Preparing students to be academicians: a national student-led summer program in teaching, leadership, scholarship, and academic medical career-building

Budgets: How They Are Planned, Prepared, and Managed

Background

Budget planning and execution is as difficult as it is vital to any practice, whether academic, private, or group. Well-planned and executed budgets are a source of revenue and growth that fuels the practice for the next cycle. Conversely, poorly planned budget is disastrous, and a badly executed one invariably leads to unrecoverable losses. Many clinicians, especially those in academic centers, are not involved in budget-planning preparation and yet are held accountable for their yearly performance in relation to the budget.

Methods

Key processes for budget planning and their significance are identified. Integrating these steps with the needs of a clinical practice, a stepwise method is described for both clinicians and administrators to work together to plan, prepare, and manage budgets.

Results

Relevant examples of how budgets affect clinical workflow and common pitfalls of budget planning and mitigation methods are identified. A simplified systematic approach allows for a streamlined, smooth budget-planning process that involves faculty and staff, which holds them accountable for the year-long performance of the entire clinical team.

Conclusions

A systematic proactive approach to budget-planning, preparation, and management provides a financial direction to the department; tracks performance; allows growth; and provides the flexibility to stay on track, change course, or reassign resources.

Medical students' academic satisfaction: Social cognitive factors matter

PURPOSE

Academic satisfaction (AS)-the extent to which people enjoy their role or experiences as medical students-has important implications for well-being and career development. This study explores the relationships between social cognitive factors and AS in a Chinese medical education context.

METHOD

The social cognitive model of academic satisfaction (SCMAS) was adopted as the theoretical framework. Within this model, AS is assumed to be related to social cognitive factors-environmental supports, outcome expectations, perceived goal progress and self-efficacy. Demographic variables, financial pressure, college entrance examination scores and social cognitive constructs in SCMAS were collected. To explore the relationships between medical students' social cognitive factors and AS, hierarchical multiple regression analyses were performed.

RESULTS

The final sampled data consisted of 127 042 medical students from 119 medical institutions. Demographic variables, financial pressure and college entrance examination scores were first entered in Model 1, explaining 4% of the variance in AS. Social cognitive factors were entered in Model 2, explaining an additional 39% of the variance. Medical students would report higher levels of AS when they (a) held strong confidence in their skills needed for success in studying medicine (β = 0.20, p < 0.05), (b) had optimistic beliefs about the outcome of studying medicine (β = 0.40, p < 0.05), (c) felt that they were making good progress in studying medicine (β = 0.06, p < 0.05) and (d) believed that they received adequate environmental support (β = 0.25, p < 0.05). The outcome expectations showed the strongest correlation with AS, and each 1-point increase was associated with 0.39 points on the AS score, controlling for all other factors in the model.

CONCLUSIONS

Social cognitive factors play an important role in medical students' AS. Intervention programmes or courses aiming to improve medical students' AS are advised to consider social cognitive factors.

Divergence and Convergence of the Public Health Leadership Competency Framework Against Others in Undergraduate Medical Education: A Scoping Review

Objective: The following scoping review is aimed at identifying leadership competency frameworks in Undergraduate Medical Education (UME) by analyzing the thematic scopes, target audiences, and methods involved. A further objective is to compare the frameworks against a standard framework. Methods: The authors extracted the thematic scope and methods of each framework based on the original author's formulations in each selected paper. The target audience was divided into three sections: UME, medical education, and beyond medical education. The frameworks were converged and diverged against the public health leadership competency framework. Results: Thirty-three frameworks covering thematic scopes such as refugees and migrants were identified. The most common methods to develop leadership frameworks were reviews and interviews. The courses targeted multiple disciplines including medicine and nurses. The identified competency frameworks have not converged among important domains of leadership such as systems thinking, political leadership, leading change, and emotional intelligence. Conclusion: There is a variety of frameworks that support leadership in UME. Nevertheless, they are not consistent in vital domains to face worldwide health challenges. Interdisciplinary and transdisciplinary leadership competency frameworks which address health challenges should be used in UME.

