L.S. Rotenstein is assistant medical director, Population Health and Faculty Development and Wellbeing, Brigham and Women's Hospital, and instructor of medicine, Harvard Medical School, Boston, Massachusetts.
R.S. Huckman is professor of business administration, Harvard Business School, unit head, Technology and Operations Management, and faculty chair, Harvard Business School Health Care Initiative, Boston, Massachusetts.
Acad Med. 2021 May 1;96(5):652-654. doi: 10.1097/ACM.0000000000003887.
The COVID-19 crisis has forced physicians to make daily decisions that require knowledge and skills they did not acquire as part of their biomedical training. Physicians are being called upon to be both managers-able to set processes and structures-and leaders-capable of creating vision and inspiring action. Although these skills may have been previously considered as just nice to have, they are now as central to being a physician as physiology and biochemistry. While traditionally only selected physicians have received management training, either through executive or joint degree programs, the authors argue that the pandemic has highlighted the importance of all physicians learning management and leadership skills. Training should emphasize skills related to interpersonal management, systems management, and communication and planning; be seamlessly integrated into the medical curriculum alongside existing content; and be delivered by existing faculty with leadership experience. While leadership programs, such as the Pediatric Leadership for the Underserved program at the University of California, San Francisco, and the Clinical Process Improvement Leadership Program at Mass General Brigham, may include project work, instruction by clinical leaders, and content delivered over time, examples of leadership training that seamlessly blend biomedical and management training are lacking. The authors present the Leader and Leadership Education and Development curriculum used at the Uniformed Services University of the Health Sciences, which is woven through 4 years of medical school, as an example of leadership training that approximates many of the principles espoused here. The COVID-19 pandemic has stretched the logistical capabilities of health care systems and the entire United States, revealing that management and leadership skills-often viewed as soft skills-are a matter of life and death. Training all physicians in these skills will improve patient care, the well-being of the health care workforce, and health across the United States.
新冠疫情迫使医生们每天都要做出决策，而这些决策需要他们掌握医学专业培训之外的知识和技能。医生不仅需要具备管理能力（包括制定流程和结构的能力），还需要具备领导能力（包括创造愿景和激发行动的能力）。虽然这些技能以前可能被认为是可有可无的，但现在它们与生理学和生物化学一样，是成为一名医生的核心技能。虽然传统上只有经过管理培训的少数医生，或者通过行政或联合学位课程，才接受过管理培训，但作者认为，这场大流行凸显了所有医生学习管理和领导技能的重要性。培训应侧重于人际关系管理、系统管理以及沟通和规划方面的技能；应与现有课程内容无缝融合到医学课程中；并由具有领导经验的现有教师来提供。虽然领导力项目，如加州大学旧金山分校的儿科服务领导力项目和麻省总医院布里格姆的临床流程改进领导力项目，可能包括项目工作、临床领导者的指导以及随着时间的推移提供的内容，但缺乏将生物医学和管理培训无缝融合的领导力培训示例。作者介绍了在统一服务大学健康科学中心使用的 Leader and Leadership Education and Development 课程，该课程贯穿医学 4 年的学习，是领导力培训的一个示例，它近似于这里所倡导的许多原则。新冠疫情大流行已经考验了医疗系统和整个美国的后勤能力，这表明管理和领导技能——通常被视为软技能——是生死攸关的问题。对所有医生进行这些技能的培训将改善患者护理、医疗保健工作者的福祉以及美国的整体健康水平。
