Zakin Elina, Abou-Fayssal Nada, Lord Aaron S, Nelson Aaron, Rostanski Sara K, Zhang Cen, Zabar Sondra, Galetta Steven L, Kurzweil Arielle
From the Department of Neurology (E.Z., N.A.-F., A.S.L., A.N., S.K.R., C.Z., S.L.G., A.K.), and Department of Medicine (S.Z.), NYU Grossman School of Medicine, New York.
Neurol Educ. 2024 Jul 12;3(3):e200138. doi: 10.1212/NE9.0000000000200138. eCollection 2024 Sep 25.
A chief resident's role incorporates administrative, academic, and interpersonal responsibilities essential to managing a successful residency program. However, rising chief residents receive little formal exposure to leadership training.
To (1) define leadership styles; (2) understand the effect of cultural competence on leadership styles; (3) learn effective methods to advocate as the chief resident; (4) provide effective peer feedback; (5) provide effective supervisor feedback; (6) learn effective conflict management; (7) ensure psychological safety.
We developed a 1-day curriculum combining didactics and simulation activities for our program's rising chief residents. Implementation of our curricular design included a morning session focusing on small groups and didactic-based lectures on specific topics pertinent to leadership, along with a debriefing of a psychometric evaluation tool administered before the curriculum day. The simulation activity consisted of 3 group objective structured clinical examination (G-OSCE) scenarios: (1) providing a struggling junior trainee with feedback; (2) debriefing an adverse clinical outcome as the team leader; (3) navigating a challenging situation with a supervising physician. Standardized participants were surveyed for specific objectives. Learners completed precurricular and postcurricular surveys on their familiarity and preparedness for their chief year.
Comparison of preintervention (n = 16) and postintervention (n = 10) data shows improvements in familiarity with leadership models ( = 0.006), cultural competence in leadership ( = 0.027), and team organizational structure ( = 0.010) with notable improvement in report of advocating for the team to 100% of participants in the postcurricular survey. In addition, although not statistically significant, familiarity with specific strategies for feedback delivery improved ( = 0.053), as did learner comfort levels with feedback delivery (comparing 51% of learners were either very or somewhat comfortable precurriculum to 90% postcurriculum). This is further supported by standardized participant data after the G-OSCEs. Although familiarity with wellness resources did improve across learners ( = 0.421), learner-reported use of wellness resources was noted to be reduced after the curricular intervention and remains a result of further interest for exploration.
A 1-day leadership development curriculum combining didactics and simulation is an effective means of preparing rising chief residents to succeed in their transition to this leadership role.
总住院医师的角色涵盖行政、学术和人际方面的职责，这些职责对于管理一个成功的住院医师培训项目至关重要。然而，新晋总住院医师很少接受正式的领导力培训。
（1）定义领导风格；（2）理解文化能力对领导风格的影响；（3）学习作为总住院医师进行有效倡导的方法；（4）提供有效的同伴反馈；（5）提供有效的上级反馈；（6）学习有效的冲突管理；（7）确保心理安全。
我们为本院的新晋总住院医师开发了一个为期1天的课程，该课程结合了教学和模拟活动。课程设计的实施包括上午的环节，重点是小组讨论以及关于与领导力相关的特定主题的教学讲座，同时对课程当天之前进行的一项心理测量评估工具进行汇报总结。模拟活动包括3个小组客观结构化临床考试（G-OSCE）场景：（1）给一名表现不佳的初级受训者提供反馈；（2）作为团队领导对不良临床结果进行汇报总结；（3）与上级医师应对具有挑战性的情况。对标准化参与者就特定目标进行了调查。学习者完成了关于他们对总住院医师年度的熟悉程度和准备情况的课前和课后调查。
干预前（n = 16）和干预后（n = 10）数据的比较显示，在领导力模型的熟悉程度（P = 0.006）、领导力方面的文化能力（P = 0.027）和团队组织结构（P = 0.010）方面有所改善，在课后调查中，100%的参与者报告为团队进行倡导方面有显著改善。此外，虽然无统计学意义，但反馈传递的特定策略的熟悉程度有所提高（P = 0.053），学习者在反馈传递方面的舒适度也有所提高（将课前51%的学习者非常或有点舒适与课后90%进行比较）。G-OSCEs之后的标准化参与者数据进一步支持了这一点。虽然学习者对健康资源的熟悉程度确实有所提高（P = 0.421），但在课程干预后，学习者报告的健康资源使用情况有所减少，这仍然是一个有待进一步探索的感兴趣的结果。
一个结合教学和模拟的为期1天的领导力发展课程是使新晋总住院医师在向这一领导角色过渡中取得成功的有效手段。
