A NEED ANALYSIS FOR TEACHING LEADERSHIP SKILLS TO MEDICAL STUDENTS IN PAKISTAN
AbstractBackground: Perspectives of practicing medicine have rapidly changed due to global shift and interconnectedness. Doctors who do not develop their leadership skills may lack the acumen to make significant choices which enhance the quality and effectiveness of care. Pakistan is one of those countries that have not yet introduced the leadership skills training for undergraduate medical students. Aim of this study was to perform “a perceived need analysis for teaching leadership skills to undergraduate medical students in Pakistan”. Methods: The study was designed using phenomenological approach to gain detailed insights into what the research participants think about leadership. Qualitative methods were used for data collection and analysis. Data were collected from fourteen medial students in their 3rd, 4th and 5th year and eight staff members of medical colleges through semi-structured interviews and focus group discussion respectively. Thematic analysis was used for data analysis. Results: Participants agreed that leadership skills are necessary for successful medical practice and can be learnt with timely and proper guidance. Need to introduce a leadership curriculum for undergraduates was recognised to acquire skills for pressure handling before entering clinical practice. The view was common that doctors in Pakistan are good at clinical skills but have no or weak leadership skills, affecting their clinical practice. Transformational leadership that encompasses behaviours resulting in empowering, inspiring and challenging the followers to make them capable of reaching their full potential was recommended necessary for developing successful physician leaders. Simulated scenarios, case-based learning, lecture-based modules and peer-led case discussions were suggested as the useful methods for course delivery. Formative method of assessment with feedback was suggested rather than summative assessment. Conclusion: There is a perceived need to introduce a leadership course in early years of medical curriculum of Pakistan, as participants acknowledge the importance of clinical leadership and depicted the preparedness to have leadership education implemented in the curriculum. Keywords: Curriculum; Education, Medical; Undergraduate; Leadership; Students, Medical
Rosenstiel L. Leadership und Change. In: Bruch H, Krummaker S & Vogel B, editors. Leadership—Best Practices und Trends. Heidelberg: Springer. pp. 145–156. 2006.
Yukl G, Gordon A, Taber T. A hierarchical taxonomy of leadership behavior: Integrating a half century of behavior research. J Leadersh Organ Stud. 2002; 9: 15–32.
Hargett CM, Doty JP, Hauck JN, Webb A MB, Cook S H et al. Developing a model for effective leadership in healthcare: A concept mapping approach. JHealthc Leadersh, 2017; 9: 69-78.
Gawande A A. Creating the educated surgeon in the 21st century. Am J Surg, 2001; 181: 551–556.
Varkey P, Peloqun J, Reed D, Lindor K, Harris I. Leadership curriculum in undergraduate medical education: A study of student and faculty perspectives. Med Teach, 2009; 31(3): 244-250.
Quince T, Abbas M, Murugesu S, Crawley F, Hyde S et al. Leadership and management in the undergraduate medical curriculum: a qualitative study of students’ attitudes and opinions at one UK medical school. BMJ Open, 2014; 4: 1-9. doi:10.1136/bmjopen-2014- 005353.
Adams C. What leadership skills will community nurses need to improve outcomes in the new NHS? Nurs Times, 2010; 48(106): 10-12.
Nasim M. Medical education needs to change in Pakistan. J Pak Med Assoc, 2011; 61(8): 808-811.
Naqvi A. Problems of medical education in Pakistan. J Pak Med Assoc, 1997.
PMDC to revise medical curriculum. DAWN. 2016 April 19th.
Miles M, Huberman AM. Qualitative data analysis: an expanded sourcebook. 2nd ed. Thousand Oaks, CA: Sage. 1994.
Davidsen AS. Phenomenological approaches in psychology and health sciences. Qual Res Psychol, 2013; 10(3): 318-339.
Alhojailan MI. Thematic analysis: a critical review of its process and evaluation. WEJSS, 2012; 1(1): 39-47.
Ng S, Lingard L, Kennedy TJ. Qualitative research methods in medical education. In Swanwick T. editors. Understanding Medical Education. Oxford, UK: ASME and Wiley-Blackwell. 2014.
Thomas, D.R. A general inductive approach for analysing qualitative evaluation data. Am J Eval, 2006; 27(2): 237-246.
Boyle DK, Kochinda C. Enhancing collaborative communication of nurse and physician leadership in two intensive care units. J Nurs Adm, 2004; 34, 60–70. doi: 10.1097/00005110-200402000-00003.
McGaghie WC, Issenberg SB, Petrusa ER and Scalese RJ. A critical review of simulation-based medical education research: 2003–2009. Med Educ, 2009; 44(1): 50–63.
Capowski G. Anatomy of a Leader: Where are the Leaders of Tomorrow? Management Review, 1994.
Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs, New Jersey: Prentice-Hall. 1984.
Bass B, Avolio B. Improving organizational effectiveness through transformational leadership. NJ: Sage, Thousand Oaks. 1994.
Swanwick T. (2011). Leadership theories and concepts. In: Swanwick, T. & McKimm, J. eds. ABC of clinical leadership 1st ed. 2011 [cited 2019 Mar 30] Available from https://www.dawsonera.com/readonline/9781444340853/startPage/11/1.
Webb AMB,Tsipis NE, McClellan TR, McNeil MJ, Xu M et al. A first step toward understanding best practices in leadership training in undergraduate medical education: a systemic review. Acad Med, 2014; 89(11): 1563-1570.
NHS Leadership Academy. Leadership Framework: A Summary [Internet]. c2011 [cited 2018 July 28] Available from: https://www.leadershipacademy.nhs.uk/wp-content/uploads/2012/11/NHSLeadership-Framework-LeadershipFramework-Summary.pdf.
Brush DR, Markert RJ, Lazarus CJ. The relationship between service learning and medical student academic and professional outcomes. Teach Learn Med, 2006; 18: 9–13.
Dobie SA, Huffine C. Training medical students in community leadership. Acad Med, 1994; 69: 428.
Mckenna MK, Gartland MP, Pugno PA. Development of physician leadership competencies: Perceptions of physician leaders, physician educators and medical students. J Health Adm Educ, 2004; 21: 343–354.
Sriratanaban J, Chiravisit M, Viputsiri O. Predictors of leadership styles of medical students: Implications for medical education. J Med Assoc Thai, 1999; 82: 900–906.
Tibbitts GM. Physician leadership. Leadership education for medical students. Physician Exec, 1996; 22: 31–34.
Shapira-Lishchinsky O. Simulation-based constructivist approach for education leaders. Educ Manag Adm & Leadersh, 2014; 1-17.
Till A, McKimm J, Swanwick T. Twelve tips for integrating leadership development into undergraduate medical education’. Med Teach, 2017. DOI: 10.1080/0142159X.2017.1392009.