Mai Daniel H, Newton Heather, Farrell Peter R, Mullan Paul, Kapoor Rupa
School of Medicine, Eastern Virginia Medical School, Norfolk, USA.
Department of Pediatrics, Eastern Virginia Medical School, Norfolk, USA.
J Med Educ Curric Dev. 2021 Jan 22;8:2382120520988593. doi: 10.1177/2382120520988593. eCollection 2021 Jan-Dec.
Although clinical leadership in physicians is associated with improved healthcare, leadership training is rarely integrated into residency training. Our objective was to perform a comprehensive needs assessment of our pediatric residents' existing leadership experiences and knowledge and to identify training gaps within our program.
First, we held focus groups with senior pediatric residents to understand their clinical leadership experiences and identify training needs. Notes were transcribed and independently coded by 2 researchers, with thematic saturation achieved. Next, we focused each session on 1 leadership content area identified from the aforementioned themes to better understand the specific training needs for each topic.
Four major themes were identified: (1) Effective and timely communication with supervisors, learners, ancillary staff, and patients is indispensable in promoting safe patient care, avoiding conflict, and preventing misunderstanding. (2) Training in teaching methods is desired, especially gaining the skills needed to teach various levels of learners, in different settings and under time constraints. (3) Time management, availability of resources, and team logistics were often learned through trial-and-error. (4) Self-care, self-acceptance, emotional regulation, and peer debriefing are relied upon to manage negative emotions; rarely are resilience and wellness strategies employed in "real-time."
Senior residents currently face gaps in clinical leadership training and may benefit from additional instruction in content areas related to these 4 themes. Our next steps are to utilize the identified themes to develop a longitudinal and skills-based clinical leadership curriculum to address the gap in graduate medical education.
尽管医生的临床领导力与改善医疗保健相关，但领导力培训很少纳入住院医师培训。我们的目标是对儿科住院医师现有的领导经验和知识进行全面的需求评估，并确定我们项目中的培训差距。
首先，我们与资深儿科住院医师进行了焦点小组讨论，以了解他们的临床领导经验并确定培训需求。由两名研究人员对笔记进行转录和独立编码，直至达到主题饱和。接下来，我们将每个环节聚焦于从上述主题中确定的一个领导内容领域，以更好地了解每个主题的具体培训需求。
确定了四个主要主题：（1）与上级、学习者、辅助人员和患者进行有效及时的沟通对于促进患者安全护理、避免冲突和防止误解必不可少。（2）希望接受教学方法培训，尤其是获得在不同环境和时间限制下教授不同层次学习者所需的技能。（3）时间管理、资源可用性和团队后勤通常是通过反复试验学到的。（4）依靠自我护理、自我接纳、情绪调节和同伴汇报来管理负面情绪；在“实时”中很少采用恢复力和健康策略。
资深住院医师目前在临床领导力培训方面存在差距，可能会从与这四个主题相关的内容领域的额外指导中受益。我们的下一步是利用确定的主题制定一个基于技能的纵向临床领导力课程，以弥补毕业后医学教育中的差距。
