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Administration and leadership competencies: establishment of a national consensus for emergency medicine

Published online by Cambridge University Press:  01 April 2015

Brent Thoma ,
Julien Poitras ,
Rick Penciner ,
Jonathan Sherbino ,
Brian R. Holroyd  and
Robert A. Woods
Brent Thoma
Affiliation:
Emergency Medicine, University of Saskatchewan, Saskatoon, SK
Julien Poitras
Affiliation:
Departement de medecine familiale et de medecine d'urgence, Universite Laval, QC
Rick Penciner
Affiliation:
Division of Emergency Medicine, University of Toronto, Toronto, ON
Jonathan Sherbino
Affiliation:
Division of Emergency Medicine, McMaster University, Hamilton, ON
Brian R. Holroyd
Affiliation:
Department of Emergency Medicine, University of Alberta, Edmonton, AB
Robert A. Woods*
Affiliation:
Emergency Medicine, University of Saskatchewan, Saskatoon, SK
*
Correspondence to: Dr. Robert A. Woods, Royal University Hospital 2689, 103 Hospital Drive, Saskatoon, SK S7N OW8; rob.woods@usask.ca.

Abstract

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Introduction: The Royal College of Physicians and Surgeons of Canada requires emergency medicine (EM) residency programs to meet training objectives relating to administration and leadership. The purpose of this study was to establish a national consensus on the competencies for inclusion in an EM administration and leadership curriculum.

Methods: A modified Delphi process involving two iterative rounds of an electronic survey was used to achieve consensus on competencies for inclusion in an EM administration and leadership curriculum. An initial list of competencies was compiled using peer-reviewed and grey literature. The participants included 14 EM residency program directors and 43 leadership and administration experts from across Canada who were recruited using a snowball technique. The proposed competencies were organized using the CanMEDS Physician Competency Framework and presented in English or French. Consensus was defined a priori as >70% agreement.

Results: Nearly all (13 of 14) of the institutions with an FRCPC EM program had at least one participant complete both surveys. Thirty-five of 57 (61%) participants completed round 1, and 30 (53%) participants completed both rounds. Participants suggested an additional 16 competencies in round 1. The results of round 1 informed the decisions in round 2. Fifty-nine of 109 (54.1%) competencies achieved consensus for inclusion.

Conclusions: Based on a national modified Delphi process, we describe 59 competencies for inclusion in an EM administration and leadership curriculum that was arranged by CanMEDS Role. EM educators may consider these competencies when designing local curricula.

Résumé

Introduction: Le Collège royal des médecins et chirurgiens du Canada exige que les programmes de résidence en médecine dˊurgence (MU) contiennent des objectifs de formation en matière dˊadministration et de pouvoir dˊinfluence. Lˊétude visait à établir un consensus national sur les compétences à inclure dans un programme d’études concernant l’administration et le pouvoir d’influence en MU.

Méthode: Une enquête électronique fondée sur une version modifiée de la méthode Delphi et comptant deux tours a servi à établir un consensus sur les compétences à inclure dans un programme d’études concernant l’administration et le pouvoir d’influence en MU. Une première liste a été dressée à l’aide de la documentation évaluée par les pairs et de la documentation parallèle. Les participants comprenaient 14 directeurs de programme de résidence et 43 experts en administration et en pouvoir d’influence, qui provenaient de toutes les régions du pays et qui avaient été sélectionnés selon la technique de «boule de neige». La liste des compétences proposées suivait la structure du Cadre des compétences CanMEDS et avait été dressée en français et en anglais. L’atteinte d’un consensus a été fixée, a priori, à un taux d’entente supérieur à 70%.

Rèsultats: Presque tous les établissements (13 sur 14) offrant un programme en vue de l’obtention du titre de FRCPC en MU comptait au moins un représentant qui s’était rendu jusqu’à la fin des deux enquêtes: 35 représentants sur 57 (61%) avaient achevé le premier tour et 30 représentants (53%) les deux tours. Les participants ont suggéré d’ajouter 16 autres compétences au premier tour. Les résultats du premier tour ont permis d’éclairer les décisions prises au deuxième tour. Au total, 59 compétences sur 109 (54.1%) ont fait l’objet de consensus quant à leur inclusion dans le programme.

Conclusions: Seront présentées 59 compétences retenues dans une enquête menée selon une version modifiée de la méthode Delphi, à l’échelle du pays, en vue de leur inclusion dans un programme d’études concernant l’administration et le pouvoir d’influence en MU, et établies selon les rôles CanMEDS. Les éducateurs en MU peuvent tenir compte de ces compétences dans l’élaboration de leur programme local d’études.

Type
Original Research
Information
Canadian Journal of Emergency Medicine , Volume 17 , Issue 2 , March 2015 , pp. 107 - 114
Copyright
Copyright © Canadian Association of Emergency Physicians 2015 

