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Hartzell JD, Servey J, Wilson R, Mount G, Barry ES, Durning SJ. The Military Medicine Leadership Life Cycle: A Model for Longitudinal Leadership Development for Staff Physicians. Mil Med 2024:usae387. [PMID: 39107050 DOI: 10.1093/milmed/usae387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/02/2024] [Accepted: 07/28/2024] [Indexed: 08/09/2024] Open
Abstract
Leadership development is a challenge for all health care systems. Military Medicine has unique challenges with increased frequency of physician turnover and more junior leaders taking on positions of leadership earlier in their careers. Military medical corps officers are also challenged with leading in clinical, academic, and operational settings. Effective leadership within the Military Healthcare System requires an intentional and ongoing leadership development process across the careers of military medical corps officers. This article describes the leadership lifecycle of military medical corps officers, highlighting existing leadership development opportunities and providing an example of a leadership lifecycle from junior staff to senior executive for other organizations. The article concludes with specific recommendations that will allow military medicine to continue to strengthen the leadership skills of its officers to meet ever growing challenges.
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Affiliation(s)
- Joshua D Hartzell
- Department of Health Professions Education, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Jessica Servey
- Department of Family Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Ramey Wilson
- Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - George Mount
- Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Erin S Barry
- Department of Health Professions Education, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Department of Anesthesiology, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
| | - Steven J Durning
- Department of Health Professions Education, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
- Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA
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Middleton R, Montgomery A, Murray S, Peters S, Halcomb E. Exploring leadership in health professionals following an industry-based leadership program: A cross-sectional survey. J Adv Nurs 2023; 79:4747-4755. [PMID: 37326228 DOI: 10.1111/jan.15738] [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: 01/17/2023] [Revised: 05/20/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Abstract
AIM To evaluate the self-reported leadership practices and behaviours of health professionals following a leadership program and explore factors that impacted leadership style. DESIGN An online cross-sectional survey was conducted from August to October 2022. METHODS The survey was disseminated via email to leadership program graduates. The Multifactor Leadership Questionnaire Form-6S was used to measure leadership style. RESULTS Eighty completed surveys were included in the analysis. Participants scored highest on transformational leadership and lowest on passive/avoidant leadership style. Participants with higher qualifications scored significantly higher in the inspirational motivation scores (p = 0.03). As years in their profession increased, there was a significant decrease in contingent reward scores (p = 0.04). The younger participants scored significantly higher on the management-by-exception than older participants (p = 0.05). There were no significant associations with the year the leadership program was completed, gender or profession and Multifactor Leadership Questionnaire Form - 6S scores. Most participants (72.5%) strongly agreed that the program enhanced their leadership development and 91.3% strongly agreed or agreed that they routinely apply the skills and knowledge learnt in the program in their workplace. CONCLUSION Formal leadership education is important in developing a transformational nursing workforce. This study found that program graduates had adopted a transformational leadership style. Education, years of experience and age impacted the specific leadership elements. Future work needs to incorporate longitudinal follow-up to relate changes in leadership with impact on clinical practice. IMPLICATIONS FOR THE PROFESSION Transformational leadership as a dominant style can contribute to nurses and other disciplines positively contributing to innovative and person-centred approaches to health service delivery. SUMMARY STATEMENT What already is known-Leadership amongst nurses and other health professionals impacts patients, staff, organizations and ultimately healthcare culture. What this paper adds-Formal leadership education is important in developing a transformational healthcare workforce. Implications for practice/policy-Transformational leadership can enhance nurses and other disciplines commitment to innovative and person-centred approaches. IMPACT STATEMENT This research identifies that lessons learnt from formal leadership education are retained over time by healthcare providers. This is important for nursing staff, and other healthcare providers, who are leading teams and overseeing care delivery, can ensure leadership behaviours and practices are enacted to influence a transformational workforce and culture. REPORTING METHOD This study adhered to STROBE guidelines. No Patient or Public Contribution.
