title: Five Key Leadership Actions Needed to Redesign Family Medicine Residencies.
abstract: BACKGROUND
  New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership.
  
  
  OBJECTIVE
  We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change.
  
  
  METHODS
  The Preparing the Personal Physician for Practice (P4) project (2007-2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign.
  
  
  RESULTS
  Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience.
  
  
  CONCLUSIONS
  Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation.
authors.forename: Stanley M
authors.initials: SM
authors.lastname: Kozakowski
authors.forename: M Patrice
authors.initials: MP
authors.lastname: Eiff
authors.forename: Larry A
authors.initials: LA
authors.lastname: Green
authors.forename: Perry A
authors.initials: PA
authors.lastname: Pugno
authors.forename: Elaine
authors.initials: E
authors.lastname: Waller
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Jones
authors.forename: Gerald
authors.initials: G
authors.lastname: Fetter
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007857:Leadership; D018802:Patient-Centered Care / Q000191:economics / Q000458:organization & administration*