Medical students' leadership competence in health care: development of a self-assessment scale

Medical leadership plays an increasing role already in early career stages. Undergraduate medical students in the transition to postgraduate education feel not well prepared for their leadership roles. While leadership curricula have been developed, instruments for students' self-assessment of leadership competences as part of their professional development are still missing. The aim of our study was to develop a self-assessment scale for undergraduate medical students' leadership competences.

The medical leadership competence scale (MeLeCoS) for undergraduate medical students was developed in twelve steps. For item generation, we employed the Medical Leadership Competence Framework (MLCF), which is also used as a framework for many leadership curricula and includes five leadership domains for three fields of education: undergraduate education, postgraduate education, and continuing practice. In a pretest, 67 items were tested with n = 88 undergraduate medical students. For content validation we performed group discussions with a total of 17 students. After item reduction a test-version with 45 items and a 5-point Likert scale (1: 'never', 2: 'rarely', 3: 'sometimes', 4: 'often', 5: 'always') was used in a test-sample of final-year students (n = 129). Descriptive statistics and factor analyses were performed.

The final version of the MeLeCoS includes 37 items and the scale's Cronbach's alpha was 0.87. Six factors could be identified and two of them, respectively, represent leadership aspects from the following three areas: (1) the medical students themselves, (2) the interrelation of the medical students with a healthcare organisation regarding general management and improvement, and (3) general leadership aspects of medical students within undergraduate medical studies and the healthcare system. The overall mean of the MeLeCoS was 3.50 ± 0.39. Factor 2 ('Demonstrating responsible behaviour and shaping relations') reached the highest mean (4,36 ± 0.37) and factor 5 ('Promoting improvement and innovation in undergraduate medical education' the lowest (1.91 ± 0.87).

The medical leadership competence self-assessment scale (MeLeCoS) is a reliable instrument for undergraduate medical students' self-assessment of leadership competence with good content validity. It could be used for students' self-reflection on leadership competences in addition to rater-based assessments in leadership curricula and for longitudinal development of students' professional identity.