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Bellomo TR, Reikersdorfer K, Grobman B, Lella SK, Zacharias N, Abai B, Slaw K, Garcia-Toca M. A Comprehensive Analysis of Leadership Attributes, Discrepancies, and Implications for Gender Equity in Vascular Surgery. J Vasc Surg 2024:S0741-5214(24)01236-9. [PMID: 38838967 DOI: 10.1016/j.jvs.2024.05.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/23/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE Well-developed leadership skills have been associated with a better understanding of healthcare context, increased team performance, and improved patient outcomes. Surgeons, in particular, stand to benefit from leadership development. While studies have focused on investigating knowledge gaps and needs of surgeons in leadership roles, there is a noticeable gap in the literature concerning leadership in Vascular Surgery. The goal of this study was to characterize current leadership attributes of vascular surgeons and understand demographic influences on leadership patterns. METHODS This retrospective cohort study was a descriptive analysis of vascular surgeons and their observers who took the leadership practice inventory (LPI) from 2020 to 2023. The LPI is a 30 question inventory that measures the frequency of specific leadership behaviors across five practices of leadership. RESULTS A total of 110 vascular surgeons completed the LPI. The majority of participants were white (56%) and identified as male (60%). Vascular surgeons most frequently observed the "enabling others to act" leadership practice style (8.90 ± 0.74) by all evaluators. Vascular surgeons were most frequently above the 70th percentile in the "challenge the process" leadership practice style (49%) compared to the average of other leaders world-wide. Observers rated vascular surgeons as displaying significantly more frequent leadership behaviors than vascular surgeons rated themselves in every leadership practice style (P-value < 0.01). The only demographic variable associated with a significantly increased occurrence of achieving 70th percentile across all five leadership practice styles was the male gender: a multivariable model adjusting for objective experience showed men were at least 3.5 times more likely to be rated above the 70th percentile than women. CONCLUSIONS Vascular surgeons under report the frequency at which they practice leadership skills across all five leadership practice styles and should recognize their strengths of enabling others to act and challenging the process. Men are recognized as exhibiting all five leadership practices more frequently than women, regardless of current position or experience level. This observation may reflect the limited leadership positions available for women, thereby restricting their opportunities to demonstrate leadership practices as frequently or recognizably as their male counterparts.
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Affiliation(s)
- Tiffany R Bellomo
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Massachusetts General Hospital, Boston, MA.
| | | | - Benjamin Grobman
- Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Srihari K Lella
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Nikolaos Zacharias
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Babak Abai
- Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Ken Slaw
- Society for Vascular Surgery, Rosemont, IL
| | - Manuel Garcia-Toca
- Division of Vascular Surgery and Endovascular Therapy, Emory University School of Medicine, Atlanta, GA
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Ma AC, Hu J, Zheng E, Levine JS, Schwaitzberg SD, Guo WA. The Changing Faces of Leadership in Surgery: Study on Presidents of Major Surgical Organizations. J Surg Res 2024; 295:340-349. [PMID: 38061239 DOI: 10.1016/j.jss.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/04/2023] [Accepted: 11/09/2023] [Indexed: 02/25/2024]
Abstract
INTRODUCTION To gain an understanding of the changing faces of leadership in surgery, we examined trends in the demographics, additional degrees pursued, and scientific publication characteristics of the past presidents of three major surgery organizations. METHODS We queried the BoardCertifiedDocs and Web of Science databases for the demographics, as well as the quantity and quality of publications, of the past presidents of the Association for Academic Surgery, Society of University Surgeons, and American College of Surgeons from 1970 to 2020. Data were analyzed by decade to identify any trends. RESULTS We identified a total of 140 presidents from the organizations. The proportion of female presidents significantly increased from the 1990s to the 2010s (10% versus 33%, P < 0.05). The percentage of non-White presidents increased from the 1970s to the 2010s (3.33% versus 21.2%, P = 0.024). The percentage of presidents with additional degrees also increased from the 1970s to the 2010s (10.0% versus 48.8%, P = 0.039). During this same time period, the most common area of expertise of presidents shifted from cardiothoracic surgery to surgical oncology. The ratio of presidents' postinduction to preinduction publications was significantly increased among all three organizations in the 2010s compared to the 1970s (P < 0.05). Co-cluster analysis revealed a research topic change from the 1970s to the 2010s. CONCLUSIONS The faces of surgical leadership have changed in terms of gender equality, racial diversity, surgical subspecialty, and additional degrees held. Such a transformation mirrors evolving diversity, equity, and inclusion initiatives, and it further highlights the adaptability of surgical leadership to the ever-changing landscape of surgery.
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Affiliation(s)
- Alison C Ma
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Jinwei Hu
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Erika Zheng
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Jordan S Levine
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Steven D Schwaitzberg
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Weidun Alan Guo
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.
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Gogalniceanu P, Kunduzi B, Ruckley C, Kaafarani H, Sevdalis N, Mamode N. Surgical leadership in a culture of safety: An inter-professional study of metrics and tools for improving clinical practice. Am J Surg 2024; 228:32-42. [PMID: 37709628 DOI: 10.1016/j.amjsurg.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Leadership in a safety culture environment is essential in avoiding patient harm. However, leadership in surgery is not routinely taught or assessed. This study aims to identify a framework, metrics and tools to improve surgical leadership and safety outcomes. METHODS Qualitative interviews were performed with leadership experts from safety-critical professions. Non-probability-based sampling was undertaken in major international airlines. Data underwent thematic analysis and clinical adaptation by multiple surgeon-analysts using the framework method. RESULTS 583 codes were synthesised into 10 themes. Leaders were identified as 'threat and error managers' who placed safety first. Their core attribute was humble confidence. This allowed them to set the tone for high standards of practice, whilst empowering individuals to speak up about safety issues. Safety-oriented leaders assumed complete responsibility and applied their authority discerningly to obtain optimal outcomes. Finally, effective leaders rallied support for their mission by instilling confidence, building collaborations and managing conflict. CONCLUSIONS Surgical leadership requires the ability to manage risk, opportunity and people. The study provides an assessment matrix and deliverable tools for improving surgical safety.
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Affiliation(s)
- Petrut Gogalniceanu
- Guy's and St.Thomas' NHS Foundation Trust, London, UK; King's College London, UK.
| | - Basir Kunduzi
- Guy's and St.Thomas' NHS Foundation Trust, London, UK
| | | | - Haytham Kaafarani
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Al Ameri M, Shanbhag NM. Developing and Implementing Postoperative Pain Management Guidelines for Breast Cancer Surgery: A Leadership Perspective. Cureus 2023; 15:e50951. [PMID: 38143729 PMCID: PMC10741179 DOI: 10.7759/cureus.50951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Persistent postoperative pain significantly diminishes the quality of life in breast cancer patients. Effective pain management post-surgery is critical for patient satisfaction, reducing complications, and facilitating quick recovery and hospital discharge. This study addresses the lack of patient-centered postoperative pain management guidelines for breast cancer patients. Aim The primary goal of this study was to develop tailored postoperative pain management guidelines for the local community in the United Arab Emirates, integrating these into a broader network of oncology facilities. Methods and Materials Employing a mixed-methods approach with a qualitative emphasis, the study gathered data from 10 female breast cancer patients (aged 39-65 years) with postoperative satisfaction surveys. Additionally, semi-structured interviews with six healthcare professionals involved in guideline development were conducted. Results A significant 90% of patients reported experiencing moderate-to-extreme pain post-surgery, indicating a need for improved pain management. Key factors identified included the need for enhanced nurse training and patient education on pain management preoperatively. The study team unanimously recognized the necessity for dedicated postoperative guidelines. Conclusion The study underscores the critical need for adequate postoperative pain management in breast cancer care. The findings advocate for creating multidisciplinary, evidence-based guidelines focused on patient-centered care. Furthermore, the study highlights the importance of international collaboration and continuous quality improvement measures, such as the Plan-Do-Study-Act (PDSA) cycle, for developing and refining these guidelines.
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Affiliation(s)
| | - Nandan M Shanbhag
- Department of Oncology, Tawam Hospital, Al Ain, ARE
- Department of Internal Medicine, United Arab Emirates University, Al Ain, ARE
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Mishra K, Kovoor JG, Gupta AK, Bacchi S, Lai CS, Stain SC, Maddern GJ. Evolving challenges of leadership in surgery to improve inclusivity, representation, and well-being. Br J Surg 2023; 110:1723-1729. [PMID: 37758505 DOI: 10.1093/bjs/znad274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/18/2023] [Accepted: 08/08/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Leadership is a complex and demanding process crucial to maintaining quality in surgical systems of care. Once an autocratic practice, modern-day surgical leaders must demonstrate inclusivity, flexibility, emotional competence, team-building, and a multidisciplinary approach. The complex healthcare environment challenges those in leadership positions. The aim of this narrative review was to consolidate the major challenges facing surgeons today and to suggest evidence-based strategies to support surgical leaders. METHODS Google Scholar, PubMed, MEDLINE, and Ovid databases were searched to review literature on the challenges faced by surgical leaders. The commonly identified areas that compromise inclusivity and productive leadership practices were consolidated into 10 main subheadings. Further research was conducted using the aforementioned databases to outline the importance of addressing such challenges, and to consolidate evidence-based strategies to resolve them. RESULTS The importance of increasing representation of marginalized groups in leadership positions, including women, ethnic groups, the queer community, and ageing professionals, has been identified by surgical colleges in many countries. Leaders must create a collegial environment with proactive, honest communication and robust reporting pathways for victims of workplace harassment. The retention of diverse, empowering, and educating leaders relies on equitable opportunities, salaries, recognition, and support. Thus, it is important to implement formal training and mentorship, burnout prevention, conflict management, and well-being advocacy. CONCLUSION There are two aspects to addressing challenges facing surgical leadership; improving advocacy by and for leaders. Systems must be designed to support surgical leaders through formal education and training, meaningful mentorship programmes, and well-being advocacy, thus enabling them to proactively and productively advocate and care for their patients, colleagues, and professional communities.
