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Training Radiation Oncologists to Be Better Leaders

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Business culture has long valued the development of employee leadership skills for long-term organizational growth and success but only recently have these priorities started to shift into focus in healthcare. With all of the changes in the medical landscape accelerating rapidly, interest in developing physician leaders at the individual, clinical team, departmental level and beyond, has intensified. Nationally, residency programs are evaluating how best to expose trainees within schedules already packed with required elements while academic institutions wrestle with how to expose faculty to leadership programs. This year, at our annual ASTRO meeting, I proposed a session entitled "Leadership Development for the Radiation Oncologist of the Future" and enlisted the support of an all-star cast to serve as experts on the panel, with 3 Radiation Oncology Department Chairs (Drs. Louis Harrison, Michael Steinberg, and Charles Thomas) and an expert in physician leadership and the emotional intelligence (EI) model (Joanne Quinn, PhD, MBA).

I was motivated to introduce the topic of physician leadership at ASTRO after work I had done at the medical school level. At the University of South Florida (USF) Morsani College of Medicine in Tampa, FL, a unique program called SELECT (Scholarly excellence, Leadership Experiences, Collaborative Training) combines longitudinal leadership training, values based care, and health systems with a Professional Development Coach (PDC) at the faculty level. My experience serving as a PDC for eight medical students over their four years of school taught me the value of coaching and was very different than the traditional role as mentor. I saw firsthand the students' growth and how this innovative program led to solid skill development that translated well to both clinical practice and individual growth. I worked with Dr. Quinn and the SELECT team for four years creating leadership curricula for the medical students at the first and second year levels that integrated a case based approach. After this role, I approached Dr. Harrison, our Chair at Moffitt Cancer Center since 2014, to pitch the idea of a longitudinal training course for our residents in radiation oncology. Since then, we have worked closely with our Residency Program Directors, Dr. Thomas Dilling and Dr. Jessica Frakes, to integrate this into our training program at Moffitt.

This year the timing was right for ASTRO to introduce this as an educational initiative. Our international colleagues published work last year on 20 elements defining the competencies underpinning a global leader training program in radiation oncology and even started to offer leadership courses at the European Society of Therapeutic Radiology and Oncology (ESTRO) meeting. With this inspiration, I suggested to our group that we start with a case integrating the audience response system. In my experience at the medical school level, I had often found that starting the session interactively would provide the scaffold to engage the audience. Our objective was to quickly switch attendees from the left brain mode leaving the clinical trial plenary session to the right brain mode to start thinking creatively about leadership challenges and strategies to manage them. The case we created integrated the optics of physician leaders at an academic center and at regional sites and asked the audience to describe the influence and conflict management styles of those involved within the setting of the changing reimbursement landscape. After the case, our 3 radiation oncology physician experts explored leadership knowledge topics relevant to our field and we ended our session with Dr. Quinn going back to the case and analyzing the leaders' influence styles, power dynamics, and conflict management approaches all within the context of the four quadrant EI model. We asked Dr. Quinn to provide links for the audience for some self-assessment tools they could do on their own time to further understand their own influence style, personality traits, and preferred mode of conflict management.

As moderator of the panel, I reflected on what a wonderful opportunity this session was for the audience to hear from three true luminaries in our field, who have role modelled during their careers what the apex of successful physician leadership looks like. Based on feedback, their talks truly resonated with attendees, several of whom told us they were having challenges dealing with team members and would be applying what they learned in how they handled their subsequent interactions. The EI strategies that were mentioned by Dr. Quinn also struck a chorus, particularly with the resident attendees who told us they would be practicing some of the techniques in their own lives. As a clinician educator, helping our trainees and junior faculty strive to reach their 360 potential has always been one of my most important goals and thus it was very rewarding that in 90 minutes this session was able to catalyze this effort.

Based on the feedback from educators at other institutions who attended this session, I'm thrilled to see that leadership training has been warmly embraced as an educational initiative at ASTRO. The challenge for us moving forward will be how we can best continue to develop content that is relevant to attendees and effective at improving their individual competence. As radiation oncologists, our numbers are small within our organizations but our voices are loud and we hope will grow ever louder. With a continued emphasis on how we can maximize our individual potential, I hope that we can each optimize our own "inner leader" and be effective advocates for our patients, our colleagues, our departments, and our organizations. I look forward to collaborating with national leaders who are similarly passionate about leadership development for our specialty. I'm grateful for the opportunity to collaborate with such amazing leadership experts on this panel and look forward to innovating ways we can expand on this in the future. At Moffitt, I've been the beneficiary of the inspirational leadership mentoring of my Chair, Dr. Harrison, and wish to multiply what I've learned to contribute to our field. This is just the beginning!

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