Wiseman Melanie, Hartzell Joshua, Kelly William F, Hemmer Paul A, Stein Michael
Internal medicine residency, National Capital Consortium, Bethesda, MD.
Department of medicine Uniformed Services University of the Health Sciences, Bethesda, MD.
J Med Educ Curric Dev. 2022 May 12;9:23821205221091523. doi: 10.1177/23821205221091523. eCollection 2022 Jan-Dec.
Leadership curricula in medical student education require assessment to determine if leadership skills can be taught to medical students and applied during clinical and medical team interactions to aid in medical student leadership development.
To examine whether medical students applied principles of their pre-clerkship leadership curriculum (character, competence, context, and communication elements across four levels: personal, interpersonal, team, and organizational) during an internal medicine clerkship.
Using art as a prompt, Uniformed Services University (USU) internal medicine clerkship students completed a structured reflection on a critical incident. Medical student essays written during a 10-week internal medicine clerkship at USU in 2019 were collected. 158 medical student submissions were de-identified and analyzed.
Sixty-four submissions (40.5%) focused on leadership or leadership and professionalism. Students identified as male (n = 34, 53%), female (21, 33%), or not reported (9, 14%). Most, 48 (75%), did not describe PITO explicitly in their essay. They instead focused on personal and interpersonal aspects (17, 27%) of leadership, the attending physicians they worked with (33, 52%), and effective leadership strategies (46, 72%). The most common themes written about were responsibility (30, 47%), teamwork (18, 28%), competence (17, 27%), and character/integrity (15, 23%).
Although the students' explicit use of the PITO model was limited, student essays centered on themes that reflected leadership concepts taught in pre-clerkship years, such as character, competence, and responsibility. This study demonstrates that an internal medicine clerkship rotation can feasibly implement a leadership reflection.
医学生教育中的领导力课程需要进行评估，以确定领导力技能是否能够传授给医学生，并在临床和医疗团队互动中应用，以促进医学生领导力的发展。
探讨医学生在内科实习期间是否应用了其临床前领导力课程的原则（品格、能力、情境和沟通要素，涵盖个人、人际、团队和组织四个层面）。
以艺术为启发，美国军医大学（USU）内科实习学生针对一个关键事件完成了结构化反思。收集了2019年USU为期10周的内科实习期间医学生所写的论文。对158份医学生提交的材料进行了去识别化处理并进行分析。
64份提交材料（40.5%）聚焦于领导力或领导力与专业素养。学生被确定为男性（n = 34，53%）、女性（21，33%）或未报告性别（9，14%）。大多数，48份（75%）在论文中未明确描述PITO。他们反而关注领导力的个人和人际方面（17，27%）、与其共事的主治医生（33，52%）以及有效的领导策略（46，72%）。所写的最常见主题是责任（30，47%）、团队合作（18，28%）、能力（17，27%）和品格/正直（15，23%）。
尽管学生对PITO模型的明确应用有限，但学生论文围绕的主题反映了临床前几年所教授的领导力概念，如品格、能力和责任。本研究表明内科实习轮转可以切实可行地实施领导力反思。
