RESUMEN
BACKGROUND: There is increasing awareness of the necessity and importance for physician leadership in health care. Despite this, formal leadership training is not widespread in medical education. APPROACH: We describe the structure, curriculum and development of a robust two-tiered leadership development programme within a community-based family medicine residency programme. Living, Leading & Medicine (LLM, tier 1) consists of nine 2.5-h discussion-based training sessions occurring thrice annually. The Advanced Leadership Track (ALT, tier 2) includes mentoring, additional readings, personal evaluations and leadership projects. EVALUATION: We used post-session surveys and exit surveys for LLM and ALT, respectively. We utilised the modified Kirkpatrick framework for programme evaluation to present outcomes from the first 3 years for each tier. Over three quarters (40 out of 53) of residents participated in LLM sessions. The post-session survey response rate for LLM was 95% (124 out of 130 participants). Eighteen out of 33 residents (54.5%) completed the ALT. Of these, 72% (13 of 18) returned exit surveys. Residents found the programme valuable and relevant (Kirkpatrick level 1). Residents demonstrated improvements in leadership knowledge and skills (3.85 v. 3.11, p < 0.0001; Kirkpatrick level 2) compared with an internal, historic control group. We noted changes in resident behaviour and attitudes towards leadership (Kirkpatrick level 3). Finally, the completion of leadership projects demonstrates Kirkpatrick level 4 outcomes. IMPLICATIONS: We have created a longitudinal, two-tiered leadership development programme that has improved the leadership capabilities of our family medicine residents.