Student Leadership Development Initiative for Medical Students: Lessons Learned From Transitioning to Virtual Modalities

Leadership training is a necessary component of undergraduate medical education. Our group successfully implemented a student-led organization starting from 2016 (Student Leadership Development Initiative; SLDI) that aimed to provide medical students with exposure to physician-leader career paths in an informal, organic, interactive setting. The COVID-19 pandemic necessitated a shift to online programming, and given the high prevalence of ZOOMTM fatigue, we incorporated monthly, freely available, self-directed modules as an additional leadership training opportunity. The goals of this study are to assess the (1) feasibility of and participation in a virtual student organization focused on leadership training, (2) whether students' perceptions of the importance of leadership were associated with participation in SLDI, and (3) lessons learned from transitioning to virtual modalities. An anonymous, retrospective cross-sectional survey with 13-items was distributed through an email listserv and a 6-question survey was sent to attendees following each virtual group-discussion. A Fisher's exact test was conducted to assess whether the number of modules completed was associated with students' perception of leadership importance. Survey results showed that 85% strongly agreed or agreed that SLDI helped them develop professional goals and career paths, and 74% reported benefits in becoming more compassionate physician leaders and valuing wellness. All respondents completed ≥1 self-directed module, and the students' perception of leadership importance did not influence the number of self-directed modules completed (p > .05). Most participants (63%) attended ≥67% of virtual events, and postevent feedback was positive; however, only 46% of respondents reported meeting someone new at events and 32% reported that they intended on connecting with new contacts. Our results suggest that virtual leadership student-organization, involving small-group discussions and self-directed modules, is feasible and beneficial for medical students. However, the inability to promote meaningful networking opportunities is a major limitation of a virtual training model.

Professional Identity Formation, Professionalism, Leadership and Resilience (PILLAR) in Medical Students: Methodology and Early Results

Objectives

The fundamental role of medical education is the transformation of students to doctors, through a process of education and professional identity formation (PIF), which can be informed by several educational, behavioural and emotional factors. PIF has been deemed to be of equal importance to the acquisition of clinical knowledge and skills and includes constructs such as professionalism, leadership and resilience. We aimed to assess professional identity formation, professionalism, leadership and resilience (PILLAR) in the junior years of medical school in the 2020/2021 academic year and illustrate the potential role of quantitative assessment to demonstrate progression in these areas. In this research, we provide the methods and baseline results for the PILLAR study.

Methods

We implemented a compulsory assessment in pre-clinical years of graduate entry and direct entry medicine at the Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland. Validated scales were used to assess students' PILLAR. Descriptive and univariable statistical techniques were used to compare student scores between respective years.

Results

A total of 1311 students (92% response rate) provided their consent for research. For the psychometric scales, there were no evident trends among the years on these assessment measures. Results indicated significant differences in all measures, however, these did not correspond to ascending years of seniority.

Conclusion

The PILLAR methodology provides important information on the challenges of quantitatively assessing medical students in the four key areas of PIF, professionalism, leadership, and resilience. Our cross-sectional results point to cohort effects, without the expected progression per year in the cross-sectional data, or suggest that the chosen quantitative measures may be problematic for these constructs in pre-clinical students. Therefore, while we believe that PILLAR has potential as a progress test for these constructs, this will only truly be elucidated by repeated measures of each cohort over time.

Teaching Medical Students to Teach: A Narrative Review and Literature-Informed Recommendations for Student-as-Teacher Curricula

PURPOSE

Medical students play an important role as teachers. This narrative review synthesizes the student-as-teacher (SaT) literature that incorporates formal teaching skills training, with the goal of proposing literature-informed recommendations for SaT curriculum development within the context of competency-based medical education.

METHOD

In January and August 2020, the authors searched Medline and Embase and conducted forward citation searches in Scopus to identify articles from 1985 to 2020 related to teaching medical students to teach. Search terms included "student(s) as teacher(s)," "near-peer teaching," and "teaching to teach." The findings from selected articles were summarized and synthesized.

RESULTS

Forty-three articles met the inclusion criteria: 33 papers describing specific SaT curricula, 3 literature reviews, 6 stakeholder surveys, and 1 Delphi study. While students often engage in teaching roles, formal teaching skills training is not always provided. Existing curricula are usually optional, delivered as short courses, and offered to senior students. Course content commonly includes topics related to planning and delivering learning activities and providing feedback. Of the numerous teaching modalities employed, students indicate a preference for interactive and experiential learning. Methods used to assess students' teaching skills vary; however, direct observation and feedback are valued assessment methods. Program evaluations have shown positive outcomes, including high student satisfaction and enhanced self-confidence as teachers.

