BMJ Leader最新文献

{"title":"Medical Specialty Interest Survey (MSIS): understanding career interest and specialty training in commencing Australian medical interns.","authors":"Christopher Chew, Lawrence Lin, Nathan Vos, Jade Stevens, Emma Nyhof, Jason Goh","doi":"10.1136/leader-2023-000874","DOIUrl":"10.1136/leader-2023-000874","url":null,"abstract":"<p><strong>Aim: </strong>To assess specialisation interests in commencing interns and create a standardised survey to aid medical schools, supervisors and health services in quantifying, understanding and supporting medical career development to improve medical workforce planning.</p><p><strong>Method: </strong>The Medical Specialty Interest Survey (MSIS) cross-sectional study was used. Incoming interns at a multisite tertiary hospital network in Melbourne, Australia rated their desire to pursue each specialty as a career using a Likert scale (1-5). 47 Medical Board of Australia Medical Specialties were included in the survey.</p><p><strong>Results: </strong>Completion rate was 123 of 124 (99.2%). The overall mean desirability was 2.62, suggesting on average more specialties were deemed less preferred. Critical care specialties were most popular, while surgical specialties had least interest. Gastroenterology and cardiology were most popular among internal medicine specialties. General practice had low correlation with other specialties (Pearson correlation mean R coefficient 0.106 compared with overall mean 0.208), suggesting interns interested in general practice exhibit less interest in other specialties, and interest in specialisation confers low interest in general practice. Psychiatry had the lowest mean R coefficient of 0.088.</p><p><strong>Conclusions: </strong>The MSIS quantifies relative interest in 47 medical specialties and specialty interest correlations among final-year medical students/incoming interns. The MSIS may be a tool for medical schools, healthcare services and government agencies to better understand the career interest among medical students and pre-vocational doctors and therefore improve doctor retention and well-being.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"134-141"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generic professional capabilities hub: developing leadership and management skills in trainees.","authors":"Kate Rachel Millar, Christopher James, Hannah Headon, Azka Afzal, Joseph Lipton, Kirsten Armit, Judy McKimm","doi":"10.1136/leader-2023-000872","DOIUrl":"10.1136/leader-2023-000872","url":null,"abstract":"<p><p>High quality leadership is key to delivering high standards of patient care. For many reasons, doctors in training are not currently well represented in leadership positions and struggle to access opportunities to develop these skills. As a key cohort within the medical workforce, using existing present opportunities within clinical training programmes would allow them to engage in leadership development and support them to lead on projects within their trusts and make sustainable changes within their own organisation.Within our anaesthetic department, we designed the Generic Professional Capabilities Hub (GPC hub)-a framework that aims to address some of the barriers to engagement in clinical leadership. Involvement in the GPC hub can be at three different levels, which allows for flexibility around other training needs. Currently, there are seven workstreams within the framework, with trainees being involved through symposia attendance, leading on projects linked to the hub or becoming a trainee workstream lead. We share our learning from setting up this framework, the benefits it brings to trainees and departments, initial evaluation results and our next steps which include regional roll out to four other anaesthetic departments.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"171-173"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71427625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding leadership development in DPT and MOT graduates at AdventHealth University via focus groups.","authors":"Elizabeth Clark, Christine Moghimi, Janelle Ealdama, Bojana Penjavic, Michael Scheraldi, Steven Vidal","doi":"10.1136/leader-2023-000847","DOIUrl":"10.1136/leader-2023-000847","url":null,"abstract":"<p><strong>Purpose: </strong>While leadership knowledge, skills and behaviours develop during graduate education, faculty members engaged in curriculum design for doctor of physical therapy (DPT) and masters of occupational therapy (MOT) professionals want to understand how this occurs. The objective of this study was to understand what influenced the development of leadership in graduates.</p><p><strong>Patients and methods: </strong>A detailed narrative was created for virtual focus groups. Purposive sampling was used and eligible participants were emailed. Those who agreed to participate reviewed an institutional review board approved consent form and were sent a link through an online, recorded Microsoft Teams session. Forty-three DPT and MOT Class of 2022 Graduates were eligible for participation. Recordings were exported, deidentified and validated for transcript accuracy and then deleted. Transcripts were analysed for emerging themes via NVivo.</p><p><strong>Results: </strong>Ten graduates consented to participate. Saturation was reached during thematic analysis and three weighted themes emerged: leadership characteristics, on-campus curriculum and off-campus curriculum. Further data analysis revealed progression in leadership skill attainment over time and graduates attributed leadership development to the programme and aligned with current frameworks of multiprofessional/interprofessional education.