The Framework of Leadership in Academic Medicine (FLAM); a mixed-methods study to develop leadership skills and competence

Abstract

Abstract Background In medical academic institutions, leadership is mostly hierarchical which is based on multiple factors including seniority and ranks. There is a dearth of structured leadership training, development, and certification programs in the medical field. This study contemplates to develop a framework of leadership in academic medicine with an intent to support medical academia in fostering their leadership skills. Methods We adopted a cross-sectional prospective design and a mixed-methods strategy. An online self-administered questionnaire-based survey and structured in-person interviews were conducted to collect the perceptions of both academic leaders and non-leaders in medicine. The data was collated, analyzed and triangulated to develop domains and themes. Results Of the 229 respondents, there were 121 leaders and 108 non-leaders. The quantitative results revealed that most leaders (60%; 73/121) were open to training and development to improve their leadership skills. Leaders favored an affiliative style of leadership (45%). The leaders concurred that leadership development programs would improve their organizational performance. They also argued that an overly bureaucratic and stagnant organizational structure was a hindrance to effective leadership (mean rank scores 136.82 and 122.85 respectively). On the other hand, the majority of non-leaders (70%; 75/108) had observed that their leaders would display a variety of key leadership behaviors such as clear communication, effective resource allocation, the creation of shared knowledge and objectives. As many as 99/108 non-leaders agreed that the lack of experience and training were barriers to effective leadership. Given that most leaders and non-leaders had no prior formal training in academic leadership, both recognized the need for an extensive, structured training program for academic leadership in medicine. The qualitative data analysis and triangulation of subthemes helped us to develop the 6 Es Framework for Leadership in Academic Medicine (FLAM); Ethics (accountability, role model, respect), Education and training (training programs, structured curriculum), Envision (clear path, talent hunting, team man), Engagement (structural foundation, achievable targets), Empowerment (employees, create passion), and Encouragement (financial rewards). Conclusions Our study underpins the need for a structured training program of leadership in academic medicine. The 6Es FLAM, with its distinct traits, can be incorporated into undergraduate and postgraduate medical curriculum to enhance the impact of leadership in academic medicine.