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Affiliation(s)
- Kritika Mishra
- Flinders University, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Joshua G Kovoor
- Discipline of Surgery, University of Adelaide, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
| | - Aashray K Gupta
- Discipline of Surgery, University of Adelaide, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Stephen Bacchi
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- University of Adelaide, Adelaide, South Australia, Australia
- Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Christine S Lai
- Discipline of Surgery, University of Adelaide, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
| | - Steven C Stain
- Department of Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Guy J Maddern
- Discipline of Surgery, University of Adelaide, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
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Abstract
BACKGROUND Fellowship directors (FDs) influence the future of trainees in the field of hand surgery. Currently, there are no studies that analyze the demographic background, institutional training, and academic experience of hand surgery FDs. This study aims to serve as a framework to understand the landscape of current leadership positions in hand surgery education and to identify opportunities to improve FD diversity. METHODS The American Society for Surgery of the Hand Fellowship Directory was reviewed to include all hand surgery fellowships in the United States. Collected demographic information regarding FDs included age, sex, ethnicity, residency/fellowship training, residency/fellowship graduation year, year hired by current institution, time since training completion until FD appointment, length in FD role, and H-index. RESULTS Of the 90 FDs included, 86.7% were men and 71.4% self-reported as Caucasian. The average H-index was 13.98 and significantly correlated with age and duration as FD; 71.1% of FDs were trained in orthopedic surgery. The most attended residency program was the University of Pennsylvania; Mayo Clinic and Harvard University were the most represented fellowship programs. CONCLUSION This review reveals specific trends in demographic backgrounds, institutional training, and academic experiences among current FDs in hand surgery. Our observations, such as racial/ethnic and sex disparities, may offer opportunities to improve the representation of the communities these physicians serve. In addition, the trends described in this study provide objective data among current hand surgery FDs and could serve as a guide for individuals who desire academic leadership roles.
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Affiliation(s)
| | | | - Andrew J. Sama
- University of Miami Leonard M. Miller School of Medicine, FL, USA
| | | | | | - Seth D. Dodds
- University of Miami Leonard M. Miller School of Medicine, FL, USA
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Gauly J, Court R, Seers K, Currie G, Grove A. In which context and for whom can interventions improve leadership of surgical trainees, surgeons and surgical teams and why: a realist review protocol. NIHR OPEN RESEARCH 2023; 3:16. [PMID: 37881463 PMCID: PMC10593322 DOI: 10.3310/nihropenres.13364.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 10/27/2023]
Abstract
Background Improving effective leadership of individuals, groups, and healthcare organisations is essential for improving surgical performance and indirectly improving health outcomes for patients. Numerous systematic reviews have been conducted which seek to determine the effectiveness of specific leadership interventions across a range of disciplines and healthcare outcomes. The purpose of this realist review is to systematically synthesise the literature which examines in which context and for whom leadership interventions improve leadership of surgeons, surgical teams, and trainees. Methods Several approaches will be used to iteratively search the scientific and grey literature to identify relevant evidence. Selected articles will inform the development of a programme theory that seeks to explain in which context and for whom interventions can improve leadership of surgical trainees, surgeons, and surgical teams. Next, empirical studies will be searched systematically in order to test and, where necessary, refine the theory. Once theoretical saturation has been achieved, recommendations for advancing leadership in surgery will be developed. Stakeholder and patient and public consultations will contribute to the development of the programme theory. The review will be written up according to the Realist And Meta-narrative Evidence Synthesis: Evolving Standards publication standards. No ethical review will be required for the conduct of this realist review. Discussion The knowledge gained from this review will provide evidence-based guidance for those planning or designing leadership interventions in surgery. The recommendations will help policymakers, educationalists, healthcare providers, and those delivering or planning leadership development programmes across the surgical disciplines to design interventions that are acceptable to the surgical community and successful in improving surgical leadership.PROSPERO registration: CRD42021230709.
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Affiliation(s)
- Julia Gauly
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Rachel Court
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Kate Seers
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Graeme Currie
- Warwick Business School, University of Warwick, Coventry, CV4 7AL, UK
| | - Amy Grove
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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Yang P, Diaz A, Chhabra KR, Byrnes ME, Rajkumar A, Nathan H, Dimick JB. Surgical Leadership Competencies for Navigating Hospital Network Expansion. J Surg Res 2023; 283:76-83. [PMID: 36375265 DOI: 10.1016/j.jss.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/24/2022] [Accepted: 10/18/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Today, many hospitals are part of a multihospital network, which changes the context in which surgeons are asked to lead. This study explores key leadership competencies that surgical leaders use to navigate this hospital network expansion. METHODS In this qualitative study, 30 surgical leaders were interviewed. Interviews were coded and analyzed via thematic analysis. RESULTS We identified three key competencies that leaders felt were important leadership skills to successfully navigate expanding hospital networks. First, leaders must steer the departmental vision within the evolving hospital network landscape. Second, leaders must align the visions of the department and of the hospital network. Third, leaders must build a network-oriented culture within their department. CONCLUSIONS As networks expand, leaders are tasked with unifying vision in their department. Leaders identified a unique opportunity to leverage their growing influence across the hospital network and invested in the people and culture of their department.
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Affiliation(s)
- Phillip Yang
- University of Michigan Medical School, Ann Arbor, Michigan.
| | - Adrian Diaz
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; National Clinician Scholars Program at the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan; Department of Surgery, Ohio State University, Columbus, Ohio
| | - Karan R Chhabra
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; National Clinician Scholars Program at the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Mary E Byrnes
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, Michigan Medicine, Ann Arbor, Michigan
| | | | - Hari Nathan
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, Michigan Medicine, Ann Arbor, Michigan
| | - Justin B Dimick
- Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, Michigan Medicine, Ann Arbor, Michigan
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Vallejo FA, Schachner B, VanderVeer-Harris N, Torres AA, Weng J, Chang H, Bollo R, Ragheb J. A snapshot of contemporary leadership at pediatric neurosurgery fellowships. J Neurosurg Pediatr 2022; 30:532-537. [PMID: 36087318 DOI: 10.3171/2022.7.peds22133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/25/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Many pathways to positions of leadership exist within pediatric neurological surgery. The authors sought to investigate common trends in leadership among pediatric neurosurgery fellowship directors (FDs) and describe how formalized pediatric neurosurgical training arrived at its current state. METHODS Fellowship programs were identified using the Accreditation Council for Pediatric Neurosurgery Fellowships website. Demographic, training, membership, and research information was collected via email, telephone, curricula vitae, and online searches. RESULTS The authors' survey was sent to all 35 identified FDs, and 21 responses were received. Response data were supplemented with curricula vitae and online data prior to analysis. FDs were predominantly male, self-identified predominantly as Caucasian, and had a mean age of 53 years. The mean duration from residency graduation until FD appointment was 13.4 years. The top training programs to produce future FDs were New York University and Washington University in St. Louis (residency) and Washington University in St. Louis (fellowship). CONCLUSIONS This study characterizes the current state of pediatric neurosurgery fellowship program leadership. The data serve as an important point of reference to compare with future leadership as well as contrast with neurosurgery and other surgical disciplines in general.
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Affiliation(s)
| | | | | | - Adrian A Torres
- 3Florida State University College of Medicine, Tallahassee, Florida
| | - John Weng
- 3Florida State University College of Medicine, Tallahassee, Florida
| | - Henry Chang
- 1University of Miami Miller School of Medicine, Miami
| | - Robert Bollo
- 4Division of Pediatric Neurosurgery, University of Utah, Salt Lake City, Utah
| | - John Ragheb
- 5Department of Neurosurgery, University of Miami Miller School of Medicine, Miami; and
- 6Division of Neurosurgery, Brain Institute, Nicklaus Children's Hospital, Miami, Florida
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Kogan LR, Booth M, Rishniw M. Factors that impact recruitment and retention of veterinarians in emergency practice. J Am Vet Med Assoc 2022; 260:1986-1992. [PMID: 36227803 DOI: 10.2460/javma.22.07.0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine factors that impact emergency veterinarians' decisions in selecting a place of employment and their perceptions of factors important in fostering a work environment conducive to long-term employment. SAMPLE 433 Veterinary Information Network members who reported practicing emergency medicine in the US and were not diplomates of the American College of Veterinary Emergency and Critical Care. PROCEDURES An electronic survey distributed via the Veterinary Information Network data collection portal, made available from May 25, 2022, through June 15, 2022. RESULTS Factors rated as most important in selecting a place of employment included working with a highly trained support staff and collegiality of coworkers. Factor analysis was used to extract factors that can influence emergency medicine practitioners' views of a work environment conducive to long-term employment. The factor found to be most important was leadership. All factors, except for professional growth, were rated as more important by female practitioners when compared to male practitioners. CLINICAL RELEVANCE Aspects promoted in emergency medicine veterinarian recruitment efforts should include, in addition to the innate nature of the position, the elements identified as most attractive to current practitioners. By better understanding the impact of gender, children status, and years practicing emergency medicine on the relative importance in creating workplace environments conducive to long term employment, hospitals can be better equipped to meet the needs of both their current employees as well as potential new hires.
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Affiliation(s)
- Lori R Kogan
- 1Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Matthew Booth
- 2NVA Compassion-First Specialty and Emergency Medicine Animal Hospitals, Boulder, CO
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Rana AM, Wiggin H, DeGaetano H, Wallace-Ross J, Jacobs RJ. Formative Evaluation of Using Action Learning in a Master of Medical Education Assessment and Measurement Course. Cureus 2022; 14:e26523. [PMID: 35936138 PMCID: PMC9345774 DOI: 10.7759/cureus.26523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/02/2022] [Indexed: 11/12/2022] Open
Abstract
Background: The future success of any graduate or professional degree program is dependent upon continuous feedback provided by instructors and students. Various teaching models used by medical educators include didactics, problem/case-based learning, small/large group work, distance/online education, simulation, labs, and service/experiential learning. Action Learning is a process “that involves a small group working on real problems, taking action, and learning as individuals, as a team, and as an organization.” Medical school curricula usually begin with a mostly knowledge-based approach to learning the relevant science courses. While it may include some experiential learning, there is limited organized reflection. The idea inherent in Action Learning is “learn while doing” and “reflect on the experience.” This paper reports the process and outcomes of using the Action Learning Model (ALM) in teaching a master’s level assessment and measurement medical education class. Objective: The objective of this quality improvement education study was to ascertain students’ knowledge, skills, and attitudes demonstrated in conducting substantive evaluations using the ALM in a graduate medical education assessment and measurement course. Method: This study was a formative evaluation of a 16-week master’s level medical education assessment and measurement course. The curriculum included teaching the traditional knowledge, skills, and attitudes (KSAs) to conduct formative and summative evaluations in medical education. In addition, students learned applicable quality improvement skills. Specifically, they learned how to identify and work with valid customer (student) requirements, how to map and improve processes, and how to collect and analyze process data. Students were taught the KSAs while conducting a formative evaluation of the class as their major project. They evaluated the class they were taking while reflecting on the experience. In addition to the ALM, the course incorporated both the Bloom Taxonomy (a hierarchical framework for cognition and learning objectives) and the Kirkpatrick Model (a globally recognized method of evaluating the results of training and learning programs). The one-sample significance test was used to evaluate the median of the difference between the pre-and post-test groups. Descriptive statistics were also performed. Results: Nine students who were medical students, dental students, physicians, and simulation lab technicians participated in the course. Students learned medical education assessment and measurement of knowledge, skills, and attitudes (KSAs) and experienced the process of performing a formative evaluation. The post-test results for all students combined revealed that 277 of the 450 (61.6%) data points were greater than zero. A total of 139 data points showed no improvement and 34 results were worse than the pretest. Discussion: The ALM for teaching assessment and measurement in medical education can be challenging, but it may provide a more realistic and rewarding educational experience. The students gained a greater appreciation of the positive and negative aspects of using an experiential approach. Finally, the weekly formative surveys provided regular feedback that led to instructional improvements. With regards to medical education, action learning is best suited for students during the clinical phase of their education.
