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ORIGINAL ARTICLE
Year : 2022  |  Volume : 15  |  Issue : 5  |  Page : 701-706  

A study to evaluate the leadership skills, personality types, leadership styles, and mental health status of first-Phase MBBS students of a peripheral medical college in West Bengal


1 Department of Physiology, Burdwan Medical College, Burdwan, West Bengal, India
2 Department of Psychiatry, D. Y. Patil Medical College, Pimpri-Chinchwad, Maharashtra, India
3 Department of Surgery, Rampurhat Government Medical College, Rampurhat, West Bengal, India

Date of Submission25-Apr-2022
Date of Decision05-Jun-2022
Date of Acceptance08-Jun-2022
Date of Web Publication19-Jul-2022

Correspondence Address:
Dr. Arunima Chaudhuri
Krishnasayar South, Borehat, Burdwan 713 102, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_341_22

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  Abstract 


Background: Medical education is one of the most stressful academic curricula across the globe and it is important for all students to have leadership and management skills because all physicians need to take responsibility as team leaders. Aims: To evaluate the leadership skills, personality types, leadership styles, and mental health status and study the correlation between mental health and leadership skills of first-phase MBBS students in a peripheral Medical College in West Bengal. Methodology and Participants: This study was conducted among first-phase MBBS students after taking institutional ethical clearance and informed consent of the participants. The participants were provided with two recorded YouTube videos which included mental health, leadership, and professionalism. Live interactive sessions were conducted. The participants had to fill up six questionnaires for assessment of leadership skills, personality types, leadership styles, perceived stress scores (PSSs) levels, mental health literacy levels, and DASS-21 scores. Feedback was taken from students. Results: One hundred and thirty-seven students could complete all tasks and so they were only included for analysis of data. One hundred and six students had PSS levels below 20 and thirty-one students had PSS levels of 20 or above. Mean ± SD of the different parameters assessed were as follows: PSS levels: 16.92 ± 4.16; Mental health literacy scores: 99.54 ± 15.31; Authoritative score: 7.85 ±1.45; Democratic score: 9.35 ± 1.7; Facilitative score: 9.52 ± 1.59; Situational score: 9.29 ± 2.54; Leadership skills test scores: 63.85 ± 14.59. DASS 21 scores: Depression: 11.45 ± 4.03; Anxiety: 12.3 ± 4.35; Stress: 15.1 ± 3.29. PSS was negatively correlated with leadership skill test scores and mental health literacy scores. Leadership skill test scores were positively correlated with mental health literacy scores. There was no significant difference between male and female students in respect of PSS levels, mental health literacy scores, leadership skill scores, authoritative scores, democratic scores, facilitative scores, and situational scores. Conclusions: Increased mental health literacy and decreased perceived stress levels were two causes of improved leadership skill test scores in the present study. Students were satisfied with the leadership skills taught to them and this study increased awareness about mental health and leadership among first-phase MBBS students.

Keywords: Leadership, medical education, mental health


How to cite this article:
Chaudhuri A, Saldanha DB, Sarkar SK, Bhattacharya D. A study to evaluate the leadership skills, personality types, leadership styles, and mental health status of first-Phase MBBS students of a peripheral medical college in West Bengal. Med J DY Patil Vidyapeeth 2022;15:701-6

How to cite this URL:
Chaudhuri A, Saldanha DB, Sarkar SK, Bhattacharya D. A study to evaluate the leadership skills, personality types, leadership styles, and mental health status of first-Phase MBBS students of a peripheral medical college in West Bengal. Med J DY Patil Vidyapeeth [serial online] 2022 [cited 2022 Dec 10];15:701-6. Available from: https://www.mjdrdypv.org/text.asp?2022/15/5/701/351332




  Introduction Top


Medical students, do not feel that they have reached a level of leadership skill needed to be effective leaders after completion of the undergraduate medical course. It is important for all students to have leadership and management skills because all physicians will have to lead at some point in their careers.[1],[2],[3],[4],[5],[6] Medical education is one of the most stressful academic curricula across the globe. Academic pressure, lack of time for leisure or hobbies, chronic physical and psychological fatigue, and peer pressure, are some of the causes that make life more stressful for medical students.[7],[8]

