The Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Geriatrics Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, New York, United States.
J Am Geriatr Soc. 2021 Apr;69(4):1063-1070. doi: 10.1111/jgs.17050. Epub 2021 Feb 13.
Geriatrics and palliative medicine specialists are uniquely trained to provide expert coordinated care for older adults and seriously ill and complex patients. Health system leadership geared towards this patient population is critically important as society ages. Currently, there is no standardized approach to teaching core leadership skills. To assess the leadership training needs of geriatrics and palliative medicine fellowship graduates, we conducted a needs assessment to identify (1) early career leadership trajectories and challenges and (2) knowledge and skills deemed essential for effective leadership.
Individuals identified as leaders in geriatrics and/or palliative medicine completed an electronic survey and a semi-structured qualitative interview. These leaders were divided into two categories: Icahn School of Medicine at Mount Sinai (ISMMS) trained leaders or non-ISMMS trained leaders. The semi-structured interviews were recorded, transcribed, and reviewed using thematic analysis.
Within 1 year of fellowship graduation, 50% of ISMMS trained leaders had leadership positions; within 6 years, 100% had a leadership role. Based on qualitative interviews, both ISMMS trained leaders and non-ISMMS trained leaders perceived leadership training gaps in two domains: (1) knowledge and (2) skills. Knowledge and skill gap themes included communication and management, mentorship and negotiation, program development, knowledge, and apprenticeship.
Geriatrics and palliative medicine physicians obtained leadership roles quickly after fellowship. Both ISMMS trained leaders and non-ISMMS trained leaders often felt unprepared, learned "on the job," and sought out additional leadership training. Early leadership training is needed to prepare fellowship graduates for the pressing demands of accelerated leadership.
老年医学和姑息医学专家经过专门培训，能够为老年人和重病及复杂患者提供专家级的协调护理。随着社会老龄化，针对这一患者群体的医疗体系领导层至关重要。目前，还没有针对核心领导力技能的标准化教学方法。为了评估老年医学和姑息医学研究员的领导力培训需求，我们进行了一项需求评估，以确定（1）早期职业领导轨迹和挑战，以及（2）有效领导被认为必不可少的知识和技能。
被确定为老年医学和/或姑息医学领域领导者的个人完成了一份电子调查和半结构化定性访谈。这些领导者分为两类：西奈山伊坎医学院（ISMMS）培训的领导者或非 ISMMS 培训的领导者。半结构化访谈进行了录音、转录，并使用主题分析进行了审查。
在 fellowship 毕业后的 1 年内，50%的 ISMMS 培训的领导者担任领导职务；在 6 年内，100%的人担任领导角色。基于定性访谈，ISMMS 培训的领导者和非 ISMMS 培训的领导者都认为在两个领域存在领导力培训差距：（1）知识，（2）技能。知识和技能差距主题包括沟通和管理、指导和谈判、项目开发、知识和学徒制。
老年医学和姑息医学医师在 fellowship 毕业后很快获得领导职位。ISMMS 培训的领导者和非 ISMMS 培训的领导者通常都感到准备不足，边工作边学习，并寻求额外的领导力培训。需要进行早期领导力培训，以帮助 fellowship 毕业生应对加速领导的紧迫需求。
