If your actions inspire others to dream more, learn more, do more and become more, you are a leader.
John Quincy Adams
As an established clinician-teacher, you might be asked to become more involved in medical education leadership. Medical training and subsequent clinical practice have shaped both your identity and your ability as a clinician. Teaching learners of all levels, from undergraduates to faculty, enables you to recognize your role and the effect you have as a teacher. But do you consider yourself a leader? Most clinician-teachers do not readily self-identify as leaders.1 The CanMEDS–Family Medicine physician competency framework recognizes the role of leader as integral to our discipline.2
Self-recognition
It is often assumed that skilled clinicians are automatically skilled teachers. Similarly, it is commonly believed that skilled teachers will be effective leaders. These assumptions are not necessarily true. Excelling at leadership requires developing specific skills that most of us were not taught during our medical training. An acknowledgment of the inherent leadership within your role is a necessary first step to self-identification as a leader. Next is an understanding of the leadership tasks within your role that will require steps toward professional self-development. The College of Family Physicians of Canada’s (CFPC’s) Fundamental Teaching Activities (FTA) Framework might guide teachers’ transitions through the steps of self-identification and professional self-development required in their leadership roles.
The FTA Framework was developed by the Working Group on Faculty Development of the CFPC’s Section of Teachers. It explicitly and succinctly describes the tasks and activities teachers undertake within the context of 3 domains: clinical preceptor, teacher outside the clinical setting, and educational leader.3 The goal of this series of related articles4,5 is to bring attention to the CFPC FTA Framework and highlight its usefulness for teachers, using a case-based approach to focus on the teacher’s tasks and activities within each domain. This article specifically addresses the educational leader domain, which encompasses 2 main tasks—educational programmer and educational administrator— both of which incorporate several leadership activities. This article will also focus on the importance of self-identification as an academic leader, the necessity for professional self-development as you evolve in your leadership capacity, and the integral need in leadership to build a team.
The FTA Framework makes explicit the multiple activities inherent in the different educational leader roles that you might play during your career. In the framework, for example, the leadership task involving local site educational programming and curriculum design and development is called educational programmer. The leadership task that requires action at several sites and entails program evaluation and possibly the involvement of external bodies or stakeholders is called educational administrator. Depending upon your academic responsibilities, you might function as an educational programmer, an educational administrator, or both (Figures 1 and 2).3 In developing the educational leader domain, the authors of the FTA Framework noted that several of the tasks involved plan-do-study-act cycles, which require reflection, inquiry, synthesis, visioning, and action. The education leader domain and the associated activities align well with the concepts of the plan-do-study-act approach derived from the quality improvement literature.6 The following 2 scenarios will demonstrate the application of the FTA Framework.
Educational programmer task, based on the Fundamental Teaching Activities Framework: This task starts at the site level.
Reprinted from Walsh et al.3
Educational administrator task, based on the Fundamental Teaching Activities Framework: This task has broader scale and scope than that of the educational programmer.
Reprinted from Walsh et al.3
Understanding the leadership tasks inherent in your role: the educational programmer
Scenario 1.
You have been asked to lead the evidence-based medicine (EBM) tutorials for residents at your local teaching site. Where do you start? Do you understand the expectations in this role? Do you recognize the leadership responsibilities and opportunities within this task? Do you understand the stewardship required to develop and implement this curriculum? Do you recognize and value the leadership inherent in this role?
In the “plan phase” it is important to carefully explore the current state of your EBM curriculum. What curriculum and learning activities are provided at your teaching site? Have the goals and objectives been defined locally or in the overall program? Are there similar teaching sites that could be sources of information? Who is the appropriate department liaison?
Next, in the “do phase,” what supports do you and your teachers need to deliver the curriculum? Meeting with your teachers to understand their concerns and conducting a needs assessment are good first steps to answer this question. Are the teachers at your site eager to improve their teaching skills? Your local, departmental, or university faculty development office might be a good resource for you and your teachers to enhance skill development.
In the “study phase,” an impact evaluation of the curriculum at your site will identify areas of both strength and weakness. Formal and informal feedback from learners can provide you with valuable information for curricular improvement. This study phase should inform the “act phase,” in which you make the needed changes to your program. Ideally this process continues as you adjust your curriculum with ongoing feedback from learners and teachers, leading to continued improvements to fit your teaching context.
