Kochis Michael A, Tang Rebecca B, Petrusa Emil R, Fleshman James W, Cochran Amalia L, Phitayakorn Roy
Massachusetts General Hospital, Department of Surgery, Boston, Massachusetts.
Massachusetts General Hospital, Department of Surgery, Boston, Massachusetts.
J Surg Educ. 2025 Jan;82(1):103341. doi: 10.1016/j.jsurg.2024.103341. Epub 2024 Nov 18.
Leadership is an important competency for surgical trainees but traditionally overlooked in residency programs. Existing leadership curricula are limited by a lack of standardized objectives and validated assessment tools. This project seeks to define the most essential leadership skills for surgical residents leading inpatient teams and to develop an instrument that can be used as a workplace-based assessment.
We surveyed the literature to compile a preliminary list of relevant leadership skills. We then recruited national experts in surgical resident leadership to participate in 2 rounds of a modified Delphi process. In the first round, panelists voted to keep, modify, or remove the preliminary items, or to add additional ones. Insufficient agreement to keep a skill necessitated revision. In the second round, panelists rated their agreement with revised items' inclusion, with consensus indicated by content validity index >0.75. Leadership behaviors were mapped onto a quality rating scale.
REDCap online forms.
Sixteen experts including senior surgeons, surgical educators/social psychologists, and advanced practice providers participated in both rounds of the Delphi process.
The preliminary list included 26 behaviors grouped into 9 domains. After the first round of the Delphi process, 18 items were modified, 3 were removed, 3 were added, and 2 domains were merged. After the second round, all 27 revised behaviors in 8 domains achieved consensus. We incorporated them into the Inpatient Leadership Assessment Device (I-LEAD).
We used a consensus of national experts to define essential leadership skills for surgical residents and created a workplace-based assessment tool. I-LEAD provides a shared mental model for residents and team members, and clear objectives for educators seeking to develop leadership curricula. These efforts align with current trends toward competency-based education and can underpin the establishment of formal leadership training programs for surgical residents on a wider scale.
领导力是外科住院医师的一项重要能力，但在传统的住院医师培训项目中常被忽视。现有的领导力课程因缺乏标准化目标和经过验证的评估工具而受到限制。本项目旨在确定外科住院医师领导住院团队所需的最基本领导技能，并开发一种可作为基于工作场所评估的工具。
我们对文献进行了调查，以编制一份相关领导技能的初步清单。然后，我们招募了外科住院医师领导力方面的全国专家，参与两轮改良的德尔菲法。在第一轮中，专家小组成员投票决定保留、修改或删除初步项目，或添加其他项目。若对保留某项技能的意见分歧较大，则需要进行修订。在第二轮中，专家小组成员对修订后的项目是否应纳入进行评分，内容效度指数>0.75表示达成共识。领导行为被映射到一个质量评级量表上。
REDCap在线表单。
16名专家，包括资深外科医生、外科教育工作者/社会心理学家和高级执业提供者，参与了两轮德尔菲法。
初步清单包括26种行为，分为9个领域。经过第一轮德尔菲法，18项被修改，3项被删除，3项被添加，2个领域被合并。第二轮之后，8个领域的所有27项修订行为均达成共识。我们将它们纳入了住院患者领导力评估工具（I-LEAD）。
我们利用全国专家的共识确定了外科住院医师的基本领导技能，并创建了一种基于工作场所的评估工具。I-LEAD为住院医师和团队成员提供了一个共享的思维模式，为寻求开发领导力课程的教育工作者提供了明确的目标。这些努力与当前基于能力的教育趋势相一致，并可为更广泛地为外科住院医师建立正式的领导力培训项目奠定基础。