CONCLUSIONS

Informed by these findings and outcome-based educational frameworks, the authors suggest 4 guiding principles for SaT curricula: (1) teaching skills training should be formally implemented in undergraduate medical education and should, whenever possible, be compulsory; (2) teaching skills should be taught longitudinally and progressively along the undergraduate to postgraduate continuum; (3) curriculum content should be aligned with a school's preexisting curriculum and local context; and (4) authentic opportunities for students to engage in teaching roles should be included. They also propose recommendations for curriculum content, teaching modalities, and assessment methods.

Leadership Development in U.S. Undergraduate Medical Education: A Scoping Review of Curricular Content and Competency Frameworks

PURPOSE

To inform research on developing or adopting leadership competency frameworks for use in U.S. undergraduate medical education (UME), this scoping review describes the content of U.S. UME leadership curricula, associated competency frameworks, and content delivery.

METHOD

The authors searched PubMed, Embase, and ERIC databases on June 22, 2020. They included English-language studies that described U.S. UME curricula in which the primary end goal was leadership development. They excluded studies published before January 1, 2000. Data were extracted on leadership competency frameworks and curricular content, audience, duration, electivity, selectivity, learning pedagogies, and outcome measures. The curricular content was coded and categorized within the Medical Leadership Competency Framework (MLCF) using the constant comparative method. A repeated search of the literature on May 14, 2021, did not yield any additional studies.

RESULTS

Of 1,094 unique studies, 25 studies reporting on 25 curricula met inclusion criteria. The course content of the curricula was organized into 91 distinct themes, most of which could be organized into the first 2 competencies of the MLCF: Demonstrating Personal Qualities and Working With Others. Thirteen curricula (52%) aligned with leadership competency frameworks, and 12 (48%) did not appear to use a framework. Number of participants and target learner level varied widely, as did curricula duration, with fewer than half (n = 12, 48%) spanning more than 1 semester. Most curricula (n = 14, 56%) were elective, and many (n = 16, 64%) offered experiential learning. Most studies (n = 16, 64%) reported outcomes as student perception data.

CONCLUSIONS

The authors found wide variation in content of U.S. UME leadership development curricula, and few curricula aligned with an established leadership competency framework. The lack of professional consensus on the scope of medical leadership and how it should be taught thwarts effective incorporation of medical leadership training within UME.

Reflective Essays During Clerkship Following a Pre-clerkship Leadership Curriculum

INTRODUCTION

Leadership curricula in medical student education require assessment - to determine if leadership skills can be taught to medical students and applied during clinical and medical team interactions to aid in medical student leadership development.

OBJECTIVES

To examine whether medical students applied principles of their pre-clerkship leadership curriculum (character, competence, context, and communication elements across four levels: personal, interpersonal, team, and organizational) during an internal medicine clerkship.

METHODS

Using art as a prompt, Uniformed Services University (USU) internal medicine clerkship students completed a structured reflection on a critical incident. Medical student essays written during a 10-week internal medicine clerkship at USU in 2019 were collected. 158 medical student submissions were de-identified and analyzed.

RESULTS

Sixty-four submissions (40.5%) focused on leadership or leadership and professionalism. Students identified as male (n = 34, 53%), female (21, 33%), or not reported (9, 14%). Most, 48 (75%), did not describe PITO explicitly in their essay. They instead focused on personal and interpersonal aspects (17, 27%) of leadership, the attending physicians they worked with (33, 52%), and effective leadership strategies (46, 72%). The most common themes written about were responsibility (30, 47%), teamwork (18, 28%), competence (17, 27%), and character/integrity (15, 23%).

CONCLUSION

Although the students' explicit use of the PITO model was limited, student essays centered on themes that reflected leadership concepts taught in pre-clerkship years, such as character, competence, and responsibility. This study demonstrates that an internal medicine clerkship rotation can feasibly implement a leadership reflection.

Is health professional education making the most of the idea of 'students as partners'? Insights from a qualitative research synthesis

Students as partners is a movement which is gaining momentum in higher education, yet disciplinary perspectives are underexplored. Using a qualitative synthesis approach informed by Major and Savin-Baden (2010), we systematically investigated how health professional education has taken up the practice of working in partnership with students. Fifty-five publications were identified in our search from 2011 to -mid 2018. The majority of literature came from North America and medicine was the most frequently represented health profession. Our three stage analysis identified five key themes: (1) framing (i.e. ethos) of the partnership; (2) drivers for partnership; (3) sustainability; (4) inclusion of student voice; and (5) understanding of partnership and its benefits and challenges. Health professional educators are well equipped to enact partnership opportunities due to their clinical skills in person-centred care. However to gain the most from student-staff partnerships, health professional education would benefit from greater awareness of the field's theoretical understandings of partnership and its key principles of reciprocity, respect and responsibility.

