leadership training for obstetrics and gynecology ... · chi-square testing was used for...

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RESEARCH POSTER PRESENTATION DESIGN © 2019 www.PosterPresentations.com Perceived Importance for Leadership Curriculum Competencies: Faculty vs Residents Senior-level obstetrics and gynecology residents are expected to demonstrate teamwork, accountability, and integrity as they lead patient care teams. While other specialties have incorporated leadership training into residency education, there have been few of these programs within obstetrics and gynecology. To determine perceived necessity as well as potential content and format needs for a leadership curriculum in obstetrics and gynecology residency training. In June-July 2019, a needs assessment survey regarding leadership training was distributed to residents and academic faculty at three US obstetrics and gynecology residency programs. Chi-square testing was used for statistical analysis. Response rate was 86/111 (77%) for residents and 79/124 (63%) for faculty. Of PGY-1 residents, 73% believe sufficient leadership training exists during residency, however only 29% of PGY2-4s (p<0.01) and 26% of faculty believed similarly (p< 0.01). Consensus exists among residents and faculty that additional leadership training would be beneficial. Small group exercises and leadership cases addressing issues pertinent to women’s health should be incorporated into obstetrics and gynecology residency training. Guided by findings from this survey, we plan to develop, implement and review a leadership curriculum specific to obstetrics and gynecology residents. 1 Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 2 Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York 3 Department of Obstetrics and Gynecology, Kaiser Permanente Northern California Oakland, Oakland, California Grace Johnson MD 1 , Emily Woodbury MD 2 , Marie Boller MD 3 , Tirsit Asfaw MD 2 , Eve Zaritsky MD 3 , Charles Kilpatrick MD, MEd 1 , Bani Ratan MD 1 Leadership Training for Obstetrics and Gynecology Residents, A Multi-Institutional Needs Assessment BACKGROUND OBJECTIVES METHODS RESULTS CONCLUSIONS FUTURE DIRECTIONS 43% 34% 23% Faculty Responses by Institution Baylor College of Medicine Weill Cornell Medicine Kaiser Permanente Oakland 52% 25% 23% Resident Responses by Institution Baylor College of Medicine Weill Cornell Medicine Kaiser Permanente Oakland 0 2 4 6 8 10 12 14 16 18 20 Instructor Associate Professor Assistant Professor Professor Partnered Not partnered Faculty Academic Rank by Institution Baylor College of Medicine Weill Cornell Medicine Kaiser Permanente Oakland 0 2 4 6 8 10 12 14 PGY1 PGY2 PGY3 PGY4 Resident Level of Training by Institution Baylor College of Medicine Weill Cornell Medicine Kaiser Permanente Oakland REFERENCES ACKNOWLEDGEMENTS Only PGY1s thought sufficient leadership training was provided. The majority of residents (84%) and faculty (82%) agree residents would benefit from a leadership curriculum. Comments regarding currently available leadership training minimal to no formal leadership training.” the admin chiefs receive [leadership] training, though no one else does.” “not sure anything is formalizedmostly ‘on the job’ training.” “I think we could have a more robust curriculumthe difficulty is balancing it with all of the other competing needs.” Special thanks to my academic advisors for this project, Dr. Bani Ratan and Dr. Charles Kilpatrick, as well as to the coordinating authors at Weill Cornell Medicine and Kaiser Permanente Northern California Oakland for going above and beyond pushing through the challenges inherent in multi-institutional projects. Blumental DM, Bernard K, Fraser TN, Bohnen J, Zeidman J, Stone VE. Implementing a pilot leadership course for internal medicine residents: design considerations, participant impressions, and lessons learned. BMC Med Educ. 2014 Nov 30; 14:257 Gallagher E, Moore A, Schabort I. Leadership training in a family medicine residency program: Cross-sectional quantitative survey to inform curriculum development. Can Fam Physician. 2017 Mar;63(3):e186-e192 QUALITATIVE COMMENTS 0 10 20 30 40 50 60 PGY1* PGY2 PGY3 PGY4 Faculty Is Sufficient Leadership Training Provided During Ob/Gyn Residency Training? Yes No * Faculty and resident views of professionalism in a leadership curriculum differed, with 31% (18/58) of faculty rating professionalism as a top two skill compared to only 6% (4/69) of residents (p<0.01). 0 10 20 30 40 50 60 Reflective Writing Video or Powerpoint Presentations Book Club or Journal Club Role Play/Simulation Lectures (in person) Small Group Exercises Leadership Case Studies Preferred Format for Leadership Curriculum Faculty Residents Faculty 1 Effective Communication (7.12) 2 Team Management (6.47) 3 Professionalism (5.97)* 4 Time Management (5.77) 5 Social Intelligence (5.64) Residents 1 Effective Communication (7.65) 2 Team Management (7.19) 3 Time Management (6.06) 4 Self-awareness (5.63) 5 Conflict Resolution (5.37) How do leadership skills required in Ob/Gyn differ from leadership skills required in other medical specialties? Clinical Setting Based Skill Set “Ob/Gyn is a specialty in which a multi-varied skill set is requiredprimary care, inpatient care, and surgical training-- all requiring slightly different leadership skills.” “Making decisions in a team environment (OR, L&D) in a collaborative, time-sensitive environment is crucialknowing when to apply a sense of urgency and directiveness vs a more collaborative approach.” Advocacy for Women’s Health “The aspect of patient advocacy/political involvement for Women’s healthcare rights is important.” “Advocacy is crucial given the constant and increasing threats to our patients’ reproductive freedom and to our autonomy as reproductive health experts.”

