Ogurek Barbara, Harendza Sigrid
Academy for Training and Career, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
III. Department of Internal Medicine, University Medical Centre Hamburg- Eppendorf, Hamburg, Germany.
BMC Med Educ. 2025 Jul 12;25(1):1044. doi: 10.1186/s12909-025-07635-4.
Medical leadership plays an increasing role in quality healthcare. Nearly all physicians hold leadership roles during their career. Therefore, the development of medical leadership competence should start during undergraduate education and continue to postgraduate training. Some medical schools offer specific leadership programs, but in many medical schools, students are just embedded in the clinical environment, observing leaders in action. The goal of our cohort study was to explore how undergraduate medical students assess their leadership competences at the beginning and at the end of the final year without participation in a leadership program.
Between November 2023 and June 2024, we conducted a cross-sectional cohort study with 112 students at the beginning (1 trimester) and 117 students at the end (3 trimester) of their final year. All participants assessed their leadership competence with the Medical Leadership Competence Scale (MeLeCoS) on a 5-point Likert scale (1: 'never', 2: 'rarely', 3: 'sometimes', 4: 'often', 5: 'always'). A t-test and Mann-Whitney-U-tests were calculated for the overall MeLeCoS score, for the six MeLeCoS factors, and the 37 items, respectively, to test for significant differences between both cohorts. Within both cohorts, factors were ordered according to their mean values. Wilcoxon-tests were calculated to look for significant differences between two adjacent factors.
No significant differences could be found between both cohorts for neither the overall MeLeCoS score nor for any of the factors or any item. In both cohorts, the factor 2 ('Demonstrating responsible behaviour and shaping relations') had the highest level in the self-assessment (1 trimester; 4.32 ± 0.40 and 3 trimester; 4.31 ± 0.36). Factor 4 ('Developing self-management and supporting management in healthcare') and 6 ('Introducing systemic perspectives into organizations') were the only factors that showed no significant difference in their adjacent mean values.
Given that there were no significant differences between both cohorts, including teaching of medical leadership into the final year is recommended. As some medical leadership competences are highly developed at the beginning of the final year, a medical leadership curriculum should start before the final year. Individual development could be monitored and reflected by self-assessment using the MeLeCoS.
医学领导力在优质医疗保健中发挥着越来越重要的作用。几乎所有医生在其职业生涯中都担任领导角色。因此，医学领导力能力的培养应从本科教育阶段开始，并持续到研究生培训阶段。一些医学院校提供专门的领导力课程，但在许多医学院校，学生只是融入临床环境，观察领导者的实际工作。我们这项队列研究的目的是探讨本科医学生在未参加领导力课程的情况下，在最后一年开始时和结束时如何评估自己的领导能力。
在2023年11月至2024年6月期间，我们对112名学生在最后一年开始时（第一学期）和117名学生在最后一年结束时（第三学期）进行了一项横断面队列研究。所有参与者使用医学领导力能力量表（MeLeCoS）在5点李克特量表（1：“从不”，2：“很少”，3：“有时”，4：“经常”，5：“总是”）上评估自己的领导能力。分别对MeLeCoS总分、六个MeLeCoS因素和37个项目进行t检验和曼-惠特尼-U检验，以检验两个队列之间的显著差异。在两个队列中，各因素按其平均值排序。计算威尔科克森检验以寻找两个相邻因素之间的显著差异。
两个队列在MeLeCoS总分、任何因素或任何项目上均未发现显著差异。在两个队列中，因素2（“表现出负责任的行为并塑造关系”）在自我评估中的水平最高（第一学期；4.32±0.40，第三学期；4.31±0.36）。因素4（“在医疗保健中发展自我管理并支持管理工作”）和因素6（“将系统观点引入组织”）是仅有的相邻平均值无显著差异的因素。
鉴于两个队列之间没有显著差异，建议在最后一年纳入医学领导力教学内容。由于一些医学领导力能力在最后一年开始时就已经高度发展，医学领导力课程应在最后一年之前开始。可以使用MeLeCoS通过自我评估来监测和反思个人发展情况。
