Reflective Essays During Clerkship Following a Pre-clerkship Leadership Curriculum

Area of Science:

• Medical Education
• Leadership Studies
• Healthcare Management

Background:

• Assessing the efficacy of leadership curricula in medical education is crucial for developing essential skills in future physicians.
• Medical student leadership development requires evaluation of applied skills during clinical rotations.

Purpose of the Study:

• To evaluate the application of leadership principles (character, competence, context, communication) taught in a pre-clerkship curriculum by medical students during an internal medicine clerkship.
• To determine if medical students can translate theoretical leadership knowledge into practical application within a clinical setting.

Main Methods:

• A qualitative analysis of 158 de-identified reflective essays from medical students during a 10-week internal medicine clerkship at Uniformed Services University (USU).
• Essays were prompted by art and focused on critical incidents, with a specific analysis of leadership themes.
• Students' reflections were analyzed for the application of the PITO (personal, interpersonal, team, organizational) leadership model and related concepts.

Main Results:

• 40.5% of essays discussed leadership or professionalism, with most students (75%) not explicitly mentioning the PITO model.
• Common themes included personal and interpersonal leadership aspects (27%), attending physicians (52%), and effective strategies (72%).
• Key themes identified were responsibility (47%), teamwork (28%), competence (27%), and character/integrity (23%).

Conclusions:

• Medical student essays reflected core leadership concepts like character, competence, and responsibility, despite limited explicit use of the PITO model.
• The internal medicine clerkship provides a feasible setting for implementing leadership reflections in medical training.
• This study supports the integration of leadership development and assessment within clinical rotations.