Medical Leaders Identify Personal Characteristics and Experiences that Contribute to Leadership Success in Medicine.

This article was migrated. The article was marked as recommended. Introduction: The approach of medical educators to preparing learners for leadership reflects the emphasis leadership theories once placed on experiential learning. But, contemporary theories now also show a renewed interest in the role of personal characteristics in effective leadership. This shift raises questions explored here: What characteristics mark top medical leaders? What experiences nurture those characteristics? Method: In a 2015 qualitative study, 48 University of Missouri-Kansas City (UMKC) medical graduates who met criteria for outstanding leadership participated in semi-structured interviews. Investigators applied directed content-analysis to their responses. Then, using iterative open-coding, investigators identified personal characteristics leaders said contributed to their leadership, clustered them into types, and counted the number of leaders who spoke to each type. Next, they coded and categorized experiences leaders discussed and counted the number of leaders who mentioned each type of experience. Finally, they identified leaders' comments about which types of experiences helped develop which types of characteristics. Results: Most leadersmentioned four types of characteristics: openness to new ideas/opportunities/astute risk-taking; intense motivation/active involvement/commitment; people-orientation; and capability/competence/ intelligence. Many discussed two additional types: self-awareness and service-orientation. Leaders said these types of experiences nurtured their characteristics: family traditions, high-school co-curricular activities, participation in medical school learning communities plus interaction with role models/mentors and authentic opportunities to practice leadership, innovation, and excellence throughout their education and in the workplace. Conclusions: Medical leaders' views of the role of personal characteristics in outstanding leadership and the power of educational and workplace experiences, especially informal ones, to mold those characteristics have enriched understanding how to prepare tomorrow's leaders.

Medical School Factors That Prepare Students to Become Leaders in Medicine.

PURPOSE: To identify medical school factors graduates in major leadership positions perceive as contributing to their leadership development. METHOD: Using a phenomenological, qualitative approach, in August-November 2015 the authors conducted semistructured interviews with 48 medical leaders who were 1976-1999 baccalaureate-MD graduates of the University of Missouri-Kansas City School of Medicine (UMKC). At UMKC, they participated in longitudinal learning communities, the centerpiece for learning professional values and behaviors plus clinical skills, knowledge, and judgment, but received no formal leadership instruction. The authors subjected interview comments to directed, largely qualitative content analysis with iterative coding cycles. RESULTS: Most graduates said their experiences and the people at UMKC positively influenced their leadership growth. Medical school factors that emerged as contributing to that growth were the longitudinal learning communities including docents, junior-senior partners, and team experiences; expectations set for students to achieve; a clinically oriented but integrated curriculum; admission policies seeking students with academic and nonacademic qualifications; supportive student-student and student-faculty relationships; and a positive overall learning environment. Graduates viewed a combination of factors as best preparing them for leadership and excellence in clinical medicine; together these factors enabled them to assume leadership opportunities after graduation. CONCLUSIONS: This study adds medical leaders' perspective to the leadership development literature and offers guidance from theory and practice for medical schools to consider in shaping leadership education: Namely, informal leadership preparation coupled with extensive longitudinal clinical education in a nurturing, authentic environment can develop students effectively for leadership in medicine.

What students learn about professionalism from faculty stories: an "appreciative inquiry" approach.

PURPOSE: To develop a method for teaching professionalism by enabling students and faculty members to share positive examples of professionalism in a comfortable environment that reflects the authentic experiences of physicians. Medical educators struggle with the teaching of professionalism. Professionalism definitions can guide what they teach, but they must also consider how they teach it, and constructs such as explicit role modeling, situated learning, and appreciative inquiry provide appropriate models. METHOD: The project consisted of students interviewing faculty members about their experiences with professionalism and then reflecting on and writing about the teachers' stories. In 2004, 62 students interviewed 33 faculty members, and 193 students observed the interviews. Using a project Web site, 36 students wrote 132 narratives based on the faculty's stories, and each student offered his or her reflections on one narrative. The authors analyzed the content of the narratives and reflections via an iterative process of independent coding and discussion to resolve disagreements. RESULTS: Results showed that the narratives were rich and generally positive; they illustrated a broad range of the principles contained in many definitions of professionalism: humanism, accountability, altruism, and excellence. The students' reflections demonstrated awareness of the same major principles of professionalism that the faculty conveyed. The reflections served to spark new ideas about professionalism, reinforce the values of professionalism, deepen students' relationships with the faculty, and heighten students' commitment to behaving professionally. CONCLUSIONS: Narrative storytelling, as a variant of appreciative inquiry, seems to be effective in deepening students' understanding and appreciation of professionalism.

Development of an instrument to measure the climate of professionalism in a clinical teaching environment.

BACKGROUND: This report describes an instrument that measures professionalism in clinical environments, reports its psychometric properties, and discusses its potential uses. METHOD: The survey asked students (n = 371) to report the frequency of peers', residents', and faculty's professionalism behaviors and faculty's professionalism teaching, and it asked faculty (n = 28) to self-assess their teaching of professionalism. The authors investigated the instrument's reliability, convergent validity, and ability to detect differences between groups. RESULTS: Coefficient alphas were .75 or higher. Correlations showed positive relationships between students' perceptions of professionalism behaviors and faculty's professionalism teaching. t-tests indicated that preclinical students rated faculty's professionalism behaviors higher than did clinical students, and students rated faculty's professionalism teaching higher than the faculty rated themselves. CONCLUSIONS: The psychometrics of the instrument's scores are sound. The instrument has potential to meet the Liaison Committee on Medical Education's mandate to measure professional standards within learning environments and to track effects of interventions promoting the professionalism of learners and faculty.