Experiential leadership training for pediatric chief residents: impact on individuals and organizations.
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ABSTRACT:
SUBMITTER: Doughty RA
PROVIDER: S-EPMC2930319 | biostudies-other | 2010 Jun
REPOSITORIES: biostudies-other
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Project description:BackgroundNonclinical skills (eg, self-regulation, team leadership, conflict resolution) are essential for success as a chief resident (CR). The literature on programs teaching these skills reports few if any effectiveness outcomes.ObjectiveWe reported the outcomes of a leadership course for CRs using participants' self-reported outcomes and assessments from their program directors (PDs).MethodsA 2-day curriculum focused on emotional intelligence competencies, including self-awareness, self-management, social awareness, and relationship management. We used a logic model to align 2017-2018 curriculum with targeted outcomes. Questionnaires before and after the course assessed short-term and intermediate outcomes for the participants and PD interviews evaluated observed changes in CRs' performance attributable to the course.ResultsA total of 74 residents participated in the course, and 65% and 59% responded to the post-course and follow-up questionnaires, respectively. Over 95% of respondents indicated developing leadership knowledge and skills and connecting with new CRs in the post-course questionnaire. During follow-up, CRs reported applying concepts learned during chief residency, using tools to address conflict, engaging in quality and patient safety projects, and continuing to interact with other participants. The relationships between reported outcomes and participants' gender/prior leadership training were not significant (P > .05), with small to medium effect sizes (0.01-0.32). All 14 PDs offered positive appraisal of the CRs, but we could not specifically attribute this growth to the course.ConclusionsParticipation in this CR leadership development course was associated with enhancement and application of leadership competencies in immediate and intermediate time frames.
| S-EPMC7161340 | biostudies-literature
Project description:IntroductionClinical leadership is an essential skill for physicians, empowering them to lead and coordinate teams, communicate clearly under various conditions, model positive behaviors, display emotional intelligence, and ultimately improve patient care outcomes. However, there are currently no standardized residency curricula or competency-based assessments for clinical leadership, as residents often assimilate leadership skills through trial-and-error or observation of their clinical faculty. By utilizing a comprehensive needs assessment and synthesizing evidence-based practices, we developed and implemented a longitudinal and skills-based clinical leadership curriculum for pediatric residents.MethodsWe modeled our clinical leadership curriculum after Kern's 6-step approach to curricular development and the Accreditation Council for Graduate Medical Education competency requirements for professionalism. We identified topics based on a resident needs assessment and synthesized evidence from published practices. The curriculum was implemented through both monthly facilitated group sessions and independent learning modules.Results44 postgraduate year-2 (PGY-2) and PGY-3 pediatric residents participated in at least one monthly session of the clinical leadership curriculum. 27 (61%) completed the survey to evaluate the efficacy of the curriculum. Of the respondents, 23 (85%) residents found the leadership sessions useful, 4 (15%) were neutral, and none (0%) rated the sessions as not useful. 26 (96%) residents reported that the sessions should be continued.ConclusionThe clinical leadership curriculum has been received favorably by senior pediatric residents at our institution. Our next steps are to pilot the curriculum within residency programs of different specialties at our own institution as well as with pediatric residencies at other institutions.
| S-EPMC9058360 | biostudies-literature
Project description:Introduction:Effective communication skills are widely recognized as an important aspect of medical practice. Several tools and curricula for communications training in medicine have been proposed, with increasing attention to the need for an evidence-based curriculum for communication with families of patients in the intensive care unit (ICU). Methods:We developed a curriculum for internal medicine residents rotating through the medical ICU that consisted of a didactic session introducing basic and advanced communication skills, computer-based scenarios exposing participants to commonly encountered dilemmas in simulated family meetings, and experiential learning through the opportunity to identify potential communication challenges prior to facilitating actual family meetings, followed by structured peer debriefing. Seventeen residents participated in the study. Results:We administered the Communication Skills Attitude Scale to participants before and after participation in the curriculum, as well as a global self-efficacy survey, with some items based on the Common Ground rating instrument, at the end of the academic year. There were no significant changes in either positive or negative attitudes toward learning communication skills. Resident self-perceived efficacy in several content domains improved but did not reach statistical significance. Discussion:Our curriculum provided interactive preparatory training and an authentic experience for learners to develop skills in family meeting facilitation. Learners responded favorably to the curriculum. Use of the Family Meeting Behavioral Skills (FMBS) tool helped residents and educators identify and focus on specific skills related to the family meeting. Next steps include gathering and analyzing data from the FMBS tool.
