A search for training of practising leadership in emergency medicine: A systematic review

Abstract

ObjectiveThis systematic review examines the medical, psychological and educational literature for training in practising leadership of a team leader in emergencies. The objectives of this paper are (1) describe how literature addresses operational training in practising leadership for the emergency medical team-leader (2) enhance understanding of leadership training in the medical environment.BackgroundWorldwide, medical supervisors find it difficult to get students to rise to the occasion as leaders of emergency teams. It appears that many residents feel unprepared to adopt the role as a leader in emergencies.MethodA systematic review was conducted (May–December 2016) in accordance with the PRISMA 2009 Checklist. A literature search was conducted against a set of inclusion criteria. Databases searched included PubMed, Psycinfo (via Ovid), and ERIC.Results27 articles covering the period 1986–2016 were analysed. Four sources of data were identified: Intervention studies practising leadership, intervention studies on simulation and leadership assessment, observation studies assessing leadership, interview/survey studies about the need for leadership training. No workable training in practising leadership in emergencies for doctors was found. The majority of the research projects focused on various different types of taxonomies.ConclusionsNo consistent and workable leadership training for the emergency medical teamleader was identified. One study for paramedics succeeded in training empowering leadership skills. For many years multiple taxonomies and leadership assessment tools have been developed but failed to come to terms with workable leadership training. The literature describes lack of leadership as highly detrimental to performance during a critical, clinical situation.

Training residents to lead emergency teams: A qualitative review of barriers, challenges and learning goals

“…The previously mentioned systematic review suggested in addition that it is necessary to work with the personal challenges associated with stressful situations. As a consequence, it is necessary to work with the resident's courage, self-confidence and authority when he or she acts as a team leader [24]. This is further supported by three studies, Hunziker et al.…”

“…As previously described in the mentioned systematic review [24], leadership is acquired through practice, and therefore leadership competencies should be acquired not through theoretical learning, but through practice as described by Mintzberg [25]. In accordance with this, surgeons learn to sew a wound together by doing it in practice.…”

“…A systematic review (conducted in 2016) searching the literature identifying training in empowering leadership for the team leader in emergencies, concluded that no focused leadership training has taken place [24]. Medical scholars have over many years interpreted leadership from a measurable perspective (simulation training and repeatedly developing taxonomy-based feedback).…”

Non-technical skills progression during anesthesiology residency in Portugal: the impact of a National Pedagogical Plan

“…The simulation scenario also helps students to understand that the leader is not necessarily the older person but the one that better faces and solves specific situations, at specific moments. Everyone´s opinion is a valuable input for every situation, and a lack of leadership could be highly detrimental to performance during a critical situation [22].…”

“…Also, behavior was less tested in the first years since at that time residents are not alone and do not make clinical decisions. Given this implies less leadership, non-technical skills were not considered important [ 22 ]. However, and over the years, students had no doubts about the impact of behavior in critical situations, which is clearly reflected on the fourth-year being the one that attributed more importance to behavioral questions.…”