Towards entrusting medical students: recognising safety behaviours.

National Health Service (NHS). In Liverpool, rather than attempting to convey the importance of leadership and teamwork within the confines of the classroom, an innovative experiential approach to encourage self-awareness and team-working was developed using elements of the well established leadership programmes developed by the armed forces. What was tried? Following months of organisation and planning with 208 Field Hospital (Liverpool), 280 Year 1 medical students were taken for an overnight stay at Altcar Training Camp. Prior to the trip, some students expressed concerns on health and religious grounds and felt that they would not be able to participate. However, with appropriate organisation to allow the provision of prayer spaces and alternatives for the more physical tasks, the vast majority of students attended the course. Students were randomly allocated into groups in order to demonstrate the reality of working in teams. The roles of leader and team member were clearly defined, and students were required to listen to and communicate with each other in order to work effectively. Each student had the opportunity of leading a team. They faced command tasks building simple structures, planning exercises solving multidimensional logistical problems, and physical elements (undertaken by most participants) that emphasised the importance of working as a team and helping weaker members to complete the tasks. All of these tasks were overseen by experienced army staff, who offered constructive feedback and suggestions, and students were encouraged to critique one another’s leadership styles and to identify their own strengths and weaknesses. After the event, all students completed a structured reflective assignment What lessons were learned? Overall, the students’ reports demonstrated that they had learned more than simply how to complete a task. They reported that they could work effectively within a randomly selected team; they realised that individually they possessed a range of skills that could help and motivate other team members; they had learned how to listen and how to observe other people’s talents and limitations, and about how this meant they could complete tasks together as a team, thereby creating a sense of pride and shared achievement; they observed that the fact that someone is quiet in a team does not mean he or she has nothing to contribute, and, finally, they had found that it was acceptable to ask for help or to admit they were struggling. Fundamentally, they had learned that as doctors they will be required to serve as both leaders and team members, and that if they want to provide the best patient care possible, the ability to work effectively with colleagues will be essential. The success of this joint initiative with the army has parallels with the recent experiential leadership development delivered by the NHS Staff College. It has reinforced our belief that leadership potential and team-working should be taught in a practical way and should be developed from the time students enter medical school. Simply teaching leadership principles in the classroom will not necessarily alter attitudes and behaviours.