TY - JOUR
T1 - Leadership and management training of pediatric intensivists
T2 - How do we gain our skills?
AU - Stockwell, David C.
AU - Pollack, Murray M.
AU - Turenne, Wendy M.
AU - Slonim, Anthony D.
N1 - Funding Information:
A. D. Slonim and W. M. Turenne are supported, in part, by grant HS14009 from the Agency for Healthcare Research and Quality. The remaining authors have no financial interests to disclose.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2005/11
Y1 - 2005/11
N2 - Background: Intensivists manage a diverse team of healthcare professionals. For decades, business literature has recognized the value of leadership and management skills, yet this is relatively unexplored in critical care. Objective: Investigate the status of intensivists' preparation for the clinical leadership and management roles that they will assume after medical training. Design: Authoritative business leadership literature was reviewed to identify attributes of successful leadership and management relevant to critical care. A survey was designed to assess the process by which intensivists learn these attributes and to assess their perceived level of preparedness (20 items). Each survey item received a preparedness score structured as a Likert scale (1 = not prepared, 5 = very prepared), representing the averaged response to each item. In addition, an inadequate preparedness percentage was created representing the percentage of respondents answering "not at all prepared" and "hardly prepared" on the Likert-scaled items. Setting: Pediatric Critical Care Medicine Board Review Course, Washington, DC, 2004. Subjects: Physician course participants (n = 259). Intervention: Survey administration. Measurements and Main Resulte: The response rate was 61% (n = 159). The majority of respondents (63%) had completed fellowship training (median, 1 yr posttraining). Modeling the behavior of other physicians was the dominant technique for leadership and management skill acquisition (88%). The respondents were taught these skills by a variety of sources (attendings, 92%; other fellows, 42%; nurses, 37%; teachers, 20%; residents, 14%). Most (82%) thought that leadership and management training was important or very important, yet only 47% had received any formal training, (40% fellowship, 36% residency, 21% medical school, 16% masters, 30% other). Overall, respondents felt only "somewhat prepared" for the 20 leadership and management items surveyed (mean ± SD of preparedness score, 2.8 ± 0.2). Respondents were least prepared to manage conflict within a team, manage conflict will other groups, and manage stress effectively (preparedness scores of 2.5, 2.4, and 2.6 and inadequate preparedness percentages of 19.5%, 15.7%, and 18.9%, respectively). Respondents were most prepared to "set high standards" (preparedness score = 3.3). Of the respondents feeling at least somewhat prepared, only 33% credited medical training as preparing them. Conclusions: Although leadership and management training was perceived as important to this sample of pediatric generally young intensivists, most feel inadequately prepared for critical aspects of these responsibilities, most notably, stress and conflict management. These findings provide an opportunity for specific curriculum development in leadership and management for those believing these skills should be further refined.
AB - Background: Intensivists manage a diverse team of healthcare professionals. For decades, business literature has recognized the value of leadership and management skills, yet this is relatively unexplored in critical care. Objective: Investigate the status of intensivists' preparation for the clinical leadership and management roles that they will assume after medical training. Design: Authoritative business leadership literature was reviewed to identify attributes of successful leadership and management relevant to critical care. A survey was designed to assess the process by which intensivists learn these attributes and to assess their perceived level of preparedness (20 items). Each survey item received a preparedness score structured as a Likert scale (1 = not prepared, 5 = very prepared), representing the averaged response to each item. In addition, an inadequate preparedness percentage was created representing the percentage of respondents answering "not at all prepared" and "hardly prepared" on the Likert-scaled items. Setting: Pediatric Critical Care Medicine Board Review Course, Washington, DC, 2004. Subjects: Physician course participants (n = 259). Intervention: Survey administration. Measurements and Main Resulte: The response rate was 61% (n = 159). The majority of respondents (63%) had completed fellowship training (median, 1 yr posttraining). Modeling the behavior of other physicians was the dominant technique for leadership and management skill acquisition (88%). The respondents were taught these skills by a variety of sources (attendings, 92%; other fellows, 42%; nurses, 37%; teachers, 20%; residents, 14%). Most (82%) thought that leadership and management training was important or very important, yet only 47% had received any formal training, (40% fellowship, 36% residency, 21% medical school, 16% masters, 30% other). Overall, respondents felt only "somewhat prepared" for the 20 leadership and management items surveyed (mean ± SD of preparedness score, 2.8 ± 0.2). Respondents were least prepared to manage conflict within a team, manage conflict will other groups, and manage stress effectively (preparedness scores of 2.5, 2.4, and 2.6 and inadequate preparedness percentages of 19.5%, 15.7%, and 18.9%, respectively). Respondents were most prepared to "set high standards" (preparedness score = 3.3). Of the respondents feeling at least somewhat prepared, only 33% credited medical training as preparing them. Conclusions: Although leadership and management training was perceived as important to this sample of pediatric generally young intensivists, most feel inadequately prepared for critical aspects of these responsibilities, most notably, stress and conflict management. These findings provide an opportunity for specific curriculum development in leadership and management for those believing these skills should be further refined.
KW - Critical care
KW - Education
KW - Intensive care
KW - Leadership
KW - Patient care management
KW - Pediatrics
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U2 - 10.1097/01.PCC.0000170614.31827.C0
DO - 10.1097/01.PCC.0000170614.31827.C0
M3 - Article
C2 - 16276333
AN - SCOPUS:27844577696
VL - 6
SP - 665
EP - 670
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
SN - 1529-7535
IS - 6
ER -