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Sanders EJ, Wu SA, Neuville AJ, Swiatek PR, Gerlach EB, Saltzman MD, Marra G. Trends in leadership at shoulder and elbow fellowships: a cross-sectional demographic review. J Shoulder Elbow Surg 2022; 31:e92-e100. [PMID: 34543746 DOI: 10.1016/j.jse.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/02/2021] [Accepted: 08/10/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To determine educational characteristics, trends, and demographics among shoulder and elbow fellowship leaders (FLs). BACKGROUND Fellowship leaders in shoulder and elbow impart lasting impact on trainees and field development. Four previous studies have analyzed the characteristics and career path trends among orthopedic surgery subspecialty FLs (spine, adult reconstruction, trauma, and sports medicine). We characterized the educational backgrounds and demographic composition of all 40 FLs including fellowship directors (FD), fellowship co-directors (co-FD), and associate fellowship directors (associate FD) of 31 American Shoulder and Elbow Surgeons (ASES)-accredited shoulder and elbow fellowships in the United States. We additionally compiled the residency and fellowship institutions that trained FLs as framework for aspiring leaders in orthopedic surgery. METHODS Using the American Shoulder and Elbow Surgeons (ASES) directory website page "ASES-Recognized Shoulder and Elbow Fellowship Programs," we identified all active shoulder and elbow fellowships within the United States as well as associated FL identifiers. Compiled data points include age, sex, ethnicity, residency/fellowship training location, time since education completion until FL appointment, length in FL role, personal research Scopus H-index, and major society and journal leadership position history. RESULTS We analyzed data from all 40 active FLs across 31 ASES-accredited shoulder and elbow fellowships, encompassing 26 FDs, 13 co-FDs, and 1 associate FD. The majority of FLs (97.5%) were male whereas 2.5% were female, with racial/ethnic identification of 80.0% Caucasian, 10.0% Asian/Pacific Islander, and 10.0% Middle Eastern. The mean Scopus H-index of the FLs was 24.63 ± 16.43. The top residency programs for producing future FLs were the University of Pittsburgh, University of Pennsylvania, University of Nebraska/Creighton, Hospital for Special Surgery, and Brown University (all n = 2). The top fellowship programs for producing future FLs were Mayo Clinic (n = 6), Columbia University (n = 6), San Francisco/California Pacific (n = 4), and Washington University in St Louis (n = 4). CONCLUSION Shoulder and elbow fellowship leaders graduate with increased frequency from certain fellowship programs with lesser correlation to residency institutions. Programs demonstrate high retention of prior trainees as future FLs. All FLs are distinguished by high indices of research productivity; however, demographic diversity remains limited, which is comparable to prior orthopedic subspecialty FL investigations.
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Affiliation(s)
- Eric J Sanders
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Scott A Wu
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Alexander J Neuville
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Peter R Swiatek
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Erik B Gerlach
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew D Saltzman
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Guido Marra
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Status Quo: Trends in Diversity and Unique Traits Among Orthopaedic Sports Medicine Fellowship Directors. J Am Acad Orthop Surg 2022; 30:36-43. [PMID: 34197355 DOI: 10.5435/jaaos-d-21-00211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/26/2021] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Fellowship directors (FD) in sports medicine are distinguished leaders and mentors of trainees. There is little literature available regarding their demographics and unique factors and training that have allowed them to rise to their prominent positions. The goal of this study was to identify FDs' demographics, research output, and education with an emphasis on surveying the diversity in these leadership positions. METHODS The Accreditation Council for Graduate Medical Education Public Accreditation Data System was used to identify all accredited and active orthopaedic sports medicine fellowship positions for 2019 to 2020. Primary data points for the FDs included race/ethnicity, age, sex, residency and fellowship training institutions, year of fellowship completion, year of hire at the current institution, year of FD appointment, and H-index. Student t-tests were used to compare FDs who trained at their current institution versus those who did not. Significance was set at P < 0.05. RESULTS The 87 active sports medicine fellowship programs surveyed were led by 86 FDs and 2 co-FDs. One (1.1%) FD was female, whereas 87 (98.9%) were male. The mean age of the 88 total FDs was 54.5 years (n = 81). FDs were predominantly White (n = 75, 85.2%), followed by Asian American (n = 6, 6.8%), African American (n = 3, 3.4%), Middle Eastern (n = 3, 3.4%), and then Hispanic/Latino (n = 1, 1.1%). Certain associations were observed between FDs' residency and fellowship and future leadership positions. The most frequently reported training locations were Hospital for Special Surgery (residency, N = 10) and the Steadman Clinic (Vail) (fellowship, N = 10). The mean H-index was 22.33 ± 16.88, and FDs leading the fellowship where they trained had significantly lower mean H-indices than FDs who were not (12.57 ± 12.57 versus 24.85 ± 17.56, respectively) (P = 0.02). CONCLUSION More diversity is possible among sports medicine FDs, who are prominent leaders. Moreover, certain programs are associated with producing a greater number of FDs.
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Weissman JP, Goedderz C, Mutawakkil MY, Swiatek PR, Gerlach EB, Patel MS, Kadakia AR. Trends in Leadership Within Orthopedic Foot and Ankle Fellowships. FOOT & ANKLE ORTHOPAEDICS 2021; 6:24730114211033299. [PMID: 35097467 PMCID: PMC8702739 DOI: 10.1177/24730114211033299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: No study in the orthopedic literature has analyzed the demographic characteristics or surgical training of foot and ankle fellowship directors (FDs). Our group sought to illustrate demographic trends among foot and ankle fellowship leaders. Methods: The American Orthopaedic Foot & Ankle Society (AOFAS) Fellowship Directory for the 2021 to 2022 program year was queried in order to identify all foot and ankle fellowship leaders at programs currently offering positions in the United States and Canada. Data points gathered included age, sex, race/ethnicity, location of surgical training, time since training completion until FD appointment, length in FD role, and individual research H-index. Results: We identified 68 fellowship leaders, which consisted of 48 FDs and 19 co-FDs. Sixty-five individuals (95.6%) were male, and 3 (4.4%) were female. As regards race/ethnicity, 88.2% of the leadership was Caucasian (n = 60), 7.4% was Asian American (n = 5), 1.5% was Hispanic/Latino (n = 1), and 1.5% was African American (n = 1). The average age was 51.5 years, and the calculated mean Scopus H-index was 15.28. The mean duration from fellowship training to fellowship leader position was 11.23 years. Conclusion: Leaders within foot and ankle orthopedic surgery are characterized by research prowess and experience, but demographic diversity is lacking. Level of Evidence: Level III.
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Affiliation(s)
- Joshua P. Weissman
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Cody Goedderz
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Muhammad Y. Mutawakkil
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Peter R. Swiatek
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Erik B. Gerlach
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Milap S. Patel
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anish R. Kadakia
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Schiller NC, Sama AJ, Spielman AF, Donnally III CJ, Schachner BI, Damodar DM, Dodson CC, Ciccotti MG. Trends in leadership at orthopaedic surgery sports medicine fellowships. World J Orthop 2021; 12:412-422. [PMID: 34189079 PMCID: PMC8223724 DOI: 10.5312/wjo.v12.i6.412] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/05/2021] [Accepted: 06/04/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fellowship directors (FDs) in sports medicine influence the future of trainees in the field of orthopaedics. Understanding the characteristics these leaders share must be brought into focus. For all current sports medicine FDs, our group analyzed their demographic background, institutional training, and academic experience.
AIM To serve as a framework for those aspiring to achieve this position in orthopaedics and also identify opportunities to improve the position.
METHODS Fellowship programs were identified using both the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America Sports Medicine Fellowship Directories. The demographic and educational background data for each FD was gathered via author review of current curriculum vitae (CVs). Any information that was unavailable on CV review was gathered from institutional biographies, Scopus Web of Science, and emailed questionnaires. To ensure the collection of as many data points as possible, fellowship program coordinators, orthopaedic department offices and FDs were directly contacted via phone if there was no response via email. Demographic information of interest included: Age, gender, ethnicity, residency/fellowship training, residency/fellowship graduation year, year hired by current institution, time since training completion until FD appointment, length in FD role, status as a team physician and H-index.
