Innovation in Leadership Development in Undergraduate Medical Education

Abstract

In response to the need for physician leaders, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell developed the Klar Leadership Development and Innovation Management program. This novel program leverages its partnership with a large Northeast health system to longitudinally provide students with leadership fundamentals and mentored experiences.

The complex and rapidly changing healthcare systems landscape demands physicians who are equipped to lead. A high level of emotional intelligence, excellent communication skills, and the ability to command highly functioning teams are proficiencies physician leaders must develop [1]. Medical schools are responding to the need for physician leaders by establishing programs that incorporate leadership skills into undergraduate medical education (UME) curricula. The lack of time within already crowded UME curricula is a significant barrier, prompting schools to look towards more longitudinal programming outside of the curriculum to reinforce leadership skills at different stages of professional development. Beyond time limitations, these attempts are limited by the lack of a standard leadership curriculum in UME [2].

In 2016, the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell (ZSOM) received a financial gift from the Klar Organization to establish a program that cultivates leadership skills among medical students, creating a physician leader pipeline. The Klar Leadership Development and Innovation Management (LDIM) program was established to build upon the ZSOM educational program and engage leadership at Northwell Health. The Klar LDIM Steering Committee includes administrative physician leaders from ZSOM and Northwell who have guided the program mission, goals, objectives, and student activities, and helped create a robust programmatic partnership with Northwell Health. While the program did not initially consider the Medical Leadership Competency Framework (MLCF, [3]), it currently strives to ensure the Klar LDIM program addresses all competencies within the framework, inclusive of (1) demonstrating personal qualities, (2) working with others, (3) managing services, (4) improving services, and (5) setting direction, thereby providing a comprehensive approach to leadership education.

Longitudinal in nature, the Klar LDIM program invites all first-year medical students to apply. Committee members interview applicants using a rubric to assess interpersonal skills, teamwork, initiative, leadership experience, integrity and honesty, and professionalism. Five Klar Scholars are selected annually to begin the program with a summer immersion.

The Klar LDIM program is based on the theory of transformational leadership, emphasizing the importance of motivating others by raising awareness of goals and through role modeling [2]. As such, the cornerstone of the summer immersion is a mentored experience where Klar Scholars interact with Northwell Health physician leaders and actively participate in a project at Northwell. Students meet potential mentors in the spring to discuss early project ideas and identify mentors who most align with their future career goals. Through time spent with their mentors combined with active observation of other Northwell leaders, participants experience a variety of leadership styles. Small-group didactic sessions expose Klar Scholars to topics such as emotional intelligence, quality improvement, physician payment models, graduate medical education, and organizational culture. Klar Scholars spend a day in the New York State Department of Health (DOH) Office of Patient Safety and Quality where they engage in a discussion of a case study with DOH physicians and administrators to promote exposure to health care advocacy and policy. During weekly reflection sessions framed by the MLCF competencies, Klar Scholars discuss their observations and project progress, enriching their summer immersion by sharing their experiences and thoughts on leadership. Because Klar Scholars have had little direct experience with leadership within medicine, they can gain valuable insight by observing communication, negotiation, team building, and strategic planning in action.

By scheduling the summer immersion between the first and second years, Klar Scholars engage in foundational leadership training outside the formal curriculum. Beyond the summer, they apply their knowledge and leadership skills and maintain longitudinal relationships with their mentors while forging new connections throughout their medical education. In their fourth year, Klar Scholars complete a leadership-centered elective block (i.e., healthcare policy, medical education, or a preceptorship with health system leadership) as well as complete and present a capstone project showcasing the leadership skills cultivated through the Klar LDIM program.

The outcomes to date have been many. Klar Scholars have led student-run electives and organized institution-wide committees and responses to current topics emerging in healthcare. For example, a 2020 Klar Scholar is a leader of the ZSOM Committee on Anti-Racism and Allyship. Klar Scholars have also championed enhanced leadership skill curricula for their peers by advocating that Klar didactic sessions be offered more broadly. As a result, the session “How Doctors Get Paid 101” was added to the first-year curriculum.

In response to the need for more physician leaders, the ZSOM has built a program that does not impose on curricular time, provides hands-on project-based learning, and is working towards aligning with the MLCF [3] to guarantee Klar Scholars are building the skills required to navigate the rapidly changing healthcare environment.

Funding

The Klar Organization.

Data Availability

Not applicable

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Code Availability

Not applicable