 5 (19%) 7 (25%) 12 (22%) 20 (74%) 19 (68%) 39 (71%) 2 (7%) 2 (7%) 4 (7%) 18 (67%) 9 (33%) 13 (48%) 3 (11%) 0 3 (11%) 0 0 10 (37%) 3 (11%) 3 (11%) 5 (19%) 3 (11%) 22 (81%) 18 (67%) 19 (70%) 20 (74%)
17 (61%) 11 (39%) 16 (57%) 4 (14%) 0 3 (11%) 1 (4%) 0 9 (32%) 3 (11%) 3 (11%) 4 (14%) 4 (14%) 23 (82%) 21 (75%) 20 (71%) 22 (79%)
35 (64%) 20 (36%) 29 (53%) 7 (13%) 0 6 (11%) 1 (2%) 0 19 (35%) 6 (11%) 6 (11%) 9 (16%) 7 (13%) 45 (82%) 39 (71%) 39 (71%) 42 (76%)
4 (15%) 4 (14%) 8 (15%) 8 (30%) 6 (21%) 14 (25%) 19 (70%) 20 (71%) 39 (71%) 4 (15%) 7 (25%) 11 (20%) 2 (7%) 7 (25%) 9 (16%) 4 (15%) 9 (32%) 13 (24%) 6 (22%) 5 (18%) 11 (20%) 5 (19%) 5 (18%) 10 (18%) 1 (4%) 6 (21%) 6 (11%) 2 (7%) 5 (18%) 7 (13%) 3 (11%) 3 (11%) 6 (11%)
a Time
off indicates residents who took at least 1 year off between medical school and residency. b Respondents could check off more than one type of leadership training or experience. The numbers and percentages in “prior leadership training” and “prior leadership experience” rows correspond to the total number of respondents who reported any kind of leadership training or experience. c Respondents were asked to check off all potential career options that they planned to pursue, and many respondents checked more than one response.
RESULTS Fifty-five of 113 eligible residents (49%) completed the survey. While 45 survey respondents (82%) had prior leadership experience, only 6 (11%) had received focused leader318
Table 2. Characteristics of leadership training desired by the 55 survey participants at Massachusetts General Hospital in 2013 and 2014
Leading with purpose
26 (96%)
25 (89%)
51 (93%)
Problem solving
27 (100%) 25 (89%)
52 (95%)
Coaching others
27 (100%) 24 (86%)
51 (93%)
Leading a team
27 (100%) 27 (96%)
54 (98%)
Confronting problem employees
25 (93%)
51 (93%)
26 (93%)
If I were to go through leadership training, I would want the training to occur in the following location: Workplace
24 (89%)
28 (100%) 52 (95%)
Medical school
1 (4%)
4 (14%)
5 (9%)
University
4 (15%)
5 (18%)
9 (16%)
If I were to go through leadership training during residency, I would want the training to occur over the following time period: Intern year Second year
8 (30%)
7 (25%)
15 (27%)
15 (56%)
16 (57%)
31 (56%)
Third year
1 (4%)
2 (7%)
3 (5%)
Any time during residency
2 (7%)
2 (7%)
4 (7%)
If I were to go through leadership training, I would want to be taught by the following people: Physician
24 (89%)
26 (93%)
50 (91%)
Business school professor
11 (41%)
20 (71%)
31 (56%)
Hospital manager
6 (22%)
13 (46%)
19 (35%)
Private industry leader
4 (15%)
13 (46%)
17 (31%)
If I were to go through leadership training, I would want to be taught using the following methods: Health care case discussion
14 (52%)
19 (68%)
33 (60%)
9 (33%)
13 (46%)
22 (40%)
12 (44%)
10 (36%)
22 (40%)
Large group discussion
9 (33%)
14 (50%)
23 (42%)
Small group discussion
20 (74%)
22 (79%)
42 (76%)
Simulation
15 (56%)
20 (71%)
35 (64%)
Role play
6 (22%)
8 (29%)
14 (25%)
Web training
7 (25%)
10 (36%)
17 (31%)
Non–health care case discussion Lectures
ship training in either medical school or residency (Table 1). Forty-eight residents (87%) somewhat or strongly agreed that the quality of clinical leadership impacts the care they deliver, and 44 survey participants (80%) agreed that there is a need for additional formal leadership training. Residents’ perceived need for additional formal leadership training did not vary by gender (P = 0.74), residency track (P = 0.48), receipt of prior leadership training (P = 0.73), or prior leadership experience (P = 0.59).