RESULTS Information was gathered for 82 FDs. Of these, 97.5% (n = 80) of the leadership were male; 84.15% (n = 69) were Caucasian, 7.32% (n = 6) were Asian-American, 2.44% (n = 2) were Hispanic and 2.44% (n = 2) were African American, and 3.66% (n = 3) were of another race or ethnicity. The mean age of current FDs was 56 years old (± 9.00 years), and the mean Scopus H-index was 23.49 (± 16.57). The mean calendar years for completion of residency and fellowship training were 1996 (± 15 years) and 1997 (± 9.51 years), respectively. The time since fellowship training completion until FD appointment was 9.77 years. 17.07% (n = 14) of FDs currently work at the same institution where they completed residency training; 21.95% (n = 18) of FDs work at the same institution where they completed fellowship training; and 6.10% (n = 5) work at the same institution where they completed both residency and fellowship training. Additionally, 69.5% (n = 57) are also team physicians at the professional and/or collegiate level. Of those that were found to currently serve as team physicians, 56.14% (n = 32) of them worked with professional sports teams, 29.82% (n = 17) with collegiate sports teams, and 14.04% (n = 8) with both professional and collegiate sports teams. Seven residency programs produced the greatest number of future FDs, included programs produced at least three future FDs. Seven fellowship programs produced the greatest number of future FDs, included programs produced at least four future FDs. Eight FDs (9.75%) completed two fellowships and three FDs (3.66%) finished three fellowships. Three FDs (3.66%) did not graduate from any fellowship training program. The Scopus H-indices for FDs are displayed as ranges that include 1 to 15 (31.71%, n = 26), 15 to 30 (34.15%, n = 28), 30 to 45 (20.73%, n = 17), 45 to 60 (6.10%, n = 5) and 60 to 80 (3.66%, n = 3). Specifically, the most impactful FD in research currently has a Scopus H-index value of 79. By comparison, the tenth most impactful FD in research had a Scopus H-index value of 43 (accessed December 1, 2019).
CONCLUSION This study provides an overview of current sports medicine FDs within the United States and functions as a guide to direct initiatives to achieve diversity equality.
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Affiliation(s)
- Nicholas C Schiller
- Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Andrew J Sama
- Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Amanda F Spielman
- Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Chester J Donnally III
- Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, PA 19107, United States
| | | | - Dhanur M Damodar
- Department of Orthopedic Surgery, University of Miami Hospital, Miami, FL 33316, United States
| | - Christopher C Dodson
- Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Michael G Ciccotti
- Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, PA 19107, United States
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Azoulay D, Eshkenazy R, Pery R, Cordoba M, Haviv Y, Inbar Y, Zisman E, Lahat E, Salloum C, Lim C. The Impact of Establishing a Dedicated Liver Surgery Program at a University-affiliated Hospital on Workforce, Workload, Surgical Outcomes, and Trainee Surgical Autonomy and Academic Output. ANNALS OF SURGERY OPEN 2021; 2:e066. [PMID: 37636559 PMCID: PMC10455269 DOI: 10.1097/as9.0000000000000066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/31/2021] [Indexed: 02/07/2023] Open
Abstract
Objective To detail the implementation of a dedicated liver surgery program at a university-affiliated hospital and to analyze its impact on the community, workforce, workload, complexity of cases, the short-term outcomes, and residents and young faculties progression toward technical autonomy and academic production. Background Due to the increased burden of liver tumors worldwide, there is an increased need for liver centers to better serve the community and facilitate the education of trainees in this field. Methods The implementation of the program is described. The 3 domains of workload, research, and teaching were compared between 2-year periods before and after the implementation of the new program. The severity of disease, complexity of procedures, and subsequent morbidity and mortality were compared. Results Compared with the 2-year period before the implementation of the new program, the number of liver resections increased by 36% within 2 years. The number of highly complex resections, the number of liver resections performed by residents and young faculties, and the number of publications increased 5.5-, 40-, and 6-fold, respectively. This was achieved by operating on more severe patients and performing more complex procedures, at the cost of a significant increase in morbidity but not mortality. Nevertheless, operations during the second period did not emerge as an independent predictor of severe morbidity. Conclusions A new liver surgery program can fill the gap between the demand for and supply of liver surgeries, benefiting the community and the development of the next generation of liver surgeons.
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Affiliation(s)
- Daniel Azoulay
- From the Centre Hépato-Biliaire, Hôpital Universitaire Paul Brousse, AP-HP, Université Paris-Saclay, Villejuif, France
- Department of General Surgery B, Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Rony Eshkenazy
- Department of General Surgery B, Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
- Intensive Care Unit, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Ron Pery
- Department of General Surgery B, Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
- Department of Surgery, Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN
| | - Mordechai Cordoba
- Department of General Surgery B, Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yael Haviv
- Intensive Care Unit, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yael Inbar
- Department of Radiology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Eliyahu Zisman
- Department of Anesthesiology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Eylon Lahat
- Department of General Surgery B, Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Chady Salloum
- From the Centre Hépato-Biliaire, Hôpital Universitaire Paul Brousse, AP-HP, Université Paris-Saclay, Villejuif, France
| | - Chetana Lim
- Department of HPB and Liver Transplantation, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
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Barnes T, Rennie SC. Leadership and surgical training part 2: training toolkit for leadership development during surgical training. ANZ J Surg 2021; 91:1075-1082. [PMID: 33825292 DOI: 10.1111/ans.16777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 11/29/2022]
Abstract
The Royal Australasian College of Surgeons identifies leadership as an everyday surgical skill and one of the 10 key competences expected of surgeons. However, there is limited opportunity for formal leadership training and development prior to becoming a consultant, with surgical leadership curricula within worldwide training programmes often poorly defined. As a consequence of a focus on general professional skill development, rather than specific training and assessment in leadership, observed trainee leadership skills show scope for improvement. Many studies indicate trainees report leadership skills training as beneficial and are receptive to interventions. However, most surgical leadership development courses prepare pre-identified leaders for formal leadership positions rather than developing all surgical trainees leadership skills. Although the recently established Royal Australasian College of Surgeons 'Surgeons as Leaders in Everyday Practice' course helps to fill this gap, it is aimed at consultant surgeons. Most successful leadership development programmes are also longitudinal throughout surgical training and multi-faceted.
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Affiliation(s)
- Tracey Barnes
- Department of General Surgery, Dunedin Hospital, Dunedin, New Zealand.,Department of Surgical Sciences, Dunedin School of Medicine, The University of Otago, Dunedin, New Zealand
| | - Sarah C Rennie
- Education Unit, The University of Otago, Wellington, New Zealand
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18
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Leadership trends among orthopaedic trauma surgery fellowship directors: a cross-sectional demographic review. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000000977] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Belk JW, Littlefield CP, Mulcahey MK, McCarty TA, Schlegel TF, McCarty EC. Characteristics of Orthopaedic Sports Medicine Fellowship Directors. Orthop J Sports Med 2021; 9:2325967120985257. [PMID: 33718502 PMCID: PMC7930510 DOI: 10.1177/2325967120985257] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022] Open
Abstract
Background: No study in the orthopaedic literature has analyzed the demographic
characteristics or surgical training of sports medicine fellowship directors
(FDs). Objective determinations as to what makes a
physician qualified for this leadership position remain unclear; thus, it is
important to identify these qualities as future physicians look to fill
these roles. Purpose: To illustrate characteristics common among sports medicine FDs. Study Design: Cross-sectional study. Methods: The 2020 Accreditation Council for Graduate Medical Education Fellowship
Directory was used to identify the FDs for all orthopaedic sports medicine
fellowship programs in the United States. The characteristics and
educational background data for FDs were gathered by 2 independent reviewers
from up-to-date curricula vitarum, Web of Science, and institutional
biographies and consolidated into 1 database. Data points gathered included
age, sex, residency/fellowship training location and graduation year, name
of current institution, length of time at current institution, time since
training completion until being appointed FD, length of time in current FD
role, and personal research H-index. Results: We identified 90 current orthopaedic sports medicine FDs. The mean Scopus
H-index was 24.1 (median, 17). The mean age of FDs was 55.4 years; 87 of 90
(96.7%) were male and 3 (3.3%) were female; and 79/90 (87.8%) were White and
3/90 (3.3%) were African-American. The mean time to complete residency was
5.1 years (range, 5.0-6.0 years), and the most attended residency programs
were the Hospital for Special Surgery (n = 9), the Harvard Combined
Orthopaedic Residency Program (n = 5), and Duke University Medical Center (n
= 4). The mean time required to complete a fellowship was 1.1 years (range,
1.0-2.0 years), and the fellowship programs that produced the most future
FDs were the American Sports Medicine Institute (n = 11), the Steadman
Hawkins Clinic (Vail) (n = 8), the Kerlan-Jobe Orthopaedic Clinic (n = 7),
and the Hospital for Special Surgery (n = 7). The mean time from completion
of fellowship to appointment as a FD was 12.8 years (range, 1-39 years). Conclusion: Women and minority groups are largely underrepresented among leadership
positions in the field of orthopaedic sports medicine.
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Affiliation(s)
- John W Belk
- Department of Orthopaedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Connor P Littlefield
- Department of Orthopaedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Torrance A McCarty
- Department of Orthopaedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Eric C McCarty
- Department of Orthopaedics, University of Colorado School of Medicine, Aurora, Colorado, USA
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Saha S. Surgical Leadership Training beyond the Traditional Mentorship Model. Indian J Plast Surg 2020; 53:416-418. [PMID: 33402775 PMCID: PMC7775246 DOI: 10.1055/s-0040-1721517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In this article, I reflect on my experience of being awarded the International Resident Travel Scholarship for “Plastic Surgery the Meeting 2019.” I was the first Indian to be awarded the scholarship, and it offered me not only monetary assistance but also mentorship for future leadership positions. The award further opened doors for several future opportunities in the form of memberships in the American Society of Plastic Surgery (ASPS) committees and Resident Advisory Board of the prestigious “Plastic and Reconstructive Surgery Journal.” I believe this article will make more residents aware and utilize such opportunities for their career development.
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Affiliation(s)
- Shivangi Saha
- Department of Plastic Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi, India
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21
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Iannacone E, Gaudino M. In the business and politics of medicine, the time to lead is now, but how? J Card Surg 2020; 35:2461-2463. [PMID: 33043650 DOI: 10.1111/jocs.14765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Erin Iannacone
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York
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Schiller NC, Donnally CJ, Sama AJ, Schachner BI, Wells ZS, Austin MS. Trends in Leadership at Orthopedic Surgery Adult Reconstruction Fellowships. J Arthroplasty 2020; 35:2671-2675. [PMID: 32507452 DOI: 10.1016/j.arth.2020.04.091] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Fellowship directors (FDs) in adult reconstruction have a profound impact on current and future trainees within orthopedics. Our group sought to evaluate the shared characteristics among current adult reconstruction FDs to provide a framework for those aspiring to achieve this position and identify possible areas of improvement. METHODS Fellowship programs were identified using the American Association of Hip and Knee Surgeons Directory. Data for each FD were gathered via electronic mail, telephone, curriculum vitae, and online searches. Demographic information collected included age, gender, ethnicity, residency/fellowship training, residency/fellowship graduation year, year hired by current institution, time since training completion until FD appointment, length in FD role, and Scopus H-index. RESULTS Information was gathered for 94 FDs. Of these, 100% were males; 80.6% were Caucasian, 12.90% were Asian American, 5.38% were Hispanic, and 1.08% were African American. The average age (52.6 years old), H-index (16.54), year of residency (2000) and fellowship (2001) graduation, and time since training until FD appointment (9.55 years) were analyzed. The top training programs to produce future FDs were Mayo Clinic (residency) and Harvard University (fellowship). CONCLUSION Adult reconstruction FDs are frequently distinguished by their level of research productivity and experience, but certainly more demographic diversity is needed within this cohort. Specific training programs may inherently have a vital role in the development of individuals for future leadership positions. These developments could be a result of unique features inherent to the training programs or because of a subset of applicants who pursue specific programs with aspirations of subsequent leadership opportunities.
