Dr. Rosenman is acting instructor, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington. Dr. Shandro is associate professor, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington. Dr. Ilgen is assistant professor, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington. Ms. Harper is associate librarian, Health Sciences Library, University of Washington Library Services, Seattle, Washington. Dr. Fernandez is associate professor, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington.
Acad Med. 2014 Sep;89(9):1295-306. doi: 10.1097/ACM.0000000000000413.
To identify and describe the design, implementation, and evidence of effectiveness of leadership training interventions for health care action (HCA) teams, defined as interdisciplinary teams whose members coordinate their actions in time-pressured, unstable situations.
The authors conducted a systematic search of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012. They identified peer-reviewed English-language articles describing leadership training interventions targeting HCA teams, at all levels of training and across all health care professions. Reviewers, working in duplicate, abstracted training characteristics and outcome data. Methodological quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI).
Of the 52 included studies, 5 (10%) focused primarily on leadership training, whereas the remainder included leadership training as part of a larger teamwork curriculum. Few studies reported using a team leadership model (2; 4%) or a theoretical framework (9; 17%) to support their curricular design. Only 15 studies (29%) specified the leadership behaviors targeted by training. Forty-five studies (87%) reported an assessment component; of those, 31 (69%) provided objective outcome measures including assessment of knowledge or skills (21; 47%), behavior change (8; 18%), and patient- or system-level metrics (8; 18%). The mean MERSQI score was 11.4 (SD 2.9).
Leadership training targeting HCA teams has become more prevalent. Determining best practices in leadership training is confounded by variability in leadership definitions, absence of supporting frameworks, and a paucity of robust assessments.
确定并描述针对医疗保健行动（HCA）团队的领导力培训干预措施的设计、实施和有效性证据，这些团队被定义为成员在时间紧迫、不稳定的情况下协调行动的跨学科团队。
作者对 PubMed/MEDLINE、CINAHL、ERIC、EMBASE、PsycINFO 和 Web of Science 数据库、主要期刊以及 2012 年 3 月之前发表的综述文章进行了系统检索。他们确定了描述针对 HCA 团队的领导力培训干预措施的同行评审的英文文章，培训对象涵盖所有医疗保健专业，培训层次也各不相同。审查员以重复方式提取培训特征和结果数据。使用医学教育研究学习质量工具（MERSQI）评估方法学质量。
在 52 项纳入的研究中，有 5 项（10%）主要关注领导力培训，而其余研究则将领导力培训作为更大的团队合作课程的一部分。很少有研究报告使用团队领导模型（2 项；4%）或理论框架（9 项；17%）来支持其课程设计。只有 15 项研究（29%）明确了培训所针对的领导行为。45 项研究（87%）报告了评估部分；其中，31 项（69%）提供了客观的结果衡量标准，包括知识或技能评估（21 项；47%）、行为改变（8 项；18%）和患者或系统水平指标（8 项；18%）。MERSQI 的平均得分为 11.4（SD 2.9）。
针对 HCA 团队的领导力培训已经变得更加普遍。领导力培训的最佳实践因领导力定义的差异、缺乏支持框架以及缺乏稳健的评估而变得复杂。