Baylor University Medical Center Proceedings
Volume 28, Number 3
Figure 1. Internal medicine residents’ self-reported leadership skill needs.
Residents believed that they would benefit from additional training to develop a number of specific leadership skills, including leading a team (98% of residents), coaching and developing others (93%), confronting problem employees (93%), self-management (84%), resolving interpersonal conflict (84%), and understanding different leadership styles (84%) (Figure 1). Respondents preferred a multimodal approach to leadership training that included teaching methods such as small group discussion, case studies, and simulations (Table 2). Over 90% of respondents wanted leadership training to take place in an environment that was convenient to access from work and for sessions to be taught by a physician rather than a business school professor, hospital manager, or private industry leader. Fifty-six percent of residents preferred to go through leadership training during the second year of residency, while 15% wanted training to occur during internship. DISCUSSION To our knowledge, ours is the first published documentation of US IM residents’ leadership training needs. Most survey respondents agreed that the quality of clinical leadership impacts clinical care quality and affirmed a need for additional formal leadership training during residency. A review of the literature indicates that this need is not met by traditional teaching methods at our institution or by the majority of medical schools or residency programs around the country (2). Our results also indicated that leadership experiences and formal leadership training prior to entering residency may not obviate IM residents’ needs for leadership training and may not adequately prepare them for the leadership roles that they assume as practicing clinicians. For example, while IM residents in most training programs, including ours, lead clinical teams, 98% of residents surveyed reported a need for focused team leadership training. This result raises questions about whether July 2015
or not trainees have been equipped with the nonclinical (i.e., managerial) skills necessary to effectively lead clinical teams. Survey respondents may have been more interested in learning about leadership from physicians—rather than from business school professors (content experts) or managers of hospitals or private corporations—for a few reasons. First, physicians may better understand the particular leadership challenges faced by IM trainees and are more likely to have the clinical experience necessary to teach residents to apply leadership skills in clinical settings. Second, residents may feel more comfortable around, and learning from, other physicians. Our findings also have significant implications for the design of effective leadership development interventions. For example, while residents may prefer to learn about leadership from other physicians, many physicians lack experience teaching leadership, so curriculum development may require collaboration with content experts. In addition, IM residents appear to prefer that leadership training take place during the second year of residency and in an environment that is convenient to access from work. Successful implementation of leadership training programs therefore requires a commitment from residency program administrators in order to coordinate residents’ schedules and meeting locations. This analysis has a number of limitations. Our analysis may have been underpowered to identify associations between resident characteristics and specific leadership training needs. Selection bias may have been introduced by the low response rate, as residents who were more interested in leadership training may have been more likely to complete the survey. Moreover, our findings may not be generalizable to attending physicians, residents at other institutions, or specialties other than IM. While our survey was determined to have good content and face validity, it has not undergone assessments of criterion or content validity.
Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital
319
Bohmer RMJ. Designing Care. Boston: Harvard Business Press, 2009:22– 23, 173–174. 2. Blumenthal DM, Bernard K, Bohnen J, Bohmer R. Addressing the leadership gap in medicine: residents’ need for systematic leadership development training. Acad Med 2012;87(4):513–522. 3. Donnithorne LR. The West Point Way of Leadership: From Learning Principled Leadership to Practicing It. New York: Doubleday, 1993: 1–85. 4. Snook SA. Leader(ship) Development. Boston: Harvard Business School Publishing, 2008. 1.
5.
6.
7.
Stoller JK, Rose M, Lee R, Dolgan C, Hoogwerf BJ. Teambuilding and leadership training in an internal medicine residency training program. J Gen Intern Med 2004;19(6):692–697. Ackerly DC, Sangvai DG, Udayakumar K, Shah BR, Kalman NS, Cho AH, Schulman KA, Fulkerson WJ Jr, Dzau VJ. Training the next generation of physician-executives: an innovative residency pathway in management and leadership. Acad Med 2011;86(5):575–579. Brouns JW, Berkenbosch L, Ploemen-Suijker FD, Heyligers I, Busari JO. Medical residents’ perceptions of the need for management education in the postgraduate curriculum: a preliminary study. Int J Med Educ 2010;1:76–82.
