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      Assessing emergency room leadership of ObGyn residents in a public university teaching hospital of Sindh, Pakistan: a cross-sectional survey

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          Abstract

          Background

          Leadership is a critical competency for medical professionals, yet it is often neglected in medical training. For ObGyn residents, leadership training is particularly crucial as it significantly impacts both maternal and newborn outcomes, as well as the operational efficiency of healthcare teams. The main objective of this study was to assess the perceptions of obstetrics and gynecology residents who served as group leaders in the emergency team at the Department of Gynecology, Ward 3, Dr. Ruth K.M. Pfau Civil Hospital Karachi.

          Methods

          A Cross-sectional survey was conducted with purposively sampled 28 year-4 residents who worked as group leaders during last 3 years (from 2018 to 2020) of their residency program at the emergency team in the department of Gynecology Ward 3 Dr Ruth KM Pfau Civil Hospital Karachi. The perceptions on leadership were assessed on 25 items scale sent through a questionnaire on email. Grading of responses was done using a 4-point ordinal scale where 1 meant little importance and 4 was regarded as having great importance. Data was summarized with relevant descriptive statistics and was analyzed on SPSS version 22.

          Results

          The mean age of residents was 30.36. The mean leadership scores of the group of residents were calculated to be 77.50 (SD ± 9.57) while 14(50%) residents showed good and 14 (50%) showed excellent leadership skills based on cumulative scores. Of the 25 traits examined in this study, the highest reported trait was humility 3.82 (± 0.39) followed by empowerment 3.68 (± 0.77) and effective communication 3.68 (± 0.77). While responding about learning experiences, 89.3% of participants felt that the experience enhanced their decision-making skills and boosted their confidence in dealing with emergencies.

          Conclusion

          Our study highlights the critical importance of leadership development in the training of ObGyn residents, particularly in high-pressure emergency settings. The findings reveal that residents value leadership traits such as humility, empowerment, and effective communication, which are essential for building teamwork and ensuring optimal patient outcomes and patient satisfaction.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12909-024-05984-0.

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          The effect of multidisciplinary care teams on intensive care unit mortality.

          Amber E. Barnato, Derek C Angus, L Fleisher … (2010)
          Critically ill patients are medically complex and may benefit from a multidisciplinary approach to care. We conducted a population-based retrospective cohort study of medical patients admitted to Pennsylvania acute care hospitals (N = 169) from July 1, 2004, to June 30, 2006, linking a statewide hospital organizational survey to hospital discharge data. Multivariate logistic regression was used to determine the independent relationship between daily multidisciplinary rounds and 30-day mortality. A total of 112 hospitals and 107 324 patients were included in the final analysis. Overall 30-day mortality was 18.3%. After adjusting for patient and hospital characteristics, multidisciplinary care was associated with significant reductions in the odds of death (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.76-0.93 [P = .001]). When stratifying by intensivist physician staffing, the lowest odds of death were in intensive care units (ICUs) with high-intensity physician staffing and multidisciplinary care teams (OR, 0.78; 95% CI, 0.68-0.89 [P < .001]), followed by ICUs with low-intensity physician staffing and multidisciplinary care teams (OR, 0.88; 95% CI, 0.79-0.97 [P = .01]), compared with hospitals with low-intensity physician staffing but without multidisciplinary care teams. The effects of multidisciplinary care were consistent across key subgroups including patients with sepsis, patients requiring invasive mechanical ventilation, and patients in the highest quartile of severity of illness. Daily rounds by a multidisciplinary team are associated with lower mortality among medical ICU patients. The survival benefit of intensivist physician staffing is in part explained by the presence of multidisciplinary teams in high-intensity physician-staffed ICUs.
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            Shifting paradigms: from Flexner to competencies.

            K Ferentz, Susan D Wolfsthal, Christine Martin … (2002)
            Realizing medical education is on the brink of a major paradigm shift from structure- and process-based to competency-based education and measurement of outcomes, the authors reviewed the existing medical literature to provide practical insight into how to accomplish full implementation and evaluation of this new paradigm. They searched Medline and the Educational Resource Information Clearinghouse from the 1960s until the present, reviewed the titles and abstracts of the 469 articles the search produced, and chose 68 relevant articles for full review. The authors found that in the 1970s and 1980s much attention was given to the need for and the development of professional competencies for many medical disciplines. Little attention, however, was devoted to defining the benchmarks of specific competencies, how to attain them, or the evaluation of competence. Lack of evaluation strategies was likely one of the forces responsible for the three-decade lag between initiation of the movement and wide-spread adoption. Lessons learned from past experiences include the importance of strategic planning and faculty and learner buy-in for defining competencies. In addition, the benchmarks for defining competency and the thresholds for attaining competence must be clearly delineated. The development of appropriate assessment tools to measure competence remains the challenge of this decade, and educators must be responsible for studying the impact of this paradigm shift to determine whether its ultimate effect is the production of more competent physicians.
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              Association between implementation of a medical team training program and surgical mortality.

