Stakeholders' Perceptions of Medical Leadership in Indian Medical Schools: A Thematic Analysis.

Background and objective In recent times, the need for structured leadership development programs to produce effective leadership in healthcare professions globally has been highlighted. Understanding how stakeholders conceptualize leadership is key to ensuring the effectiveness of leadership training programs. Stakeholders' perceptions of what makes an effective leader will influence their expectations about the content of such programs. Training programs are more successful if there is end-user acceptance of the underlying rationale of the program. Developing leadership development programs that echo and reflect user perceptions is key to the programs' success. If trainees' expectations about the program are not met, they are less likely to have positive attitudes toward the program. Thus, it is important to understand different stakeholders' perceptions about leadership and the currently existing leadership program curriculum. Very few studies in the literature have focused on the perceptions of diverse groups of stakeholders in the healthcare context. Studies focusing on the perceptions of medical leadership and leadership training in Indian medical schools are scarce. This study aimed to address this gap by exploring the perceptions of different stakeholders on medical leadership, current leadership training curricula, and factors influencing leadership training. Methods This was a qualitative study involving different stakeholders with leadership experience. We selected 20 participants with leadership experience. Stakeholder groups included five medical students (year four undergraduates, interns, postgraduates), five clinician leaders who are also department heads, five medical scientists (lecturer/tutor, assistant, and associate professors), and five institute leaders (associate dean, assistant dean, vice-dean, and dean). The participants were members of the institute's undergraduate curriculum committee at a rural Indian medical school. We collected the data through semi-structured interviews and analyzed it using Braun and Clarke's six-phase thematic analysis. Results Stakeholders expect the leaders to be role models and sources of inspiration who can communicate their vision, manage disagreements, and make decisions effectively. Stakeholders considered leadership curriculum, learners, faculty, institutional administrators, time availability and context of the institutions as factors that influence leadership training. Conclusions Based on our understanding of participants' perceptions, we highlight the need for a Specific, Measurable, Attainable, Relevant, Timely (SMART), and sustainable leadership curriculum. We propose the ripple model of leadership which could influence stakeholders' identity, perceptions, competency, and actions that in turn would enhance enablers and reduce barriers to leadership training at all levels of the healthcare system to provide the desired outcome: effective healthcare leadership.