References

1. Royal College of Physicians and Surgeons. Emergency medicine objectives of training. Available at: http://rcpsc.medical.org/information/index.php?specialty5122&submit5Select (accessed January 10, 2012).Google Scholar
2. Royal College of Physicians and Surgeons. Emergency medicine specialty training requirements. Available at: http://rcpsc.medical.org/information/index.php?specialty5122&submit5Select (accessed January 10, 2012).Google Scholar
3. Association of Faculties of Medicine of Canada. The future of medical education in Canada: postgraduate project. A collective vision for postgraduate education in Canada. Available at: http://www.afmc.ca/future-of-medical-education-in-canada/postgraduateproject/final-report.php (accessed April 6, 2012).Google Scholar
4. American Board of Emergency Medicine. The model of clinical practice of emergency medicine. Available at: http://www.abem.org/PUBLIC/portal/alias__Rainbow/lang__en-US/tabID__4223/DesktopDefault.aspx (accessed January 10, 2012).Google Scholar
5. Heitz, C, Hamilton, GC. The Academic Chair in emergency medicine: current demographics and survey results identifying the skills and characteristics desired for the role. Acad Emerg Med 2011;18:981–987, doi:10.1111/j.1553-2712.2011.01144.x.Google Scholar
6. Accreditation Council for Graduate Medical Education and American Board of Emergency Medicine. The Emergency Medicine Milestone Project. Available at: https://www.abem.org/PUBLIC/_Rainbow/Documents/EMMilestonesMeeting4_Final1092012.pdf (accessed January 3, 2013)..Google Scholar
7. The College of Emergency Medicine. Curriculum and Assessment Systems for Core Specialty Training ACCS CT1-3 & Higher Specialty Training ST4-6 Training Programmes. Available at:http://www.collemergencymed.ac.uk/Training-Exams/Curriculum/Curriculum%20from%20August%202010/accessed March 19, 2012).Google Scholar
8. Academy of Medical Royal Colleges & National Health Service: Institute for Innovation and Improvement. Medical Leadership Competency Curriculum. Available at: http://www.aomrc.org.uk/publications/statements/doc_view/133-medicalleadership-competency-curriculum.html (accessed January 3,2013).Google Scholar
9. Gillam, S. Teaching doctors in training about management and leadership. BMJ 2011;343:d5672 doi:10.1136/bmj. d5672.Google Scholar
10. Falvo, T, McKniff, S, Simolin, G, et al 2009 The business of emergency medicine: a nonclinical curriculum proposal for emergency medicine residency programs. Acad Emerg Med 2009;16:900–907, doi:10.1111/j.1553-2712.2009.00506.x.Google Scholar
11. Paller, M, Becker, T, Cantor, B, Freeman, S. Introducing physicians to a career in management: the physician management pathway. Acad Med 2000;75:761–764, doi:101097/00001888-200007000-00025.CrossRefGoogle ScholarPubMed
12. Patel, SN. Emergency medicine medicolegal curriculum for fourth year medical students. Ann Emerg Med 2011;58(4 Supple):S336 doi:10.1016/j.annemergmed.2011.06.500.Google Scholar
13. Greysen, SR, Wassermann, T, Payne, P, Mullan, F. Teaching health policy to residents – three-year experience with a multi-specialty curriculum. J Gen Intern Med 2009;24:1322–1326, doi:10.1007/s11606-009-1143-1.Google Scholar
14. Shortt, SE, Hodgetts, PG.. A curriculum for the times: an experiment in teaching health policy to residents in family medicine Can Med Assoc J 1997;157:1567–1569.Google Scholar
15. Kelly, JJ, Thallner, E, Broida, RI, et al. Emergency medicine quality improvement and patient safety curriculum. Acad Emerg Med 2010;17:e110–29, doi:10.1111/j.1553-2712.2010. 00897.x.Google Scholar
16. Salluzo, RF, Mayer, TA, Strauss, RW, Kidd, PS. Emergency department management: principles and applications. St Louis Mosby; 1997.Google Scholar
17. Rosen, R. Managing to get it right: the ACEP user’s guide to emergency department management. Dallas (TX) American College of Emergency Physicians; 1998.Google Scholar
18. Penciner, R, Langhan, R, Lee, R, et al. Using a Delphi process to establish consensus on emergency medicine clerkship competencies. Med Teach 2011;33:e333–9, doi:10.3109/ 0142159X.2011.575903.CrossRefGoogle ScholarPubMed
19. Stringer, E. Action research, 2nd ed. Thousand Oaks (CA) Sage; 2007.Google Scholar
20. Hasson, F, Keeney, S, Mckenna, H. Research guidelines for the Delphi survey technique. J Adv Nurs 2000;32:1008–1015.CrossRefGoogle ScholarPubMed
21. Scott, BS. Administrative fellowships in emergency medicine. Physician Executive 1995;21(8):35.Google Scholar
22. Frank, JR. CanMEDS 2005 Physician Competency Framework.Available at: http://meds.queensu.ca/medicine/obgyn/pdf/CanMEDS2005.booklet.pdf.Google Scholar
23. Penciner, R, Woods, R, McEwen, J, et al. Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative. CJEM 2013;15:24–33.Google Scholar
24. Ham, C. Improving the performance of health services: the role of clinical leadership. Lancet 2003;361:1978–1980, doi:10.1016/S0140-6736 03):13593–3.Google Scholar
25. McKimm, J, Swanwick, T. Leadership development for clinicians: what are we trying to achieve? Clin Teach 2011;8:181–185, doi:10.1111/j.1743-498X.2011.00473.x.Google Scholar
26. Swanwick, T, McKimm, J. What is clinical leadership...and why is it important? Clin Teach 2011;8:22–26, doi:10.1111/ j.1743-498X.2010.00423.x.Google Scholar
27. Schwartz, RW, Pogge, C. Physician leadership: essential skills in a changing environment. Am J Surg 2000;180:187–192, doi:10.1016/S0002-9610(00)00481-5.Google Scholar
28. Warren, OJ, Carnall, R. Medical leadership: why it’s important, what is required, and how we develop it. Postgrad Med J 2011;87:27–32, doi:10.1136/pgmj.2009.093807.Google Scholar