Physicians' Perceptions and Experiences Regarding Leadership: A Link Between Beliefs and Identity Formation.

IF 3.4 Q1 HEALTH POLICY & SERVICES
Journal of Healthcare Leadership Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI:10.2147/JHL.S464289
Robin Lüchinger, Marie-Claude Audétat, Nadia M Bajwa, Anne-Claire Bréchet-Bachmann, Hélène Richard-Lepouriel, Melissa Dominicé Dao, Noëlle Junod Perron
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引用次数: 0

Abstract

Introduction: Despite the development of national recommendations and training programs for effective leadership, junior and senior medical leaders often find themselves ill-prepared to take on these new responsibilities. This study aimed to explore physicians' perceptions, feelings, and beliefs regarding leadership and to provide recommendations regarding appropriate training and institutional post-training support.

Methods: We conducted a qualitative study at the Geneva University Hospitals. A purposeful sample of residents (R), fellows (F), attending physicians (A), and chairpersons (CP) were invited to participate in focus groups (or semi-structured interviews) between April and June 2021. We investigated their understanding of leadership, self-perception as leaders, difficulties, and paths to improvement in their leadership skills. Focus groups were transcribed verbatim and analyzed both inductively and deductively using Fishbein's model of behavior prediction and Irby's professional identity formation framework.

Results: We conducted ten focus groups (R=3; F=4, A=2, and CP=1) and one interview (CP). Physicians expressed poor self-efficacy at all hierarchical levels: feelings of insecurity and confusion (R and F), frustration (A), and feeling stuck between divisional and institutional governance (CP). Such negative feelings were nurtured by personal beliefs with an intuitive and idealized representation of leadership. Beliefs focused more on personal characteristics rather than on skills, processes, or perceived institutional norms. Unclear expectations regarding physicians' role as leaders, overemphasis on academic achievement, and silo professional organizations fueled their feelings. Participants reported developing their leadership through trial and error, observing role models, and turning to personal resources rather than formal training.

Conclusion: Our results show that physicians' leadership skills are still mainly acquired intuitively and that institutional norms do not encourage clarification of leadership roles and processes. Physician training in leadership skills, together with more explicit and clear institutional processes, may help to improve physicians' self-efficacy and develop their identity as leaders.

医生对领导力的看法和经验:信念与身份形成之间的联系。
导言:尽管国家制定了有效领导力的建议和培训计划,但初级和高级医疗领导者往往发现自己在承担这些新职责时准备不足。本研究旨在探讨医生对领导力的看法、感受和信念,并就适当的培训和培训后的机构支持提出建议:我们在日内瓦大学医院开展了一项定性研究。2021 年 4 月至 6 月期间,我们有目的地邀请住院医师(R)、研究员(F)、主治医师(A)和主任医师(CP)参加焦点小组(或半结构式访谈)。我们调查了他们对领导力的理解、作为领导者的自我认知、遇到的困难以及提高领导力的途径。我们对焦点小组进行了逐字记录,并采用费什宾的行为预测模型和艾尔比的职业认同形成框架进行了归纳和演绎分析:我们进行了 10 次焦点小组讨论(R=3;F=4;A=2;CP=1)和 1 次访谈(CP)。医生们在各个层级上都表示自我效能感不高:感到不安全和困惑(R 和 F)、沮丧(A),以及觉得自己被困在部门和机构管理之间(CP)。这些消极情绪是由个人对领导力的直观和理想化表述所滋生的。这些信念更多地侧重于个人特点,而不是技能、流程或感知到的机构规范。对医生作为领导者角色的不明确期望、对学术成就的过分强调以及各自为政的专业组织助长了他们的情绪。参与者表示,他们是通过不断尝试、观察榜样、利用个人资源而非正规培训来发展自己的领导力的:我们的研究结果表明,医生的领导技能仍主要通过直觉获得,而机构规范并不鼓励明确领导角色和流程。对医生进行领导技能培训,再加上更加明确清晰的制度流程,可能有助于提高医生的自我效能感,并培养他们作为领导者的身份认同感。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Healthcare Leadership
Journal of Healthcare Leadership HEALTH POLICY & SERVICES-
CiteScore
5.40
自引率
2.30%
发文量
27
审稿时长
16 weeks
期刊介绍: Efficient and successful modern healthcare depends on a growing group of professionals working together as an interdisciplinary team. However, many forces shape the delivery of healthcare; changes are being driven by the markets, transformations in concepts of health and wellbeing, technology and research and discovery. Dynamic leadership will guide these necessary transformations. The Journal of Healthcare Leadership is an international, peer-reviewed, open access journal focusing on leadership for the healthcare professions. The publication strives to amalgamate current and future healthcare professionals and managers by providing key insights into leadership progress and challenges to improve patient care. The journal aspires to inform key decision makers and those professionals with ambitions of leadership and management; it seeks to connect professionals who are engaged in similar endeavours and to provide wisdom from those working in other industries. Senior and trainee doctors, nurses and allied healthcare professionals, medical students, healthcare managers and allied leaders are invited to contribute to this publication
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