Physician-scientist or basic scientist? Exploring the nature of clinicians' research engagement

Theoretical understanding of what motivates clinician researchers has met with some success in launching research careers, but it does not account for professional identification as a factor determining sustained research engagement over the long-term. Deeper understanding of clinicians' research-related motivation may better foster their sustained research engagement post-training and, by extension, the advancement of medicine and health outcomes. This study used an integrated theoretical framework (Social Cognitive Career Theory and Professional Identity Formation) and appreciative inquiry to explore the interplay of professional identification and research context in shaping post-training research success narratives. To foreground professional identification, 19 research-active clinicians and 17 basic scientists served as interviewees. A multi-institutional, multi-national design was used to explore how contextual factors shape external valuation of research success. The findings suggest that research-active clinicians do not identify as the career scientists implied by the modern physician-scientist construct and the goal of many clinician research-training programs. Their primary identification as care providers shapes their definition of research success around extending their clinical impact; institutional expectations and prevailing healthcare concerns that value this aim facilitate their sustained research engagement. Integrated developmental and organizational interventions adaptive to research context and conducive to a wider range of medical inquiry may better leverage clinicians' direct involvement in patient care and advance progress toward human health and well-being.

Systematic review of interventions to encourage careers in academic medicine

AIMS

Academic medicine is a career route that historically struggles to recruit and retain suitable doctors. The aim of this paper is to review the evidence for interventions to encourage careers in academic medicine by way of a descriptive systematic review.

METHODS

Key databases were searched in February 2017. Studies that evaluated interventions to encourage careers in academic medicine and that used a pre-post analysis or included a comparison group were included. Interventions reporting only learner satisfaction were excluded. The review was specific to medical students and graduates.

RESULTS

Twenty-four studies were identified for inclusion within the review. The included studies identified interventions across five domains: postgraduate funding, postgraduate training, mentoring, undergraduate interventions, and institutional change. The papers varied in terms of strength of conclusion and method of analysis with broad, structured, well-funded programs having the most palpable results.

CONCLUSIONS

The five domains identified offer a framework that can be used by institutions who wish to develop similar programs. It also offers a body of research on which an evidence base can be built.

Inspiring the next generation of academic physicians: the academic health careers program

There is growing evidence in the medical education literature for the aggressive need to recruit and retain the next generation of academic physicians. In 2008, the University of Kentucky College of Medicine (UK COM) developed an academic health careers (AHCs) program for preclinical medical students as an introduction into the practice of academic medicine. The goals of this elective experience included (1) highly customized training and mentorship experiences in research, teaching, and other aspects of academic medicine; (2) information and perspectives to assist students in making informed career choices, including options for academic careers; (3) access to academic career mentors and role models related to individual faculty research interests and teaching responsibilities; and (4) opportunities to network with UK COM administrators. This short communication provides a detailed overview of the AHC experience - along with preliminary findings from a 2016-17 follow-up of program graduates exploring the program's role in their career aspirations and decisions.

Assessment of medical students' leadership traits in a problem/case-based learning program

BACKGROUND

Healthcare delivery is shifting to team-based care and physicians are increasingly relied upon to lead and participate in healthcare teams. Educational programs to foster the development of leadership qualities in medical students are needed to prepare future physicians for these roles.

OBJECTIVE

Evaluate the development of leadership attributes in medical students during their first 2 years of medical school while participating in leadership training integrated into a problem/case-based learning program utilizing the Leadership Traits Questionnaire assessment tool.

DESIGN

Ninety-eight students enrolled at Zucker School of Medicine participated in Patient-Centered Explorations in Active Reasoning, Learning and Synthesis (PEARLS), a hybrid problem/case-based learning program, during the first and second years of medical school. The Leadership Traits Questionnaire, designed to measure 14 distinct leadership traits, was utilized. It was administered to students, peers in students' PEARLS groups and their faculty facilitators. Participants completed questionnaires at three-time points during the study. Likert scale data obtained from the questionnaire was analyzed using a two-level Hierarchal Linear Model.

RESULTS

Complete data sets were available for 84 students. Four traits, including self-assured, persistent, determined, and outgoing, significantly increased over time by measurements of both peer and facilitator-rated assessments. Six additional traits significantly increased over time by measurement of facilitator-rated assessment. By contrast, a majority of student self-rated assessments trended downward during the study.