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Affiliation(s)
- Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, Australia
| | - Amy Montgomery
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, Australia
| | - Suzanne Murray
- South Eastern Sydney Local Health District, Kogarah, Australia
| | - Sally Peters
- South Eastern Sydney Local Health District, Kogarah, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, Australia
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Ramelli S, Lal S, Sherbino J, Dickson G, Chan TM. LEADS+ Developmental Model: Proposing a new model based on an integrative conceptual review. MEDICAL EDUCATION 2023; 57:857-869. [PMID: 36813746 DOI: 10.1111/medu.15062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/21/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Leaders in academic health sciences centres (AHCs) must navigate multiple roles as an inherent component of their positions. Changing accountabilities, varying expectations, differing leadership capabilities required of multiple leadership roles can be exacerbated by health system disruption, such as during the COVID-19 pandemic. We need improved models that support leaders in navigating the complexity of multiple leadership roles. METHOD This integrative conceptual review sought to examine leadership and followership constructs and how they intersect with current leadership practices in AHCs. The goal was to develop a refined model of healthcare leadership development. The authors used iterative cycles of divergent and convergent thinking to explore and synthesise various literature and existing leadership frameworks. The authors used simulated personas and stories to test the model and, finally, the approach sought feedback from knowledge users (including healthcare leaders, medical educators and leadership developers) to offer refinements. RESULTS After five rounds of discussion and reformulation, the authors arrived at a refined model: the LEADS+ Developmental Model. The model describes four nested stages, organising progressive capabilities, as an individual toggles between followership and leadership. During the consultation stage, feedback from 29 out of 65 recruited knowledge users (44.6% response rate) was acquired. More than a quarter of respondents served as a senior leader in a healthcare network or national society (27.5%, n = 8). Consulted knowledge users were invited to indicate their endorsement for the refined model using a 10-point scale (10 = highest level of endorsement). There was a high level of endorsement: 7.93 (SD 1.7) out of 10. CONCLUSION The LEADS+ Developmental Model may help foster development of academic health centre leaders. In addition to clarifying the synergistic dynamic between leadership and followership, this model describes the paradigms adopted by leaders within health systems throughout their development journey.
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Affiliation(s)
- Sandra Ramelli
- Division Innovation and Education, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sarrah Lal
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- University of Waterloo, Waterloo, Ontario, Canada
| | - Jonathan Sherbino
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- McMaster Education Research, Innovation, and Theory (MERIT) program, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Graham Dickson
- Leadership Studies Royal Roads University, Victoria, British Columbia, Canada
- Canadian Health Leadership Network and Canadian Society of Physician Leaders and Principal, LEADS Global, Victoria, British Columbia, Canada
| | - Teresa M Chan
- Division Innovation and Education, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- McMaster Education Research, Innovation, and Theory (MERIT) program, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Continuing Professional Development, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Debets M, Jansen I, Lombarts K, Kuijer-Siebelink W, Kruijthof K, Steinert Y, Daams J, Silkens M. Linking leadership development programs for physicians with organization-level outcomes: a realist review. BMC Health Serv Res 2023; 23:783. [PMID: 37480101 PMCID: PMC10362722 DOI: 10.1186/s12913-023-09811-y] [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: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization's performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing. OBJECTIVE To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes. METHODS We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O). RESULTS In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories 'culture', 'quality improvement', and 'the leadership pipeline': 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes. CONCLUSIONS LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes.
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Affiliation(s)
- Maarten Debets
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands.
