by Blake Mangum, PharmD, PGY1 Pharmacy Practice Resident, University of Mississippi Medical Center
When enrolling in a professional health program such as medicine, pharmacy, or nursing, many students must adjust to the demands of their program. The material is complex, the workload is demanding, and there are often co-curricular organizations and responsibilities to make time management even more complicated. Didactic instruction is critical in career development to understand the core material needed, but it's equally important to develop the professional and leadership skills required to excel. We often focus on helping students develop as future clinicians and instill the requisite foundational knowledge for their chosen professional field. But it is easy to overlook the importance of helping students develop as future leaders. Organizations that accredit professional programs, such as the Accreditation Council for Pharmacy Education (ACPE), require the curricula to address professional development and leadership. However, the method and material to be covered are left to the individual program. This introduces some variability between programs as institutions have various philosophies on the optimal method to deliver this material and may even define leadership differently. Do you structure the leadership curriculum by delivering a series of lectures, a couple of exams, and a final project? Or do you divide students into teams and have small-group discussions? Or do you send students out on their clinical rotations to develop their leadership skills in the "real world"? This essay will reflect on methods currently used in leadership development education and the outcomes reported by those using these methods.
Optimal Structure of a Leadership Curriculum
During my time as a pharmacy student, I took several professional and leadership development courses that were required in my program. I had assumed the structure and methods used would be similar at every health professions program. My classes started by taking a strengths finder analysis and discussing the impacts that various skills could have on team dynamics and performance. While researching what goes into making a leadership development course, I found that some programs take a similar approach, but others are very different. A recent scoping review examined fourteen published reports on leadership education in PharmD programs.1 Of those, only six employed traditional didactic lectures in the required curriculum. Others relied on co-curricular activities, elective courses, and leadership retreats. Even didactic lectures had variable content and schedules. Another systematic review provides insight into what components give us the most return on investment.2 The review used Kirkpatrick levels of evaluation to determine the effectiveness of each intervention or approach. They found that leadership interventions that combined didactic lectures with projects, lab activities, and small groups were more effective than didactic lectures alone.2 Both papers report that students prefer a multimodal approach. The course structure is not the only variable to consider.
Optimal Duration of a Leadership Curriculum
We have all heard that practice makes perfect. It is important to consider how long it takes to conduct a program aimed at leadership development and how often the participants should meet. The literature is quite variable in this regard. Some programs met once monthly for a semester or entire academic year, while others consisted of a 5-module series over multiple years, and others were a single-day leadership retreat.1,2 The exact length of a program and how often to meet will depend on several institution-specific factors, such as the availability of professors to deliver lectures, the schedules of students' other classes, physical facilities, and more. Based on a review of the literature, longitudinal courses have greater efficacy than shorter program durations; however, programs that lasted half a day were compared to programs that lasted the entire four-year curriculum.2 The answer to how long to teach and how often to meet is debatable, but a good starting point would be a standard semester-long course.
Optimal Class Size
The literature reviews report cohorts ranging from 6 to over 200 students.1,2 Smaller cohorts scored higher on efficacy rankings than large cohorts. This area is a little harder to navigate as not much can be done about a class size if you require the entire student body to complete the program. One possible method of ensuring smaller cohorts would be to divide classes into sections, with some sitting in a lecture for one week while the other section is involved in a skills lab, and perhaps dividing up the cohort into even smaller groups for discussion sessions. This method would provide students with a multimodal learning experience and more direct learning opportunities.
Optimal Course Development
The University of Massachusetts Medical School recently created a course to enhance medical students' leadership and teamwork skills.3 The course objectives included leadership style, communication within the health care team, giving and receiving feedback, delegating responsibilities, and setting direction for a team. These leadership skills were identified as core competencies in a previous needs assessment survey. The course involved six 90-minute sessions. A portion of each session was a didactic lecture, plus there were interactive activities to reinforce the material, post-session questionnaires, and individual reflections. Similar to previous studies, the authors used pre- and post-course surveys to gauge course impact. Students completed a survey eight months after the course conclusion to assess the long-term skill use and effects of the course. The authors documented increased student confidence related to each course objective and the key skills learned during the course were still being used in everyday life eight months later. This model indicates that surveying students about impact is a best practice to assess the effectiveness of a course. Of note, the creators of this course were students themselves! This underscores the fact that students actively seek to strengthen their leadership skills and, in this case, help others develop them as well. Healthcare is a team sport, and having the ability to lead the team in your area of expertise is an essential skill.
Leadership skill development is not routinely considered when entering a clinical profession. However, these skills are critically important and need to be considered when developing a curriculum. The optimal methods will vary between institutions, but using a multimodal approach with lectures, longitudinal projects, and having smaller cohorts in classes are factors that can improve the effectiveness of a leadership course.
References
- DeVolld T, DiPietro Mager N, et al. Management, entrepreneurship, continuing professional development, and leadership education in United States doctor of pharmacy curricula: A scoping review. Curr Pharm Teach Learn 2022;14(6):798–808
- Evans MA, James EJ, Misa Mi. Leadership training in undergraduate medical education: A systematic review. Int J Med Students 2023;11(1):58–66.
- Richard K, Noujaim M, Thorndyke L, Fischer MA. Preparing medical students to be physician leaders: A leadership training program for students designed and led by students.. Med Ed Portal. 2019; 15: 10863
