Developing leadership through talk: how small group reflections can enhance leadership competence

Competency-based medical education in postgraduate medical education (PGME) prioritises developing holistic physicians, including leadership competence. The leadership competence encompasses self-management, working effectively in teams, considering organisational and societal demands and navigating complex situations. Although group reflection has proven valuable for leadership development in other professional fields, its role in PGME remains underexplored. This qualitative study investigated how small group reflection can support the development of leadership competence among PGME residents.

Using a constructivist grounded theory approach, a purposive sample of seven residents and seven counsellors from three Danish psychiatric hospitals were interviewed. Data analysis followed an iterative process of open, axial and selective coding, eventually constructing three themes.

Three central themes related to leadership development were constructed: (1) community and safety, (2) perspective taking and (3) engagement. Residents valued a sense of community, which enabled open dialogues and a willingness to express vulnerability. This safe and supportive environment supported small group discussions. Exposure to diverse perspectives through group reflection broadened residents' understanding of leadership and helped them identify their strengths, areas for improvement and opportunities for action. Group reflection reinforced learning and facilitated further planning of leadership development.

These findings show that group reflection is perceived as a valuable method for residents to develop leadership competence, supported by a sense of community and psychological safety. These insights can inform the design of new learning activities using group reflection as an educational tool, fostering leadership competences in PGME.