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Affiliation(s)
- Nicholas C Schiller
- Department of Education, University of Miami Leonard M. Miller School of Medicine, Miami, FL
| | - Chester J Donnally
- Department of Orthopedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, PA
| | - Andrew J Sama
- Department of Education, University of Miami Leonard M. Miller School of Medicine, Miami, FL
| | - Benjamin I Schachner
- Department of Education, University of Miami Leonard M. Miller School of Medicine, Miami, FL
| | - Zachary S Wells
- Department of Orthopedic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Matthew S Austin
- Department of Orthopedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, PA
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Lee TC, Reyna C, Shah SA, Lewis JD. The road to academic surgical leadership: Characteristics and experiences of surgical chairpersons. Surgery 2020; 168:707-713. [PMID: 32660864 DOI: 10.1016/j.surg.2020.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The evolving landscape of academic surgery demands leaders who are not only effective clinicians and researchers, but also administrators able to navigate complex hospital organizations, financial pressures in the era of quality measures, and inclusion of an increasingly diverse workforce. The aim of this study was to characterize achievements and assess perspectives in becoming a surgical chair in order to guide young surgeons in their career trajectories to surgical leadership. METHODS A survey encompassing demographics, surgical training, nonmedical advanced degrees, academic advancement, and leadership experiences was sent via electronic mail to members of the American College of Surgeons Society of Surgical Chairs in December 2018. RESULTS Of 191 Society of Surgical Chairs members, 52 (27.2%) completed the survey, with 6 (11.5%) women, 40 (76.9%) white, and the majority becoming chair between ages 46 and 60 (n = 39, 75.0%). Training beyond residency included fellowships (n = 41, 78.8%) and advanced nonmedical degrees (n = 15, 28.8%). Median H-index was 47 (range 10-120) with 126 (5-500) research publications, and grants received was 2 (0-38) for federal and 5 (0-43) for industry. Female chairs appear to have fewer nonmedical degrees (n = 1) and no difference in age at becoming chair (66.7% vs 79.6% between ages 46 and 60), H-index (26 [10-41] vs 49 [17-120]), or publications (93 [10-189] vs 150 [5,500]). Prior educational (n = 36, 69.2%) and clinical (n = 44, 84.6%) leadership roles were common, with 30 chairs (57.7%) having held both roles. Experiences which respondents felt have most helped them function as chair included serving as a clinical division director (n = 37, 71.2%), residency program director (n = 28, 53.8%), leadership courses (n = 28, 53.8%), a research career (n = 22, 42.3%), and being a vice/interim chair (n = 15, 28.8%). Personal traits felt to be most important in becoming a successful chair included being effective at communication (n = 37, 71.2%), collaborative (n = 35, 67.3%), trustworthy (n = 30, 57.7%), and a problem-solver (n = 27, 51.9%). CONCLUSION Becoming a department surgical chair often involves not only surgical subspecialty expertise, but also nonmedical training and prior leadership roles, which help facilitate development of skills integral to navigating the collaborative and diverse nature of academic surgery in the current era.
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Affiliation(s)
- Tiffany C Lee
- Department of Surgery, University of Cincinnati College of Medicine, OH
| | - Chantal Reyna
- Department of Surgery, University of Cincinnati College of Medicine, OH
| | - Shimul A Shah
- Department of Surgery, University of Cincinnati College of Medicine, OH
| | - Jaime D Lewis
- Department of Surgery, University of Cincinnati College of Medicine, OH.
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Morris MC, Baker JE, Edwards MJ. Surgeons, Scholars, and Leaders Symposium: A 5-Year Experience. Am Surg 2020. [DOI: 10.1177/000313481908501224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Department of Surgery at the University of Cincinnati developed the Surgeons, Scholars, and Leaders Symposium to address the underappreciated aspects of surgical education that are critical in the development of the academic surgeon. Surgical education has undergone many gaps since the beginning of a traditional surgical residency, first pioneered by Dr. Halsted in 1904; still, many gaps in surgical education remain. Topics such as research, financial planning, leadership, career development, and many others are not adequately addressed in formalized training. The Surgeons, Scholars, and Leaders Symposium was first held in January 2015 in Jackson Hole, WY, and has subsequently become an annual event. Recurrent themes addressed at the Symposium include global health, resident autonomy, research program development, leadership, mentorship, career development, and managing transitions. The annual Surgeons, Scholars, and Leaders Symposium has been instrumental in addressing these underappreciated aspects of surgeon development and will continue to be an important venue for the next generation of surgical leaders.
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Affiliation(s)
- Mackenzie C. Morris
- Department of Surgery, Section of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Jennifer E. Baker
- Department of Surgery, Section of General Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Michael J. Edwards
- Department of Surgery, Section of General Surgery, University of Cincinnati, Cincinnati, Ohio
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Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE To illustrate demographic trends among spine fellowship leaders (FLs). SUMMARY OF BACKGROUND DATA No previous study in the orthopedic literature has analyzed the demographic characteristics or past surgical training of FL in an orthopedic sub-specialty. We attempt to illustrate demographic trends among spine fellowship leadership including fellowship directors (FDs) and co-fellowship directors (co-FDs). We also highlight the institutions that have trained these leaders at various levels. METHODS Our search for FDs was constructed from the 2018 to 2019 North American Spine Surgery (NASS) Fellowship Directory. Datapoints gathered included: age, sex, residency/fellowship training location, time since training completion until FD appointment, length in FD role, and personal research H-index. RESULTS We identified 103 FLs consisting of 67 FDs, 19 co-FDs, and another 16 individuals with a synonymous leadership title. 96.1% (99) of the leadership consisted of males while 3.9% (4) were female. The mean age was 52.9 years old and the mean h-index of the FLs was 23.8. FLs were trained in orthopedic surgery (n = 89), neurosurgery (n = 13), or combined orthopedic surgery and neurosurgery training (n = 1). The top fellowships programs producing future FLs were: Case Western Reserve University, Cleveland (n = 10), Washington University, St. Louis (n = 9), and Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia (n = 7). CONCLUSION Spine surgery fellowship directors are more likely to have graduated from certain residency and fellowship programs. This finding could be a result of the training provided by these centers or the institution's predilection to select applicants that are more likely to later seek academic leadership roles post-training. LEVEL OF EVIDENCE 4.
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Sharp G, Bourke L, Rickard MJFX. Review of emotional intelligence in health care: an introduction to emotional intelligence for surgeons. ANZ J Surg 2020; 90:433-440. [PMID: 31965690 DOI: 10.1111/ans.15671] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this review is to explain the components of emotional intelligence (EI) and explore the benefits within today's health care system with an emphasis on surgery. EI is a person's ability to understand their own emotions and those of the individuals they interact with. Higher individual EI has multiple proposed benefits, such as reducing stress, burnout and increasing work satisfaction. The business world recognizes EI as beneficial in terms of performance and outcomes. Could surgeons benefit from being more cognisant of EI and methods of assessing and improving EI to reap the aforementioned benefits? METHODS A search of Embase, Cochrane and Medline databases using the following search terms; emotional intelligen*, surg*, medic* yielded 95 articles. After review of all the literature 39 remaining articles and five text books were included. RESULTS To perform optimally, surgeons must be aware of their own emotions and others. EI differs from IQ and can be taught, learnt and improved upon. EI is measured via validated self-reporting questionnaires and 'multi-rater' assessments. High EI is positively associated with leadership skills in surgeons, non-technical skills, reduction in surgeon stress, burnout and increased job satisfaction, all of which translate to better patient relationships and care. Future implications of EI have been postulated as a measure of performance, a selection tool for training positions and a marker of burnout. EI should be an explicit part of contemporary surgical education and training.
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Affiliation(s)
- Gary Sharp
- Department of General Surgery, Royal Prince Alfred Hospital, Institute of Academic Surgery, Sydney, New South Wales, Australia
| | - Lorna Bourke
- Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Matthew J F X Rickard
- Department of Colorectal Surgery, Concord Hospital, Sydney, New South Wales, Australia.,Discipline of Surgery, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Beasley SW, Smith K, Watters D. What leadership means as a core surgical competence in everyday practice. ANZ J Surg 2020; 90:154-158. [DOI: 10.1111/ans.15640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/29/2019] [Accepted: 12/03/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Spencer W. Beasley
- Department of Paediatric SurgeryChristchurch Hospital and Christchurch School of Medicine, University of Otago Christchurch New Zealand
| | - Kyleigh Smith
- Education DevelopmentPeter MacCallum Cancer Centre Melbourne Victoria Australia
| | - David Watters
- Department of SurgeryDeakin University and Barwon Health Geelong Victoria Australia
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Vu JV, Harbaugh CM, De Roo AC, Biesterveld BE, Gauger PG, Dimick JB, Sandhu G. Leadership-Specific Feedback Practices in Surgical Residency: A Qualitative Study. JOURNAL OF SURGICAL EDUCATION 2020; 77:45-53. [PMID: 31492642 PMCID: PMC6944744 DOI: 10.1016/j.jsurg.2019.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/02/2019] [Accepted: 08/19/2019] [Indexed: 05/12/2023]
Abstract
OBJECTIVE The importance of feedback is well recognized in surgical training. Although there is increased focus on leadership as an essential competency in surgical training, it is unclear whether surgical residents receive effective feedback on leadership performance. We performed an exploratory qualitative study with surgical residents to understand current leadership-specific feedback practices in one surgical training program. DESIGN We conducted semistructured interviews with surgical residents. Using line-by-line coding in an iterative process, we focused on feedback on leadership performance to capture both semantic and conceptual data. SETTING The general surgery residency program at the University of Michigan, a tertiary care, academic institution. PARTICIPANTS Residents were purposively selected to include key informants and comprise a balanced sample with respect to postgraduate year, gender, and race. RESULTS Four major themes were identified during the thematic analysis: (1) the importance of feedback for leadership development in residency; (2) inadequacy of current feedback mechanisms; (3) barriers to giving and receiving leadership-specific feedback; and (4) resident-driven recommendations for better leadership feedback. CONCLUSIONS Many surgical residents do not receive effective leadership feedback, although they express strong desire for formal evaluation of leadership skills. Establishing avenues for feedback on leadership performance will help bridge this gap. Additionally, training to give and receive leadership-specific feedback may improve the quality and incorporation of delivered feedback for developing surgeon-leaders.
