Division of Family and Community Medicine (FCM) professor Sonja Van Hala, MD, MPH, FAAFP, recognized the need for a way to track residents’ understanding of their leadership skills after drawing from her experience as a faculty supervisor of family medicine residents.
Dr. Van Hala was overseeing a resident who was experiencing challenges leading a multidisciplinary team effectively and she wanted to provide constructive feedback and coaching. Before approaching the resident, she sought to understand how the resident assessed their own leadership abilities.
After consulting the literature, Dr. Van Hala found there were no published self-assessment instruments for leadership skills in graduate medical education. Determined to fill this gap, she assembled a research team to develop and validate the Foundational Healthcare Leadership Self-assessment (FHLS).
The team included faculty members from FCM: Susan Pohl, MD, FAAFP; Susan Cochella, MD, MPH; and Division Chief Bernadette Kiraly, MD. The project involved collaboration across the Department of Family & Preventive Medicine (DFPM) including Public Health professor Lisa Gren, PhD, MSPH, and Eliza Taylor, MPH, from the department’s Central Administration Research Office (CARO). The project also enlisted contributions from Caren Frost, PhD, MPH, professor in the College of Social Work.
“Interdisciplinary collaboration was instrumental in developing the FHLS, as it required both qualitative and quantitative work, with focus groups and survey distribution to residents across the country, with a principal component analysis to help refine the instrument,” said Van Hala. “As a clinician educator, I did not have the skills to conceptualize how to create and validate a self-assessment instrument.”
The development of the FHLS in 2018 led the team to publish a successful pilot study in June 2024, titled “Leadership Development in Graduate Medical Education: A Pilot Study of Implementation of a Validated Self-assessment Instrument.”
The FHLS is a validated 21-item self-assessment of leadership skills residents need to be effective team leaders in health care settings. It generates a composite score along five foundational leadership domains: accountability, collaboration, communication, team management, and self-management.
The University of Utah Family Medicine Residency Program integrated the FHLS into the residency’s longitudinal leadership curriculum using coaching, self-directed learning, and reflective practice. Throughout residency leadership rotations, the FHLS guides residents in an organized structure that promotes the development of leadership skills throughout the three years of residency.
Dr. Van Hala believes leadership skills are important for all clinicians to learn, not only those in leadership roles. The FHLS is organized around a coaching paradigm, “Leadership for All,” that encourages clinicians, in both formal and non-formal leadership roles, to learn how to lead teams on the front line and impact change.
“FHLS has been serving our residents for several years now, and other programs have reached out to Dr. Van Hala to use it as well,” said Cochella. “I consider this an immensely valuable tool and curriculum for Family Medicine residents, an important contribution to our discipline."
In addition to the local impact, FHLS has had a wider application. Study results support the usefulness of the FHLS within a residency leadership curricula across the board, to promote self-awareness and engagement in leadership development.
In the future, Dr. Van Hala aims to develop a website to host the FHLS educational tool to support leadership curricula for other residency educational programs.