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GME Leadership is one of six domains identified as important for measuring and developing GME Institutional level performance.

The GME Leadership Model and Program Director Survey were developed via a series of meetings, drafts of model prototypes, and solicitation of subject matter expert feedback including:

1. Brainstorming sessions between Performance Improvement expert, GME Assistant Dean and GME Academic Director to determine appropriateness and applicability of the concept and the adaptation of Lominger’s Leadership Model for Marketing ®.

2. Three broad leadership categories and competency clusters were identified: “Resident,” “People,” and “Business.”

3. A draft model was presented to the GME Performance Improvement Committee to obtain residency Program Director (PD) feedback.

4. The GME Leadership Program Director Survey was developed to assess perceived importance and competence in tasks and skills related to each of the leadership performance domains.

5. The PD Survey was designed utilizing job task analysis items based on each leadership performance domain.

6. PDs were asked to rate the perceived importance and competence of 25 items using a 5-point Likert scale. Ten items reside in the “Resident” leadership category, five items reside in the “People” category, and ten items reside in the “Business” category.

7. The initial survey was distributed via New Innovations (NI) Residency Management Suite® email link with a follow up survey distributed via Survey Monkey® email link (to increase response rate for PDs unfamiliar with NI).

Developing Successful Leaders: A Model for Graduate Medical Education

Objectives To develop a leadership model for Graduate Medical Education (GME) Residency Program Directors that is inclusive of resident,

people, and business aspects of their required duties and needed skills.

To ascertain Program Directors’ perceived importance and competence with the elements of the GME leadership model.

Wayne State University GME Leadership Model

Methods

References1. ACGME Common Program Requirements. Accessed online: http://www.acgme.org2. http://www.amee.org3. Garman K et al; Faculty Development: Why bother?; Acad Med 2001; Vol 76, 10;S74-764. Korschun H et al; Realizing the Vision of Leadership Development in an Academic Health Center: The Woodruff Leadership

Academy; Acad Med 2007, B 2:264-2715. Made S et al; Effects of Participation in the Executive Leadership in Academic Medicine (ELAM) Program on Women Faculty’s

Perceived Leadership Abilities; Acad Med, 2004; Vol 79, No 4, 302-3096. Batalden P et al, General Competencies and Accreditation in Graduate Medical Education; Health Affairs; 2002 Vol 21, No 5, 103-

1117. http://www.Lominger.com8. Lombardo M, Eichinger R; For Your Improvement: A Guide for Development and Coaching TM, 4th Edition;2004;Minneapolis:

Lominger Inc.

Wilhelmine Wiese-Rometsch, MD; Ingrid Guerra-Lopez, PhD; Heidi Kromrei, MADepartment of Graduate Medical Education, Wayne State University School of Medicine

Wayne State University College of Education

Introduction

The survey sample included all PDs at Wayne State University School of Medicine (n=58). The response rate was 76% (44/58)

While PDs felt that all of the leadership survey items were at least somewhat important they did not report consistently high competence for all items.

Overall, PDs reported the highest perceptions of competence in the “Resident” leadership category. The “People” and “Business”leadership category ratings revealed that while PDs perceived these items to be important, they felt less competent in their abilities.

Table 1: Program Director Leadership Survey

Resident People BusinessUnderstanding Resident Needs Assembling and Managing Teams Leading Execution

Goals and educational activities Staffing teams to maximize interpersonal and cross-functional collaboration

Competing internally for resources

Regulatory requirements and of economic, industry, and patient trends

Managing dynamics among team members and impact of changes

Allocating staff and resources

Communication channels in meeting resident’s needs

Attending internal and external team issues and demands

Identifying external resources

Requirements for resident’s need for work-life balance

Responding to resident requests and changes

Maintaining control of all elements of complex issues

Taking Care of Resident Needs Attracting and Retaining Talent Driving Fiscal Effectiveness

Learning to say “no” Selecting diverse people with specific skills and attitudes

Creating budgets

Dealing with unsatisfied residents Developing selection criteria Resource allocation

Responding to resident emergencies and problems

Developing retention strategies with members who seek diversity of experience

Changing revenue models

Informing residents’ about their progress

Using internal reports to manage program performance and budgets

Planning & costing program initiatives

Building Resident Relationships Driving Performance Driving the Creative Process

Expanding services to residents (e.g. individual education plans)

Providing criteria for successful performance

Fostering diverse relationships

Networking with people, councils, committees, institutions

Allowing divergent views and creativity

Communicating program and intuitional issues

Working effectively with employers, licensing boards, and institutions

Resolving performance issues Ensuring alignment with resident, program, and institutional needs

Delivering negative feedback

Promoting contributors and leaders

Winning New Residents Developing Team Members Growing Expertise and Relationships

Orienting and mentoring residents from other institutions and cultures

Orienting and mentoring staff from other institutions and cultures

Remain informed about developments in medical education

Leveraging opportunities to communicate and showcase work at conference and networking setting

