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      Medical leadership: An important and required competency for medical students

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          Abstract

          Good medical leadership is the key to building high-quality healthcare. However, in the development of medical careers, the teaching of leadership has traditionally not equaled that of technical and academic competencies. As a result of changes in personal standards, the quality of medical leadership has led to variations between different organizations, as well as occasional catastrophic failure in the standard of care provided for patients. Leaders in the medical profession have called for reform in healthcare in response to challenges in the system and improvements in public health. Furthermore, there has been an increased drive to see leadership education for doctors starting earlier, and continuing throughout their careers so that they can take on more important leadership roles throughout the healthcare system. Being a physician requires not only management and leadership but also the need to transfer competencies to communication and critical thinking. These attributes can be obtained through experience in teamwork under the supervision of teaching staff. Therefore, medical students are expected to develop skills to deal with and resolve conflicts, learn to share leadership, prepare others to help and replace them, take mutual responsibility and discuss their performance.

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          Most cited references21

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          Brief leadership instructions improve cardiopulmonary resuscitation in a high-fidelity simulation: a randomized controlled trial.

          The influence of teaching leadership on the performance of rescuers remains unknown. The aim of this study was to compare leadership instruction with a general technical instruction in a high-fidelity simulated cardiopulmonary resuscitation scenario. Prospective, randomized, controlled superiority trial. Simulator Center of the University Hospital Basel in Switzerland. Two-hundred thirty-seven volunteer medical students in teams of three. During a baseline visit, the medical students participated in a video-taped simulated witnessed cardiac arrest. Participants were thereafter randomized to receive instructions focusing either on correct positions of arms and shoulders (technical instruction group) or on leadership and communication to enhance team coordination (leadership instruction group). A follow-up simulation was conducted after 4 mos. The primary outcome was the amount of hands-on time, defined as duration of uninterrupted cardiopulmonary resuscitation in the first 180 secs after the onset of the cardiac arrest (hands-on time) [corrected]. Secondary outcomes were time to start cardiopulmonary resuscitation, total leadership utterances, and technical skills. Outcomes were compared based on videotapes coded by two independent researchers. After a balanced performance at baseline, the leadership instruction group demonstrated a longer hands-on time (120 secs; interquartile range, 98-135 vs. 87 secs; interquartile range, 61-108; p < .001), a shorter median time to start cardiopulmonary resuscitation (44 secs; interquartile range, 32-62; vs. 67 secs; interquartile range, 43-79; p = .018), and had more leadership utterances (7; interquartile range, 4-10; vs. 5; interquartile range, 2-8; p = .02) in the follow-up visit. The rate of correct arm and shoulder positions was higher in teams with technical instruction (59%; 19 out of 32; vs. 23%; 7 out of 31; p = .003). Video-assisted leadership and technical instructions after a simulated cardiopulmonary resuscitation scenario showed sustained efficacy after a 4-mo duration. Leadership instructions were superior to technical instructions, with more leadership utterances and better overall cardiopulmonary resuscitation performance.
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            The role of the situation in leadership.

            Leadership depends on the situation. Few social scientists would dispute the validity of this statement. But the statement can be interpreted in many different ways, depending, at least in part, on what one means by leadership. This article begins with a definition of leadership and a brief description of 3 historically important theories of leadership. The most recent of these, contingency theories, is argued to be most consistent with existing evidence and most relevant to professional practice. The Vroom, Yetton, and Jago contingency models of participation in decision making are described in depth, and their work provides the basis for identifying 3 distinct ways in which situational or contextual variables are relevant to both research on and the practice of leadership.
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              A first step toward understanding best practices in leadership training in undergraduate medical education: a systematic review.

              To characterize leadership curricula in undergraduate medical education as a first step toward understanding best practices in leadership education.
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                Author and article information

                Journal
                Ci Ji Yi Xue Za Zhi
                Ci Ji Yi Xue Za Zhi
                TCMJ
                Tzu-Chi Medical Journal
                Medknow Publications & Media Pvt Ltd (India )
                1016-3190
                2223-8956
                Apr-Jun 2018
                : 30
                : 2
                : 66-70
                Affiliations
                [a ]Department of Anesthesiology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
                [b ]Department of Medical Education, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
                Author notes
                [* ] Address for correspondence: Dr. Tsung-Ying Chen, Department of Anesthesiology, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, Taiwan. E-mail: chenyting@ 123456tzuchi.com.tw
                Article
                TCMJ-30-66
                10.4103/tcmj.tcmj_26_18
                5968745
                29875585
                27ab6b59-0032-4960-b301-8517edfa809f
                Copyright: © 2018 Tzu Chi Medical Journal

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 10 July 2017
                : 04 September 2017
                : 23 September 2017
                Categories
                Review Article

                future physicians,leadership,medical education,mentoring

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