Exploration of ‘perception of self’ as medical leader: does perception of self require a paradigm shift from clinician to clinical leader?

Abstract

BackgroundClinical leadership is key to quality improvement; however, there is limited research regarding doctors’ perceptions of clinical leadership.AimTo investigate senior trainees’ perception of self as medical leader and explore what influenced their perception.MethodsA questionnaire with open and closed questions was distributed before and after a medical leadership module. Twelve trainees were then interviewed.ResultsOne hundred and fifty-six questionnaires were completed (95.7 % response rate). A significant number of senior trainees did not consider themselves to be a leader; however, there was a statistically significant shift in their self-perception during the programme. Themes identified during the interviews included a lack of understanding of the leadership concept, a lack of clarity of the medical leader’s role and vehicles for perspective transformation.ConclusionsTo our knowledge, this is the first study to explore senior trainees’ perception of self as medical leader. Findings suggest, following a paradigm shift from clinician to clinical leader, senior trainees are a potential, valuable resource for quality improvement. To aid understanding of the leadership self-development process, a conceptual model is offered. The significance of the model is its focus on the individual’s leadership paradigm, as the starting point for self-exploration. This model could inform leadership development programmes.

Exploring medical leader identity and its formation

“…'Intersectionality' helps explain how multiple identities function and has relevance for medical leadership (Jones, 2003;Thomas and Crenshaw, 2004) and 'leadership' were inhibiting factors in terms of how they saw themselves as leaders and their subsequent leadership development (Moen et al, 2018). This makes it harder for those who do not fit the 'leader' stereotype to be seen as credible and gain positions of influence, exacerbated by the lack of (e.g.…”

“…Whilst students/doctors seem to relatively easily incorporate 'clinical leadership' (of situations, teams etc.) into their doctor identity, forming a strong identity as a leader and manager (of services and organisations) seems less straightforward (Moen et al, 2018;Spurgeon and Ham, 2017;Gordon et al 2015).…”

“…The fluid development of professional and leadership identities means that opportunities must be created in both undergraduate and postgraduate medical education for individuals to develop, understand and reflect upon their identities (Moen et al 2018). The ongoing nature of MLIF also means that as with MPI, MLI is subject to the threats and challenges previously discussed, which organisations and medical educators must recognise in order to support individuals who may find their identity challenged.…”

“…Narrative reflection: Medical professionals must develop self-insight into their strengths, weaknesses, values, attitudes and beliefs, and narrative reflection can be used to facilitate this learning about their identity, strengths and areas for development (Moen et al 2018;Ricoeur, 1992). Reflective writing has been used alongside training on mindfulness, resilience and wellbeing to support MPIF and move away from a focus on "doing the work of a doctor" to "being a doctor" (Wald et al, 2015).…”

“…Moen et al's (2018) research into how senior doctors in training perceive clinical leadership and themselves as leaders (or not) reinforces that these doctors' views were clearly grounded in social constructs of leadership. These constructs of "self" and "leadership" were inhibiting factors in terms of how they saw themselves as leaders and their subsequent leadership development (Moen et al, 2018). This makes it harder for those who do not fit the "leader" stereotype to be seen as credible and gain positions of influence, exacerbated by the lack of (e.g.…”