Summary
Background
The established medical hierarchy, dramatic expansion of scientific knowledge and emphasis on valueâbased health care means that graduating physicians need to know how to manage and lead positive change. There is a critical gap in the teaching of these skills in undergraduate medical education.
Methods
Our medical school developed a firstâyear medical student competencyâbased leadership curriculum that focused on: leading yourself; teams and teamwork; influence and communication; problem solving; and systems thinking. The course used four methods of teaching leadership: experiential learning; targeted development; reflection; and feedback. The formal curriculum included topics such as developing a leadership agenda, challenging conversations and negotiations. The informal curriculum (learning outside of the structured curriculum) included applying leadership in coâcurricular and extracurricular activities (e.g. in a studentârun free clinic). Students recorded leadership experiences using a novel reflective assessment tool, obtained multiâsource feedback and then articulated a plan for improvement.
Results
Course evaluations noted that only oneâthird of firstâyear students responded that the curriculum developed skills in communication, and the ability to problemâsolve, apply systems thinking and build teams. Students selfâreported that they were often building, leading and managing productive teams, and applying influence and communication. The multiâsource feedback assessment revealed that students, on average, were rated as competent to proficient.
Discussion
Creating a robust curriculum for medical students in the first year is challenging. Student reactions ranged from affirming to critical. The next steps will focus on increasing interactive teaching and on helping students understand why, where and how leadership is important.