              Julia Neily, Peter D Mills, Yinong Young-Xu … (2010)
              There is insufficient information about the effectiveness of medical team training on surgical outcomes. The Veterans Health Administration (VHA) implemented a formalized medical team training program for operating room personnel on a national level. To determine whether an association existed between the VHA Medical Team Training program and surgical outcomes. A retrospective health services study with a contemporaneous control group was conducted. Outcome data were obtained from the VHA Surgical Quality Improvement Program (VASQIP) and from structured interviews in fiscal years 2006 to 2008. The analysis included 182,409 sampled procedures from 108 VHA facilities that provided care to veterans. The VHA's nationwide training program required briefings and debriefings in the operating room and included checklists as an integral part of this process. The training included 2 months of preparation, a 1-day conference, and 1 year of quarterly coaching interviews The rate of change in the mortality rate 1 year after facilities enrolled in the training program compared with the year before and with nontraining sites. The 74 facilities in the training program experienced an 18% reduction in annual mortality (rate ratio [RR], 0.82; 95% confidence interval [CI], 0.76-0.91; P = .01) compared with a 7% decrease among the 34 facilities that had not yet undergone training (RR, 0.93; 95% CI, 0.80-1.06; P = .59). The risk-adjusted mortality rates at baseline were 17 per 1000 procedures per year for the trained facilities and 15 per 1000 procedures per year for the nontrained facilities. At the end of the study, the rates were 14 per 1000 procedures per year for both groups. Propensity matching of the trained and nontrained groups demonstrated that the decline in the risk-adjusted surgical mortality rate was about 50% greater in the training group (RR,1.49; 95% CI, 1.10-2.07; P = .01) than in the nontraining group. A dose-response relationship for additional quarters of the training program was also demonstrated: for every quarter of the training program, a reduction of 0.5 deaths per 1000 procedures occurred (95% CI, 0.2-1.0; P = .001). Participation in the VHA Medical Team Training program was associated with lower surgical mortality.
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                Author and article information

                Contributors
                Hira Tariq:
                ORCID: http://orcid.org/0000-0002-2841-2600
                hira.tariq@aku.edu
                Journal
                Journal ID (nlm-ta): BMC Med Educ
                Journal ID (iso-abbrev): BMC Med Educ
                Title: BMC Medical Education
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1472-6920
                Publication date (Electronic): 13 September 2024
                Publication date PMC-release: 13 September 2024
                Publication date Collection: 2024
                Volume: 24
                Electronic Location Identifier: 1001
                Affiliations
                [1 ]GRID grid.449639.5, ISNI 0000 0004 5995 0705, Vice- Chancellor-Shaheed Mohtarma Benazir Bhutto Medical University, ; Larkana, Pakistan
                [2 ]Jinnah Postgraduate Medical Center, ( https://ror.org/00952fj37) Karachi, Pakistan
                [3 ]Present Address: Liaquat National Medical College, Karachi, Pakistan
                [4 ]Department of Community Health Sciences, Aga Khan University, ( https://ror.org/03gd0dm95) Karachi, Pakistan
                Author information
                http://orcid.org/0000-0002-2841-2600
                Article
                Publisher ID: 5984
                DOI: 10.1186/s12909-024-05984-0
                PMC ID: 11401368
                PubMed ID: 39272035
                SO-VID: ab5652e9-b216-4b68-b9d9-0c78bf94ff76
                Copyright © © The Author(s) 2024
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 31 May 2024
                Date accepted : 3 September 2024
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © BioMed Central Ltd., part of Springer Nature 2024

                ScienceOpen disciplines: Education
                Keywords: decision making,leadership,karachi,medical competencies,medical residents
                Data availability:
                ScienceOpen disciplines: Education
                Keywords: decision making, leadership, karachi, medical competencies, medical residents

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