Avocations
Easter lily. Photo copyright © Rolando M. Solis, MD. Dr. Solis (e-mail: [email protected]) is an interventional cardiologist with Baylor Scott and White Health and practices at Baylor Medical Center at Garland and The Heart Hospital Baylor Plano.
320
Baylor University Medical Center Proceedings
Volume 28, Number 3
Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising secondyear IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents’ gender or previous leadership training and experience. Commonly cited leadership skill needs included “leading a team” (98% of residents), “confronting problem employees” (93%), “coaching and developing others” (93%), and “resolving interpersonal conflict” (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees.
E
ffective clinical leadership is critical to the success of cost control and quality improvement efforts (1). Although no universal definition of leadership exists, effective leaders articulate and build consensus around a vision and empower their team members (2). For physicians in the modern interdisciplinary practice environment, clinical leadership is crucial to health care quality and organizational performance (2). Evidence suggests that leadership training can improve leadership quality (3–5). However, medical schools and residency programs do not emphasize leadership training (2, 6). Moreover, we know little about the leadership development needs of internal medicine (IM) residents, and a paucity of quantitative data exists to guide the development of leadership training programs for them. We report the results of a leadership needs assessment survey of IM residents at an academic medical center.
Proc (Bayl Univ Med Cent) 2015;28(3):317–320
METHODS The Massachusetts General Hospital is a 1057-bed teaching hospital affiliated with Harvard Medical School. The Department of Medicine residency program at Massachusetts General Hospital includes approximately 55 categorical, primary care, and medicine-pediatrics residents in each residency class. A Leadership Needs Assessment Survey (LNAS) was designed by IM residents at Massachusetts General Hospital to characterize residents’ need for and preferences regarding leadership training. Several survey questions were adapted from a previously published needs assessment survey of Dutch IM residents (7). Answers to LNAS questions were structured on a 5-point Likert scale, yes/no, “choose all that apply,” “choose only one,” or free-text format. The LNAS was reviewed by Dr. Eric Campbell, a professor of medicine at Harvard Medical School and an expert in survey design, for face and content validity and by two IM residents for clarity. The LNAS contained questions about resident demographics and leadership experience, perceived need for leadership training, and content and format of desired leadership training. In May 2013 and 2014, we administered surveys to rising junior residents in the categorical, primary care, and combined medicine-pediatrics programs. Participants were given 2 months to respond to the survey, and e-mail reminders were sent bimonthly. To motivate survey participation, participants received a $5 gift card for completing the LNAS. Survey responses were deidentified. We administered all surveys through RED Cap, a secure online data repository (REDCap; Vanderbilt University, Nashville, TN). Data were analyzed using JMP Pro 11 (SAS Inc.; Cary, NC) and Microsoft Excel (Microsoft Inc.; Redmond, WA). We summarized data by count and percentage for categorical outcomes and used the Fisher’s exact test to compare the perceived need for leadership training among subgroups of residents. This study was deemed exempt by our institution’s institutional review board. From the Department of Medicine (Fraser, Blumenthal, Iyasere), Division of Cardiology (Blumenthal), and Department of Emergency Medicine (Bernard), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Corresponding author: Traci Fraser, MD, Massachusetts General Hospital, 55 Fruit Street, GRB 740, Boston, MA 02114 (e-mail: [email protected]).
317
Table 1. Characteristics of 55 survey participants at Massachusetts General Hospital in 2013 and 2014 Characteristic Gender Male Female Residency program Primary care Categorical Medicine-pediatrics Marital status Single Married Time offa Advanced degree MBA or MPH MPP PhD Military training Prior leadership trainingb Through employer During medical school Through college Through extracurricular organization Prior leadership experienceb During medical school During college Led a team Career plansc Basic science Clinical research Clinical fellowship General medical fellowship Health care administration Health policy fellowship Hospitalist Primary care Private industry Translational research Undecided
2013–14 2014–15 interns interns
Total Characteristic
13 (48%) 16 (57%) 29 (53%) 14 (52%) 12 (43%) 26 (47%)
I have a need for training in leadership competencies.
