Clinical Fellow Division of Gastroenterology, Hepatology & Nutrition, Boston Children's Hospital Boston, Massachusetts, United States
Background: Despite multiple organizations advocating for leadership development for physicians-in-training, this development often happens unintentionally, leaving some trainees unprepared to assume leadership roles when they graduate. Simulation can be effective for intentional leadership training, but efforts have predominantly focused on senior-level residents. Education targeted at early-stage learners provides residents the greatest opportunity to consolidate and apply these skills during training. Objective: We aimed to understand how non-clinical simulation facilitates the development of leadership skills among pediatric interns. Design/Methods: Interns in their first 6 months of pediatric residency participated once in a facilitated non-medical survival simulation (Cascades Survival Simulation™, Human Synergistics International) conducted 4 times from July to November 2022. Using a constructivist grounded theory approach, we explored how the simulation fostered leadership development in these early-stage learners. We recorded simulation debriefs and conducted semi-structured focus groups with all participants. Transcripts were coded line-by-line and then organized into themes and finally a theory. We performed member checking to triangulate findings. Results: A total of 49 interns participated. Theoretical sufficiency was achieved after 3 debrief-focus group pairs, with no novel insights gained from the fourth. Participants reported valuing personal familiarity and the leveling of the playing field by the unfamiliar content. They described how this environment made it safe to experiment and compelled them to examine their own behaviors and their interactions with others. Participants highlighted how they extrapolated this experience to their clinical work and began to identify themselves as leaders. The interaction of these key themes is shown in Figure 1, representing a theoretical model for how non-clinical simulation fosters leadership development among interns.
Conclusion(s): Non-clinical simulation prompts early-stage clinicians to experiment with and examine their actions and group interactions for leadership behaviors and opportunities, to link these to clinical experiences, and to begin to build a leadership identity. This understanding can equip educators to better support residents in their leadership development. PAS Abstract - Leadership_Figure1_FINAL.jpeg
.jpg)