| | - Iris Jansen
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Kiki Lombarts
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, Research On Responsive Vocational and Professional Education, HAN University of Applied Sciences, Nijmegen, Netherlands
- Research On Learning and Education, Radboud University Medical Centre, Radboudumc Health Academy, Nijmegen, Netherlands
| | - Karen Kruijthof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Yvonne Steinert
- Faculty of Medicine and Health Sciences, Institute of Health Sciences Education, McGill University, Montreal, Canada
| | - Joost Daams
- Medical Library, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, Netherlands
| | - Milou Silkens
- Department of Health Services Research & Management, City University of London, London, UK
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
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Chan TM, Sherbino J, Sockalingam S. Blueprints for Connection: A Meta-Organizational Framework for Layering Theory, Philosophy, and Praxis Within Continuing Education in the Health Professions. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:S41-S46. [PMID: 38054491 DOI: 10.1097/ceh.0000000000000533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
ABSTRACT As a field, Continuing Professional Development (CPD) lies at the intersection of many disciplines. Tensions can occur as scholars from fields ranging from education to quality improvement seek to advance the practices and workplaces of health care professionals. Owing to the diversity of people working to affect change within the field of CPD, it remains a very challenging space to collaborate and understand the various philosophies, epistemologies, and practice of all those within the field.In this article, the authors have proposed a meta-organizational framework for how we might re-examine theory, application, and practice within the field of CPD. It is their belief that this proposal might inspire others to reflect on how we can cultivate and invite diverse scientists and scholars using a range of theories to add to the fabric of the field of CPD.
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Affiliation(s)
- Teresa M Chan
- Dr. Chan: Dean of the School of Medicine and Vice President of Medical Affairs, Toronto Metropolitan University. She is also Associate Clinical Professor, Division of Emergency Medicine and Division of Education & Innovation, Department of Medicine, McMaster University, Hamilton, Ontario, Canada, Faculty of Health Sciences, McMaster University and an Adjunct Scientist, McMaster Education Research, Innovation, and Theory (MERIT) program, Hamilton, Ontario, Canada, Dr. Sherbino: Professor, Department of Medicine; Assistant Dean, Health Professions Education Research; Faculty of Health Sciences, McMaster University, and Dr. Sockalingam: Professor and Vice Chair, Education, Department of Psychiatry, University of Toronto, and Chief Medical Officer, Vice President Education and Senior Scientist , Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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van Diggele C, Roberts C, Lane S. Leadership behaviours in interprofessional student teamwork. BMC MEDICAL EDUCATION 2022; 22:834. [PMID: 36461010 PMCID: PMC9718460 DOI: 10.1186/s12909-022-03923-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Effective leaders support high-quality patient care and improve patient safety by embodying a collective leadership style. Training in leadership skills needs to be integrated longitudinally throughout a clinician's career. Models of leadership drawn from organisational theories can provide a conceptual framework for cultivating student leadership qualities during teamwork and the evaluation of emergent outcomes. Using the conceptual framework of Situational Leadership Theory, we sought to explore the leadership qualities identified by students of their team members, during a large scale interprofessional learning activity. METHODS In 2018, 1674 students from 11 health disciplines were required to participate in the "Health Collaboration Challenge" (HCC). The HCC required students to work in small interprofessional teams of five or six students. Following team activities, students were required to provide constructive written feedback to their team members. Peer feedback data were coded and categorised into themes using the conceptual framework of Situational Leadership Theory. Data were then quantified within each theme. RESULTS A total of 1282 comments were analysed. The most frequent comments related to 'delegating' (456/1282, 36%) and 'supporting' (402/1282, 31%). This was followed by comments categorised as 'directing' (244/1282, 19%), and 'coaching' (180/1282, 14%) leadership styles. Notably, a total of 1112/2597 (43%) of comments were unconstructive. A total of 298 comments provided by students informed their peers of areas for self-improvement. The most frequent comments were recommendations relating to 'active team member contribution' (111/298; 37%), followed by 'communication' (83/298; 28%), 'interprofessional practice' (77/298; 26%), and 'disciplinary knowledge' (27/298; 9%). CONCLUSION Although most students demonstrated a reasonable ability to display leadership behaviours appropriate to teamwork, further development is needed through training. Leadership skills are an expectation of health professional graduates, and should be explicitly taught and vertically integrated within interprofessional education curricula. Further research is warranted in how students contribute to and understand the requirements of leadership within interprofessional teams.
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Affiliation(s)
- Christie van Diggele
- Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Sydney, Australia.
| | - Chris Roberts
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Stuart Lane
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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