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Page 1: Leadership Training for Obstetrics and Gynecology ... · Chi-square testing was used for statistical analysis. Response rate was 86/111 (77%) for residents and 79/124 (63%) for faculty

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PerceivedImportanceforLeadershipCurriculumCompetencies:FacultyvsResidents

Senior-level obstetrics and gynecology residents are expected to demonstrate teamwork, accountability, and integrity as they lead patient care teams. While other specialties have incorporated leadership training into residency education, there have been few of these programs within obstetrics and gynecology.

To determine perceived necessity as well as potential content and format needs for a leadership curriculum in obstetrics and gynecology residency training.

In June-July 2019, a needs assessment survey regarding leadership training was distributed to residents and academic faculty at three US obstetrics and gynecology residency programs. Chi-square testing was used for statistical analysis.

Response rate was 86/111 (77%) for residents and 79/124 (63%) for faculty. Of PGY-1 residents, 73% believe sufficient leadership training exists during residency, however only 29% of PGY2-4s (p<0.01) and 26% of faculty believed similarly (p< 0.01).

Consensus exists among residents and faculty that additional leadership training would be beneficial. Small group exercises and leadership cases addressing issues pertinent to women’s health should be incorporated into obstetrics and gynecology residency training.

Guided by findings from this survey, we plan to develop, implement and review a leadership curriculum specific to obstetrics and gynecology residents.

1DepartmentofObstetricsandGynecology,BaylorCollegeofMedicine,Houston,Texas2DepartmentofObstetricsandGynecology,WeillCornellMedicine,NewYork,NewYork

3DepartmentofObstetricsandGynecology,KaiserPermanenteNorthernCaliforniaOakland,Oakland,California

GraceJohnsonMD1,EmilyWoodburyMD2,MarieBollerMD3,TirsitAsfawMD2,EveZaritskyMD3,CharlesKilpatrickMD,MEd1,BaniRatanMD1

LeadershipTrainingforObstetricsandGynecologyResidents,AMulti-InstitutionalNeedsAssessment

BACKGROUND

OBJECTIVES

METHODS

RESULTS

CONCLUSIONS

FUTURE DIRECTIONS

43%

34%

23%

FacultyResponsesbyInstitution

BaylorCollegeofMedicineWeillCornellMedicineKaiserPermanenteOakland

52%25%

23%

ResidentResponsesbyInstitution

BaylorCollegeofMedicineWeillCornellMedicineKaiserPermanenteOakland

02468

101214161820

Instructor

AssociateProfessor

AssistantProfessor

Professor

Partnered

Notpartnered

FacultyAcademicRankbyInstitution

BaylorCollegeofMedicineWeillCornellMedicineKaiserPermanenteOakland

0

2

4

6

8

10

12

14

PGY1 PGY2 PGY3 PGY4

ResidentLevelofTrainingbyInstitution

BaylorCollegeofMedicineWeillCornellMedicineKaiserPermanenteOakland

REFERENCES

ACKNOWLEDGEMENTS

Only PGY1s thought sufficient leadership training was provided.

The majority of residents (84%) and faculty (82%) agree residents would benefit from a leadership curriculum.

Commentsregardingcurrentlyavailableleadershiptraining

“…minimaltonoformalleadershiptraining.”“…theadminchiefsreceive[leadership]training,thoughnooneelsedoes.”“notsureanythingisformalized…mostly‘onthejob’training.”“Ithinkwecouldhaveamorerobustcurriculum…thedifficultyisbalancingitwithalloftheothercompetingneeds.”

Special thanks to my academic advisors for this project, Dr. Bani Ratan and Dr. Charles Kilpatrick, as well as to the coordinating authors at Weill Cornell Medicine and Kaiser Permanente Northern California Oakland for going above and beyond pushing through the challenges inherent in multi-institutional projects.

Blumental DM, Bernard K, Fraser TN, Bohnen J, Zeidman J, Stone VE. Implementing a pilot leadership course for internal medicine residents: design considerations, participant impressions, and lessons learned. BMC Med Educ. 2014 Nov 30; 14:257 Gallagher E, Moore A, Schabort I. Leadership training in a family medicine residency program: Cross-sectional quantitative survey to inform curriculum development. Can Fam Physician. 2017 Mar;63(3):e186-e192

QUALITATIVE COMMENTS

HowdoleadershipskillsrequiredinOb/Gyndifferfromleadershipskillsrequiredinothermedicalspecialties?

