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Logo of bmjThis ArticleThe BMJ
BMJ. 2005 July 16; 331(7509): 161–162.
PMCID: PMC558741

Clinical leadership in hospital care

Leadership and teamwork skills are as important as clinical management skills
Marino S Festa, consultant in paediatric intensive care

Editor—Olsen and Neale conclude that improving leadership and teamwork skills among today's doctors is both important and necessary.1 However, opportunities in everyday hospital medicine to acquire, practise, and receive feedback on these skills remain scarce.

Unlike other industries—such as aviation, which allow experienced team members to observe teams in their work environment, thereby enabling structured feedback on leadership and team behaviours—medicine has not yet placed adequate importance and resources into training clinical teams in similarly important non-technical skills.

The focus of undergraduate teaching and postgraduate advanced life support courses remains the acquisition of technical skills and delivery of health care in the context of one doctor, one patient.

Competent practitioners must learn to interact in and eventually lead teams of healthcare workers, yet little or no formal teaching is aimed at developing individual doctors' leadership skills or to helping them to understand the impact of their behaviour and actions on the team.

Simulation training is one way of developing, practising, and gaining insight into non-technical skills. Careful consideration of course aims and attention to maximising equipment, environmental, and psychological fidelity can build the right environment for teams of doctors, nurses, and other healthcare workers to acquire leadership and teamwork skills.2

Opportunities for feedback and acquisition of leadership and teamwork skills, be it in a real or simulated clinical environment, should become an established part of postgraduate training. The current focus on acquiring technical skills alone is too narrow and should be seen as a failure of medical training.


Competing interests: None declared.


1. Olsen S, Neale G. Clinical leadership in the provision of hospital care. BMJ 2005;330: 1219-220. (28 May.) [PMC free article] [PubMed]
2. Gosling N, Moore M, Williams C, Festa M. Can simulation recreate a realistic and appropriately stressful environment to observe team behaviours in the setting of paediatric critical illness? Arch Dis Child 2005;90(SII): A82.

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