Coaching team members to develop new skills and improve existing skills

Analyze program performance in: leadership, education, accreditation, communication, and management

Delivering impactful presentations Appropriately taking risks in assigning people to new types of work or clients

Gain insight into competitors’ services and activities

Developing creativity with limited resources (financial, time, technology, human)

Helping staff gain experience in other disciplines

Maintaining contact or relationships at other institutions

Maintaining relationship with residents who are not currently in the program

Deciding when to bring in other people or resources to best meet program needs

GME PerformanceManagement

System

Program Performance

Portfolio

GME Institutional

Portfolio

Internal and External

Accreditation Education Communication EvaluationLeadership

Management & Continuous

Improvement

Survey Results

Developing competent Program Directors in GME is a well recognized need1.

Organizations (Association for Medical Education in Europe –AMEE, Accreditation Council for Graduate Medical Education-ACGME ) provide faculty development via conference workshops and seminars,2-5 yet many institutions are unable to provide leadership training due to lack of resources or expertise.

The ACGME utilizes the Dreyfus model for training residents on the six core competencies and provides materials and faculty development workshops for program directors6.

Corporate entities have a vast repertoire of strategies for successful leadership. The Lominger Leadership Model is a validated, competency-based framework applicable to a variety of settings7-8.

Program director leadership development is a GME administration responsibility. A unified leadership model for program directors is lacking.

Conclusions WSU SOM Program Directors support the importance and relevance of this leadership model for their work.

The gap between perceived importance and competence indicate opportunities for leadership development in Graduate Medical Education.

Interventions already implemented range from professional development workshops to leadership coaching for Program Directors.

As expected, Program Directors reported the greatest confidence in their capabilities related to leading residents.

Current culture is based on the belief that competency in leading residents is the only leadership skill required for successfulresidency program management.

The PD survey suggests the lack of business and management acumen in GME leaders.

The data raises the question as to what constitutes leadership excellence in program directors.

This model assisted in identifying skills, knowledge, and attitudes that will enhance a program directors’ success. Potential interventions should be aligned with a need identified in the model.

While these initial findings are interesting, more data needs to be collected in order to strengthen its generalizability.

“Resident” Leadership Category Perceived Importance * Perceived Competence *

Not Some Imp Very Extra Not Some Comp Very Extra

Creating & Evaluating Competency-Based Curricula

0 9 27 34 30 2.3 15.9 43.2 31.8 6.8

Communicating with Residents 0 0 0 30 71 0 0 9.1 56.8 34.1

Communicating with Former Residents 0 6.8 38.6 45.5 9.1 4.5 9.1 47.7 29.5 9.1

Managing & Evaluating Resident Performance

0 0 6.8 38.6 54.5 0 4.5 22.7 56.8 15.9

Managing Resident Conflicts & Problems 0 0 9.1 36.4 54.5 0 6.8 29.5 45.5 18.2

Recruiting Resident Candidates 0 0 6.8 34.1 59.1 0 9.1 40.9 34.1 15.9

“People” Leadership Category Perceived Importance * Perceived Competence *

Not Some Imp Very Extra Not Some Comp Very Extra

Maximizing Program Performance with Limited Resources

0 0 11.6 41.9 46.5 4.7 11.6 39.5 32.6 11.6

Selecting & Recruiting Program Faculty and Support Staff

0 0 9.1 43.2 47.7 4.5 18.2 38.6 34.1 4.5

Managing Program Faculty & Support Staff Conflicts and Problems

0 0 15.9 45.5 38.6 0 20.5 34.1 36.4 9.1

Retaining Program Faculty & Support Staff 0 0 11.4 40.9 47.7 4.5 2.3 43.2 45.5 4.5

Promoting Program Faculty & Staff Professional Development

0 0 23.3 46.5 30.2 0 18.2 43.2 36.4 2.3

“Business” Leadership Category Perceived Importance * Perceived Competence *

Not Some Imp Very Extra Not Some Comp Very Extra

Maximizing Program Performance with Limited Resources

0 0 11.6 41.9 46.5 4.7 11.6 39.5 32.6 11.6

Competing Internally for Resources 0 4.5 20.5 50 25 2.3 20.5 47.7 25 4.5

Managing and Allocating Resources 0 0 13.6 47.7 38.6 0 13.6 43.2 31.8 11.4

Creating & Management Budgets 0 2.3 29.5 38.6 29.5 6.8 18.2 38.6 31.8 4.5

Negotiating with Institutional Leadership 0 0 15.9 50 34.1 9.1 13.6 40.9 31.8 4.5

Negotiating with Internal & External Institutions

0 2.3 31.8 43.2 22.7 6.8 15.9 36.4 31.8 9.1

Communicating / Relationship with Leadership Peers

0 2.3 20.5 54.5 22.7 0 9.1 29.5 45.5 15.9