A Retreat on Leadership Skills for Residents

Objective: It is widely acknowledged that residents must develop their leadership skills. The ACGME Residency Review Committee guidelines state that residency programs should include “assignments during which residents learn to work with other members of the health-care team and to become leaders in the organization and management of patient care.” With this consideration in mind, we developed a three-year curriculum in leadership skills for residents, the goals being that residents should be able to appreciate and practice principles of personal effectiveness, effectively manage resident ward teams, and be able to appreciate and practice principles of effective leadership. Most of this curriculum is delivered in either annual resident orientation sessions or annual resident retreats, with a stepwise emphasis of our three goals across the three years of training. We describe a component of this curriculum, a half-day retreat for interns entitled “Leadership Skills for Residents.” Description: As part of our leadership-skills curriculum, a one-day, six-hour retreat for interns was held prior to the start of their second year of training. It was divided between the themes of teaching and leadership. Small-group tasks and discussions were integrated with large-group introductions and summaries by the retreat faculty. Themes and activities related to leadership were brainstorming the qualities of stellar upper-level residents (setting personal vision), brainstorming the qualities of stellar interns (understanding their constituency), leadership vs. management, building a team, practical negotiation skills, providing effective feed-back, and problem-solving as a team leader. Instructional methods included facilitated active discussions, panel sessions with more experienced residents, working through scenarios, and role-playing. Discussion: All the participants completed entry and exit questionnaires responding to items using a four-point Likert scale (4 = strongly agree to 1 = strongly disagree). They reported increased confidence in their abilities to lead a ward team (p = .0002) and fulfill their responsibilities as upper-level residents (p = .0002), and having identified qualities they aspired to as upper-level residents (p = .0014). They also reported that as a result of the retreat they better appreciated their roles as team leader and manager (mean = 3.76, SD.44) and felt better prepared to deal with the challenges of being upper-level residents (mean = 3.65, SD.61). The participants also believed that they would use what they learned at this retreat as upper-level residents (mean = 3.88, SD.33). We are now in the process of finalizing a follow-up questionnaire to all retreat participants to assess whether these findings are sustained over the first six months of their PGY2 training. We are planning to further develop our three-year longitudinal curriculum in leadership skills for residents. We currently address issues of personal effectiveness at our intern orientation sessions (developing personal mission statements, etc.). We are planning another retreat for PGY2s moving into their PGY3 training that emphasizes higher-order leadership skills (e.g., “leading beyond the ward team”). We hope that these efforts will help prepare our residents to respond to the leadership challenges they will encounter.