Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 2/2016

Open Access 01-05-2016 | Debate

Untangling approaches to management and leadership across systems of medical education

Author: Kathy Hartley

Published in: BMC Health Services Research | Special Issue 2/2016

Login to get access

Abstract

Aims

How future doctors might be educated and trained in order to meet the population and system needs of countries is currently being debated. Incorporation of a broad range of capabilities, encompassed within categories of management and, increasingly, leadership, form part of this discussion. The purpose of this paper is to outline a framework by which countries’ progress in this area might be assessed and compared.

Methods

Key databases and journals related to this area were reviewed. From relevant articles potential factors impacting on the incorporation of aspects of management and leadership within medical education and training were identified. These factors were tested via an online survey during 2013 with six members of a European Association of doctors who promote medical involvement in hospital management, including members from countries less represented in the health management literature.

Results

A framework for analysing how management and leadership education is being approached within different systems of healthcare is developed and presented.

Conclusions

More systematic work across a wider range of countries is needed if we are to have a better understanding of how countries within and beyond Europe are approaching and progressing the education of doctors in management and leadership.
Literature
1.
World Federation for Medical Education (WFME). Postgraduate Medical Education: WFME Global Standards for Quality Improvement. University of Copenhagen. Farney-Voltaire, France and Copenhagen: WFME Office; 2003.
2.
Frenk J, Chen L, Bhutta Z, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2011;376(9756):1923–58.CrossRef
3.
4.
Irby DM, Cooke M, O’Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010;85:10–27.
5.
6.
Hodges BD, Segouin C. Medical education: it’s time for a transatlantic dialogue. Med Educ. 2008;42:2–3.PubMed
7.
Exworthy M, Halford S. Professionals and the new managerialism in the public sector. Philadelphia: Open University Press; 1999.
8.
Kuhlmann E, Von Knorring M. Management and medicine: why we need a new approach. J Health Serv Res Policy. 2014;19:189–91.CrossRefPubMed
9.
McGivern G, Currie G, Ferlie E, Fitzgerald L, Waring J. Hybrid manager-professionals’ identity work, the maintenance and hybridization of professionalism in managerial contexts. Public Administration - Online first. 2015.
10.
Spurgeon P, Clark J, Ham C. Clinical leadership: From the dark side to centre stage. London: Radcliffe Publishing; 2011.
11.
Baker RG, Denis J-L. Medical leadership in health care systems: from professional authority to organizational leadership. Public Manag Money. 2011;3:355–62.CrossRef
12.
Darzi A. High Quality Care for All: NHS Next Stage Review, Final report Cm. 7432. London: Department of Health; 2008.
13.
McDonald R. Leadership and leadership development in healthcare settings – a simplistic solution to complex problems? Int J Health Policy Manag. 2014;3:227–9.CrossRefPubMedPubMedCentral
14.
O’Reilly D, Reed M. ‘Leaderism’: An evolution of managerialism in UK public sector reform. Public Adm. 2010;88:960–78.CrossRef
15.
Bolton S, Muzio D, Boyd C. Making sense of modern medical careers: the case of the UK’s National Health Service. Sociology. 2011;45:682–99.CrossRef
16.
Spurgeon P, Long P, Clark J, Daly F. Do we need medical leadership or medical engagement? Leadersh Health Serv. 2015;28:173–84.CrossRef
17.
Noordegraaf M. Remaking professionals? How associations and professional education connect professionalism and organizations. Curr Sociol. 2011;59:465–88.CrossRef
18.
Kirkpatrick I, Jespersen P, Dent M. Medicine and management in a comparative perspective: the cases of England and Denmark. Sociol Health Illn. 2009;31:642–58.CrossRefPubMed
19.
