Preparing the Next Generation of Physician Leaders: Teaching Management Skills to Medical Students and Residents

Preparing the Next Generation of Physician Leaders: Teaching Management Skills to Medical Students and Residents

I. Michael Leitman (Icahn School of Medicine at Mount Sinai, USA) and Brian Nickerson (Icahn School of Medicine at Mount Sinai, USA)
DOI: 10.4018/978-1-7998-1468-9.ch007

Abstract

Formal training in leadership development has become increasingly popular among physicians. There is a growing interest to provide this educational content to medical students and residents so that they will have these skills upon the start of their clinical or academic medical practice. It is possible to provide the proper management skills to medical trainees so they will have the opportunity to utilize and master these competences during their education. This chapter provides an overview of the available content and the literature to support the integration of this curriculum into formal undergraduate and graduate medical education. This chapter provides a template for the development of a longitudinal experience and the necessary proficiencies to allow trainees to develop as effective clinical leaders.
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Background

Will we have enough candidates to fill leadership positions in academic medicine in the next few decades? Physician education in the 21st century faces a number of challenges, including an increasingly complex health care system, rapid changes in technology, increasing regulation of working and learning hours, and reductions of resources for student and resident education. While most physicians eventually complete the long process of multidimensional growth needed to become a competent practitioner, only some continue their careers as medical leaders or educators, and fewer seek to become educational leaders in undergraduate and graduate medical education. Medical school, residency, and fellowship have always prepared learners to organize, communicate, educate, and administer, but today’s physicians who choose a career path outside of the traditional practice model, or perhaps even within it, need to acquire additional skills that were often not part of traditional medical education.

The seemingly growing refrain for more management and leadership education of physicians, even at the very early career stage, is not new. For instance, in 2004, the Institute of Medicine (IOM) recommended that academic medical centers “develop leaders at all levels who can manage the organizational and system changes necessary to improve health through innovation in health professions education, patient care, and research.” Furthering this charge as it relates to graduate medical education, in 2014 the IOM issued consensus suggestions urging greater outcome measurement of education aimed at such areas as increasing value and health care delivery system effectiveness, as well as improving physician interpersonal skills around coordination of care, communication skills, and patient engagement. Similarly, Jardine et al (2015), as a member of the Council of Review Committee Residents, Leadership Subcommittee of the Accreditation Council for Graduate Medical Education (ACGME), advocated on behalf of residents and fellows for a national leadership curriculum. As a result, this educational content is consistent with the Common Program Requirements for residency and fellowship programs, beyond the development of skills in patient safety and quality improvement.

Moreover, according to Martins (2010), management education for internists should be “spiral,” starting from medical school and expanding to incorporate new activities and responsibilities as the physician matures. A 2015 study by Frich and Brewster conducted a systematic review of the literature and found no fewer than 35 reports on leadership training programs designed exclusively for physicians. The vast majority of these programs focused on skills training and substantive knowledge, while only a small number used more high-impact educational practices involving interactive techniques to increase self-awareness or stressed system-level, as opposed to only individual-level, impact.

On a broader scale, the American Medical Association (AMA) jointly issued with the American Hospital Association (AHA) a “discussion document” identifying principles for developing successful physician, as well as interprofessional, leadership to achieve better integrated health systems. In addition to the mastery of a number of core operational functions (e.g., financial planning), the AMA and AHA emphasize development of strong interpersonal skill sets for physicians, including team-building, communication, and effective negotiation.

As academic medical centers continue to integrate management education into their curricula, current trainees and practicing physicians can access such education through a combination of workshops, residential courses, and online courses. This chapter describes essential managerial and leadership skills and associated learning activities during the graduate medical education phase of training for those who will manage the education of future physicians.

Key Terms in this Chapter

Feedback: A process in which information about the past or the present influences the same phenomenon in the present or future.

Self-Awareness: An awareness of one’s own personality or individuality.

Interprofessional: A group of health care professionals from diverse fields who work together in a coordinated fashion toward a common goal for the patient.

Constituencies: The group of people involved in or served by an organization.

Psychometric assessment: The process of psychological and mental testing and of a person’s psychological traits or attitudes or mental processes.

Simulation: The modern-day methodology for training health care professionals through the use of advanced educational technology. Medical simulation is the experiential learning every health care professional will need but does not necessarily have the opportunity to see in regular practice.

Management: Health information management (HIM) is the practice of acquiring, analyzing, and protecting digital and traditional medical information vital to providing quality patient care by combining business, science, and information technology.

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