CONCLUSIONS

Medical students demonstrated development of several important leadership traits during the first 2 years of medical school. This was accomplished while participating in the PEARLS program and without the addition of curricular time. Future work will examine the impact of third year clerkships on leadership traits.

Effect of a national focused course on academic medicine for UK candidates applying for a Clinical Academic Programme

Background Academic medicine is crucial for healthcare advancement. However, recruitment of junior doctors into academia remains an area of concern globally. In the UK, a national integrated clinical academic pathway was developed to address these issues, with the Academic Foundation Programme as the 'first opportunity for research'. We aimed to evaluate whether a focused course on academic medicine could enhance knowledge, confidence and preparedness of candidates wishing to apply for an academic programme. Methods UK medical students attended a national course conducted by current UK Academic Foundation Programme doctors that comprised lectures on academic medicine and various aspects of the Academic Foundation Programme. An online questionnaire-based cross-sectional study was conducted with participants rating measures including knowledge, preparedness and confidence related to Academic Foundation Programme applications. Outcomes were measured using Likert scales (1=low; 5=high). Results In total, 103 out of 155 attendees from 11 different UK medical schools responded to the survey (66% response rate). Pre and post-course data showed increase in participants' knowledge (median score 2 vs 4, p < 0.0001), understanding of the application process (median score 2 vs 4, p < 0.0001), confidence (median score 2 vs 4, p < 0.0001) and preparedness (median score 2 vs 4, p < 0.0001) in applying for the Academic Foundation Programme. Conclusion To our knowledge this is the first study in the available literature that demonstrates a focused course on academic medicine may enhance UK medical students' knowledge, confidence and preparedness in applying for a clinical academic programme. Further research will ascertain whether such courses can augment trainee numbers undertaking and remaining within academic medicine.

Introducing Trainees to Academic Medicine Career Roles and Responsibilities

INTRODUCTION

The future of academic medicine depends on attracting motivated trainees to the academic career path, but challenges to recruitment include unfamiliarity with academic career options.

METHODS

This workshop comprises a didactic session with small-group case discussion to enable trainees to learn how to: (1) define academic medical center roles and responsibilities, (2) assess the alignment of academic medical center roles with personal goals and interests, and (3) identify factors that support an academic medicine career trajectory. Workshop evaluations were collected at five academic medicine conferences for medical students and residents held across the U.S.

RESULTS

Among the 139 conference participants who completed an evaluation form, the majority had a statistically significant increase in confidence regarding their building a foundation for a career in academic medicine, and in identifying an academic medicine career role aligning with their own personal and professional interests. The majority strongly agreed or agreed that the workshop objectives were met. Trainees reported that the workshop was "illuminating," "informative," and "educational."

DISCUSSION

Improved understanding of academic medicine career roles and responsibilities can increase trainees' awareness of the opportunities in academic medicine and may support development of the next generation of academic physicians.

Creating More Effective Mentors: Mentoring the Mentor

Given the diversity of those affected by HIV, increasing diversity in the HIV biomedical research workforce is imperative. A growing body of empirical and experimental evidence supports the importance of strong mentorship in the development and success of trainees and early career investigators in academic research settings, especially for mentees of diversity. Often missing from this discussion is the need for robust mentoring training programs to ensure that mentors are trained in best practices on the tools and techniques of mentoring. Recent experimental evidence shows improvement in mentor and mentee perceptions of mentor competency after structured and formalized training on best practices in mentoring. We developed a 2-day "Mentoring the Mentors" workshop at UCSF to train mid-level and senior HIV researchers from around the country [recruited mainly from Centers for AIDS Research (CFARs)] on best practices, tools and techniques of effective mentoring. The workshop content was designed using principles of Social Cognitive Career Theory (SCCT) and included training specifically geared towards working with early career investigators from underrepresented groups, including sessions on unconscious bias, microaggressions, and diversity supplements. The workshop has been held three times (September 2012, October 2013 and May 2015) with plans for annual training. Mentoring competency was measured using a validated tool before and after each workshop. Mentoring competency skills in six domains of mentoring-specifically effective communication, aligning expectations, assessing understanding, fostering independence, addressing diversity and promoting development-all improved as assessed by a validated measurement tool for participants pre- and -post the "Mentoring the Mentors" training workshops. Qualitative assessments indicated a greater awareness of the micro-insults and unconscious bias experienced by mentees of diversity and a commitment to improve awareness and mitigate these effects via the mentor-mentee relationship. Our "Mentoring the Mentors" workshop for HIV researchers/mentors offers a formal and structured curriculum on best practices, tools and techniques of effective mentoring, and methods to mitigate unconscious bias in the mentoring relationship. We found quantitative and qualitative improvements in mentoring skills as assessed by self-report by participants after each workshop and plan additional programs with longitudinal longer-term assessments focused on objective mentee outcomes (grants, papers, academic retention). Mentoring training can improve mentoring skills and is likely to improve outcomes for optimally-mentored mentees.

