Barry Erin S, Dong Ting, Durning Steven J, Schreiber-Gregory Deanna, Torre Dario, Grunberg Neil E
Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD.
Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD.
Mil Med. 2019 Dec 1;184(11-12):653-660. doi: 10.1093/milmed/usz121.
Many medical schools in the United States are introducing leader and leadership curricula. However, there is a large gap regarding how to assess leader performance during undergraduate medical education. With the guidance of a conceptual framework, leadership assessment measures can be developed, learners can make expected improvements in performance over time, and assessment measures can be used in relevant, applied, medical teaching settings. Uniformed Services University (USU) medical students are educated to become healthcare leaders who can perform effectively in various settings. Medical students are assessed on multiple occasions for elements of leader performance during "Operation Bushmaster" - the capstone military medical field practicum event for fourth year medical students - by experienced faculty. A conceptual framework guides the assessment approach for leader performance during Bushmaster. The USU Leader and Leadership Education and Development program developed an assessment tool to measure student leader performance used in a military medical field practicum. The present paper examines whether: (1) leader performance can be measured at Bushmaster; (2) leader performance changed during Bushmaster; (3) leader performance elements are related to each other; and (4) overall leader performance is related to other medical academic performance.
Trained faculty assessed students' leader performance. Data from three cohorts of USU medical students (N = 509) were collected. All data were collected, compiled, deidentified, and analyzed with approval from the USU Institutional Review Board (Protocol number: KM83XV). Descriptive statistics, repeated measures t-tests, trend analyses, and correlation analyses were performed.
Data were available from 483/509 [95%] students. Results revealed that: (1) average leader performance was satisfactory; (2) overall leader performance and performance on each of the major elements of leader performance significantly improved over the course of Bushmaster; (3) major elements of leader performance were significantly correlated with each other and with overall leader performance; (4) leader performance was not correlated with students' performance on the MCAT total score or USMLE Step exam scores.
With the guidance of a conceptual framework, the assessment tool was used to assess leader performance in a relevant, applied, medical teaching setting. The findings of this study indicate that leader performance can be measured. Additionally, leader performance appears to be a separate skillset from medical academic performance and both types of performance can be taught and developed. This was a retrospective correlation study and was conducted during a military medical field practicum at a single institution. Gathering additional validity evidence of the assessment tool is needed. With additional validity evidence, the assessment tool could be applied to other medical exercises in different settings and help with the assessment of leader performance beyond medical school.
美国许多医学院校正在引入领导力及领导力课程。然而，在本科医学教育中，对于如何评估领导力表现存在很大差距。在一个概念框架的指导下，可以开发领导力评估措施，学习者可以随着时间的推移在表现上取得预期的进步，并且评估措施可以应用于相关的、实际的医学教学环境中。美国军医大学（USU）的医学生接受培训，旨在成为能够在各种环境中有效履行职责的医疗领导者。在“丛林大师行动”期间，经验丰富的教员会多次对医学生在领导力表现方面的要素进行评估，“丛林大师行动”是四年级医学生的顶点军事医学领域实践活动。一个概念框架指导着“丛林大师行动”期间领导力表现的评估方法。USU领导力教育与发展项目开发了一种评估工具，用于衡量军事医学领域实践中学生的领导力表现。本文探讨以下问题：（1）在“丛林大师行动”中能否衡量领导力表现；（2）在“丛林大师行动”期间领导力表现是否发生变化；（3）领导力表现要素之间是否相互关联；（4）整体领导力表现与其他医学学术表现是否相关。
训练有素的教员对学生的领导力表现进行评估。收集了来自USU三届医学生（N = 509）的数据。所有数据均在获得USU机构审查委员会批准（协议编号：KM83XV）后进行收集、整理、去识别和分析。进行了描述性统计、重复测量t检验、趋势分析和相关性分析。
从483/509 [95%] 的学生中获取了数据。结果显示：（1）领导力表现的平均水平令人满意；（2）在“丛林大师行动”过程中，整体领导力表现以及领导力表现各主要要素的表现均有显著提升；（3）领导力表现的主要要素之间以及与整体领导力表现均显著相关；（4）领导力表现与学生的医学院入学考试（MCAT）总成绩或美国医师执照考试（USMLE）步骤考试成绩无关。
在一个概念框架的指导下，该评估工具被用于在相关的、实际的医学教学环境中评估领导力表现。本研究结果表明，领导力表现是可以衡量的。此外，领导力表现似乎是一种与医学学术表现不同的技能集，并且这两种表现都可以通过教学和培养得到提升。这是一项回顾性相关性研究，是在一所机构的军事医学领域实践中进行的。需要收集该评估工具的更多效度证据。有了更多效度证据，该评估工具可应用于不同环境中的其他医学实践，并有助于在医学院校之外评估领导力表现。