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Affiliation(s)
- Joceline V Vu
- Department of Surgery, University of Michigan, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan.
| | - Calista M Harbaugh
- Department of Surgery, University of Michigan, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan
| | - Ana C De Roo
- Department of Surgery, University of Michigan, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan
| | | | - Paul G Gauger
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Justin B Dimick
- Department of Surgery, University of Michigan, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, Ann Arbor, Michigan
| | - Gurjit Sandhu
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
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Watters DA, Smith JA. Being a better surgeon: a multi‐competency challenge. ANZ J Surg 2019; 89:461-463. [DOI: 10.1111/ans.15233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 11/30/2022]
Affiliation(s)
- David A. Watters
- Department of SurgeryGeelong Hospital and Deakin University Geelong Victoria Australia
| | - Julian A. Smith
- Department of SurgeryMonash University Melbourne Victoria Australia
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30
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van Ark AE, Wijnen-Meijer M. "Doctor Jazz": Lessons that medical professionals can learn from jazz musicians. MEDICAL TEACHER 2019; 41:201-206. [PMID: 29688097 DOI: 10.1080/0142159x.2018.1461205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
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.
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Affiliation(s)
- Allard E van Ark
- a Center for Research and Development of Education , University Medical Center Utrecht , Utrecht , The Netherlands
| | - Marjo Wijnen-Meijer
- a Center for Research and Development of Education , University Medical Center Utrecht , Utrecht , The Netherlands
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Abstract
Knowledge management (KM) is the source for creating a sustainable competitive advantage, and it helps the organizations to retain, develop, organize and utilize their knowledge. Due to globalization, the organizations must maintain their knowledge assets to survive. Many organizations have realized the potential of KM and are applying it. Since the healthcare industry is growing significantly, it is continuously generating a wealth of knowledge. This knowledge can be recorded, communicated and used by many health care professionals with the help of KM. There is a wealth of research on KM in healthcare of developed countries, but very few studies regarding KM implementation can be found in developing countries i.e., Pakistan. Pakistan is now looking towards the implementation of KM; it is in its initial stages. The implementation of KM in the healthcare of Pakistan is affected by different barriers. In this study, the barriers will be identified and analyzed. An interrelationship between the barriers will be determined, and how the different barriers support each other (driving power), and how they influence each other (dependence power). The results of interpretive structural modeling (ISM) and MICMAC (Matrice d’Impacts croises-multipication appliqué an classment i.e., cross-impact matrix multiplication applied to classification) approach show that lack of support from top management, insufficient strategic planning and lack of support from organizational structure are the main barriers to KM adoption in the healthcare of Pakistan. This study provides a solution in determining the main barriers that need to be solved first, and to ensure effective implementation of KM in the healthcare of Pakistan.
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32
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Watters DA, Smith K, Tobin S, Beasley SW. Follow the leader: followership and its relevance for surgeons. ANZ J Surg 2018; 89:589-593. [DOI: 10.1111/ans.14912] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 09/19/2018] [Indexed: 11/30/2022]
Affiliation(s)
- David A. Watters
- Department of SurgeryDeakin University and Barwon Health, University Hospital Geelong Melbourne Victoria Australia
| | - Kyleigh Smith
- Education DevelopmentVictorian Comprehensive Cancer Centre Melbourne Victoria Australia
| | - Stephen Tobin
- Department of EducationRoyal Australasian College of Surgeons Melbourne Victoria Australia
| | - Spencer W. Beasley
- Department of Paediatric SurgeryCanterbury District Health Board Christchurch New Zealand
- Department of PaediatricsUniversity of Otago Christchurch New Zealand
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Sanfey H, Schenarts K, Rogers DA, Nagler A, Blair PG, Newman S, Sachdeva AK. Needs Assessment for an American College of Surgeons Certificate in Applied Surgical Education Leadership (CASEL). JOURNAL OF SURGICAL EDUCATION 2018; 75:e112-e119. [PMID: 29945771 DOI: 10.1016/j.jsurg.2018.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Surgeon educators in departments of surgery play key roles in leading and advancing surgical education. Their activities include ensuring sound curricula and evaluation systems, monitoring education resources, overseeing faculty development, and providing mentorship. For more than 25 years, the American College of Surgeons (ACS) has offered a comprehensive "Surgeons as Educators" (SAE) course to address fundamental topics in surgical education. This study aims to identify future career needs of SAE graduates to inform the development of an American College of Surgeons Certificate in Applied Surgical Education Leadership program. DESIGN An IRB exempt, anonymous electronic survey was developed to determine educational roles, career aspirations, and needs of SAE Graduates. SETTING AND PARTICIPANTS Participants included all 763 1993-2016 SAE graduates. RESULTS One hundred and thirty-five responses were received from 600 (22.5%) graduates with valid email addresses. Sixty (45%) respondents completed the SAE Course > 5 years prior to the study (M5YRS) and 75 (55%) within the last 5 years (L5YRS). L5YRS respondents were less likely to be full professors (8% vs. 44%) or to serve as program directors (32% vs. 57%), and more likely to be associate program directors (25% vs. 17%) or clerkship directors (40% vs. 18%). High percentages of both L5YRS and M5YRS reported not pursuing additional educational opportunities post-SAE due to time and fiscal constraints. One-fifth of respondents were unaware of additional opportunities and 19% of M5YRS versus 6% of L5YRS stated that existing programs did not meet their needs. Overall improving skills as educational leaders, developing faculty development programs, and conducting educational research were noted as priorities for future development. Differences were observed between the L5YRS and M5YRS groups. The dominant preferences for course format were full-time face-to-face (41%) or a combination of full-time face-to-face with online modules (24%). The most important considerations in deciding to pursue a certificate course were course content, and interest in advancing career and time constraints. CONCLUSIONS An SAE graduate survey has confirmed the need for additional formal training in surgical education leadership in order to permit surgeon educators meet the demands of the changing landscape of surgical education. The needs of early career faculty may differ from those of more senior surgeon educators.
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Affiliation(s)
- Hilary Sanfey
- Department of Surgery, Southern Illinois University, Springfield, Illinois.
| | - Kimberly Schenarts
- Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska
| | - David A Rogers
- Departments of Faculty Affairs and Professional Development, Surgery, Medical Education, Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama
| | - Alisa Nagler
- Division of Education, American College of Surgeons, Chicago, Illinois
| | | | - Susan Newman
- Division of Education, American College of Surgeons, Chicago, Illinois
| | - Ajit K Sachdeva
- Division of Education, American College of Surgeons, Chicago, Illinois
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Shetty K, Poo SXW, Sriskandarajah K, Sideris M, Malietzis G, Darzi A, Athanasiou T. "The Longest Way Round Is The Shortest Way Home": An Overhaul of Surgical Ward Rounds. World J Surg 2018; 42:937-949. [PMID: 29067515 PMCID: PMC5843677 DOI: 10.1007/s00268-017-4267-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Ward rounds, a keystone of hospital surgical practice, have recently been under the spotlight. Poor-quality ward rounds can lead to a greater number of adverse events, thereby cascading to an increased financial strain on our already burdened healthcare systems. Faced with mounting pressures from both outside and inside health organizations, concerted efforts are required to restore it back into prominence where it can no longer take a backseat to the other duties of a surgeon. Methods The nucleus of this narrative review is derived from an extensive literature search on surgical ward rounds. Results In this review, we focus on the need for reforms, current characteristics of surgical ward rounds, obstacles encountered by competing interests and proposed solutions in delivery of effective ward rounds that can meet with newly laid guidelines. Conclusion Ward rounds should be standardized and prioritized to improve patient care.
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Affiliation(s)
- Kunal Shetty
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Stephanie Xiu Wern Poo
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | | | | | - George Malietzis
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Ara Darzi
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK
| | - Thanos Athanasiou
- Department of Surgery and Cancer, St Mary's Hospital, Imperial College London, London, UK.
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Torbeck L, Rozycki G, Dunnington G. Leaders Growing Leaders: Designing a Tier-Based Leadership Program for Surgeons. JOURNAL OF SURGICAL EDUCATION 2018; 75:947-956. [PMID: 29428368 DOI: 10.1016/j.jsurg.2017.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/19/2017] [Accepted: 12/30/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Leadership has emerged as a crucial component of professional development for physicians in academic medicine. Most leadership skills can be learned and therefore best practices of delivering leadership development are in high demand. For practicing surgeons, specific strategies to teach leadership have been lacking. OBJECTIVE The purpose of this paper is to describe the structure of a tier-based leadership development program called Leaders Growing Leaders, to identify the major curricular components to each tier including measures and outcomes, and to share lessons learned for those who may want to begin a similar leadership development program.
