Sailing a safe ship: improving patient safety by enhancing the leadership skills of new consultant specialist surgeons.
BACKGROUND
The potential for "discontinuities in care" arising from the turbulent transition from specialist trainee to consultant specialist presents risks to patient safety. But it is easy to lose sight of the affective needs of individuals facing the burden of keeping patients safe. This article describes a 2-day program focused on new and prospective consultant specialist ophthalmic surgeons entitled "Sailing a Safe Ship" (SASS). The purpose was to facilitate understanding and analysis of their personal holistic learning needs and enhance individual agency in optimizing learning during the transition period.


METHODS
The program used gaming, team challenges, meta-planning, role play and professional actors, interactive presentations, and self-analysis tools to portray the real world of consultant specialist practice in terms of ill-defined problems requiring "elite communication" and effective negotiation of value differences and priorities for their resolution. Participants' insights into their individual learning were recorded in scheduled reflective sessions. The immediate impact on their learning was also considered in terms of direct (instructional) and indirect (nurturant) effects.


RESULTS
Participants' insights reflected 4 key themes: admitting vulnerability and uncertainty, taking responsibility for managing risk, being self-aware and reflexive, and internalizing authentic leadership. Four instructional and 4 nurturant effects were revealed. Preliminary findings on long-term impact on participants' practice are outlined.


CONCLUSIONS
Evidence from the evaluation indicated that participants felt empowered to construct a personal strategic response to unfamiliar and unanticipated workplace demands and pressures, adopt a capability mindset that would accelerate their capacity to fulfill an enhanced leadership role, and take a holistic approach to their continuing self-directed development as leaders and educators.
Consultant Specialist Ophthalmic Surgeon, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Director of Education (Eyes and Vision), UCL Partners Academic Health Science Centre and National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, Professor of Glaucoma, Centre for Health and Social Care Improvement, School of Health, Wolverhampton University.
Peter
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Shah
Vinette
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Cross
Freda
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Sii
D002983:Clinical Competence / Q000592:standards*; D003253:Consultants / Q000523:psychology*; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000592:standards; D004502:Education, Medical, Continuing / Q000379:methods*; D006801:Humans; D007857:Leadership; D009885:Ophthalmology; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D061214:Patient Safety; D015397:Program Evaluation; D013038:Specialization
capability; clinical leadership; communities of practice; competence; continuing medical education; education; ophthalmology; surgery