Beyond the Clinic: Physician Assistant Student Perspectives on Careers in Physician Assistant Education

PURPOSE

Professional training programs for physician assistants (PAs) have been rapidly expanding. The profession therefore needs to develop a sufficiently robust teaching workforce.

METHODS

This study surveyed current PA students from all Physician Assistant Education Association member programs to ascertain their level of interest in and understanding of careers in PA education, including faculty and precepting roles.

RESULTS

The study revealed that interest was greatest in precepting roles. A higher level of education before attending a PA program correlated with a higher interest in PA education roles, although an education-related degree did not show a significant relationship with such roles.

CONCLUSION

These and other study findings are important to consider as the profession continues to develop a pipeline to education careers for students and clinicians.

Health care leadership development and training: progress and pitfalls

Formal training in the multifaceted components of leadership is now accepted as highly desirable for health care leaders. Despite natural leadership instincts, some core leadership competencies ("differentiating competencies") must be formally taught or refined. Leadership development may begin at an early career stage. Despite the recognized need, the number of comprehensive leadership development opportunities is still limited. Leadership training programs in health care were started primarily as internal institutional curricula, with a limited scope, for the development of faculty or practitioners. More comprehensive national leadership programs were developed in response to the needs of specific cohorts of individuals, such as programs for women, which are designed to increase the ranks of senior women leaders in the health sciences. As some programs reach their 20th year of existence, outcomes research has shown that health care leadership training is most effective when it takes place over time, is comprehensive and interdisciplinary, and incorporates individual/institutional projects allowing participants immediate practical application of their newly acquired skills. The training should envelop all the traditional health care domains of clinical practice, education, and research, so the leader may understand all the activities taking place under his/her leadership. Early career leadership training helps to develop a pipeline of leaders for the future, setting the foundation for further development of those who may chose to pursue significant leadership opportunities later in their career. A combination of early and mid-to-late career development may represent the optimal training for effective leaders. More training programs are needed to make comprehensive leadership development widely accessible to a greater number of potential health care leaders. This paper addresses the skills that health care leaders should develop, the optimal leadership development concepts that must be acquired to succeed as a health care leader today, some resources for where such training may be obtained, and what gaps are still present in today's system.

A first step toward understanding best practices in leadership training in undergraduate medical education: a systematic review

PURPOSE

To characterize leadership curricula in undergraduate medical education as a first step toward understanding best practices in leadership education.

METHOD

The authors systematically searched the PubMed, Education Resources Information Center, Academic Search Complete, and Education Full Text databases for peer-reviewed English-language articles published 1980-2014 describing curricula with interventions to teach medical students leadership skills. They characterized educational settings, curricular format, and learner and instructor types. They assessed effectiveness and quality of evidence using five-point scales adapted from Kirkpatrick's four-level training evaluation model (scale: 0-4) and a Best Evidence Medical Education guide (scale: 1-5), respectively. They classified leadership skills taught into the five Medical Leadership Competency Framework (MLCF) domains.

RESULTS

Twenty articles describing 24 curricula met inclusion criteria. The majority of curricula (17; 71%) were longitudinal, delivered over periods of one semester to four years. The most common setting was the classroom (12; 50%). Curricula were frequently provided to both preclinical and clinical students (11; 46%); many (9; 28%) employed clinical faculty as instructors. The majority (19; 79%) addressed at least three MLCF domains; most common were working with others (21; 88%) and managing services (18; 75%). The median effectiveness score was 1.5, and the median quality of evidence score was 2.

CONCLUSIONS

Most studies did not demonstrate changes in student behavior or quantifiable results. Aligning leadership curricula with competency models, such as the MLCF, would create opportunities to standardize evaluation of outcomes, leading to better measurement of student competency and a better understanding of best practices.