</p><p><strong>Conclusion: </strong>These findings should be used to guide curriculum design for effective leadership development. These experiences align with the goal of advanced clinical practice of future healthcare leaders.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"159-161"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10433981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mission possible: open innovation in nursing and patient care services at Massachusetts General Hospital.","authors":"Hiyam M Nadel, Nour Al-Sultan, Alex Berger, Paula McCree, Gaurdia Banister, Olivia Jung","doi":"10.1136/leader-2023-000777","DOIUrl":"10.1136/leader-2023-000777","url":null,"abstract":"<p><strong>Objectives: </strong>Although front-line nurses and staff are uniquely positioned to identify the inefficiencies and gaps in care delivery, formal processes are not always in place to hear from those very employees.</p><p><strong>Design: </strong>We established a scalable process that embodies open innovation principles, to broaden and distribute the innovation locus.</p><p><strong>Setting: </strong>Massachusetts General Hospital, Boston, MA.</p><p><strong>Particpitants: </strong>We invited 8800+ nurses and other direct caregivers to participate in organisational problem solving.</p><p><strong>Interventions: </strong>We solicited employees to (1) identify pain points and develop solutions and (2) crowd vote to indicate which ideas they want to see implemented.</p><p><strong>Results: </strong>177 employees submitted 225 ideas, and 928 cast a vote. The 40 participants who submitted top-voted ideas were invited to develop a detailed implementation plan; of those, 27 submitted one. Four ideas emerged as winners.</p><p><strong>Conclusions: </strong>Formulating a clear call for ideas, securing leadership buy-in and generating excitement about the process were essential to our efforts. Challenges associated with opening the innovation process involved managing a large volume of participants and submissions, and providing on-the-go training to nurses and staff who were not used to being asked to participate in organisational problem solving.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"162-166"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Followership in interprofessional healthcare teams: a state-of-the-art narrative review.","authors":"Erin S Barry, Pim Teunissen, Lara Varpio","doi":"10.1136/leader-2023-000773","DOIUrl":"10.1136/leader-2023-000773","url":null,"abstract":"<p><strong>Objective: </strong>A state-of-the-art (SotA) literature review-a type of narrative review- was conducted to answer: What historical developments led to current conceptualisations of followership in interprofessional healthcare teams (IHTs)?</p><p><strong>Design: </strong>Working from a constructivist orientation, SotA literature reviews generate a chronological overview of how knowledge evolved and presents this summary in three parts: (1) this is where we are now, (2) this is how we got here and (3) this is where we should go next. Using the SotA six-stage methodology, a total of 48 articles focused on followership in IHTs were used in this study.</p><p><strong>Results: </strong>Articles about followership within IHTs first appeared in 1993. Until 2011, followership was framed as leader-centric; leaders used their position to influence followers to uphold their dictums. This perspective was challenged when scholars outside of healthcare emphasised the importance of team members for achieving goals, rejecting a myopic focus on physicians as leaders. Today, followership is an important focus of IHT research but two contradictory views are present: (1) followers are described as active team members in IHTs where shared leadership models prevail and (2) conceptually and practically, old ways of thinking about followership (ie, followers are passive team members) still occur. This incongruity has generated a variable set of qualities associated with good followership.</p><p><strong>Conclusions: </strong>Leadership and followership are closely linked concepts. For leaders and followers in today's IHTs to flourish, the focus must be on followers being active members of the team instead of passive members. Since theories are increasingly encouraging distributed leadership, shared leadership and/or situational leadership, then we must understand the followership work that all team members need to harness. We need to be cognizant of team dynamics that work within different contexts and use leadership and followership conceptualisations that are congruent with those contexts.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"127-133"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10210621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of the representation of the allied health professions in senior leadership positions in the UK National Health Service.","authors":"Nicola Eddison, Aoife Healy, Nina Darke, Mary Jones, Millar Leask, Gwen L Roberts, Nachiappan Chockalingam","doi":"10.1136/leader-2023-000737","DOIUrl":"10.1136/leader-2023-000737","url":null,"abstract":"<p><strong>Background: </strong>Allied health professionals (AHPs) are an important group within the National Health Service (NHS) in the UK and make up a large portion of the workforce. Investment in AHP leadership is believed to lead to improvements in patient care, resource use, collaboration and innovation. This study aims to assess the current state of AHP strategic leadership within the NHS.