Defining leadership competencies for pediatric critical care fellows: Results of a national needs assessment

Leadership Development Strategies in Interprofessional Healthcare Collaboration: A Rapid Review

Background

Contemporary healthcare practitioners require leadership skills for a variety of professional roles related to improved patient/client outcomes, heightened personal and professional development, as well as strengthened interprofessional collaboration and teamwork.

Objective/Aim

The aim of this study is to systematically catalogue literature on leadership in healthcare practice and education to highlight the leadership characteristics and skills required by healthcare practitioners for collaborative interprofessional service delivery and the leadership development strategies found to be effective.

Methods/Design

A rapid review was conducted. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) diagram shows that the 11 databases, yielded 465 records. A total of 147 records were removed during the initial screening phase. The remaining 318 records were uploaded onto Rayyan, an online collaborative review platform. Following abstract level screening, a further 236 records were removed with 82 records meeting the eligibility criteria at full text level, of which 42 were included in the data extraction. The Mixed Methods Appraisal Tool (MMAT) was used for quality appraisal.

Results

Results showed variability in methodologies used, representing various healthcare disciplines with a range in population size (n = 6 to n = 537). Almost half of the results reported on new programs, with interprofessional collaboration and teamwork being the most frequently mentioned strategies. The training content, strategies used as well as the length of training varied. There were five outcomes which showed positive change, namely skills, knowledge, confidence, attitudes, and satisfaction.

Conclusion

This rapid review provided an evidence-base, highlighted by qualitative, quantitative, and mixed methods research, which presents distinct opportunities for curriculum development by focusing on both content and the methods needed for leadership programs. Anchoring this evidence-base within a systematic search of the extant literature provides increased precision for curriculum development.

Variations in Demonstrated Emotional Intelligence: Trainee to Experienced Faculty Member

OBJECTIVES

To identify differences in emotional intelligence (EI)-related competencies between fellows and faculty in a cohort of pediatric critical care physicians.

DESIGN

Single-center, cross-sectional observation study.

SETTING

Seventy-two-bed multidisciplinary pediatric critical care unit at a quaternary children's hospital (Children's Hospital of Philadelphia, Philadelphia, PA).

SUBJECTS

Forty-seven critical care physicians, including 19 fellows and 28 faculty members, were assessed. A multidisciplinary team of 83 physicians, nurses, and nurse practitioners contributed to the assessments.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

A multirater EI assessment tool (Emotional and Social Competency Inventory 360) was used to measure EI competencies of participating physicians across 12 core competencies. Utilizing a priori scoring definitions, physician EI competencies were classified as strengths or areas for growth. Results were stratified based on provider experience, generating comparisons between fellow and faculty cohorts. Ninety-four percent (177/188) of distributed assessments were completed. Fellow strengths were identified as organization awareness, achievement orientation, and teamwork; areas for growth were influence and emotional self-awareness. Compared with fellows, faculty members demonstrated additional strengths in the domains of adaptability, emotional self-control, coach and mentor, positive outlook, inspirational leadership, and influence.

CONCLUSIONS

This study provides the first characterization of EI competencies among trainees and faculty members using a validated multirater assessment tool. The descriptions of physician EI, based on years of experience, are an important piece of the foundation for future explorations into the advancement of physician EI and effective leadership.

Establishing Competencies for Leadership Development for Postgraduate Internal Medicine Residents

BACKGROUND

Although graduate medical education accrediting bodies recognize the importance of leadership for residents and encourage curricular development, it remains unclear which competencies are most important for early career physicians to possess.

OBJECTIVE

To generate a prioritized list of essential postgraduate leadership competencies to inform best practices for future curricular development.

METHODS

In 2019, we used a Delphi approach, which allows for generation of consensus, to survey internal medicine (IM) physicians in leadership roles with expertise in medical education and/or leadership programming within national professional societies. Panelists ranked a comprehensive list of established leadership competencies for health care professionals, across 3 established domains (character, emotional intelligence, and cognitive skills), on importance for categorical IM residents to perform by the end of residency. Respondents also identified number of content hours and pedagogical format best suited to teach each skill.

RESULTS

Sixteen and 14 panelists participated in Delphi rounds 1 and 2, respectively (88% response rate). Most were female (71%) and senior (64% in practice > 15 years, 57% full professor). All practiced in academic environments and all US regions were represented. The final consensus list included 12 "essential" and 9 "very important" leadership skills across all 3 leadership domains. Emotional intelligence and character domains were equally represented in the consensus list despite being disproportionately underweighted initially. Panelists most frequently recommended content delivery via mentorship/coaching, work-based reflection, and interactive discussion.