2013–14 interns
2014–15 interns
Total
22 (81%)
22 (79%)
44 (80%)
I would like training in the following competencies: 5 (19%) 7 (25%) 12 (22%) 20 (74%) 19 (68%) 39 (71%) 2 (7%) 2 (7%) 4 (7%) 18 (67%) 9 (33%) 13 (48%) 3 (11%) 0 3 (11%) 0 0 10 (37%) 3 (11%) 3 (11%) 5 (19%) 3 (11%) 22 (81%) 18 (67%) 19 (70%) 20 (74%)
17 (61%) 11 (39%) 16 (57%) 4 (14%) 0 3 (11%) 1 (4%) 0 9 (32%) 3 (11%) 3 (11%) 4 (14%) 4 (14%) 23 (82%) 21 (75%) 20 (71%) 22 (79%)
35 (64%) 20 (36%) 29 (53%) 7 (13%) 0 6 (11%) 1 (2%) 0 19 (35%) 6 (11%) 6 (11%) 9 (16%) 7 (13%) 45 (82%) 39 (71%) 39 (71%) 42 (76%)
4 (15%) 4 (14%) 8 (15%) 8 (30%) 6 (21%) 14 (25%) 19 (70%) 20 (71%) 39 (71%) 4 (15%) 7 (25%) 11 (20%) 2 (7%) 7 (25%) 9 (16%) 4 (15%) 9 (32%) 13 (24%) 6 (22%) 5 (18%) 11 (20%) 5 (19%) 5 (18%) 10 (18%) 1 (4%) 6 (21%) 6 (11%) 2 (7%) 5 (18%) 7 (13%) 3 (11%) 3 (11%) 6 (11%)
a Time
off indicates residents who took at least 1 year off between medical school and residency. b Respondents could check off more than one type of leadership training or experience. The numbers and percentages in “prior leadership training” and “prior leadership experience” rows correspond to the total number of respondents who reported any kind of leadership training or experience. c Respondents were asked to check off all potential career options that they planned to pursue, and many respondents checked more than one response.
RESULTS Fifty-five of 113 eligible residents (49%) completed the survey. While 45 survey respondents (82%) had prior leadership experience, only 6 (11%) had received focused leader318
Table 2. Characteristics of leadership training desired by the 55 survey participants at Massachusetts General Hospital in 2013 and 2014
Leading with purpose
26 (96%)
25 (89%)
51 (93%)
Problem solving
27 (100%) 25 (89%)
52 (95%)
Coaching others
27 (100%) 24 (86%)
51 (93%)
Leading a team
27 (100%) 27 (96%)
54 (98%)
Confronting problem employees
25 (93%)
51 (93%)
26 (93%)
If I were to go through leadership training, I would want the training to occur in the following location: Workplace
24 (89%)
28 (100%) 52 (95%)
Medical school
1 (4%)
4 (14%)
5 (9%)
University
4 (15%)
5 (18%)
9 (16%)
If I were to go through leadership training during residency, I would want the training to occur over the following time period: Intern year Second year
8 (30%)
7 (25%)
15 (27%)
15 (56%)
16 (57%)
31 (56%)
Third year
1 (4%)
2 (7%)
3 (5%)
Any time during residency
2 (7%)
2 (7%)
4 (7%)
If I were to go through leadership training, I would want to be taught by the following people: Physician
24 (89%)
26 (93%)
50 (91%)
Business school professor
11 (41%)
20 (71%)
31 (56%)
Hospital manager
6 (22%)
13 (46%)
19 (35%)
Private industry leader
4 (15%)
13 (46%)
17 (31%)
If I were to go through leadership training, I would want to be taught using the following methods: Health care case discussion
14 (52%)
19 (68%)
33 (60%)
9 (33%)
13 (46%)
22 (40%)
12 (44%)
10 (36%)
22 (40%)
Large group discussion
9 (33%)
14 (50%)
23 (42%)
Small group discussion
20 (74%)
22 (79%)
42 (76%)
Simulation
15 (56%)
20 (71%)
35 (64%)
Role play
6 (22%)
8 (29%)
14 (25%)
Web training
7 (25%)
10 (36%)
17 (31%)
Non–health care case discussion Lectures
ship training in either medical school or residency (Table 1). Forty-eight residents (87%) somewhat or strongly agreed that the quality of clinical leadership impacts the care they deliver, and 44 survey participants (80%) agreed that there is a need for additional formal leadership training. Residents’ perceived need for additional formal leadership training did not vary by gender (P = 0.74), residency track (P = 0.48), receipt of prior leadership training (P = 0.73), or prior leadership experience (P = 0.59).
Baylor University Medical Center Proceedings
Volume 28, Number 3
Figure 1. Internal medicine residents’ self-reported leadership skill needs.
