BMJ Leader最新文献

Background: Dr Andrea Doria is Professor and Vice-Chair of Radiology (Clinical Practice Improvement) at the University of Toronto, Research Director, Senior Scientist and Imaging Lead of Personalised Child Health, The Hospital for Sick Children (SickKids), Toronto, Canada. Over the past few decades, Dr Doria has established a track record of healthcare leadership. Based on Dr Doria's extensive leadership experience, she believes it is essential for established healthcare leaders to be involved in cultivating emerging healthcare leaders.

Methods: An interview was conducted with Dr Doria to learn about key lessons she believes are essential for healthcare leaders to help develop the next generation. Dr Doria reflected on her leadership style and experiences, sharing what has worked to improve the effectiveness of her teams.

Results: Key messages were reflected upon, including practical ways for senior leaders to support the next generation; leadership insights gained from the pandemic; the importance of building diversity in teams and nurturing leaders from underrepresented minorities; challenges to be aware of for the future of healthcare leadership; finding inspiration from team members and essential traits for healthcare leaders.

Conclusion: Through cultivating the next generation of healthcare leaders, established leaders can be involved in establishing a brighter future for healthcare. This article describes reflections and practical takeaways that can help established leaders support emerging leaders and build their leadership skills.

Background: High burnout and low retention rates among trainee doctors threaten the future viability of the UK medical workforce. This study empirically examined factors that can sustain trainee doctors.

Method: A total of 323 trainee doctors from 25 National Health Service (NHS) Trusts in England and Wales completed an online survey on their training and employment experiences. A mixed method approach was employed.

Results: Structural equation modelling revealed that perceived compassionate leadership of hospital senior leaders (CLSL) (i.e., doctors in senior clinical and management positions, and senior managers) is directly and negatively associated with trainee doctors' burnout and intention to quit. We propose the associations may be indirectly strengthened through two mediating pathways: increased psychological contract fulfilment (PCF) of training/organisational support and reduced worry about the state of the NHS; however, only the former is supported. The model can explain a substantial 37% of the variance in reported burnout and 28% of intention to quit among trainee doctors. Being a Foundation Year (FY) trainee was significantly associated with poor PCF and burnout. Rich qualitative data further elaborated on their experiences in terms of senior leaders' awareness of their training/working experiences, listening to and acting on.

Conclusions: Active and demonstrable CLSL plays a vital role in trainee doctors' retention. It has both direct (through support) and indirect effects through improving trainee doctors' PCF to reduce burnout and intention to quit. This seems particularly valuable among FY doctors. Implications for the development and management of the medical workforce are discussed.

The Kingdom of Saudi Arabia's (KSA) Ministry of Health's (MOH) healthcare transformation strategy aims to improve the quality of life of Saudi citizens in line with the 'Vision 2030' strategic objectives. The MOH is reforming the way healthcare will be managed in the future and is in the process of transferring healthcare service delivery responsibilities to clusters with ratified boards, while also moving the MOH from a provision of service model to a regulatory one. Several early pathfinding clusters were initiated in the eastern central and western regions. To ensure northern and southern regions were not left behind, the early innovation, while awaiting cluster nomination status, the northern and southern business units of Health Holding Company implemented the accelerated transformation programme (ATP). The ATP's remit was to develop capabilities and stimulate local engagement and ownership in the healthcare transformation process. This paper summarises the process of healthcare transformation undertaken in the northern and southern regions of KSA to date. It reviews the success in engaging with local healthcare professional communities in a standardised way and the learning from previous clusters, and elaborates on emerging implementation issues and how we may overcome them and introduce the lessons learnt from this journey.

Background: Medical faculties in Finland are responsible for the quality and content of continuous medical education programmes that also includes compulsory management studies (10 European Credit Transfer and Accumulation System). The aim of this study is to evaluate medical specialists' experiences of the compulsory management studies and their attitudes towards leaders and managers.

Methods: The Universities of Turku and Tampere conducted a survey among doctors who completed their specialist training between 1 January 2016 and 1 January 2019. Of these doctors, 83 completed the survey (response rate 25%). The analysis was carried out using a cross-table, and in the visual analysis, a box plot has been used.

Results: Of the respondents, 38% were content with management and leadership studies, and they reported a particular need for improving skills in human resources management, healthcare economy, legislation, organisational management, and social and healthcare systems. Most respondents (83%) showed interest in future leadership roles.

Conclusions: The findings of this study show that newly qualified doctors do wish for added education and training in management and leadership.

Programme leaders in graduate medical education (GME) are responsible for the final stage of physician training, guiding the transition from supervised to independent practice. The influence of GME programme leaders extends beyond clinical practice, affecting trainees' relationship with and attitudes towards the healthcare system, future leadership behaviours, work-life prioritisations and professional identity among others. Given the potential magnitude of GME programme leaders' impact, both positive and negative, on GME trainees, we reflected on our shared leadership model that developed iteratively as a leadership team. We draw on our experiences to emphasise practical leadership behaviours and provide a summary of our observations, leading to nine recommendations for effective GME programme leadership and associated suggestions for implementation. We divide our recommendations into four leadership recommendations and five management recommendations. Throughout, we highlight the process of developing our shared leadership model, recognising that our process and observations will aid leadership teams in evaluating and, potentially, adapting our recommendations to meet their needs. We anticipate that leaders and leadership teams at every level will find value in our recommendations, even if our intended audience is GME leaders from chief residents to programme directors.

Aim: 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.

Method: 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.

Results: 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.

Conclusions: 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.

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.