The Tools to Lead: Developing a Leadership Curriculum for Doctors in Training ADPIM Workshop C.A. Iyasere and M. Baggett April 20, 2016 Total Time: 60 minutes At no point in recent history has the need for exceptional physician leadership been more clear. In an era of increased transparency for patients, reimbursement based on risk sharing and bundled payments, and expectations of gains in efficiency unseen, the role of physicians as agents of change in an ever more dynamic healthcare environment is unparalleled. Similarly, the increased complexity of care delivery calls for clinical leaders well versed in managing across multiple domains; for physicians in the modern practice environment, leadership skills are crucial to healthcare quality and organizational performance as individual physicians can no longer achieve optimal patient outcomes on their own. Given the ever growing demands for exceptional physician leadership, the Massachusetts General Hospital (MGH) Department of Medicine Residency Program developed a formal leadership course for its residents in the fall of 2013. The course is based on the case method created at Harvard Business School, and provides residents with hands on learning around key leadership concepts that they can immediately bring to practice in their everyday care environments. This seminar will outline the development, refinement and ongoing research embedded in the leadership course at MGH with an emphasis on providing participants with lessons learned and a seed framework in which they can build a leadership curriculum at their home institutions. Example curriculum, reference materials and structural components of the program and MGH will be provided as points of discussion. Participants will engage in active discussion with colleagues about the specific needs of their residency program and how to build a successful leadership program for residents in training. Workshop Goals: 1. Learn about the development of a leadership program in Massachusetts General Hospital Department of Medicine Residency Program with an emphasis on lessons learned and generalizable concepts for participant home institutions. 2. Deliver structural framework to think about the development, implementation and evaluation of a resident leadership program at their home institution. Iyasere and Baggett APDIM Leadership Workshop 2016 Page 1
Deliverables: This work shop will provide participants with: A structural framework on which to think about and build a leadership program at their home institution Examples of existing curriculum and teaching notes for faculty A tailored bibliography of research literature and reference materials to develop a leadership curriculum at their home institution. Agenda: 1. Introduction a. The importance of leadership training for all physicians. b. Residency as a key period in physician development and opportunity for leadership skill building. c. Challenges to the creation of resident leadership programs and how they can be overcome. 2. Core Leadership skills for physicians. a. Leadership theory and its application during graduate medical education. b. Relationship of leadership skills to ACGME core competencies. 3. Massachusetts General Hospital Department of Medicine Leadership Course: Lessons Learned. a. Guiding Principles, development and resource requirements b. Leadership case method 4. Design your own resident leadership course a. What is your programs crucible story (e.g. why do you need to do this)? b. How are your residents currently learning leadership skills? c. Whom will the program target, how will you do it, when will you do it? d. What existing educational venues and faculty could you utilize to teach these concepts? e. Are there local experts in leadership outside the medical field with whom you could collaborate? Iyasere and Baggett APDIM Leadership Workshop 2016 Page 2
5. Closing f. What resources will you need to get off the ground - first six months, first year, year 2? g. How will you evaluate your program? h. What are the possible research and/or grant opportunities? a. Anticipated challenges (faculty development, resident time, resident buy in, encouraging observation and feedback from diverse group of colleagues, maintaining enthusiasm for the material, resident leader turnover). b. Group brainstorming: How can we overcome these challenges? Provided Materials: 1. Example case with accompanying leadership theory and faculty teaching note 2. Small group worksheet 3. Bibliography of relevant articles Iyasere and Baggett APDIM Leadership Workshop 2016 Page 3
Building the Tools to Lead: Developing a Leadership Curriculum for Doctors in Training General Leadership: Selected Bibliography Goleman, D. What Makes a Leader. Harvard Business Review 2014, Jan: 4-12. Tannenbaum R and Schmidt W. How to Choose a Leadership Pattern. Harvard Business Review, May 1973: 162-180. George B, Sims P, McLean A and Mayer D. Discovering Your Authentic Leadership. Harvard Business Review, Feb 2007: 1-9. Leadership and Physicians: Frich JC, Brewster AL, Cherlin EJ and Bradley EH. Leadership Development Programs for Physicians: A Systematic Review. J Gen Intern Med 30 (5): 656-74 2014. Dhaliwal G and Sehgal LN. Demystify Leadership in Order to Cultivate It. Academic Medicine, 2014: Vol. 89: 1114. Resident Leadership Training: Jardine D, Correra R and Schultz H et. al. The Need for a Leadership Curriculum for Residents. ACGME News and Views. Journal of Graduate Medical Education, 2015: 307-309. Blumenthal DM et al. Implementing a pilot leadership course for internal medicine residents: design considerations, participant impressions, and lessons learned. BMC Medical Education 2014, 14: 257. Stoller JK, Help Wanted: Developing Clinician Leaders. Perspect Med Educ, 2014, 3: 233-237. Fraser TN, Blumenthal DB, Bernard K and Iyasere C. Assessment of Leadership Training Needs of Internal Medicine Residents at Massachusetts General Hospital. Proc Bayl Univ Med Cent 2015, 28: 317-320. Blumenthal DM, Bernard K, and Bohmer R. Addressing the Leadership Gap in Medicine: Residents Need for Systematic Leadership Development Training. Academic Medicine 2012, 87: 1-10. Leadership and Outcomes: Neily J, Mills PD, Young-XY et. al., Association Between Implementation of a Medical Team Training Program and Surgical Mortality. JAMA 2010, 15: 1693-700. Emotional Intelligence: Goleman, D. Leadership that Gets Results. Harvard Business School Review. March-April 2000. Iyasere and Baggett Resident Leadership APDIM Workshop Page 1
Stoller JK, Taylor CA, and Farver C, Emotional Intelligence Competencies Provide a Developmental Curriculum for Medical Training. Medical Teacher 2013, 35: 243 247. Negotiation: Harvard Business Essentials. Negotiation. Harvard Business Review Press 2003. Leary K, Illemer J and Wheeler M. Negotiating with Emotion. Harvard Business Review, Jan 2013. Conflict Management: Stone D, Patton B and Heen S. Difficult Conversations. Penguin Books, LTD 2010. Teams: Huckman R and Coutu D. Why Teams Don t Work. Harvard Business Review 2009, May: 99. Edmondson A. Teaming: How Organizations Learn, Innovate and Compete in the Knowledge Economy. John Wiley and Sons 2012. Iyasere and Baggett Resident Leadership APDIM Workshop Page 2