Medical Student Leader Performance in an Applied Medical Field Practicum

Abstract

Introduction Many medical schools in the United States are introducing leader and leadership curricula. However, there is a large gap regarding how to assess leader performance during undergraduate medical education. With the guidance of a conceptual framework, leadership assessment measures can be developed, learners can make expected improvements in performance over time, and assessment measures can be used in relevant, applied, medical teaching settings. Uniformed Services University (USU) medical students are educated to become healthcare leaders who can perform effectively in various settings. Medical students are assessed on multiple occasions for elements of leader performance during “Operation Bushmaster” – the capstone military medical field practicum event for fourth year medical students – by experienced faculty. A conceptual framework guides the assessment approach for leader performance during Bushmaster. The USU Leader and Leadership Education and Development program developed an assessment tool to measure student leader performance used in a military medical field practicum. The present paper examines whether: (1) leader performance can be measured at Bushmaster; (2) leader performance changed during Bushmaster; (3) leader performance elements are related to each other; and (4) overall leader performance is related to other medical academic performance. Materials and Methods Trained faculty assessed students’ leader performance. Data from three cohorts of USU medical students (N = 509) were collected. All data were collected, compiled, deidentified, and analyzed with approval from the USU Institutional Review Board (Protocol number: KM83XV). Descriptive statistics, repeated measures t-tests, trend analyses, and correlation analyses were performed. Results Data were available from 483/509 [95%] students. Results revealed that: (1) average leader performance was satisfactory; (2) overall leader performance and performance on each of the major elements of leader performance significantly improved over the course of Bushmaster; (3) major elements of leader performance were significantly correlated with each other and with overall leader performance; (4) leader performance was not correlated with students’ performance on the MCAT total score or USMLE Step exam scores. Conclusion With the guidance of a conceptual framework, the assessment tool was used to assess leader performance in a relevant, applied, medical teaching setting. The findings of this study indicate that leader performance can be measured. Additionally, leader performance appears to be a separate skillset from medical academic performance and both types of performance can be taught and developed. This was a retrospective correlation study and was conducted during a military medical field practicum at a single institution. Gathering additional validity evidence of the assessment tool is needed. With additional validity evidence, the assessment tool could be applied to other medical exercises in different settings and help with the assessment of leader performance beyond medical school.

Leadership Development in U.S. Undergraduate Medical Education: A Scoping Review of Curricular Content and Competency Frameworks

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Predictors of Performance on the United States Medical Licensing Examination Step 2 Clinical Knowledge: A Systematic Literature Review

“…Interestingly, volunteering, such as that at a student-run free clinic, had shown to have a positive correlation to Step 2 CK scoring [ 6 , 25 ]. On the other hand, leadership training courses did not seem to have a significant impact on Step 2 CK scoring [ 26 ].…”

“… Blue et al, 2006 [ 25 ] N = 263 Volunteerism Students in the highest service group (>18.5 hours) had significantly higher Step 2 CK scores before and after controlling for premedical GPA (p = 0.0086). Barry et al, 2019 [ 26 ] N = 483 out 509 (complete data sets available) Leadership qualities Analyses revealed that leader performance was not correlated with students’ performance on Step 2 Clinical Knowledge examination score (r = 0.09, p = 0.06). Arvidson et al, 2015 [ 28 ] N = 1,328 Extended curriculum time Students taking extended curriculum time had first-time Step 2 CK pass rate of 83% compared to 97% of their peers (χ² = 53.24, p < 0.001).…”

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