Development of a Tool to Assess the Team Leadership Skills of Medical Residents

Abstract

Med Educ Online [serial online] 2006;11:27 Available from http://www.med-ed-online.org Orlander JD, Wipf JE, Lew RA. Development of a tool to assess the team leadership skills of medical residents. Abstract Purpose: To develop a tool to assess the team leadership skills of internal medicine residents. Method: A 27-item pilot instrument developed by two authors was distributed to interns on ward and intensive care unit teams at the end of rotations from a single institution's internal medicine res-idency program. These items were factor analyzed and reduced to a seven-item resident leadership scale (RLS). Validity of the instrument was assessed by comparing the rating on the RLS to scores on a validated measure of teaching skills provided at the same time and by the program director's global rating of team leadership skill for each resident at the completion of data collection. Results: The three principal components from the factor analysis explained 82 percent of the vari-ance. By introspection we reduced the scale to the final 7-item RLS that had a Cronbach alpha reliability estimate of 0.95. 490 ratings on 134 individual residents were available for analysis. The RLS scores correlated highly with both the validated measure of teaching skill and the program director's ratings. Conclusion: The RLS has robust psychometric properties. It may provide a useful tool for a broader assessment of trainee skill if validated in other settings. The organizational structure of most internal medi-cine training programs places PGY2 and PGY3 medical residents in the position of leading a team of junior train-ees during their ward and intensive care unit rotations. Many programs have incorporated teacher training into their curriculum. 1 These programs have demonstrated effectiveness through improved teaching evaluations by more junior trainees 2-5 or assessment of teaching skills through objective structured teaching exercises (OS-TEs). 6 Some training programs, including those at Bos-ton University and the University of Washington, have incorporated some aspect of team leadership / manage-ment training into the curriculum for their housestaff. The skills necessary to be an effective team leader on a medical ward or intensive care unit medicine team fall more aptly into a construct of team management, but we retain the term team leader because it is common within the training environment. In fact, the Accreditation Coun-cil for Graduate Medical Education (ACGME) mandates programs to increase residents' leadership and adminis-trative roles with each successive year of training. 7