Narratives of Actionable Medical Leadership From Senior Leaders for Aspiring Leaders in Academic Medicine.

Background: Physicians understand that certain personal attributes are essential in medical leaders, but they often do not know what actions are expected of them as leaders or what they should do to be more effective leaders. Purpose: We sought to compile, through interviews with senior leaders at an academic institution, real leadership scenarios for a series of case-based examples to be used during group mentoring sessions for aspiring medical leaders. Methods: We conducted one-to-one interviews using open-ended questions with 11 current and emeritus chairpersons or chiefs of major departments or divisions at our academic medical center. Questions were designed to elicit anecdotes and examples of actions that demonstrate effective and ineffective leadership. Responses were analyzed with qualitative techniques to generate topics of leadership behaviors, which then were compiled into a collection of illustrative examples. Results: The leaders interviewed discussed challenges they encountered in daily routines and described how they addressed certain dilemmas. Topics included making decisions without complete information, winning over reluctant administrators, building alliances with peers, involving subordinates in initiatives, and using knowledge to defend one's position. Actions requiring interpersonal skills also were discussed, including varying modes of communication, avoiding adversity, displaying gratitude toward subordinates, and safeguarding one's professional image. The leaders' insights and recommendations were compiled into a themed collection of topics to be used during group mentoring sessions to enhance leadership skills. Conclusions: This qualitative study suggests that the wisdom and experience of senior leaders may be gleaned for a collection of case-based topics that could complement other formal training programs for aspiring medical leaders.