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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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Murphy VL, Chao P, Koea J, Srinivasa S. Systematic review of the efficacy and purpose of student surgical interest groups. ANZ J Surg 2023; 93:2580-2588. [PMID: 37861106 DOI: 10.1111/ans.18732] [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: 07/25/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND There is concern around projected unmet need in the surgical workforce internationally. Current barriers to medical students pursuing surgical careers include lack of early exposure, low confidence in surgical skills, and perceived lifestyle barriers. This review aimed to examine both the purpose of student surgical interest groups (SIGs) globally, and their effect on metrics representing student surgical career interest. barriers. METHODS MEDLINE, EMBASE, PubMed, and Google Scholar were searched for papers analysing surgical interest group purpose and efficacy. Risk of bias was assessed for survey-based papers using a 20-point checklist. Descriptive analysis was performed based on qualitative data. RESULTS Twenty-eight papers were included in the analysis including 13 surveys. These were of moderate quality. The analysed SIGs had 100-1000 student members and a diverse range of funding sources. Purpose of SIGs was described by 26 of 28 papers with common themes including promotion of surgical career choice and developing theoretical/practical surgical skills. Common initiatives of SIGs included surgical lectures/teaching and practical skills workshops. Data from 15 papers analysing efficacy of SIGs suggested they positively influenced self-reported student interest in surgical careers (78.6%) and confidence in surgical knowledge (80%), as well as confidence in practical skills, knowledge about surgical careers/lifestyle, mentorship opportunity, and research involvement. CONCLUSION Student SIGs make a unique contribution to early medical student experience through positive effect on promoting surgical careers. They target relevant metrics such as surgical knowledge and confidence that are known to influence surgical career choice in the modern surgical landscape.
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Affiliation(s)
| | - Phillip Chao
- Department of Surgery, North Shore Hospital, Auckland, New Zealand
| | - Jonathan Koea
- Department of Surgery, North Shore Hospital, Auckland, New Zealand
| | - Sanket Srinivasa
- Department of Surgery, North Shore Hospital, Auckland, New Zealand
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Mansour LT, Banker K, Blackwood E, Ibrahim M, Daudu D, Raubenheimer K, Franco H, Fitzpatrick S, Gladman MA. The Australasian Students' Surgical Association: organizational growth amidst the challenges of the COVID-19 pandemic. ANZ J Surg 2022; 92:1596-1597. [PMID: 35950671 PMCID: PMC9538627 DOI: 10.1111/ans.17902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/15/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Laure Taher Mansour
- Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Karan Banker
- Medical School, University of Auckland, Auckland, New Zealand
| | - Emma Blackwood
- Medical School, Macquarie University, Sydney, New South Wales, Australia
| | - Muhammad Ibrahim
- Medical School, James Cook University, Townsville, Queensland, Australia
| | - Davina Daudu
- Department of Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia.,School of Medicine, University of Western, Australia
| | - Kyle Raubenheimer
- Department of Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Helena Franco
- Department of Surgery, Queensland Health, Brisbane, Queensland, Australia.,Harvard Medical School, Boston, Massachusetts, USA.,Medical School, Bond University, Gold Coast, Australia
| | - Siobhan Fitzpatrick
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Plastics and Reconstructive Surgery Department, Flinders Medical Center, Adelaide, South, Australia
| | - Marc A Gladman
- Section of Academic Surgery, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
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