A Team-Based “Sport”
Surgical education should include team-based medical management, communication, and leadership skills training, program directors said.
Explore this issue:January 2019
“Interprofessional care and education are important, because both medical and surgical care have become team-based sports. How will you work with a radiation oncologist, a nurse, an anesthesiologist, a speech pathologist, a dentist, a pharmacist, or a social worker? The interprofessional team is crucial to delivering care that is safe, timely, compassionate, value-based, efficient, and high quality,” she said. The University of Michigan Medical School has a Center for Interprofessional Education to prepare surgeons to work in an interdisciplinary care model. “As a head and neck cancer surgeon, there is no question that I want to deliver that type of care to my patients and to have a strong interprofessional team.”
At Vanderbilt University Medical Center in Nashville, the department of otolaryngology instituted a leadership curriculum nine years ago for its head and neck surgeons that includes four intense modules over four years of study: leadership training modeled after programs used by the military, public speaking, a “micro-MBA” course, and a capstone project focused on
prevention and population health. They include leadership and management skills training with peer-to-peer critiques, not criticism, designed to give constructive feedback to learners on how they deliver a research talk or communicate the death of a patient to family members, for example. This innovative program includes techniques used in graduate business schools, such as group discussion and feedback instead of traditional lectures, said Roland D. Eavey, MD, Guy M. Maness Chair and professor of otolaryngology, chair of the department of otolaryngology, and professor of hearing and speech sciences at Vanderbilt University in Nashville.
“We tell our residents that your job is changing in the future, and the whole healthcare system is changing,” says Dr. Eavey. “Do I assume that, as a doctor, I am a leader because I write a prescription and a pharmacist fills it? Or that I give an order and the nurse on the floor implements it? Doctors need to realize that there is a lot of talent around them. Leadership training is important, because 99% of the work that we do is taking care of problems that are not glamorous. Our purpose is to serve others, not to be served. We have to inculcate that in our residents. This is a cultural shift.”
Rapid changes in health care mean that surgical trainees need better preparation to manage a broad range of skills in the evolving practice of medicine, said Dr. Malekzadeh. “Many graduate with limited knowledge of government regulatory requirements, health policy, quality and safety, and the general business of medicine. We need to identify pathways to better integrate and impart this information during residency,” she said.