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Affiliation(s)
- Laura Torbeck
- Department of Surgery, Indiana University, Indianapolis, Indiana.
| | - Grace Rozycki
- Department of Surgery, Indiana University, Indianapolis, Indiana
| | - Gary Dunnington
- Department of Surgery, Indiana University, Indianapolis, Indiana
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Turner S, Chan MK, McKimm J, Dickson G, Shaw T. Discipline-specific competency-based curricula for leadership learning in medical specialty training. Leadersh Health Serv (Bradf Engl) 2018; 31:152-166. [PMID: 29771224 DOI: 10.1108/lhs-08-2017-0048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Doctors play a central role in leading improvements to healthcare systems. Leadership knowledge and skills are not inherent, however, and need to be learned. General frameworks for medical leadership guide curriculum development in this area. Explicit discipline-linked competency sets and programmes provide context for learning and likely enhance specialty trainees' capability for leadership at all levels. The aim of this review was to summarise the scholarly literature available around medical specialty-specific competency-based curricula for leadership in the post-graduate training space. Design/methodology/approach A systematic literature search method was applied using the Medline, EMBASE and ERIC (education) online databases. Documents were reviewed for a complete match to the research question. Partial matches to the study topic were noted for comparison. Findings In this study, 39 articles were retrieved in full text for detailed examination, of which 32 did not comply with the full inclusion criteria. Seven articles defining discipline-linked competencies/curricula specific to medical leadership training were identified. These related to the areas of emergency medicine, general practice, maternal and child health, obstetrics and gynaecology, pathology, radiology and radiation oncology. Leadership interventions were critiqued in relation to key features of their design, development and content, with reference to modern leadership concepts. Practical implications There is limited discipline-specific guidance for the learning and teaching of leadership within medical specialty training programmes. The competency sets identified through this review may aid the development of learning interventions and tools for other medical disciplines. Originality/value The findings of this study provide a baseline for the further development, implementation and evaluation work required to embed leadership learning across all medical specialty training programmes.
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Affiliation(s)
- Sandra Turner
- Department of Radiation Oncology, Westmead Hospital, Sydney, Australia
| | - Ming-Ka Chan
- Department of Pediatrics and Child Health, University of Manitoba , Winnipeg, Canada
| | - Judy McKimm
- School of Medicine, Swansea University , Swansea, UK
| | - Graham Dickson
- Centre for Health Leadership and Research, Royal Roads University , Victoria, Canada
| | - Timothy Shaw
- Charles Perkins Centre, School of Health Sciences, University of Sydney , Sydney, Australia
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Does the Implementation of Clinical Pathways Affect Hierarchical Structures Within a Surgical Department? A Qualitative Study. Int Surg 2018. [DOI: 10.9738/intsurg-d-17-00028.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective:
To explore effects of the implementation of clinical pathways (CPs) on hierarchical structures within a surgical department.
Summary of background data:
CPs are care plans stipulating diagnostic and therapeutic measures along a time axis for a given condition or procedure. They are widely used in surgery. There is limited evidence to what extent CP implementation has an effect on hierarchical structures within surgical departments.
Methods:
Semistructured individual interviews were conducted with key members of a CP project team in a large academic surgery department. Interviews were carried out by an external researcher to increase the likelihood of obtaining unbiased opinions. Using an interview guide, it was ensured that respondents provided opinions on various issues related to CP implementation, including hierarchical relationships within the department, but also between caregivers and patients. The transcribed text was independently content analyzed by 2 researchers who converged their findings.
Results:
Clinical pathway implementation changed perceived surgical hierarchy from a top-down to a participatory approach. However, it was acknowledged that some form of hierarchy is required to ensure successful clinical pathway implementation. Respondents felt that clinical pathways changed surgical culture from a largely eminence-based to more evidence-based medicine.
Conclusions:
The implementation of CPs potentially affects several dimensions of surgical hierarchy. It changes “traditional” surgical hierarchy and is associated with perception of increased autonomy and competency in junior staff. The clinical approach appears to shift from eminence- to evidence-based medicine. The knowledge about these changes is important for carrying out CP projects in surgery.
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38
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Team of Teams or Team of Rivals. J Trauma Acute Care Surg 2018; 81:8-12. [PMID: 27120320 DOI: 10.1097/ta.0000000000001094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wood TC, Raison N, Haldar S, Brunckhorst O, McIlhenny C, Dasgupta P, Ahmed K. Training Tools for Nontechnical Skills for Surgeons-A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2017; 74:548-578. [PMID: 28011262 DOI: 10.1016/j.jsurg.2016.11.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 09/11/2016] [Accepted: 11/28/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Development of nontechnical skills for surgeons has been recognized as an important factor in surgical care. Training tools for this specific domain are being created and validated to maximize the surgeon's nontechnical ability. This systematic review aims to outline, address, and recommend these training tools. DESIGN A full and comprehensive literature search, using a systematic format, was performed on ScienceDirect and PubMed, with data extraction occurring in line with specified inclusion criteria. SETTING Systematic review was performed fully at King's College London. RESULTS A total of 84 heterogeneous articles were used in this review. Further, 23 training tools including scoring systems, training programs, and mixtures of the two for a range of specialities were identified in the literature. Most can be applied to surgery overall, although some tools target specific specialities (such as neurosurgery). Interrater reliability, construct, content, and face validation statuses were variable according to the specific tool in question. CONCLUSIONS Study results pertaining to nontechnical skill training tools have thus far been universally positive, but further studies are required for those more recently developed and less extensively used tools. Recommendations can be made for individual training tools based on their level of validation and for their target audience. Based on the number of studies performed and their status of validity, NOTSS and Oxford NOTECHS II can be considered the gold standard for individual- and team-based nontechnical skills training, respectively, especially when used in conjunction with a training program.
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Affiliation(s)
- Thomas Charles Wood
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Nicholas Raison
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom.
| | - Shreya Haldar
- Department of Opthalmology, Stoke Mandeville Hospital, Aylesbury, United Kingdom
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom
| | - Craig McIlhenny
- Department of Urology, NHS Forth Valley, Larbert, United Kingdom
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital, King's College London, London, United Kingdom
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40
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Aydin A, Fisher R, Khan MS, Dasgupta P, Ahmed K. Training, assessment and accreditation in surgery. Postgrad Med J 2017; 93:441-448. [DOI: 10.1136/postgradmedj-2016-134701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/06/2017] [Accepted: 04/02/2017] [Indexed: 12/16/2022]
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41
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Green B, Mitchell D, Stevenson P, Kane T, Reynard J, Brennan P. Leading article: how can I optimise my role as a leader within the surgical team? Br J Oral Maxillofac Surg 2016; 54:847-850. [DOI: 10.1016/j.bjoms.2016.05.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 05/10/2016] [Indexed: 10/21/2022]
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Genovese B, Yin S, Sareh S, Devirgilio M, Mukdad L, Davis J, Santos VJ, Benharash P. Surgical Hand Tracking in Open Surgery Using a Versatile Motion Sensing System: Are We There Yet? Am Surg 2016; 82:872-875. [DOI: 10.1177/000313481608201002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With changes in work hour limitations, there is an increasing need for objective determination of technical proficiency. Electromagnetic hand-motion analysis has previously shown only time to completion and number of movements to correlation with expertise. The present study was undertaken to evaluate the efficacy of hand-motion-tracking analysis in determining surgical skill proficiency. A nine-degree-of-freedom sensor was used and mounted on the superior aspect of a needle driver. A one-way analysis of variance and Welch's t test were performed to evaluate significance between subjects. Four Novices, four Trainees, and three Experts performed a large vessel patch anastomosis on a phantom tissue. Path length, total number of movements, absolute velocity, and total time were analyzed between groups. Compared to the Novices, Expert subjects exhibited significantly decreased total number of movements, decreased instrument path length, and decreased total time to complete tasks. There were no significant differences found in absolute velocity between groups. In this pilot study, we have identified significant differences in patterns of motion between Novice and Expert subjects. These data warrant further analysis for its predictive value in larger cohorts at different levels of training and may be a useful tool in competence-based training paradigms in the future.
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Affiliation(s)
- Bradley Genovese
- Division of Cardiac Surgery, University of California at Los Angeles, Los Angeles, California
- Center for Advanced Surgical and Interventional Technology, University of California at Los Angeles, Los Angeles, California
| | - Steven Yin
- Electrical Engineering Department, University of California at Los Angeles, Los Angeles, California; and
| | - Sohail Sareh
- Division of Cardiac Surgery, University of California at Los Angeles, Los Angeles, California
| | - Michael Devirgilio
- Division of Cardiac Surgery, University of California at Los Angeles, Los Angeles, California
| | - Laith Mukdad
- Division of Cardiac Surgery, University of California at Los Angeles, Los Angeles, California
| | - Jessica Davis
- Division of Cardiac Surgery, University of California at Los Angeles, Los Angeles, California
| | - Veronica J. Santos
- Center for Advanced Surgical and Interventional Technology, University of California at Los Angeles, Los Angeles, California
- Mechanical and Aerospace Engineering Department, University of California at Los Angeles, Los Angeles, California
| | - Peyman Benharash
- Division of Cardiac Surgery, University of California at Los Angeles, Los Angeles, California
- Center for Advanced Surgical and Interventional Technology, University of California at Los Angeles, Los Angeles, California
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Patel VM, Ashrafian H, Uzoho C, Nikiteas N, Panzarasa P, Sevdalis N, Darzi A, Athanasiou T. Leadership behaviours and healthcare research performance: prospective correlational study. Postgrad Med J 2016; 92:663-669. [PMID: 27190092 DOI: 10.1136/postgradmedj-2016-134088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 04/08/2016] [Accepted: 04/17/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The aims of the study were to determine whether differences in leadership self-perception/behaviour in healthcare researchers may influence research performance and to evaluate whether certain leadership characteristics are associated with enhanced leadership efficiency in terms of motivation, effectiveness and satisfaction. DESIGN AND PARTICIPANTS All Faculty of Medicine Professors at Imperial College London (n=215) were sent the Multifactor Leadership Questionnaire (MLQ) Self form as a means of evaluating self-perception of leadership behaviours. MAIN OUTCOME MEASURES For each professor, we extracted objective research performance measures (total number of publications, total number of citations and h index) from 1 January 2007 to 31 December 2009. The MLQ measured three leadership outcomes, which included motivation, effectiveness and satisfaction. Regression analysis was used to determine associations. RESULTS A total number of 90 responses were received, which equated to a 42% response rate. There were no significant correlations between transformational, transactional or passive/avoidant leadership behaviours and any of the research performance measures. The five transformational leadership behaviours (ie, idealised attributes (IA), idealised behaviours (IB), inspirational motivation (IM), intellectual stimulation (IS), individual consideration (IC)) were highly significant predictors of leadership outcomes, extra effort (all B>0.404, SE=0.093-0.146, p<0.001), effectiveness (IA, IM, IS, IC B>0.359, SE=0.093-0.146, p<0.001; IB B=0.233, SE=0.103, p=0.026) and satisfaction (IA, IM, IS, IC B>0.483, SE=0.086-0.139, p<0.001; IB B=0.296, SE=0.101, p=0.004). Similarly, contingent reward was a significant predictor of extra effort (B=0.400, SE=0.123, p=0.002), effectiveness (B=0.353, SE=0.113, p=0.002) and satisfaction (B=0.326, SE=0.114, p=0.005). CONCLUSIONS This study demonstrates that transformational leadership and contingent reward positively influence leadership efficiency in healthcare researchers. Although we did not show an association between leadership behaviours and research performance metrics, further studies using contextual performance measures at team and organisational levels are required.
