Questions to be answered Methods Introduction

You’ve Either Got It Or You Haven’t EM Non-Consultant Doctors’ Beliefs About Leadership Teaching Dr A Kansagra, Dr C Turner, Dr R Cheong, Dr K Kitchener University Hospitals of Coventry and Warwickshire

Questions to be answered 1) Do non-consultant doctors believe that leadership skills can be taught? 2) For those that have accessed leadership training, has this been useful? 3) Have non consultant doctors had their leadership skills evaluated on the shop floor?

3) Have you ever had your Leadership skills evaluated and fed back? (Y/N)

10 9 8 7

Yes

6

Introduction

No

5

Since the Francis Inquiry there has been a greater emphasis put on medical leadership, both in how this is displayed and how this is taught. Leadership assessment has been incorporated into the RCEM fellowship curriculum in line with GMC guidance and courses are becoming more prevalent. We were interested in whether junior doctors at UHCW felt that medical leadership could be taught, as if they felt leadership was innate this could form a significant barrier to learning. Following on from this we wished to know if they had attended leadership teaching and , if so, how useful it was. Finally, we wished to know if nonconsultant Drs felt they had received leadership skills feedback.

Methods Over the course of 6 months in 2015-2016 we surveyed 50 members of junior medical staff. ‘SHOs’ include FY2, ACCS, GPVTS and Clinical fellows. ‘Middle Grades’ consist of Emergency Medicine Registrars and SAS doctors with equivalent competencies. The surveys were of mixed design with dichotomous, Likert and free text components. Data was extracted anonymously by AK and RC. The following results are from responders that were working within the Emergency Medicine department on the ‘SHO’ tier or ‘Middle Grade’ tier.

4

No Response

3 2 1 0

MGs

SHOs

• 92% of SHOs but only 55% of our MGs believed that leadership could be taught, with 27% of MGs believing firmly that leadership could not be taught. • There was no difference between the number of SHOs or MGs that had received Medical Leadership Training, but these numbers are small. • Satisfaction with leadership training was generally very low with only 1 doctor describing it as ‘useful’. 2 had no comment and 3 stated it was ‘very poor’, lacked ‘real benefit’ and ‘did not directly apply’. • 55% of MGs have had feedback compared to only 15% of SHOs.

Discussion Results 1) “Leadership skills are natural and cannot be taught” MGs

SHOs

Stongly Agree or Agree Neither Agree or Disagree Disagree or Strongly Disagree

2) Have you ever had Medical Leadership training? (Y/N)

This study has relatively small numbers, but it provides a qualitative appreciation of the overall view of medical leadership within our emergency department. Leadership teaching is still only accessed by the minority of doctors and satisfaction with this teaching is very low. The middle grade cohort were less likely to believe that leadership could be taught, but had received more leadership skills assessments. This suggests that these assessments have not been fit for purpose and there is probably scope for an ED leadership assessment framework (perhaps a retooling of the Flowerdew model for leadership). For leadership teaching to be truly effective, consideration of these beliefs will have to be taken into account by trainers. An evidence base for the impact of leadership training would be a good starting place.

9 8

Take home messages

7

Middle Grade doctors were less likely to believe that leadership skills could be taught than SHOs.

6 Yes No No Response

5 4

The numbers undergoing leadership teaching are still small, losing key opportunities. Satisfaction with leadership teaching is very low, suggesting it requires a significant rethink.

3 2

Feedback from leadership opportunities needs to improve so that the recipients feel they are developing.

1 0

MGs

SHOs

References http://webarchive.nationalarchives.gov.uk/20150407084003/http://www.midstaffspublicinquiry.com/ http://www.gmc-uk.org/guidance/ethical_guidance/11812.asp

Dave

@orangedis Chris

Kieran