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The Impact of Leadership Training Programs on Physicians in Academic Medical Centers: A Systematic Review

Straus, Sharon E. MD, MSc; Soobiah, Charlene; Levinson, Wendy MD, MSc

doi: 10.1097/ACM.0b013e31828af493

Purpose To identify the impact of leadership training programs at academic medical centers (AMCs) on physicians’ knowledge, skills, attitudes, behaviors, and outcomes.

Method In 2011, the authors conducted a systematic review of the literature, identifying relevant studies by searching electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register), scanning reference lists, and consulting experts. They deemed eligible any qualitative or quantitative study reporting on the implementation and evaluation of a leadership program for physicians in AMCs. Two independent reviewers conducted the review, screening studies, abstracting data, and assessing quality.

Results The authors initially identified 2,310 citations. After the screening process, they had 11 articles describing 10 studies. Three were controlled before-and-after studies, four were before-and-after case series, and three were cross-sectional surveys. The authors did not conduct a meta-analysis because of the methodological heterogeneity across studies. Although all studies were at substantial risk of bias, the highest-quality ones showed that leadership training programs affected participants’ advancement in academic rank (48% versus 21%, P = .005) and hospital leadership position (30% versus 9%, P = .008) and that participants were more successful in publishing papers (3.5 per year versus 2.1 per year, P < .001) compared with nonparticipants.

Conclusions The authors concluded that leadership programs have modest effects on outcomes important to AMCs. Given AMCs’ substantial investment in these programs, rigorous evaluation of their impact is essential. High-quality studies, including qualitative research, will allow the community to identify which programs are most effective.

Dr. Straus is professor, Department of Medicine, and director, Division of Geriatric Medicine, University of Toronto Faculty of Medicine; and director, Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada.

Ms. Soobiah is research associate, Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada.

Dr. Levinson is Sir John and Lady Eaton Professor and chair of medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.

Supplemental digital content for this article is available at

Correspondence should be addressed to Dr. Levinson, Department of Medicine, University of Toronto, Suite 3-805, R. Fraser Elliot Building, 190 Elizabeth St., Toronto, Ontario, Canada, M5G 2C4; telephone: (416) 946-8071; fax: (416) 946-5420; e-mail:

© 2013 Association of American Medical Colleges