| S-EPMC7062545 | biostudies-literature
Project description:PurposeTo analyze the initial impact of the SARS-CoV-2 pandemic on surgical skills training and performance of Pediatric Surgery Residents.MethodsRetrospective study considering the modifications on the Pediatric Surgery Residency training from March 1st-May 31st, 2020. Exposure to OR learning opportunities was compared to the same 2018-2019 trimesters. An anonymous survey about self-perception on surgical skills development was also performed.ResultsResidents performed 209 procedures as leading surgeons during the 2020 trimester with a mean number of surgeries per resident of 20.9, representing a reduction of 46% and 56.8% compared to the 2018-2019 averages, respectively. Reduction in both the number and the percentage of total procedures (n: 209, 56.8%) compared to both 2019 (n: 354, 68.7%, p: 0.000272) and 2018 (n: 420, 76.1%, p < 0,00,001) showed statistical correlation with no changes in their complexity pattern. From the survey (response rate: 100%), hours dedicated to simulation-based training were highly increased. More time was spent studying, but only 60% achieved better preparation for surgery and 70% perceived a decrease in surgical confidence.ConclusionsEven though the pandemic promoted new teaching strategies and the use of simulation-based training, it drastically reduced "on-the-job" learning opportunities with potential effects on residents' performance and self-confidence during surgery.
| S-EPMC8284692 | biostudies-literature
Project description:To graduate internal medicine residents with basic competency in palliative care, we employ a two-pronged strategy targeted at both residents and attending physicians as learners. The first prong provides a knowledge foundation using web-based learning programs designed specifically for residents and clinical faculty members. The second prong is assessment of resident competency in key palliative care domains by faculty members using direct observation during clinical rotations. The faculty training program contains Competency Assessment Tools addressing 19 topics distributed amongst four broad palliative care domains designed to assist faculty members in making the clinical competency assessments. Residents are required to complete their web-based training by the end of their internship year; they must demonstrate competency in one skill from each of the four broad palliative care domains prior to graduation. Resident and faculty evaluation of the training programs is favorable. Outcome-based measures are planned to evaluate long-term program effectiveness.
| S-EPMC3162123 | biostudies-literature
Project description:BackgroundEffective leadership for organizational change is critical to the implementation of evidence-based practices (EBPs). As organizational leaders in behavioral health organizations often are promoted from within the agency for their long-standing, effective work as counselors, they may lack formal training in leadership, management, or practice change. This study assesses a novel implementation leadership training designed to promote leadership skills and successful organizational change specific to EBP implementation.MethodsWe conducted a pre-post outcome evaluation of the Training in Implementation Practice Leadership (TRIPLE), delivered via three in-person, half-day training sessions, with interim coaching and technical support. Sixteen mid-level leaders (75% female, 94% Caucasian, mean age 37?years) from 8 substance abuse treatment agencies participated. Professional roles included clinical managers, quality improvement coordinators, and program directors. Participants completed surveys prior to the first and following the final session. At both time points, measures included the Implementation Leadership Scale, Implementation Climate Scale, and Organizational Readiness for Implementing Change Scale. At post-test, we added the Training Acceptability and Appropriateness Scale (TAAS), assessing participant satisfaction with the training. Qualitative interviews were conducted 6 to 8 months after the training.ResultsMost participants (86% and 79%, respectively) reported increased implementation leadership skills and implementation climate; paired samples t tests indicated these pre-post increases were statistically significant. Implementation leadership scores improved most markedly on the Proactive and Knowledgeable subscales. For implementation climate, participants reported the greatest increases in educational support and recognition for using EBP. Post-test scores on the TAAS also indicated that participants found the training program to be highly acceptable and appropriate for their needs. Qualitative results supported positive outcomes of training that resulted in both increased organizational implementation as well as leadership skills of participants.ConclusionsThis training program represents an innovative, effective, and well-received implementation strategy for emerging behavioral healthcare leaders seeking to adopt or improve the delivery of EBPs. Reported implementation leadership skills and implementation climate improved following the training program, suggesting that TRIPLE may have helped fulfill a critical need for emerging behavioral healthcare leaders.
| S-EPMC6585005 | biostudies-literature
Project description:BackgroundPediatric residency programs offer many conferences and activities to meet the educational needs of their residents. We developed and assessed the Pediatric Chief Resident Exchange Program where pediatric chief residents visited another institution for a day with the goal of sharing educational and curricular innovations between residency programs in an experiential manner.Approach/innovationPediatric chief residents participated in various activities during the exchange including educational conferences and discussions with residency program leadership at the host institutions. Surveys were administered to all participating chiefs to determine if any changes to educational conferences or curriculum were made or planned to be made at their home program based upon what they observed at the other institution and to have chiefs reflect on what they gained from the experience.ResultsTwenty-eight chief residents from 9 programs participated in the exchange program over 3 academic years (2015-2018). All respondents felt the exchange experience was worthwhile. The majority (67%) of programs planned to implement a change at their institution based on participation in the exchange with over half actually making a change by the end of the academic year. Participating chiefs gained a sense of camaraderie, appreciated that other programs experienced similar struggles, and developed further insight into the chief resident role.DiscussionThe Pediatric Chief Resident Exchange Program is a novel method of sharing educational practices between institutions that can lead to curricular changes at participating programs. It can also be an opportunity for chief resident professional development.