In this role, you must also be cognizant of learners who might be experiencing difficulty or challenges in meeting the curriculum’s objectives. How can you help them? Would specific adjustments such as individualized learning plans help? The teachers working with these learners might also need assistance in delivering a modified curriculum. Your faculty developers or your university liaisons would be valuable resources. With time and with repeated program and curriculum evaluation and feedback from learners and teachers, you will become more confident in your leadership ability. The framework describes activities along a developmental trajectory (Figure 1),3 and you might begin to collaborate with other sites in your work. Possibly your experience will lead you to mentor others in their own work as educational programmers and perhaps to share (disseminate) your insights through scholarly activities such as presentations, publications, or services to other educational committees. This process of reflection, inquiry, and synthesis is applicable to any of the leadership roles you might be asked to assume as either an educational programmer or an educational administrator.
Understanding the leadership tasks inherent in your role: the educational administrator
Scenario 2.
By now, you have handled many tasks and projects; others are now consulting you at your site and within your department. Not long ago, it seems, you were asking others for their opinions. Now you are leading the teaching of EBM for undergraduate medical students. In this broader leadership capacity, the process of reflection, inquiry, synthesis, and visioning applied with the FTA Framework can also be a guide. In this role you are implementing a multisite program evaluation and ensuring compliance with accreditation standards. On reviewing the educational administrator section of the framework, you recognize the need to identify the stakeholders’ expectations. In addition, you realize that recruiting and training tutors for your program, optimizing program resources, and supporting both faculty and learners are required leadership activities within your role.
Professional self-development is needed at many points in your leadership trajectory, requiring a commitment to continued learning. Professional self-development at this stage might take the form of typical faculty development programs, but also consider less-formal options such as coaching from your predecessor or through working with a mentor.
Mentoring is one of the most powerful ways to assist clinician-leaders in developing their expertise.7–9 We encourage you to share your knowledge and to guide emerging leaders and educators in your program. The FTA Framework can be used both as a guide for one’s ongoing personal self-development and as a map for novice clinician-leaders to follow in their leadership journeys (Figure 2).3
Building your team and leadership expertise
Alongside professional self-development, leaders-in-development need to build support teams. No leader functions in isolation. Support teams need to be fluid and dynamic and can change based on your leadership activities and responsibilities. A support team might include like-minded individuals, trusted individuals with opposing creative viewpoints or ideas, individuals you identify as mentors, and individuals with the skill base or expertise you need to help your team function optimally. Another way to build your team is to reach out to others within your clinic, teaching unit, hospital, or local department who might also be interested in developing their leadership skills. There are other ways to develop your expertise: faculty development courses or workshops and online learning modules in leadership are offered through universities. Your provincial CFPC chapter’s annual meeting and the national CFPC Family Medicine Forum are excellent opportunities to connect with peers locally and across Canada. There is also extensive literature on business leadership that might suit your learning style.10
Although at first it might seem daunting to identify yourself as a leader, it is important to recognize that leaders come with many different backgrounds and skill sets. With careful reflection we can all recognize how to “lead from where we stand.”11
Acknowledgments
We thank the Women’s College Hospital Academic Family Health Team Peer Support Writing Group.
Notes
TEACHING TIPS
Clinician-teachers are often called upon to take on leadership roles, but the necessary skills to excel in leadership are not usually taught during medical training. This article outlines the educational leader domain and demonstrates how the Fundamental Teaching Activities Framework might guide teachers’ transitions in leadership roles.
Acknowledging the inherent leadership within your role is a necessary first step to self-identification as a leader. Next is an understanding of the leadership tasks within your role that will require professional self-development as you evolve in your leadership capacity. Finally, leaders need to build a team to support their leadership activities and responsibilities.
Teaching Moment is a quarterly series in Canadian Family Physician, coordinated by the Section of Teachers of the College of Family Physicians of Canada. The focus is on practical topics for all teachers in family medicine, with an emphasis on evidence and best practice. Please send any ideas, requests, or submissions to Dr Viola Antao, Teaching Moment Coordinator, at viola.antao{at}utoronto.ca.
Footnotes
This article is eligible for Mainpro+ certified Self-Learning credits. To earn credits, go to www.cfp.ca and click on the Mainpro+ link.
La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du numéro d’octobre 2017 à la page e444.
Competing interests
None declared
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