Hodges BD, Maniate JM, Martimianakis MA, Alsuwaidan M, Segouin C. Cracks and crevices: globalization discourse and medical education. Med Teach. 2009;31(10):910–7.CrossRefPubMed
20.
Norris TE, Schaad DC, DeWitt D, Ogur B, Hunt DD. Longitudinal integrated clerkships for medical students. An innovation adopted by medical schools in Australia, Canada, South Africa and the United States. Acad Med. 2009;84(7):902–7.CrossRefPubMed
21.
Schmidt HG, Dauphinee WD, Patel VL. Comparing the effects of problem-based and conventional curricula in an international sample. Acad Med. 1987;62(4):305-15.
22.
Bokey L, Chapuis PH, Dent OF. Problem-based learning in medical education: one of many learning paradigms. Med J. 2014;3:134-6.
23.
Remmen R, Scherpbler A, Van der Vieben C, Denekens J, Derese A, Hermann J, et al. Effectiveness of basic clinical skills training programmes: a cross-sectional comparison of four medical schools. Med Educ. 2001;35(2):121–8.CrossRefPubMed
24.
Cook DA. If you teach them, they will learn: why medical education needs comparative effectiveness research. Adv Health Sci Educ Theory Pract. 2012;17(3):305–10.CrossRefPubMed
25.
Ham C. Enhancing Engagement in Medical Leadership: A rapid survey of International Experience. Academy of Royal Colleges/University of Birmingham/NHS Institute for Innovation and Improvement; 2008.
26.
BMA. Doctors’ perspectives on clinical leadership. London: BMA Health Policy and Research Unit; 2012.
27.
28.
Pearce CL, Conger JA. Shared Leadership: Reframing the Hows and Whys of Leadership. Thousand Oaks: CA: Sage; 2002.
29.
Dath D, Chan M-K, Abbott C. CanMEDS 2015: From Manager to Leader. Ottawa: The Royal College of Physicians and Surgeons of Canada; 2015.
30.
Martin G, Learmonth M. A critical account of the rise and spread of ‘leadership’: the case of U.K. healthcare. Soc Sci Med. 2012;74:281–8.CrossRefPubMed
31.
Moorcroft R. Managing in the 21st Century. Br J Adm Manag. 2001;1:8-10.
32.
Dwyer A. Medical managers in contemporary healthcare organisations: a consideration of the literature. Aust Health Rev. 2010;34:514–22.CrossRefPubMed
33.
Giordano R. Leadership needs of medical directors and clinical directors. London: The Kings Fund; 2010.
34.
Mintzberg H. The Nature of Managerial Work. New York: Harper and Row, 1973.
35.
Llewellyn S. Two-way windows. Clinicians as medical managers. Organ Stud. 2001;22(4):593–623.CrossRef
36.
Academy of Medical Royal Colleges & NHS Institute for Innovation and Improvement. Medical Leadership Competency Framework: Enhancing engagement in medical leadership. 3rd ed. Coventry: NHS Institute for Innovation and Improvement; 2010.
37.
38.
39.
40.
41.
McKimm J, Swannick T. Leadership development for clinicians: What are we trying to achieve. Clin Teach. 2011;8:181–85.CrossRefPubMed
42.
House RJ, Hanges PJ, Javidan M, Dorfman PW, Gupta V. Culture, Leadership, and Organizations: The GLOBE Study of 62 Societies. Thousand Oaks: Sage Publications; 2004.
43.
Veronesi G, Kirkpatrick I, Vallascas F. Clinicians on the board: What difference does it make? Soc Sci Med. 2013;77:147–15.CrossRefPubMed
44.
45.
Storey J, Holti R. Possibilities and pitfalls for clinical leadership in improving service quality, innovation and productivity. Final report. NIHR Service Delivery and Organisation programme. London: HMSO; 2013.
46.
Coltart CEM et al. Leadership development for early career doctors. Lancet Viewpoint. 2012;379:1847–49.CrossRef
47.
Gamble JA, Vaux EB. Limited opportunities in current training programmes for trainees development of skills. Clin Med. 2014;14:2–15.
48.
Wilkie V, Spurgeon P. Translation of the MLCF into a multisource feedback form for doctors in training utilising a verbal protocol technique. Educ Prim Care. 2013;24(1):36–44.CrossRefPubMed
49.
Blumenthal D, Bernard K, Bohnen J, Bohmer R. Addressing the gap in medicine: Residents’ need for systematic leadership development training. Acad Med. 2012;87:513–22.CrossRefPubMed
50.
Dath D, Iobst W. The importance of faculty development in the transition to competency-based medical education. Med Teach. 2010;32(8):683–86.CrossRefPubMed
51.
