The Crucible simulation: Behavioral simulation improves clinical leadership skills and understanding of complex health policy change.

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Title: The Crucible simulation: Behavioral simulation improves clinical leadership skills and understanding of complex health policy change.
Authors: Cohen, D
Vlaev, I
McMahon, L
Harvey, S
Mitchell, A
Borovoi, L
Darzi, A
Item Type: Journal Article
Abstract: BACKGROUND: The Health and Social Care Act 2012 represents the most complex National Health Service reforms in history. High-quality clinical leadership is important for successful implementation of health service reform. However, little is known about the effectiveness of current leadership training. PURPOSE: This study describes the use of a behavioral simulation to improve the knowledge and leadership of a cohort of medical doctors expected to take leadership roles in the National Health Service. METHODOLOGY: A day-long behavioral simulation (The Crucible) was developed and run based on a fictitious but realistic health economy. Participants completed pre- and postsimulation questionnaires generating qualitative and quantitative data. Leadership skills, knowledge, and behavior change processes described by the "theory of planned behavior" were self-assessed pre- and postsimulation. RESULTS: Sixty-nine medical doctors attended. Participants deemed the simulation immersive and relevant. Significant improvements were shown in perceived knowledge, capability, attitudes, subjective norms, intentions, and leadership competency following the program. Nearly one third of participants reported that they had implemented knowledge and skills from the simulation into practice within 4 weeks. CONCLUSIONS: This study systematically demonstrates the effectiveness of behavioral simulation for clinical management training and understanding of health policy reform. Potential future uses and strategies for analysis are discussed. PRACTICE IMPLICATIONS: High-quality care requires understanding of health systems and strong leadership. Policymakers should consider the use of behavioral simulation to improve understanding of health service reform and development of leadership skills in clinicians, who readily adopt skills from simulation into everyday practice.
Issue Date: 1-Jul-2019
Date of Acceptance: 1-May-2017
ISSN: 1550-5030
Publisher: Wolters Kluwer Health, Inc.
Start Page: 246
End Page: 255
Journal / Book Title: Health Care Management Review
Volume: 44
Issue: 3
Copyright Statement: © 2017 Wolters Kluwer Health, Inc. All rights reserved. This is a non-final version of an article published in final form in Health Care Management Review available at:
Sponsor/Funder: National Institute of Health Research
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Policy & Services
Health Care Sciences & Services
behavior change
behavioral simulation
clinical leadership
health policy
Health Policy & Services
1117 Public Health and Health Services
1503 Business and Management
Publication Status: Published
Conference Place: United States
Online Publication Date: 2017-05-11
Appears in Collections:Division of Surgery
Faculty of Medicine

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