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Affiliation(s)
- Vanash M Patel
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Chukwudi Uzoho
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nikolaos Nikiteas
- Second Department of Propedeutic Surgery, University of Athens School of Medicine, Laiko General Hospital, Athens, Greece
| | - Pietro Panzarasa
- School of Business and Management, Queen Mary University of London, London, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service & Population Health Department, King's College London, London, UK
| | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Thanos Athanasiou
- Department of Surgery and Cancer, Imperial College London, London, UK
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Sadideen H, Weldon SM, Saadeddin M, Loon M, Kneebone R. A Video Analysis of Intra- and Interprofessional Leadership Behaviors Within "The Burns Suite": Identifying Key Leadership Models. JOURNAL OF SURGICAL EDUCATION 2016; 73:31-39. [PMID: 26699279 DOI: 10.1016/j.jsurg.2015.09.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 09/12/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Leadership is particularly important in complex highly interprofessional health care contexts involving a number of staff, some from the same specialty (intraprofessional), and others from different specialties (interprofessional). The authors recently published the concept of "The Burns Suite" (TBS) as a novel simulation tool to deliver interprofessional and teamwork training. It is unclear which leadership behaviors are the most important in an interprofessional burns resuscitation scenario, and whether they can be modeled on to current leadership theory. The purpose of this study was to perform a comprehensive video analysis of leadership behaviors within TBS. METHODS A total of 3 burns resuscitation simulations within TBS were recorded. The video analysis was grounded-theory inspired. Using predefined criteria, actions/interactions deemed as leadership behaviors were identified. Using an inductive iterative process, 8 main leadership behaviors were identified. Cohen's κ coefficient was used to measure inter-rater agreement and calculated as κ = 0.7 (substantial agreement). Each video was watched 4 times, focusing on 1 of the 4 team members per viewing (senior surgeon, senior nurse, trainee surgeon, and trainee nurse). The frequency and types of leadership behavior of each of the 4 team members were recorded. Statistical significance to assess any differences was assessed using analysis of variance, whereby a p < 0.05 was taken to be significant. Leadership behaviors were triangulated with verbal cues and actions from the videos. RESULTS All 3 scenarios were successfully completed. The mean scenario length was 22 minutes. A total of 362 leadership behaviors were recorded from the 12 participants. The most evident leadership behaviors of all team members were adhering to guidelines (which effectively equates to following Advanced Trauma and Life Support/Emergency Management of Severe Burns resuscitation guidelines and hence "maintaining standards"), followed by making decisions. Although in terms of total frequency the senior surgeon engaged in more leadership behaviors compared with the entire team, statistically there was no significant difference between all 4 members within the 8 leadership categories. This analysis highlights that "distributed leadership" was predominant, whereby leadership was "distributed" or "shared" among team members. The leadership behaviors within TBS also seemed to fall in line with the "direction, alignment, and commitment" ontology. CONCLUSIONS Effective leadership is essential for successful functioning of work teams and accomplishment of task goals. As the resuscitation of a patient with major burns is a dynamic event, team leaders require flexibility in their leadership behaviors to effectively adapt to changing situations. Understanding leadership behaviors of different team members within an authentic simulation can identify important behaviors required to optimize nontechnical skills in a major resuscitation. Furthermore, attempting to map these behaviors on to leadership models can help further our understanding of leadership theory. Collectively this can aid the development of refined simulation scenarios for team members, and can be extrapolated into other areas of simulation-based team training and interprofessional education.
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Affiliation(s)
- Hazim Sadideen
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
| | - Sharon-Marie Weldon
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Munir Saadeddin
- Department of Orthopedic Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Mark Loon
- Worcester Business School, University of Worcester, Worcester, United Kingdom
| | - Roger Kneebone
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Gordon LJ, Rees CE, Ker JS, Cleland J. Leadership and followership in the healthcare workplace: exploring medical trainees' experiences through narrative inquiry. BMJ Open 2015; 5:e008898. [PMID: 26628525 PMCID: PMC4679996 DOI: 10.1136/bmjopen-2015-008898] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To explore medical trainees' experiences of leadership and followership in the interprofessional healthcare workplace. DESIGN A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. SETTING Multisite study across four UK health boards. PARTICIPANTS Through maximum variation sampling, 65 medical trainees were recruited from a range of specialties and at various stages of training. Participants shared stories about their experiences of leadership and followership in the healthcare workplace. METHODS Data were analysed using thematic and narrative analysis. RESULTS We identified 171 personal incident narratives about leadership and followership. Participants most often narrated experiences from the position of follower. Their narratives illustrated many factors that facilitate or inhibit developing leadership identities; that traditional medical and interprofessional hierarchies persist within the healthcare workplace; and that wider healthcare systems can act as barriers to distributed leadership practices. CONCLUSIONS This paper provides new understandings of the multiple ways in which leadership and followership is experienced in the healthcare workplace and sets out recommendations for future leadership educational practices and research.
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Affiliation(s)
- Lisi J Gordon
- Medical Education Institute, School of Medicine, University of Dundee, Dundee, UK
| | - Charlotte E Rees
- Faculty of Medicine, Nursing & Health Sciences, HealthPEER (Health Professions Education and Education Research),Monash University, Clayton Campus, Victoria, Australia
| | - Jean S Ker
- Medical Education Institute, School of Medicine, University of Dundee, Dundee, UK
| | - Jennifer Cleland
- Division of Medical and Dental Education (DMDE), School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
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Tschuor C, Raptis DA, Morf MC, Staffelbach B, Manser T, Clavien PA. Job satisfaction among chairs of surgery from Europe and North America. Surgery 2014; 156:1069-77. [DOI: 10.1016/j.surg.2014.04.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 04/14/2014] [Indexed: 11/27/2022]
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Mintz LJ, Stoller JK. A systematic review of physician leadership and emotional intelligence. J Grad Med Educ 2014; 6:21-31. [PMID: 24701306 PMCID: PMC3963790 DOI: 10.4300/jgme-d-13-00012.1] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 06/21/2013] [Accepted: 09/16/2013] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE This review evaluates the current understanding of emotional intelligence (EI) and physician leadership, exploring key themes and areas for future research. LITERATURE SEARCH We searched the literature using PubMed, Google Scholar, and Business Source Complete for articles published between 1990 and 2012. Search terms included physician and leadership, emotional intelligence, organizational behavior, and organizational development. All abstracts were reviewed. Full articles were evaluated if they addressed the connection between EI and physician leadership. Articles were included if they focused on physicians or physicians-in-training and discussed interventions or recommendations. APPRAISAL AND SYNTHESIS We assessed articles for conceptual rigor, study design, and measurement quality. A thematic analysis categorized the main themes and findings of the articles. RESULTS The search produced 3713 abstracts, of which 437 full articles were read and 144 were included in this review. Three themes were identified: (1) EI is broadly endorsed as a leadership development strategy across providers and settings; (2) models of EI and leadership development practices vary widely; and (3) EI is considered relevant throughout medical education and practice. Limitations of the literature were that most reports were expert opinion or observational and studies used several different tools for measuring EI. CONCLUSIONS EI is widely endorsed as a component of curricula for developing physician leaders. Research comparing practice models and measurement tools will critically advance understanding about how to develop and nurture EI to enhance leadership skills in physicians throughout their careers.
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Sadideen H, Alvand A, Saadeddin M, Kneebone R. Surgical experts: Born or made? Int J Surg 2013; 11:773-8. [DOI: 10.1016/j.ijsu.2013.07.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 06/27/2013] [Accepted: 07/02/2013] [Indexed: 01/20/2023]
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McLaughlin N, Winograd D, Chung HR, Van de Wiele B, Martin NA. Impact of the time-out process on safety attitude in a tertiary neurosurgical department. World Neurosurg 2013; 82:567-74. [PMID: 23891814 DOI: 10.1016/j.wneu.2013.07.074] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 05/31/2013] [Accepted: 07/19/2013] [Indexed: 01/06/2023]
Abstract
OBJECTIVE In July 2011, the UCLA Health System released its current time-out process protocol used across the Health System. Numerous interventions were performed to improve checklist completion and time-out process observance. This study assessed the impact of the current protocol for the time-out on healthcare providers' safety attitude and operating room safety climate. METHODS All members involved in neurosurgical procedures in the main operating room of the Ronald Reagan UCLA Medical Center were asked to anonymously complete an online survey on their overall perception of the time-out process. RESULTS The survey was completed by 93 of 128 members of the surgical team. Overall, 98.9% felt that performing a pre-incision time-out improves patient safety. The majority of respondents (97.8%) felt that the team member introductions helped to promote a team spirit during the case. In addition, 93.5% felt that performing a time-out helped to ensure all team members were comfortable to voice safety concerns throughout the case. All respondents felt that the attending surgeon should be present during the time-out and 76.3% felt that he/she should lead the time-out. Unanimously, it was felt that the review of anticipated critical elements by the attending surgeon was helpful to respondents' role during the case. Responses revealed that although the time-out brings the team together physically, it does not necessarily reinforce teamwork. CONCLUSION The time-out process favorably impacted team members' safety attitudes and perception as well as overall safety climate in neurosurgical ORs. Survey responses identified leadership training and teamwork training as two avenues for future improvement.
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Affiliation(s)
- Nancy McLaughlin
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Deborah Winograd
- Department of Quality Management, Ronald Reagan UCLA Medical Center and Santa Monica UCLA Medical Center & Orthopedic Hospital, University of California, Los Angeles, California, USA
| | - Hallie R Chung
- Department of Quality Management, Ronald Reagan UCLA Medical Center and Santa Monica UCLA Medical Center & Orthopedic Hospital, University of California, Los Angeles, California, USA
| | - Barbara Van de Wiele
- Department of Anesthesiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Neil A Martin
- Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
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50
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Rothmund M. Surgical leadership. Br J Surg 2013; 100 Suppl 6:S25-7. [PMID: 23804051 DOI: 10.1002/bjs.9052_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- M Rothmund
- Faculty of Medicine, Philipps University, Baldingerstrasse, Marburg 35033, Germany.
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