| S-EPMC8437398 | biostudies-literature
Project description:BackgroundMany departments have multiple chief residents. How these coleaders relate to each other could affect their performance, the residency program, and the department.ObjectiveThis article reports on how co-chiefs work together during the chief year, and what may allow them to be more effective coleaders.MethodsA phenomenological research design was used to investigate experiences of outgoing chief residents from 13 specialties at the University of Iowa Hospitals and Clinics over a 2-year period from 2012 through 2013. Thematic analysis of semistructured interviews was conducted to investigate commonalities and recommendations.ResultsFace-to-face interviews with 19 chief residents from 13 different specialties identified experiences that helped co-chiefs work effectively with each other in orienting new co-chiefs, setting goals and expectations, making decisions, managing interpersonal conflict, leadership styles, communicating, working with program directors, and providing evaluations and feedback. Although the interviewed chief residents received guidance on how to be an effective chief resident, none had been given advice on how to effectively work with a co-chief, and 26% (5 of 19) of the respondents reported having an ineffective working relationship with their co-chief.ConclusionsChief residents often colead in carrying out their multiple functions. To successfully function in a multichief environment, chief residents may benefit from a formal co-orientation in which they discuss goals and expectations, agree on a decision-making process, understand each other's leadership style, and receive feedback on their efficacy as leaders.
| S-EPMC4512790 | biostudies-literature
Project description:IntroductionUnintentional traumatic injury remains the leading cause of pediatric death in the United States. There is wide variation in the assessment and management of pediatric trauma patients in emergency departments. Resident education on trauma evaluation and management is lacking. This workshop focused on developing resident familiarity with the primary and secondary trauma survey in pediatric patients.MethodsThis hands-on workshop utilized patient-actors and low-fidelity simulators to instruct learners on the initial assessment of trauma patients during the primary and secondary trauma surveys. It was designed for residents across all levels of training who care for pediatric trauma patients (including pediatrics, medicine-pediatrics, emergency medicine, and family medicine) and adapted for different session durations and learner group sizes.ResultsEighteen residents participated in this workshop at two separate institutions. Participants strongly agreed that the workshop was relevant and effective in teaching the initial primary and secondary trauma survey assessment of pediatric trauma patients. Residents also reported high levels of confidence in performing a primary and secondary trauma survey after participation in the workshop.DiscussionThis workshop provided residents with instruction and practice in performing the primary and secondary trauma survey for injured pediatric patients. Additional instruction is needed on assigning Glasgow Coma Scale and AVPU (alert, voice, pain, unresponsive) scores to injured patients. The structure and time line of this curriculum can be adapted to the needs of an individual institution's program and the number of workshop participants.
| S-EPMC7821439 | biostudies-literature
Project description:BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) recommends that residents gain broad procedural competence in pediatrics training. There is little recent information regarding practice patterns after graduation. OBJECTIVE: We analyzed reported procedures performed in actual practice by graduates of a general pediatrics residency program. METHODS: We conducted an online survey from April 2007 to April 2011 of graduates of a single pediatrics program from a large children's hospital. Eligible participants completed general pediatrics residency training between 1992 and 2006. Graduates were asked about the adequacy of their training for each procedure, as well as the frequency of commonly performed procedures in their practice. As the primary analysis, procedures were divided into emergent and urgent procedures. RESULTS: Our response rate was 54% (209 of 387). General pediatricians rarely performed emergent procedures, such as endotracheal intubation, intraosseous line placement, thoracostomy, and thoracentesis. Instead, they more commonly performed urgent procedures, such as laceration repair, fracture or dislocation care, bladder catheterization, foreign body removal, and incision and drainage of simple abscesses. Statistically significant differences existed between emergent and urgent procedures (P < .001). CONCLUSIONS: In a single, large, urban, pediatrics residency, 15 years of graduates who practiced general pediatrics after graduation reported they rarely performed emergent procedures, such as endotracheal intubation, but more often performed urgent procedures, such as laceration repair. These results may have implications for ACGME recommendations regarding the amount and type of procedural training required for general pediatrics residents.
| S-EPMC3613326 | biostudies-other