Transformative Leadership Training in Medical Education: A Topology

Abstract

Issue: Efforts to improve medical education often focus on optimizing technical aspects of teaching and learning. However, without considering the connection between the pedagogical-curricular and the foundational philosophically-defined educational aims of medicine and medical education, critical system reform is unlikely. The transformation of medical education requires leaders uniquely prepared to view medicine and medical education critically as it is and as it ought to be, and who have the capacity to lead changes aimed at overcoming the identified gaps. This paper proposes a five-level topology to guide leaders to develop this capacity. Evidence: Without reference to a shared understanding of a larger, more profound philosophical vision of the ideal physician and of the educational process of “becoming” that physician, efforts to change medical education are likely to be incremental and insufficient rather than transformative. Such efforts may lead to frequent pedagogical-curricular reforms, shifting evaluation models, and paradigmatic conflicts in medical education systems across contexts. This paper describes a leadership program meant to develop transformational educational leaders. The leadership program is built on and teaches the five-level topology we describe here. The five levels are 1) Philosophy 2) Philosophy of Education 3) Theory of Practice 4) Implementation and 5) Evaluation. Implications: The leadership development program exemplifies how the topology can be implemented as a framework to foster transformation in medical education. The topology is a metaphor exemplified by the Mobius Strip, a continuous and never-broken object, which reflects the ways in which the five levels are inherently connected and reflect on each other. Medical education leadership requires deeper engagement with paradigmatic thought to transform the field for the future.

Keywords:

• Medical education
• philosophy
• evaluation
• leadership training

Acknowledgements

For their engagement in early conversations that helped formulate this manuscript we thank Fabrice Jotterand, PhD, Rachell H. Ellaway, PhD and Lara Varpio, PhD. We thank all the participants in the Mandel School for Educational Leadership experimental program in Transformative Leadership in Medical Education as well as the Mandel faculty, graduates and fellows who contributed to the effort of transformation.

Disclosure statement

The authors have no conflicts of interest to report.

Notes

a For a study of Engel’s translations of his ideas of biopsychosocial medicine to the practice of educating students in medical interviewing, see Marom D. Insights on medical educational leadership from the biography of the founder of biopsychosocial medicine, George L. Engel (Manuscript).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.