Leadership training in emergency medicine: A national survey

Background

Emergency medicine (EM) is a uniquely stressful environment in which leadership training could improve individual and team performance, patient outcomes, well-being, and EM career intentions. The primary aim was to evaluate EM-specific leadership training (EMLeaders) compared to no leadership training. A secondary comparison was with other forms of leadership training.

Methods

An online survey was distributed to Royal College of Emergency Medicine (RCEM) members in England. Three groups were recruited: those who reported receiving EMLeaders training, no training, and other training. Information was collected on group demographics, job roles, responses to 14 leadership knowledge and skills items, well-being at work, and EM career intentions.

Results

A total of 417 responders (177 EMLeaders, 148 no training, 92 other training) were largely representative of RCEM members, although the EMLeaders group were at less senior career grades. Although all groups provided generally positive responses, EMLeaders demonstrated more positive ratings for seven of 14 leadership items relative to no training (all p < 0.05): knowledge about clinical leadership, application of clinical leadership, empowerment to make decisions, managing the emergency department environment, ability to influence the EM environment, confidence in leadership, and confidence in facilitating teams. The other training group demonstrated superior ratings for five of seven of the same items, except empowerment to make decisions and ability to influence the EM environment. Direct comparison of EMLeaders with other training identified ability to influence the EM environment as a unique benefit of EMLeaders (p < 0.05), while knowledge about clinical leadership favored other training (p < 0.05).

Conclusions

EMLeaders improved many aspects of perceived leadership knowledge and skills, but there was little evidence of impact on well-being or EM career intentions. EMLeaders particularly appears to enhance perceived ability to influence the EM environment. Considering that the EMLeaders group were generally earlier in their career, the findings are promising and can inform the refinement of future EM-specific training.