UK trainees' perceptions of leadership and leadership development.

PURPOSE: This paper reports on trainees' perceptions of leadership and leadership development, to inform the support that may be provided to them. It draws on a formative evaluation of the new role of clinical leadership mentor (CLM), introduced by Health Education England South-West in 2018. CLMs are responsible for 'overseeing the process and progress of leadership development among the trainees within their Trust/Local Education Provider'. METHODS: The evaluation was a formative evaluation, based on interviews with CLMs, trainees and trainers and a survey of trainees and trainers. Recruitment was through 8 of the 19 CLMs in the South West. A report for each participating CLM was available to support the development of their individual role. In exploring trainees' perceptions of leadership and leadership development, this paper draws on data from trainees: 112 survey returns which included over 7000 words of free text data and 13 interviews. FINDINGS: Our findings suggest a more nuanced understanding of leadership in medical trainees than was previously reported in the literature, and a wider acceptance of their leadership role. We highlight the problem of considering postgraduate doctors as a homogeneous group, particularly with reference to specialty. We also highlight that the organisational context for leadership development can be supportive or non-supportive. Leadership learning through genuine leadership experience with appropriate support from trainers and the wider Trust offers opportunities for both trainees and Trusts. PRACTICAL IMPLICATIONS: Trainees are accepting of their roles as leaders. The value of leadership learning through genuine leadership experience was highlighted. Improving the environment for leadership development offers Trusts and trainees opportunities for genuine service improvement.

Stopping, goal-conflict, trait anxiety and frontal rhythmic power in the stop-signal task.

The medial right frontal cortex is implicated in fast stopping of an initiated motor action in the stop-signal task (SST). To assess whether this region is also involved in the slower behavioural inhibition induced by goal conflict, we tested for effects of goal conflict (when stop and go tendencies are balanced) on low-frequency rhythms in the SST. Stop trials were divided, according to the delays at which the stop signal occurred, into short-, intermediate-, and long-delay trials. Consistent with goal-conflict processing, intermediate-delay trials were associated with greater 7-8 Hz EEG power than short- or long-delay trials at medial right frontal sites (Fz, F4, and F8). At F8, 7-8 Hz power was linked to high trait anxiety and neuroticism. A separate 4-7 Hz power increase was also seen in stop, relative to go, trials, but this was independent of delay, was maximal at the central midline site Cz, and predicted faster stopping. Together with previous data on the SST, these results suggest that the right frontal region could be involved in multiple inhibition mechanisms. We propose a hierarchical model of the control of stopping that integrates the literature on the neural control of fast motor stopping with that on slower, motive-directed behavioural inhibition.