Medical leadership training gets a refresh; burnout concerns prompt removal of ‘selfless’ before ‘service’

Duke University researchers have made changes to the influential Duke Healthcare Leadership Model, which is commonly consulted by medical educators at both the undergraduate and graduate levels. 

The model’s aim is to help make sure tomorrow’s physicians learn not only how to practice medicine with ethical intentionality but also how to lead others with sound character, specific skills and concerted efforts. 

A standout example of what’s out and what’s in: 

Emotional intelligence had been defined as “The ability to recognize and understand thinking and emotions in yourself and others, and to use this awareness to effectively manage your behavior and relationships.”

That’s been jettisoned in favor of an expansive definition with four parts:

• Developing Self-Awareness: “Being aware of one’s own values, principles and assumptions, and how they interplay within the team dynamic.”
   
• Cultivating Personal Resilience: “Ability to cope with and contextualize demanding situations.”
   
• Maintaining Personal Balance: “Prioritizing activities to maintain mental and physical health as well as cultivate a positive outlook.”
   
• Cultural Humility: “The ability to maintain an interpersonal stance that is other-oriented in relation to aspects of cultural identity that are most important to the person.”

The original version of the model was released in 2017 and published in the Journal of Healthcare Leadership. 

Good leadership doesn’t just happen 

The updated edition is current in the same journal. 

In it, corresponding author Joseph Doty, PhD, and colleagues Steven Cook, MD, and Nick Tsipis, MD, MPH—all of whom had a hand in producing the original—explain the reasons for their re-think.

“The initial research and development of the Healthcare Leadership Model and subsequent integration into a medical education community provided a first step toward understanding best practices in leadership curricula in medical education,” the authors write. 

“As interest in including leadership development curriculum into undergraduate and graduate medical education continues to gain momentum, we hope our research and model will contribute to these efforts.”

Heading off burnout well ahead of symptoms

Other notable changes include subtracting a word from one of the core competencies laid out in the model: “Selfless Service” is now simply “Service.”

“Selfless service is one of the most challenging competencies to embody day in and day out,” Doty and co-authors state. “Many students and trainees felt this was at odds in some fashion with a growing body of literature on physician burnout.”

More: 

“Being completely selfless—if that means not taking care of one’s own needs (physically, emotionally, spiritually)—results in the burnout challenges that healthcare professionals are constantly experiencing. Therefore, in the spirit of emphasizing a culture of wellness and balance, we removed the word selfless from the model and just emphasized service.”

For more, including details on modification methodology, read the interesting paper—which the journal has posted in full for free.