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Critical route for leadership competencies in medical students in 35 PAHO members states: A scoping review and thematic analysis
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  • Pablo Rodríguez-Feria,
  • Martina Paric,
  • Luis Jorge Hernández Flórez,
  • Suzanne Babich,
  • Katarzyna Czabanowska
Pablo Rodríguez-Feria
Universiteit Maastricht Department of International Health

Corresponding Author:p.rodriguezferia@maastricht.university.nl

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Martina Paric
Universiteit Maastricht Department of International Health
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Luis Jorge Hernández Flórez
Universidad de los Andes
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Suzanne Babich
Indiana University Richard M Fairbanks School of Public Health Department of Health Policy and Management
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Katarzyna Czabanowska
Universiteit Maastricht Department of International Health
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Abstract

The 35 member states (MS) of the Pan American Health Organization (PAHO) have been committed to training physicians in leadership competencies since 2008. However, four reviews on teaching leadership using competency-based education (CBE) in undergraduate medical education (UME) identified only two MS: Canada and the USA that worked on identifying gaps in teaching leadership in UME. Previous reviews did not focus on factors influencing leadership education and did not use qualitative methodology to support their findings. Therefore, this review aims to identify facilitating and inhibiting factors in teaching leadership in UME using a scoping review and thematic analysis. Six databases containing grey and indexed literature in English, Spanish, and Portuguese were searched including hand search and authors’ consultations. Forty-eight documents out of 7849 were selected based on eligibility criteria. Braun and Clarke’s thematic analysis guide was used, resulting in seven themes: curriculum, intended learning outcomes, teaching methods, assessment, addressing barriers, supporting organizational change, and building networks. Considering these themes, the authors propose a critical route for teaching leadership in UME in the Americas. First, institutional design should consider governance gaps, such as having national and international policies for leadership in UME with an inter-professional, trans-professional, and citizen-focused approach. This means that there is a pressing need to equip physicians and other professionals from the government, academia, non-governmental organizations, hospitals, and national and international organizations whose missions are related to health or education with leadership competencies. Networking among actors for leadership education and teacher training is also essential. Second, instructional design reveals knowledge-do gaps in MS when incorporating leadership into the medical curriculum. This includes using leadership frameworks, defining learning outcomes, and employing assessment and monitoring tools for leadership education. Mechanisms to reduce these gaps in MS include the Equator Network and Evidence-Informed Policy Networks which foster knowledge translation and governance.
19 Sep 2023Submitted to International Journal of Health Planning and Management
28 Sep 2023Submission Checks Completed
28 Sep 2023Assigned to Editor
28 Sep 2023Review(s) Completed, Editorial Evaluation Pending
21 Nov 2023Reviewer(s) Assigned
01 Feb 20241st Revision Received
07 Feb 2024Reviewer(s) Assigned