Recent events have not only thrust physician leadership to the forefront, but the broader field of medical education and academia have as well. Increased efforts are needed to be implemented in medical education to tackle this deficiency through different leadership building and skills training at the undergraduate medical level which should focus on areas of essential medical leadership and management skills for undergraduate medical education, including quality improvement, managed care, use of resources, and healthcare cost, “the role of the doctor”, patient safety, and general leadership and management. The difficulty in undergraduate medical education is the compromise between adding more content to an already content-dense education.[1],[2],[3],[4],[5],[6],[9]

One potential solution may be to utilize a module-based system in which the learning is more self-paced throughout undergraduate medical education. There is an emerging need for expanded areas of leadership development because leadership needs are also changing. The hidden curriculum provided by near-peer learning can provide a powerful supplementary teaching mechanism for leadership development. The assessment plan should focus on leadership competencies pre-identified and defined in the institutional framework.[2],[3],[4],[5]

There appears to be a gap in training as it relates to required management and leadership skills. Serving on medical school committees, student interest group involvement, involvement in organized medicine, and working on, and completing, projects were some of the examples listed previously as beneficial for leadership growth. Gaps still persist in the residency program in leadership qualities like “leading a team”, “confronting problem employees”, and “resolving interpersonal conflict”. The most frequent ways they are hoped to gain those skills are through interactive methods like case discussion, small group discussion, simulation, and lectures.[1],[2],[3],[4],[5],[6],[9]

The medical students will be future healthcare providers and many times team leaders of healthcare management. It is important to find out what kind of coping strategies medical students employ to deal with the huge amount of pressure, expectation, and responsibility that they go through and the consequent levels of generalized anxiety, free-floating worry, depressive illness, and suicidal thoughts or intent.[10],[11],[12],[13],[14],[15],[16]

Keeping this problem in mind the present study was conducted to assess the leadership skills, Personality types, Leadership styles, and mental health status of First Phase MBBS students of a Peripheral Medical college in West Bengal. This may help to increase awareness among students about the importance of leadership in medical professionals as well as mental health status and help them to modify their strengths and weakness in course of time.


  Methodology and Participants Top


This study was conducted in a time span of two months in a teaching institution among first-phase MBBS students (Batch 2021-2022) after taking institutional ethical clearance and informed consent of the participants. Administrative approval was taken before conducting the study.

Inclusion Criteria: First-phase MBBS students of the institution.

Sampling procedure and sample size calculation:

The participants were randomly selected from the first-phase MBBS students of the institution. Random numbers were generated using an online randomizer. There are 200 students in the first-phase batch.

The sample size was calculated at https://www.calculator.net/sample-size-calculator.html

Confidence level: 95%;

Margin of error: 5%;

Calculated sample size: 132.

Considering dropouts 150 students were included in the study.

Lesson plans were prepared by faculty members of the Physiology Department and validated. Two workshops were conducted to sensitize faculty members. A feedback questionnaire was prepared by the senior faculty member of the Physiology Department and pre-validated.

The participants were provided with two recorded YouTube videos prepared by the faculty members of the Institution (https://youtu.be/QD6BNiibWbo; https://youtu.be/l10OMFCNoSQ).

One video included mental health and other leadership and professionalism. A live interactive session was conducted to clear the doubts of the students after watching the recorded sessions.

The participants had to fill up six questionnaires:

  1. Participants had to click this link to assess their knowledge about various leadership styles and assess their own skills. https://testyourself.psychtests.com/testid/2152.


  2. The following assessment helped to evaluate whether participants possess the personality traits and skills that characterize good leaders. There exists a certain natural tendency combined with learned skills to become a good leader. While some individuals are certainly not cut out to head up a group, others just need a boost from some leadership training courses. After finishing the test, participants received Snapshot Reports with an introduction, a graph, and a personalized interpretation of their test scores.

