Academic Paediatrician and Hospitalist The Hospital for Sick Children Toronto, Ontario, Canada
Background: Leadership is a core skill set as described by the Royal College of Physicians and Surgeons of Canada’s (RCPSC) CanMEDS framework; however, there is a dearth of structured leadership training in postgraduate medical education (PGME) nationally, as most programs struggle with how to incorporate it. The RCPSC’s Competence-By-Design (CBD) model promotes personal development and learning experiences tailored to the developmental acquisition of competencies throughout training. The University of Toronto (U of T) Paediatric program’s transition to CBD, thus, affords the opportunity to intentionally integrate leadership development in keeping with its philosophy to support a growth mindset and an equitable learning environment. Objective: In response to the RCPSC’s requirement for leadership training, we conducted a needs assessment using the U of T Paediatric Residency Training program as a case study to identify gaps and opportunities for leadership development in Paediatric PGME. Design/Methods: An online quantitative survey was administered to U of T Paediatric residents and faculty, and was analyzed using descriptive statistics. Paediatric residency program directors across Canada were surveyed through a qualitative questionnaire. Open-ended, semi-structured interviews and focus groups were conducted. Transcripts of qualitative data were coded inductively and deductively to generate themes that corresponded to CBD priorities and identified perceived learner needs. Results: Most participants viewed leadership (174/185) and EDI (equity, diversity, inclusivity) training within it (177/185) as being important. Residents and faculty identified vision-setting, listening, and compassion as characteristics of effective leaders. Of those trained in Toronto, most felt there is a moderate (42%) or significant (35%) need for leadership training. Residents voiced feeling intimidated taking on leadership roles amidst experts. All participants identified lack of time and entrustment by faculty as barriers to training. Respondents endorsed leadership development through a formal curriculum, experiential learning, feedback, and coaching.
Conclusion(s): Paediatric trainees and faculty recognize the need for a leadership curriculum that includes an EDI focus and are highly supportive of an implementation of formal leadership training using constructivist approaches. A developmentally staged leadership curriculum with a formal component and integration into the clinical setting holds the potential to foster a growth mindset and address the need for leadership training in PGME.
