Exploring medical students' perspectives of physician leadership

BACKGROUND

Leadership has been recognized as an important competency in medicine. Nevertheless, leadership curricula for Canadian medical students lacks standardization and may not be informed by medical students' perspectives of physician leadership. The purpose of this study was to elicit these perspectives on physician leadership.

METHODS

The present study utilized semi-structured interviews to ascertain the views of medical student participants, including students in their first, second and third years of medical school, on physician leadership. Interview questions were based on 'the 3-C model' of physician leadership, which includes three aspects of leadership, namely character, competence and commitment. The interviews were audio-recorded, transcribed and then coded using thematic analysis.

RESULTS

The medical students of this study provided rich examples of resident and staff physicians demonstrating effective and ineffective leadership. The participants identified the importance of character to effective physician leadership, but some participants also described a feeling of disconnect with the relevance of character at their stage of training. When discussing physician competence, medical students described the importance of both medical expertise and transferable skills. Lastly, the leadership aspect of commitment was identified as being relevant, but medical students cautioned against the potential for physician burnout. The medical student participants' suggestions for improved leadership development included increased experiences with examples of physician leadership, opportunities to engage in leadership and participation in reflection exercises.

CONCLUSIONS

Overall, the study participants demonstrated an appreciation for three aspects of leadership; character, competence and commitment. Furthermore, they also provided recommendations for the future design of medical leadership curricula.

Complexity of the Diagnosis of COVID-19 in the Context of Pandemicity: Need for Excellence in Diagnostic Acumen

Coronavirus disease 2019 (COVID-19) is a highly infectious disease that has caused a pandemic devastating many countries worldwide. It is a complex and multifaceted disease with a unique coronavirus etiology, pathogenesis, zoonotic, and human-to-human transmission, causing acute respiratory distress syndrome with high mortality. Accurate and timely diagnosis is of utmost importance. In this study, we discussed the complexities of COVID-19 diagnostic elements in the context of pandemicity, drawing from our awareness, observations, and lessons learned from two previous coronavirus pandemics, namely SARS-CoV (severe acute respiratory syndrome coronavirus) in 2002 and MERS-CoV (Middle East respiratory syndrome-related coronavirus) in 2012, and how they applied to the diagnosis of COVID-19 today. Diagnosis of COVID-19 takes place without physician-patient personal contact due to isolation or quarantine or in the hospital setting, emergency units, and critical care units with the cumbersome barriers of personal protective equipment. Technical diagnosis is important, but we also emphasized the human impact of diagnosing COVID-19. Conveying the diagnosis of a critical disease to patients and families requires aspects of excellence in professionalism: ethics, empathy, and humility. Diagnostic skills in COVID-19 should extend to prognostication for patients suffering at the end of life, so that they will not be deprived of high-quality palliative care and comfort.

What do humble doctors do? A conceptualization of clinician humility from the patient's perspective

OBJECTIVE

Humility is a desirable trait for clinicians (e.g., physicians, nurse practitioners, physician assistants), but it can be difficult to achieve. Although commentary and empirical studies on clinician humility exist, the literature has overlooked what exactly constitutes a humble clinician through the patients' eyes. Using a mixed-methods approach, this study explored clinician humility from the patient's perspective.

METHOD

Participants (N = 326; 42.1% female; Mage = 40.65, SDage = 11.73) listed humble behaviors that their clinician displayed and evaluated their clinician's overall humility through an online survey. All participants were from the United States of America.

RESULTS

Participants rated their clinician favorably on humility, M = 4.06, SD = 0.94 (on a 1-5 scale). Through thematic analyses, we created five themes about clinician humility: approachability, respect for patient, nonverbal communication, patient-focus, and acknowledgement of limitations.

CONCLUSIONS

The themes coincide with facets of humility within the literature and overlap with important strategies to improve the clinician-patient relationship.

PRACTICE IMPLICATIONS

Clinician humility may serve as a useful framework to categorize important clinician behaviors in the medical interaction. Instead of attempting to remember a myriad of concepts, one may need to keep in mind a modest unifying notion: "be humble".

Teaching Intellectual Humility Is Essential in Preparing Collaborative Future Pharmacists

Interprofessional teams contribute significantly to patient care and safety. However, barriers to effective interdisciplinary collaboration have been identified, such as power dynamics and mistrust among team members, contrasting ideologies, interests and levels of engagement of clinicians, and disciplinary territoriality, which could negatively impact patient care. Teaching current health professional students behaviors and personal values that promote collaboration is critical in equipping them to function effectively in an interdisciplinary care setting. In this commentary, we put forward the idea that teaching intellectual humility is important in preparing collaborative future pharmacists. The core dimensions of intellectual humility, namely, open-mindedness, intellectual modesty, engagement, and corrigibility are important behaviors that could address the above-mentioned barriers, and promote successful interdisciplinary collaboration. Furthermore, we suggest strategies through which student pharmacists could be taught intellectual humility, mainly within the interprofessional education setting.