Seven leadership and followership lessons from kidney transplantation during lockdown.

BACKGROUND: The renal transplant team in Northern Ireland performed 70 transplants in 61 days during the first wave of COVID-19, an 8-fold increase in their typical activity. Mobilising diverse professional skills to achieve this number, especially under COVID-19 conditions, required extraordinary effort on the part of everyone involved along the transplant patient pathway, management and staff from other patient groups. METHODS: Fifteen transplant team members were interviewed to explore their experiences during this time. RESULTS: Seven key leadership and followership lessons, contextualised within The Healthcare Leadership model, were learnt from these experiences. CONCLUSIONS: While circumstances were untypical, the achievement and motivation of staff were no less commendable. We contend that this was not only because of the unusual circumstances but as a result of extraordinary leadership and followership, teamworking and individual agility.Recommendations for those leading services which require a quick response and collaborative effort are made.

Doctors in distress: The personality profile of derailing doctors.

OBJECTIVE: This study looked at the bright and dark-side personality profile of distressed and potentially derailing doctors (82% male). The derailing doctors were on average 48.75 years old, and from many specialities, in particular, general practice and surgery. METHOD: In all, a group of 77 derailing British doctors, and a control group of 357 doctors completed a valid multi-dimensional test of bright-side (normal) personality (NEO-PI-R) and one of dysfunctional interpersonal themes (sub-clinical personality disorders) (HDS: Hogan Development Survey). RESULTS: Controlling for sex and age, the derailing doctors were more Neurotic (less resilient), and less Agreeable, Conscientious, Extraverted and Open-to- Experience. They were also more Excitable (Borderline), Sceptical (Paranoid), Cautious (Avoidant), Reserved (Schizoid), Leisurely (Passive Aggressive) and Bold (Narcissistic). Discriminant analysis showed age, Neuroticism, Extraversion, Leisurely and Excitable were, in that order, the greatest personality discriminators between those who did and did not derail. CONCLUSION: More research needs to be done on doctor derailment to inform the selection and training of doctors.

GP trainers and trainees - trait and gender differences in personality: implications for GP training.

This study looked at differences between established GP trainers and current GP trainees in relation to personality traits. Personality differences are particularly important for training in the UK context where the attributes of successful GPs may be evolving as the context changes, and where there is a unique one-to-one relationship between trainer and trainee. GP trainers and trainees attending educational events were invited to participate in this study by completing the NEO-PI-R, a personality measure. Correlation and multiple regression analysis demonstrated differences between these groups; some in line with expected differences relating to age and gender. Others, such as lower reported levels of emotional resilience, may be particular to this trainee population. Overall the gender differences are significant given the trend towards the feminisation of the medical profession. Generational differences may also explain some behaviour and attitudinal differences which can aid trainers' understanding of training issues. The findings have important implications for training, particularly in relation to the development of emotional resilience for GP trainees, and for recruitment. Further research correlating educational outcomes and perceived satisfaction with a GP career and GP training would indicate if trainer/trainee personality differences have a direct bearing on educational outcomes and future practice.

Defining insight: a challenge that matters.

BACKGROUND: Insight is a fundamental consideration in the maintenance and improvement of performance. What is required is a definition that can be used consistently along with an understanding of the dynamic nature of insight, and therefore its potential for improvement. CONTEXT: The work presented is a review of contemporary literature about insight, self-awareness and emotional intelligence, and experience from the National Clinical Assessment Service (NCAS) in the assessment of 300 doctors with performance problems. SUMMARY OF RESULTS: This work has led to the construction of a working definition of insight that incorporates reflection, emotional intelligence, self-awareness and motivation. The validity and utility of this definition was tested using data from NCAS's growing experience. CONCLUSIONS: The assessment of insight in NCAS performance assessments has involved the use of information from a variety of sources, including psychometric profiling, multisource feedback and self-assessment. This has been corroborated with findings from clinical performance assessment and the outcomes of remediation plans. IMPLICATIONS: A definition of insight is offered that is greater than just self-awareness, and that involves emotional intelligence and motivation. The use of this broad definition is of fundamental importance in the production of educational and development programmes at all levels.