“…awidebreadthofknowledgeandskillisrequired.Forexampleprimarycare,inpatientcare,andsurgicaltrainingareequallyimportant.”

“…multi-taskingisalargerpartofOb/Gynthanothermedicalspecialties.”

“Theaspectofpatientadvocacy/politicalinvolvementforwomen’shealthcarerightsisuniquetoOb/Gyn.Advocacyiscrucialgiventheconstantandincreasingthreatstoourpatients’reproductivefreedomandtoourautonomyasreproductivehealthexperts.”

“…[theneedtomake]decisionsina…collaborative,direct,time-sensitiveenvironment[and]knowingwhentoapplyasenseofurgencyanddirectivenessvsamorecollaborativeapproach.”

“…highacuity…WealsodealwithvulnerablepopulationsandIbelievethatourprofessiondemandsthatweleadasadvocates.”

0102030405060

PGY1* PGY2 PGY3 PGY4 Faculty

IsSufficientLeadershipTrainingProvidedDuringOb/GynResidency

Training?

Yes No

*  Faculty and resident views of professionalism in a leadership curriculum differed, with 31% (18/58) of faculty rating professionalism as a top two skill compared to only 6% (4/69) of residents (p<0.01).

0 10 20 30 40 50 60

ReflectiveWriting

VideoorPowerpointPresentations

BookCluborJournalClub

RolePlay/Simulation

Lectures(inperson)

SmallGroupExercises

LeadershipCaseStudies

PreferredFormatforLeadershipCurriculum

FacultyResidents

0123456789

ConflictResolution

EffectiveCommunication

EmotionalResilience

Feedback

Networking

Professionalism

*

Self-awareness

SocialIntelligence

TeamManagement

TimeM

anagement

PerceivedImportanceforLeadershipCurriculum

Competencies

Faculty Residents

Faculty

1 EffectiveCommunication(7.12)

2 TeamManagement(6.47)

3 Professionalism(5.97)*

4 TimeManagement(5.77)

5 SocialIntelligence(5.64)

Residents

1 EffectiveCommunication(7.65)

2 TeamManagement(7.19)

3 TimeManagement(6.06)

4 Self-awareness(5.63)

5 ConflictResolution(5.37)

ClinicalSettingBasedSkillSet

• “Ob/Gynisaspecialtyinwhichamulti-variedskillsetisrequired–primarycare,inpatientcare,andsurgicaltraining--allrequiringslightlydifferentleadershipskills.”

• “Makingdecisionsinateamenvironment(OR,L&D)inacollaborative,time-sensitiveenvironmentiscrucial–knowingwhentoapplyasenseofurgencyanddirectivenessvsamorecollaborativeapproach.”

AdvocacyforWomen’sHealth

• “Theaspectofpatientadvocacy/politicalinvolvementforWomen’shealthcarerightsisimportant.”

• “Advocacyiscrucialgiventheconstantandincreasingthreatstoourpatients’reproductivefreedomandtoourautonomyasreproductivehealthexperts.”

HowdoleadershipskillsrequiredinOb/Gyndifferfromleadershipskillsrequiredinothermedicalspecialties?

ClinicalSettingBasedSkillSet

“Ob/Gynisaspecialtyinwhichamulti-variedskillsetisrequired–primarycare,inpatientcare,andsurgicaltraining--allrequiringslightlydifferentleadershipskills.”“Makingdecisionsinateamenvironment(OR,L&D)inacollaborative,time-sensitiveenvironmentiscrucial–knowingwhentoapplyasenseofurgencyanddirectivenessvsamorecollaborativeapproach.”

AdvocacyforWomen’sHealth

“Theaspectofpatientadvocacy/politicalinvolvementforWomen’shealthcarerightsisimportant.”

“Advocacyiscrucialgiventheconstantandincreasingthreatstoourpatients’reproductivefreedomandtoourautonomyasreproductivehealthexperts.”

ClinicalSettingBasedSkillSet

• “Ob/Gynisaspecialtyinwhichamulti-variedskillsetisrequired–primarycare,inpatientcare,andsurgicaltraining--allrequiringslightlydifferentleadershipskills.”

• “Makingdecisionsinateamenvironment(OR,L&D)inacollaborative,time-sensitiveenvironmentiscrucial–knowingwhentoapplyasenseofurgencyanddirectivenessvsamorecollaborativeapproach.”

AdvocacyforWomen’sHealth

• “Theaspectofpatientadvocacy/politicalinvolvementforWomen’shealthcarerightsisimportant.”

• “Advocacyiscrucialgiventheconstantandincreasingthreatstoourpatients’reproductivefreedomandtoourautonomyasreproductivehealthexperts.”