</p><p><strong>Methods: </strong>A freedom of information (FOI) request was sent to all NHS Trusts and health boards (HBs) within the UK NHS. The questions focused on the AHP workforce, with a particular interest in the chief AHPs (or equivalent roles) working in an NHS setting. Analysis of the FOI used a range of descriptive statistics.</p><p><strong>Results: </strong>Of the 217 Trusts/HBs contacted, responses were received from 160 (74%). The majority (81%) reported that they employed a Chief AHP or equivalent role, with only 14% of these having a position on the Trust/HB executive board. There were 50 different job titles reported as the titles for the chief AHP or equivalent roles: with director of AHPs (18.6%), lead AHP (13.9%) and chief AHP (11.6%) being the most reported titles. The results identified an inequity of representation of AHP professions within senior AHP leadership; with most of these roles (70%) held by physiotherapists and occupational therapists.</p><p><strong>Conclusion: </strong>Changes in AHP strategic leadership are needed to address the inequities identified in this study. Addressing these issues is required to enable inclusive leadership, which is crucial to improve the contribution of AHPs to healthcare.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"119-126"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10064926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situations of moral injury and ambiguity will always go on in healthcare: it is how we deal with them that is important.","authors":"Kim Nurse, Hannah Baird","doi":"10.1136/leader-2022-000691","DOIUrl":"10.1136/leader-2022-000691","url":null,"abstract":"<p><p>The article explores the concepts of moral distress and moral injury experienced by healthcare professionals, from the perspective of two junior doctors, in the National Health Service. It highlights the daily challenges faced by doctors due to insufficient resources, staff shortages and time constraints, leading to an inability to provide the expected level of care, which if not addressed can result in long-term psychological harm and impaired functioning.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"99-101"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of hospital leadership in pandemic preparedness: experience at a tertiary hospital in Kenya during the COVID-19 pandemic.","authors":"Lucy W Mwangi, William Macharia, Benjamin W Wachira, Jemimah Kimeu, Boniface Mativa, Lukoye Atwoli","doi":"10.1136/leader-2023-000833","DOIUrl":"10.1136/leader-2023-000833","url":null,"abstract":"<p><strong>Introduction: </strong>Pandemic preparedness refers to being ready for, responding to and recovering from public health crises, and is integral for health security. Hospital leadership is a critical building block of an effective healthcare system, providing policy, accountability and stewardship in a health crisis.</p><p><strong>Objectives and methods: </strong>We aimed to describe the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi, a private not-for-profit tertiary healthcare facility, following the COVID-19 pandemic. We reviewed over 200 hospital documents archived in the COVID-19 repository including those received from the Kenya Ministry of Health, emails, memos, bulletins, meeting minutes, protocols, brochures and flyers. We evaluated and described pandemic preparedness at the hospital under four main themes: (a) leadership, governance and incident management structures; (b) coordination and partnerships; (c) communication strategies; and (d) framework to resolve ethical dilemmas.</p><p><strong>Results: </strong>The hospital expeditiously established three emergency governance structures, namely a task force, an operations team and an implementation team, to direct and implement evidence-based preparedness strategies. Leveraging on partners, the hospital ensured that risk analyses and decisions made: (1) were based on evidence and in line with the national and global guidelines, (2) were supported by community leaders and (3) expedite financing for urgent hospital activities. Communication strategies were put in place to ensure harmonised COVID-19 messaging to the hospital staff, patients, visitors and the public to minimise misinformation or disinformation. An ethical framework was also established to build trust and transparency among the hospital leadership, staff and patients.</p><p><strong>Conclusion: </strong>The establishment of a hospital leadership structure is crucial for efficient and effective implementation of pandemic preparedness and response strategies which are evidence based, well resourced and ethical. The role of leadership discussed is applicable to healthcare facilities across low and middle-income countries to develop contextualised pandemic preparedness plans.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"111-118"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10351088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT: a novel AI assistant for healthcare messaging-a commentary on its potential in addressing patient queries and reducing clinician burnout.","authors":"Benjamin Laker, Emily Currell","doi":"10.1136/leader-2023-000844","DOIUrl":"10.1136/leader-2023-000844","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"147-148"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact and effectiveness of leadership and management in academic health sciences.","authors":"Claire Donnellan","doi":"10.1136/leader-2023-000843","DOIUrl":"10.1136/leader-2023-000843","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"153-158"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}