Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development

Abstract

BackgroundThere is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in this developing field of medical education.MethodsWe searched major electronic databases and citation indexes within the disciplines of medicine, education, social science and management. We undertook hand searching of major journals, and reference and citation tracking. We accessed websites of UK medical institutions and contacted individuals working within the field.Results26 studies were included. Most were conducted in the USA, using mainly quantitative methods. We used inductive analysis of the topics addressed by each study to identity five main content areas: Quality Improvement; Managed Care, Use of Resources and Costs; General Leadership and Management; Role of the Doctor, and Patient Safety. Students have positive attitudes to clinical practice guidelines, quality improvement techniques and multidisciplinary teamwork, but mixed attitudes to managed care, cost containment and medical error. Education interventions had variable effects on students' attitudes. Medical students perceive a need for leadership and management education but identified lack of curriculum time and disinterest in some activities as potential barriers to implementation.ConclusionsThe findings from our review may reflect the relatively little emphasis given to leadership and management in medical curricula. However, students recognise a need to develop leadership and management competences. Although further work needs to be undertaken, using rigorous methods, to identify the most effective and cost-effective curriculum innovations, this review offers the only currently available summary of work examining the attitudes of students to this important area of development for future doctors.

Final year medical students’ understanding of family medicine

“…When comparing our results to the results of other studies, we were able to conrm that students understand the clinical competences of family doctors (8), but fail to understand some other competences of family doctors (7,(9)(10)(11). In a qualitative research synthesis about medical students' perception of and attitudes towards family medicine, it was found that most of the included studies describe factors which inuence a career choice for family medicine (24).…”

“…We could add that students also recognise the importance of organisational and management skills of family doctors and recognise them as teachers in organisational and management skills. In a systematic review it was found that students recognised the need to develop leadership and management competences, since relatively little emphasis was placed on leadership and management in medical curricula (11).…”

“…Students usually understand the clinical competences of family doctors (8), but fail to understand other competences of family doctors, such as long term care and patient centeredness (9,10), community orientation (7) and medical leadership and management (11).…”

Dental Students Perceptions Regarding Practical And Management Skills And Their Career Aspirations

“…Therefore, the development of management skills is becoming crucial for dentists to manage their practices successfully (Dunning, & Tacha, 2011;Willis, 2009). These skills are often neglected in faculty curriculum plan despite tendencies that students recognize them as crucial (Abbas, & Benson, 2011;Kalenderian, & Timothé, 2010).…”

Deliberate Integration of Student Leadership Development in Doctor of Pharmacy Programs

“…Investigators from programs in dentistry, [58][59][60][61] medicine, 62,63 and physical therapy 64 have conducted surveys and interviews of students, academic administrators, faculty members, practitioners, and alumni to determine the need for teaching SLD and perceptions on the best approach to teaching it.…”