Frank J, Danoff D. The CanMEDS initiative: Implementing an outcomes-based framework of physician competencies. Med Teach. 2007;29:642–7.CrossRefPubMed
52.
Ten Cate O, Snell L, Carracio C. Medical competence: the interplay between individual ability and the health care environment. Med Teach. 2010;32(98):669–75.CrossRefPubMed
53.
54.
55.
Careau E, Biba G, Van Dijk JP, Vermas S, Paterson M, Tassone M. Health leadership education programs, best practices, and impact on learners’ knowledge, skills, attitudes, and behaviours and system change: a literature review. J Healthcare Leadersh. 2014;20:39–50.CrossRef
56.
Edmonstone J. Whither the elephant?: The continuing development of clinical leadership in the UK National Health Services. Int J Health Plann Manag. 2014;29:280–91.CrossRef
57.
Dickinson H, Ham C, Snelling I, Spurgeon P. Are We There Yet? Models of Medical Leadership and their effectiveness: An Exploratory Study. Southampton: NETSCC, HS&DR; 2013.
58.
Ibarra H, Snook S, Guillén Ramo L. Identity-based leader development. In: Nohria, N. and Khorana, R, editors. Handbook of leadership theory and practice: A Harvard Business School Centennial Colloquium. Harvard University-proceed as is stated: Harvard Business School Press; 2010
59.
Lord RG, Hall RJ. Identity, deep structure and the development of leadership skill. Leadersh Q. 2005;16:591–615.CrossRef
60.
Nilsson K, Furåker C. Learning leadership through practice–healthcare managers’ experience. Leadersh Health Serv. 2012;25:106–22.
61.
Day DV, Harrison MM. A multilevel, identity- based approach to leadership development. Hum Resour Manag Rev. 2007;17:360–73.CrossRef
62.
Noordegraaf M, Schneider MME, Van Rensen EL, Boselie PPEF. Cultural complementarity: reshaping professional and organizational logics in developing frontline medical leadership. Public Manag Rev. 2015. doi:10.​1080/​14719037.​2015.​1066416.
63.
Day DV, Fleenor JW, Atwater LE, Sturn RE, McKee RA. Advances in leader and leadership development: a review of 25 years of research and theory. Leadersh Q. 2014;25:63–82.CrossRef
64.
Cho Y, Marshall-Egan T. Action learning: a systematic review and conceptual framework. Hum Resour Dev Rev. 2009;8:431–62.
65.
Sartirana M, Noordegraaf M. Opportunity does matter: supporting doctors in management. In: Pedersen A, Waldorff S, Ferlie E, Fitzgerald L, editors. Managing Change: from Health Policy to Practice. London: Palgrave; 2015.
66.
Bircher J. Extending GP, training and the development of leadership skills: the experience of the North West deanery pilot. Educ Prim Care. 2013;241:57–72.CrossRef
67.
Redelinghuys J, Fellow-Smith E. In practice learning by doing: management experience for specialist registrars. Clin Manag. 2006;3:155–8.
68.
Miller S, Dalton K. Learning from an evaluation of Kent, surrey and sussex Deanery’s clinical leadership fellowship programme. Int J Clin Leadersh. 2011;17:73–8.
69.
Burgoyne J, Hirsh W, Williams S. The Development of Management and Leadership Capability and its Contribution to Performance: The evidence, the prospects and the research need. 2004. DfEs: Research report RR560.
70.
Metadata
Title
Untangling approaches to management and leadership across systems of medical education
Author
Kathy Hartley
Publication date
01-05-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue Special Issue 2/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1391-9

Other articles of this Special Issue 2/2016

BMC Health Services Research 2/2016 Go to the issue

Debate

Clinical leadership and hospital performance: assessing the evidence base

Debate

Medical doctors in healthcare leadership: theoretical and practical challenges

Editorial

Medicine and management in European hospitals: a comparative overview

Research

Hybrid management, organizational configuration, and medical professionalism: evidence from the establishment of a clinical directorate in Portugal

Debate

Comparing medicine and management: methodological issues

Research

The involvement of medical doctors in hospital governance and implications for quality management: a quick scan in 19 and an in depth study in 7 OECD countries