Leadership Development Programs for Physicians: A Systematic Review

Abstract

BackgroundPhysician leadership development programs typically aim to strengthen physicians’ leadership competencies and improve organizational performance. We conducted a systematic review of medical literature on physician leadership development programs in order to characterize the setting, educational content, teaching methods, and learning outcomes achieved.MethodsArticles were identified through a search in Ovid MEDLINE from 1950 through November 2013. We included articles that described programs designed to expose physicians to leadership concepts, outlined teaching methods, and reported evaluation outcomes. A thematic analysis was conducted using a structured data entry form with categories for setting/target group, educational content, format, type of evaluation and outcomes.ResultsWe identified 45 studies that met eligibility criteria, of which 35 reported on programs exclusively targeting physicians. The majority of programs focused on skills training and technical and conceptual knowledge, while fewer programs focused on personal growth and awareness. Half of the studies used pre/post intervention designs, and four studies used a comparison group. Positive outcomes were reported in all studies, although the majority of studies relied on learner satisfaction scores and self-assessed knowledge or behavioral change. Only six studies documented favorable organizational outcomes, such as improvement in quality indicators for disease management. The leadership programs examined in these studies were characterized by the use of multiple learning methods, including lectures, seminars, group work, and action learning projects in multidisciplinary teams.DiscussionPhysician leadership development programs are associated with increased self-assessed knowledge and expertise; however, few studies have examined outcomes at a system level. Our synthesis of the literature suggests important gaps, including a lack of programs that integrate non-physician and physician professionals, limited use of more interactive learning and feedback to develop greater self-awareness, and an overly narrow focus on individual-level rather than system-level outcomes.

Effective physician leaders: an appreciative inquiry into their qualities, capabilities and learning approaches

“…Feedback and evaluations were valued for improving self-awareness, which, in healthcare leadership programmes, is often missed 8. Systematic feedback, however, does not guarantee behaviour change—it was participants’ focus on learning, which helped them benefit from these practices 10.…”

“…The existing evidence on effective leader and leadership development in and outside of healthcare is not being applied 3 10. The frequent use of brief programmes that focus on conceptual knowledge and individual skills training fail to address personal development and collaborative capacity—both cornerstones for effective leadership 8. The design and delivery commonly employ ineffective teaching approaches, lack relevant theoretical underpinnings and have limited adaptation to the healthcare context 1 9…”

“…While competencies are the application of knowledge, skills and attitudes to known problems with proven solutions, capabilities involve learning how to use and adapt these competencies in unfamiliar environments to address unfamiliar challenges 12. Given this difference, we need to understand how effective physician leaders have learnt to adapt their competencies to guide their organisations towards better performance 8. This identification of capabilities requires linking competencies to the effectuation of change.…”

Leadership for All: An Internal Medicine Residency Leadership Development Program

“…At this time, it is not clear how to best integrate leadership training in residency programs. [8][9][10] In 2012, The Ohio State University Wexner Medical Center Internal Medicine Residency Program implemented the Internal Medicine Leadership Development Program (LDP). The theme for the LDP is ''Leaders From Day One,'' and it starts at the beginning of residents' first postgraduate year (PGY), occurs over the entire year, and targets all residents.…”

To Lead or Not to Lead? Structure and Content of Leadership Development Programs

“…4 The authors searched OVID Medline for English-language peerreviewed studies published between 1950 and 2013. The authors included articles that reported educational programs that trained physicians in leadership skills (or exposed them to leadership concepts), outlined teaching methods, and reported results.…”