研究生医学教育领导力发展：文献系统评价。

Leadership Development in Postgraduate Medical Education: A Systematic Review of the Literature.

机构信息

N. Sultan is nephrologist and assistant professor, Department of Nephrology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. J. Torti is research associate, Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0003-4518-0255. W. Haddara is associate professor, Division of Endocrinology and Metabolism, Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; ORCID: https://orcid.org/0000-0002-9817-5524. A. Inayat is a neuroscience student, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0002-1685-9616. H. Inayat is a neuroscience student, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-1601-5269. L. Lingard is professor, Department of Medicine, and director, Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.

出版信息

Acad Med. 2019 Mar;94(3):440-449. doi: 10.1097/ACM.0000000000002503.

DOI:10.1097/ACM.0000000000002503

PMID:30379659

Abstract

PURPOSE

To evaluate and interpret evidence relevant to leadership curricula in postgraduate medical education (PGME) to better understand leadership development in residency training.

METHOD

The authors conducted a systematic review of peer-reviewed, English-language articles from four databases published between 1980 and May 2, 2017 that describe specific interventions aimed at leadership development. They characterized the educational setting, curricular format, learner level, instructor type, pedagogical methods, conceptual leadership framework (including intervention domain), and evaluation outcomes. They used Kirkpatrick effectiveness scores and Best Evidence in Medical Education (BEME) Quality of Evidence scores to assess the quality of the interventions.

RESULTS

Twenty-one articles met inclusion criteria. The classroom setting was the most common educational setting (described in 17 articles). Most curricula (described in 13 articles) were isolated, with all curricula ranging from three hours to five years. The most common instructor type was clinical faculty (13 articles). The most commonly used pedagogical method was small group/discussion, followed by didactic teaching (described in, respectively, 15 and 14 articles). Study authors evaluated both pre/post surveys of participant perceptions (n = 7) and just postintervention surveys (n = 10). The average Kirkpatrick Effectiveness score was 1.0. The average BEME Quality of Evidence score was 2.

CONCLUSIONS

The results revealed that interventions for developing leadership during PGME lack grounding conceptual leadership frameworks, provide poor evaluation outcomes, and focus primarily on cognitive leadership domains. Medical educators should design future leadership interventions grounded in established conceptual frameworks and pursue a comprehensive approach that includes character development and emotional intelligence.

摘要

目的

评估和解释与研究生医学教育（PGME）领导力课程相关的证据，以更好地理解住院医师培训中的领导力发展。

方法

作者对 1980 年至 2017 年 5 月 2 日期间在四个数据库中发表的 4 篇同行评审的英文文章进行了系统回顾，这些文章描述了旨在培养领导力的具体干预措施。他们描述了教育环境、课程格式、学习者水平、教师类型、教学方法、概念领导力框架（包括干预领域）和评估结果。他们使用柯克帕特里克有效性评分和最佳医学教育证据（BEME）证据质量评分来评估干预措施的质量。

结果

21 篇文章符合纳入标准。课堂环境是最常见的教育环境（在 17 篇文章中描述）。大多数课程（在 13 篇文章中描述）是孤立的，所有课程从 3 小时到 5 年不等。最常见的教师类型是临床教师（13 篇文章）。最常用的教学方法是小组/讨论，其次是教学（分别在 15 篇和 14 篇文章中描述）。研究作者评估了参与者感知的预/后调查（n = 7）和仅干预后调查（n = 10）。柯克帕特里克有效性评分的平均值为 1.0。BEME 证据质量评分的平均值为 2.0。