Defining leadership competencies for pediatric critical care fellows: Results of a national needs assessment

Abstract

Introduction: Physicians in training, including those in Pediatric Critical Care Medicine, must develop clinical leadership skills in preparation to lead multidisciplinary teams during their careers. This study seeks to identify multidisciplinary perceptions of leadership skills important for Pediatric Critical Care Medicine fellows to attain prior to fellowship completion.

Methods: We performed a multi-institutional survey of Pediatric Critical Care Medicine attendings, fellows, and nurses. Subjects were asked to rate importance of 59 leadership skills, behaviors, and attitudes for Pediatric Critical Care practitioners and to identify whether these skills should be achieved before completing fellowship. Skills with the highest ratings by respondents were deemed essential.

Results: Five hundred and eighteen subjects completed the survey. Of 59 items, only one item (“displays honesty and integrity”) was considered essential by all respondents. When analyzed by discipline, nurses identified 21 behaviors essential, fellows 3, and attendings 1 (p < 0.05). Nurses differed (p < 0.05) from attendings in their opinion of importance in 64% (38/59) of skills.

Conclusions: Despite significant variability among Pediatric Critical Care attendings, fellows, and nurses in identifying which clinical leadership competencies are important for graduating Pediatric Critical Care fellows, they place the highest importance on skills in self-management and self-awareness. Leadership skills identified as most important may guide the development of interventions to improve trainee education and interprofessional care.

Acknowledgments

The Education in Pediatric Intensive Care (EPIC) Investigators include:

Grace M. Arteaga, MD (Mayo Clinic)

Courtenay Barlow, MD (Stanford)

Don Boyer, MD (Children’s Hospital of Philadelphia)

Melissa L. Brannen, MD (Lehigh Valley Health Network)

Meredith Bone, MD (Ann & Robert H. Lurie Children’s Hospital of Chicago)

Amanda Emke, MD (Washington University)

Melissa Evans, MD (Medical University of South Carolina)

Geoffrey M. Fleming, MD (Vanderbilt University School of Medicine)

Denise M. Goodman, MD (Ann & Robert H. Lurie Children’s Hospital of Chicago)

Michael Green, MD (UT Southwestern)

Melinda F. Hamilton, MD (Children’s Hospital of Pittsburgh/UPMC)

Jim Killinger, MD (Weill Cornell Medical Center)

K. Jane Lee, MD (Medical College of Wisconsin)

Tensing Maa, MD (Nationwide Children’s Hospital)

Karen Marcdante, MD (Medical College of Wisconsin)

Kathy Mason, MD (Rainbow Babies and Children’s Hospital)

Megan E. McCabe, MD (The Children’s Hospital at Montefiore)

Richard Mink, MD MACM (Harbor-UCLA Medical Center)

Akira Nishisaki, MD (Children’s Hospital of Philadelphia)

Peggy O'Cain, MD (University of Tennessee Health Science Center)

Niyati Patel, MD (Minnesota Children’s Hospital)

Toni Petrillo, MD (Children’s Healthcare of Atlanta/Emory)

Sara Ross, MD (The Floating Hospital for Children/Tufts)

James Schneider, MD (Cohen Children’s Hospital, NY)

Jennifer Schuette, MD (Johns Hopkins Medical Center)

Marie Steiner, MD (University of Minnesota/Amplatz Children’s Hospital)

Stephanie A. Storgion, MD (University of Tennessee Health Science Center)

Pat Teaford, MD (Children’s Hospital of Phoenix)

Hossein Tcharmtchi, MD (Texas Children’s Hospital)

David A. Turner, MD (Duke Children’s Hospital/Duke University Medical Center)

Jason Werner, MD (St. Louis University)

Margaret K. Winkler, MD (Children’s Hospital of Alabama/UAB).

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Health Care Leadership Demonstration of skills that involve the appropriate and ethical influence exerted by an individual to alter, modify, or change the reactions, attitudes, or behaviors of other individuals to maintain or further core values of the health professions.

Gabel S. 2014. Expanding the scope of leadership training in medicine. Acad Med. Jun;89:848-852.

Notes on contributors

Michael L. Green, MD, is an assistant professor, Department of Pediatrics, Division of Critical Care, University of Texas Southwestern Medical Center, Dallas, Texas.

Margaret Winkler, MD, is a professor in the Department of Pediatrics, Division of Critical Care Medicine, at the University of Alabama at Birmingham. Division Director, Pediatric Critical Care Medicine. Medical Director, Pediatric Intensive Care Unit. Medical Director, Pediatric Critical Care Transport Team. Ann Dial McMillan Endowed Chair in Pediatric Critical Care Medicine. Children’s Hospital of Alabama.

Richard Mink, MD, MACM, is the chief of the Division of Pediatric Critical Care Medicine and director of the Pediatric Critical Care Fellowship, Harbor-UCLA Medical Center, Torrance, CA and Professor of Pediatrics, David Geffen School of Medicine at UCLA.

Melissa L. Brannen, MD, is a pediatric hospitalist at Lehigh Valley Health Network, Allentown, PA.

Meredith Bone, MD, is an assistant professor of Pediatrics, Division of Pediatric Critical Care, Northwestern University Feinberg School of Medicine, Chicago, IL.

Tensing Maa, MD, is an assistant professor of Clinical Pediatrics in the Division of Critical Care Medicine at Nationwide Children’s Hospital, The Ohio State University College of Medicine in Columbus, Ohio.

Grace M. Arteaga, MD, is division chair of Pediatric Critical Care Medicine, an assistant professor of Pediatrics and an assistant professor of Physiology at Mayo Clinic, Rochester, Minnesota.

Megan E. McCabe, MD, is an assistant professor, Department of Pediatrics, Division of Critical Care Medicine at the Children’s Hospital at Montefiore, Bronx, New York.

Karen Marcdante, MD, is a professor of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.

James Schneider, MD, is an assistant professor, Department of Pediatrics, Division of Critical Care Medicine, Hofstra-North Shore LIJ School of Medicine, Cohen Children’s Medical Center, New Hyde Park, NY.

David A. Turner, MD, is an Associate Director of Graduate Medical Education at Duke University Hospital and Health System and is also an Associate Professor in the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children’s Hospital, Durham, NC.