Point/Counterpoint: Are Outstanding Leaders Born or Made?

Leadership Development in Pharmacy Students: A Literature Review

Background

A deeper understanding of leadership competencies and development of these competencies in pharmacy students are essential to enable future pharmacists to take a more advanced role in patient care and serve as interdisciplinary team members and leaders. Such efforts are also needed to help guide succession planning.

Objective

To identify and describe the competencies and experiences involved in leadership development for pharmacy students.

Data Sources

A literature review was conducted using the MEDLINE, PubMed, and Google Scholar databases (from inception to November 2023), as well as syllabi from pharmacy leadership courses.

Study Selection and Data Extraction

Articles discussing leadership competencies in a health care setting and during pharmacy education and training were included. Competencies and experiences related to leadership development were extracted and organized into categories, with each category given a single descriptor.

Data Synthesis

A total of 34 resources were included in the analysis, which revealed the following 7 leadership competencies: leadership knowledge, self-awareness, collaboration, leading change, business skills, systems thinking, and lifelong learning.

Conclusions

Pharmacy students can develop their leadership abilities through a variety of experiences and activities aligned with the core leadership competencies identified here. Pharmacy schools in Canada can design and offer leadership placements to help enhance students' leadership skills. This study has highlighted activities that may help prepare pharmacy students for leadership roles in the changing landscape of pharmacy practice.

Nontechnical Skills for Surgeons as a Framework to Evaluate Cardiopulmonary Bypass Management Skills of Resident Trainees

BACKGROUND

Nontechnical skills are critical in cardiac surgery but currently there is no formal paradigm to teach these in residency training. We investigated the use of the Nontechnical skills for surgeons (NOTSS) system as a framework to assess and teach nontechnical skills related to cardiopulmonary bypass (CPB) management.

METHODS

Single-center retrospective analysis of Integrated and Independent pathway thoracic surgery residents who participated in dedicated nontechnical skills evaluation and training. Two CPB management simulation scenarios were utilized. All residents received a lecture on CPB fundamentals and then individually participated in the first simulation ("Pre-NOTSS"). Immediately following this, nontechnical skills were rated by self-assessment and by a NOTSS trainer. All residents then underwent group NOTSS training followed by the second individual simulation ("Post-NOTSS"). Nontechnical skills were rated as before. NOTSS categories assessed included Situation Awareness, Decision Making, Communication and Teamwork, and Leadership.

RESULTS

Nine residents were divided into 2 groups: Junior (n = 4, PGY1-4) and Senior (n = 5, PGY5-8). Pre-NOTSS resident self-ratings were higher for Senior than Junior in the categories of Decision Making, Communication and Teamwork, and Leadership while trainer ratings were similar between the groups. Post-NOTSS, resident self-ratings were higher for Senior than Junior in Situation Awareness and Decision Making while trainer scores were higher for both groups in Communication and Teamwork and Leadership.

CONCLUSIONS

The NOTSS framework in conjunction with simulation scenarios provides a practical framework to evaluate and teach nontechnical skills related to CPB management. NOTSS training can lead to improvements in both subjective and objective ratings of nontechnical skills for all PGY levels.

Review article: Use of the Team Emergency Assessment Measure in the rating of emergency teams' non-technical skills: A mapping review

The present study aims to explore the utility of the Team Emergency Assessment Measure (TEAM) in relation to the enhancement of emergency team non-technical skills based on research conducted over the last decade. In this mapping review, a citation mining process identified 22 primary studies for inclusion, published between 2012 and 2022. It provides outcome data on emergency teams' non-technical skills following team training and/or real-life patient emergencies. Emergency team studies related to resuscitation teams (adult, paediatric, newborn and obstetric cases) and medical emergency team (MET) management of patient deterioration. Team performance ratings varied, ranging from approximately 90% for experienced clinical teams down to 38% for students. Statistically significant improvements in performance were notable following training and/or repeated practice. Validity evidence, across 11 studies that provided change data described positive learning outcomes and moderate intervention effects. However, according to Kirkpatrick's model of educational evaluation the studies were limited to professional development phases of learning and immediate post-training assessments rather than care quality improvement. The review highlights a lack of studies evidencing quality improvement or clinical impact such as change of patient care practice or health service performance. There is a need to conduct well-designed studies that explore both technical and non-technical skills of resuscitation teams and METs. Currently, non-technical skills training and repeated performance evaluations using the TEAM contribute immensely to the proficiency of emergency teams.

Completing the Academic Leadership Fellows Program During the Pandemic

The COVID-19 pandemic caused the Academic Leadership Fellows Program (ALFP) of the American Association of Colleges of Pharmacy to shift to a virtual format for Cohort 17. Major differences compared to previous years included changes in networking strategies among fellows, lack of in-person team-building activities, and adjustments to the preparation and delivery of the team debates. Adaptations in fellow peer interactions and the learning approach proved that strong relationships and collaborations can be formed in a virtual setting. Concurrent mentorship and leadership opportunities at the fellows' home institutions remain fundamental components of the program to enhance personal growth. The ALFP program proved that it can still deliver a meaningful professional development opportunity for faculty leaders in a virtual setting.

Publication Records and Bibliometric Indices of Pharmacy School Deans

Objective. To characterize the publication records and bibliometric indices of current CEO deans at pharmacy schools and colleges in the United States. Methods. Using the Web of Science database, the publication records of all CEO pharmacy deans in the US were collected. Bibliometric indices calculated included: lifetime publications, publications/year, h-index, m-quotient, lifetime citations, citations/year, average citations/paper, productivity, and creativity. The Kruskal-Wallis analysis of variance for nonparametric data was used to assess differences between groups. Results. All bibliometric parameters were different between pharmacy schools and colleges that were research-intensive vs teaching-intensive, academic health center-based vs non-academic health center-based, and public vs private. Additionally, the discipline and degree of each dean yielded significant differences. There were no significant differences in bibliometric parameters between male or female deans. Conclusion. Deans of current SCOP display a varied range of publication records and bibliometric indices.

Community pharmacists' attitudes, opinions and beliefs about leadership in the profession: An exploratory study

Background

The profession of pharmacy needs effective leaders to navigate change. Indirect indicators suggest there are insufficient numbers of pharmacists who actually want to be leaders. A paucity of research limits our understanding of what motivates and demotivates pharmacists to be leaders. This exploratory study was undertaken to investigate community pharmacists' attitudes, opinions and beliefs about leadership.

Methods

Interviews with 38 pharmacists were conducted either in person or using telecommunication applications such as Skype. A semistructured interview guide was used to elicit comments about leadership in general and in pharmacy, perceived leadership roles and barriers/enablers to leadership. Data were analyzed using Chan and Drasgow's motivation-to-lead framework.

Results

Key barriers to assuming leadership roles included lack of education/support, inadequate compensation, concerns about work-life balance, time constraints and a generalized discontent about leadership in society and in the profession.

Discussion

While some of these barriers could be addressed through formal education (such as conflict management training) or through managerial influence (e.g., remuneration or scheduling to improve work-life balance), some (such as cynicism about leadership) will be more challenging to address. The need to address these barriers will grow as the need for new and emerging leaders in pharmacy continues to evolve.