Residents believed that they would benefit from additional training to develop a number of specific leadership skills, including leading a team (98% of residents), coaching and developing others (93%), confronting problem employees (93%), self-management (84%), resolving interpersonal conflict (84%), and understanding different leadership styles (84%) (Figure 1). Respondents preferred a multimodal approach to leadership training that included teaching methods such as small group discussion, case studies, and simulations (Table 2). Over 90% of respondents wanted leadership training to take place in an environment that was convenient to access from work and for sessions to be taught by a physician rather than a business school professor, hospital manager, or private industry leader. Fifty-six percent of residents preferred to go through leadership training during the second year of residency, while 15% wanted training to occur during internship. DISCUSSION To our knowledge, ours is the first published documentation of US IM residents’ leadership training needs. Most survey respondents agreed that the quality of clinical leadership impacts clinical care quality and affirmed a need for additional formal leadership training during residency. A review of the literature indicates that this need is not met by traditional teaching methods at our institution or by the majority of medical schools or residency programs around the country (2). Our results also indicated that leadership experiences and formal leadership training prior to entering residency may not obviate IM residents’ needs for leadership training and may not adequately prepare them for the leadership roles that they assume as practicing clinicians. For example, while IM residents in most training programs, including ours, lead clinical teams, 98% of residents surveyed reported a need for focused team leadership training. This result raises questions about whether July 2015
or not trainees have been equipped with the nonclinical (i.e., managerial) skills necessary to effectively lead clinical teams. Survey respondents may have been more interested in learning about leadership from physicians—rather than from business school professors (content experts) or managers of hospitals or private corporations—for a few reasons. First, physicians may better understand the particular leadership challenges faced by IM trainees and are more likely to have the clinical experience necessary to teach residents to apply leadership skills in clinical settings. Second, residents may feel more comfortable around, and learning from, other physicians. Our findings also have significant implications for the design of effective leadership development interventions. For example, while residents may prefer to learn about leadership from other physicians, many physicians lack experience teaching leadership, so curriculum development may require collaboration with content experts. In addition, IM residents appear to prefer that leadership training take place during the second year of residency and in an environment that is convenient to access from work. Successful implementation of leadership training programs therefore requires a commitment from residency program administrators in order to coordinate residents’ schedules and meeting locations. This analysis has a number of limitations. Our analysis may have been underpowered to identify associations between resident characteristics and specific leadership training needs. Selection bias may have been introduced by the low response rate, as residents who were more interested in leadership training may have been more likely to complete the survey. Moreover, our findings may not be generalizable to attending physicians, residents at other institutions, or specialties other than IM. While our survey was determined to have good content and face validity, it has not undergone assessments of criterion or content validity.
Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital
319
Bohmer RMJ. Designing Care. Boston: Harvard Business Press, 2009:22– 23, 173–174. 2. Blumenthal DM, Bernard K, Bohnen J, Bohmer R. Addressing the leadership gap in medicine: residents’ need for systematic leadership development training. Acad Med 2012;87(4):513–522. 3. Donnithorne LR. The West Point Way of Leadership: From Learning Principled Leadership to Practicing It. New York: Doubleday, 1993: 1–85. 4. Snook SA. Leader(ship) Development. Boston: Harvard Business School Publishing, 2008. 1.
5.
6.
7.
Stoller JK, Rose M, Lee R, Dolgan C, Hoogwerf BJ. Teambuilding and leadership training in an internal medicine residency training program. J Gen Intern Med 2004;19(6):692–697. Ackerly DC, Sangvai DG, Udayakumar K, Shah BR, Kalman NS, Cho AH, Schulman KA, Fulkerson WJ Jr, Dzau VJ. Training the next generation of physician-executives: an innovative residency pathway in management and leadership. Acad Med 2011;86(5):575–579. Brouns JW, Berkenbosch L, Ploemen-Suijker FD, Heyligers I, Busari JO. Medical residents’ perceptions of the need for management education in the postgraduate curriculum: a preliminary study. Int J Med Educ 2010;1:76–82.
Avocations
Easter lily. Photo copyright © Rolando M. Solis, MD. Dr. Solis (e-mail: [email protected]) is an interventional cardiologist with Baylor Scott and White Health and practices at Baylor Medical Center at Garland and The Heart Hospital Baylor Plano.
320
Baylor University Medical Center Proceedings
Volume 28, Number 3
