The Leadership Inventory for Medical Education (LIME): A Novel Assessment of Medical Students’ Leadership Skills

Abstract

Purpose: We sought to develop a novel measurement instrument for leadership knowledge, skills and behaviors of medical students as part of the program evaluation for a curriculum redesign.

Method: The Leadership subgroup of our curriculum redesign process generated a definition of leadership consisting of four domains: 1) leading teams, 2) systems based practice, 3) influence and communication, and 4) problem solving. The definition of each domain was used to generate a 12-item instrument (the Leadership Inventory for Medical Education, or LIME) with items rated on a 4-point frequency scale. 315 medical students from two cohorts at a large midwestern university medical school completed the instrument at matriculation and at the end of the M1 and M2 year with an abbreviated version of the Ways of Coping Scale. The 4 domain structure of the LIME was tested using Confirmatory Factor Analysis and correlations of LIME subscores with 8 Ways of Coping were computed as evidence of construct validity.

Results: The LIME showed acceptable unidimensionality with Cronbach’s alpha = .79 and a four-factor structure closely matching the four target domains. Subscores were derived from the observed factor structure: Analysis, Culture, Policy, and Communication. LIME scores increased slightly but non-significantly from matriculation to the end of M1 except for Communication scores which rose significantly (t(141) = 2.13, p < 0.05). LIME scores correlated positively with proactive coping styles (Seeking Social Support and Planful Problem-Solving) and negatively with emotional, passive styles (Distancing).

Conclusions: Given the growing importance of teamwork and the rapidly shifting landscape of healthcare, medical students will need strong leadership skills to be clinically effective in their careers. Despite this need, little work has been done to research the effectiveness of curricular strategies for developing leadership. The LIME may be a useful tool for measuring and tracking students’ leadership skills during their professional development.