CONCLUSIONS

This study's results suggest that postgraduate curricular interventions should emphasize emotional intelligence and character domains of leadership and prioritize coaching, discussion, and reflection for delivery.

Leadership in intensive care: A review

An integrative review of the literature specific to leadership within the intensive care unit was planned to guide future research. Four databases were searched. Study selection was based on predetermined inclusion and exclusion criteria and a quality check was done. Data extraction and synthesis involved developing a preliminary thematic coding framework based on a sample of papers. The coding framework and all selected papers were entered into NVivo software. All papers were then coded to the previously identified themes. Themes were summarised and presented with illustrative quotes highlighting key findings. In total, 1102 relevant quotations were coded across the 28 included papers. Four themes pertaining to leadership were described and analysed: (a) leadership dimensions and discourses; (b) leadership experiences; (c) facilitators and/or barriers to leadership; and (d) leadership outcomes. The literature was found to focus on leader behaviours, as well as the leader dimensions of role allocation, clinical and communication skills and traditional hierarchies. Positive behaviours mentioned included good decision-making, staying calm under pressure and being approachable. Leadership experiences (and outcomes) are typically reported to be positive. Personal individual factors seem the biggest enablers and barriers to leadership within the intensive care unit. Training is considered to be a facilitator of leadership within the intensive care unit. This study highlights the current literature on leadership in intensive care medicine and provides a basis for future research on interventions to improve leadership in the intensive care unit.

Education and Training in Pediatric Cardiac Critical Care: International Perspectives

Pediatric cardiac intensive care is an evolving and maturing field. There have been advances in education and training in recent years, specifically progress toward standardization of curricula, competencies, and certifications. International partnerships have fostered similar advancements in less resourced countries. For all disciplines and levels of expertise, simulation remains a versatile and effective modality in education. Although there is improved standardization for the training of physicians and nurses, the certification process remains undetermined.

Alignment of Preventive Medicine Physicians' Residency Training With Professional Needs

Preventive medicine (PM) physicians promote population-based approaches to health care with training that emphasizes public health, epidemiology, and policy. PM physicians use these skills in varied, often nonclinical, practice settings. PM career diversity challenges educators when designing residency curricula. Input from PM physicians about workforce environments is needed to ensure that residency requirements match skills needed post-residency. Graduates of one PM residency were sent a cross-sectional survey in 2016. Questions included professional experience, importance of 18 Accreditation Council for Graduate Medical Education sub-competencies and 13 leadership/management skills to current position, and residency training adequacy in those sub-competencies/skills. Responses were rated on 3-point Likert scales. Analyses were completed in 2017. Pearson's chi-square tests examined relationships between position type (academic/government) and perception of competencies' importance and training adequacy. Eighty PM physicians responded (46%): 44% worked in academia and 25% in federal/state/local government. Half (53%) were PM board certified. A total of 88% completed clinical residency prior to PM. Thirteen of 18 competencies were important to work, and respondents felt well trained in 16 of 18 competencies. Respondents did not feel well trained in emergency preparedness and surveillance systems during residency and their opinions about the importance of these sub-competencies varied based on where they worked. Respondents rated all 13 leadership/management skills as important, but reported inadequate residency training. In conclusion, respondents rated most Accreditation Council for Graduate Medical Education sub-competencies as important to current work and felt well trained, indicating good alignment between residency training and professional needs. Respondents also reported leadership/management training deficiencies. PM residencies might consider incorporating formal leadership training into curricula.

"Doctor Jazz": Lessons that medical professionals can learn from jazz musicians

BACKGROUND

The worlds of a physician and a jazz musician seem entirely different. Various studies, however, relating the concepts behind jazz music to medical practice and education, have been published. The aim of this essayistic review is to summarize previously described concepts behind jazz music and its required artistic skills that could be translated to medicine, encouraging doctors, medical students and medical educators to see their professional environment from a different perspective.

METHODS

A systematic search was conducted using PubMed, Embase, and ERIC databases, combining keywords with regard to jazz, medicine and medical education. Background information concerning jazz music and several jazz musicians was retrieved through an additional nonsystematic search using Google Scholar.

RESULTS

Lessons with regard to improvisational skills, both in communication with patients and in a technical context, communication skills, leadership, interprofessional teamwork and coping with errors are presented.

CONCLUSIONS

Doctors and medical students could learn various lessons from jazz music performance and jazz musicians. The potential and the possibilities of implementing jazz into the medical curriculum, in order to contribute to the development of professional skills and attitudes of medical students, could be explored further.