Developing Residents into Leaders

Residents learn many skills they need to become excellent doctors in their first years of training. But not many are taught the tools that they will need to become impactful leaders. That’s where the Department of Head and Neck Surgery & Communication Sciences’ Leadership Lived Out Program comes in.

The Leadership Lived Out Program is a professional and leadership-development initiative led by Walter T. Lee, MD, MHS, Professor of Head and Neck Surgery & Communication Sciences (HNA&CS) and the department’s chief of staff. It is one of several examples of the Department’s commitment to leadership and professional development.

Participation in Leadership Lived Out isn’t required, but all fourth-year HNS&CS residents (PGY4s) are invited to take part in the program to help not only prepare them for being chief residents, but also for their future.

“Being a chief resident is a position of responsibility and leadership, and it’s a different role than residents have been in since they started the program. Being a leader of residents — no longer merely a co-resident or colleague — requires a different skill set that they may not have developed yet,” Dr. Lee says.

A Distinctive Approach to Resident Leadership

“Leadership Lived Out is particularly helpful in developing those skills because it gives them feedback on what they’ve done well and what they can improve on, and then they work with a professional coach, Dr. Barry Doublestein, to try to minimize those gaps,” Dr. Lee says.

The program is built on the Professionalism Intelligence Model, which was developed by the department leadership in 2010. This framework emphasizes three dimensions of leadership:

• Cognitive Intelligence: skills like focused thinking, problem solving, and decision making.
• Emotional Intelligence: including self-awareness, empathy, and self-regulation.
• Leadership Intelligence: the ability to translate knowledge and awareness into effective action.

Each domain is grounded in timeless virtues such as compassion and integrity. “If you don’t anchor leadership in virtues,” Dr. Lee says, “you risk creating someone who’s smart and persuasive, but not trustworthy. The virtues keep us grounded.”

How It Works

The program comprises three educational components that are based on best practices and designed to provide different insights:

• An online forum that includes a cohort of 10 members in the department who have different occupations. “This has fostered among the chief residents a better understanding of and respect for the different roles people have,” Dr. Lee says.
• A tool called the 360 Professional Quotient Inventory, in which residents evaluate themselves and ask for evaluation and feedback from at least three “peers,” three “direct reports,” and their “supervisor.”  This allows them to compare their perspective with the perspectives of others with whom they work closely. They get feedback on things like how well they communicate with or inspire others.  When they meet with Dr. Doublestein, they might find out they did very well in certain areas, but there are a few areas that they need to work on. “I don’t know of any other program in the country that hires a professional coach to work with their residents like this,” says Dr. Lee.

• Personalized coaching, where each participant works with Dr. Doublestein to review the 360 evaluation and to recognize their strengths and identify blind spots and weaknesses. From these meetings, tools are provided and skills taught to develop an actionable plan to improve on identified areas.

Gaining Actionable Insights

Current chief resident Hannah Martin, MD, took advantage of the Leadership Lived Out Program to prepare for her new chief resident position.

“The program encouraged me to take the time to reflect on my own leadership growth and experiences, gain insight from hearing stories from other participants in the program, and make active plans for intentionally building my leadership skills over the course of the year,” Dr. Martin said. “I appreciated the opportunity to take the course with team members in a variety of roles in the healthcare system, which lent a novel perspective on my own role in our healthcare system and the ways in which we can support and impact each other on a day-to-day basis.”

Khalil Issa, MD, got a lot out of the program, as well. “The most meaningful part of the experience for me was the 360 Professional Quotient Inventory,” he said. “It was eye-opening to compare how I see myself as a leader with how colleagues, supervisors, and direct reports perceive me.”

“A shared understanding of how we treat each other”
Rather than adding new projects or requirements, the program encourages residents to “live out” leadership in their daily work.

“We don’t need them to do a leadership project,” Dr. Lee notes. “They already have full schedules. We want them to take what they’re learning and apply it directly to where they are—to the OR, the clinic, the team they’re leading.”

While there’s no metric or test to quantify how much participation in Leadership Lived Out has changed the HNS&CS resident culture, “it has contributed to a basic, shared understanding of how we strive to treat each other and how we treat ourselves,” says Dr. Lee. “It’s powerful to have that kind of common understanding explicitly taught.”

For Dr. Lee, the measure of success is simple. “If 5 years after graduation, someone tells me one of our alumni is a joy to work with and a great leader, that’s all the evidence I need. That’s what this program is about. We’re continuing to build the reputation of Duke’s HNS&CS residency program as one that produces outstanding surgeons who are wonderful leaders and great people to work with.”