  3. To discover their personality type participants had to click this link https://www.humanmetrics.com/personality.This free personality test is based on Carl Jung's and Isabel Briggs Myers' typological approach to personality: Discover your personality. According to Jung's theory of psychological type, persons can be characterized using the following criteria:


    1. Extroversion, Introversion.
    2. Intuition, Sensing.
    3. Feeling, Thinking.
    4. Perceiving, Judging.


    The 16 personality types described are ESTJ, ISTJ, ENTJ, INTJ, ESTP, ISTP, ENTP, INTP, ESFJ, ISFJ, ENFJ, INFJ, ESFP, ISFP, ENFP, and INFP.

    It is important to understand one's own personality and this is one of the key factors to successful leadership. A leader is most effective when his or her strongest personal traits are being engaged. Some personal qualities are crucial for successful leadership and if they are not developed enough, they can be improved.

  4. Participants were provided with a leadership style questionnaire available online at https://www.Centenary.edu. This helped them to assess their authoritative, democratic, facilitative, situational styles and will further help them to focus on their strengths and weakness in the future.
  5. Perceived stress scale of Shelden Cohen[17]
  6. Mental health literacy scale[18]
  7. DASS 21 scale.[19]


A session was conducted where the students had to solve problem-based questions. Narratives were provided to students along with questions. Simulations prepared by faculty in form of recorded videos were provided to enhance interest of learners and questions were asked after students watched the simulations. This was a group activity and fifteen participants were included in each group. Group members were chosen based on Carl Jung's and Isabel Briggs Myers' typological approach to personality to improve group dynamics. The facilitators helped the students to solve their problems and encouraged students to develop self-directed learning skills. A checklist was provided to facilitators for assessing the students during this group activity. Feedback was provided to the participants regarding their leadership qualities and mental health status. Feedback was also taken from the students using a Google form.

Statistical analysis

Data was analyzed using JAMOVI software. Data was checked for normality. T-Test was used to compare the two groups and the correlation coefficient was calculated to evaluate the correlation between mental health literacy, perceived stress scores (PSSs), and leadership skill test scores.


  Results Top


One hundred and thirty-seven students could complete all tasks and so they were only included for analysis of data. Ninety-eight male students and thirty-nine female students participated in the study. One hundred and six students had PSS levels below 20 and thirty-one students had PSS levels of 20 or above. Mean ± SD of the different parameters assessed were as follows: PSS levels: 16.92 ± 4.16; Mental health literacy scores: 99.54 ± 15.31; Authoritative score: 7.85 ±; Democratic score: 9.35 ± 1.7; Facilitative score: 9.52 ± 1.59; Situational score: 9.29 ± 2.54; Leadership skills test scores: 63.85 ± 14.59. PSS were negatively correlated with leadership skill test scores and mental health literacy scores (r value -0.047 and -0.012; P value: 0.58; 0.88, respectively) [Figure 1] and [Figure 2]. Leadership skill test scores were positively correlated with mental health literacy scores with an r-value of 0.064; a P value of 0.45 [Figure 3]. There was no significant difference between male and female students in respect of PSS levels, mental health literacy scores, leadership skill scores, authoritative scores, democratic scores, facilitative scores, and situational scores (p-value: 0.87; 0.31; 0.94; 0.25; 0.42; 0.25; 0.94) [Table 1]. The personality types of students are shown in [Table 2] and [Figure 4]. DASS 21 Scores: Depression: 11.45 ± 4.03; Anxiety: 12.3 ± 4.35; Stress: 15.1 ± 3.29.
Table 1: Comparison of parameters of male and female students

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Table 2: The personality types of students

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Figure 1: Correlation of PSS and leadership skill test scores

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Figure 2: Correlation of mental health literacy scores and PSS

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Figure 3: Correlation of leadership skill test scores and of mental health literacy scores

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Figure 4: The personality types of students

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According to feedback provided by the students, they were satisfied with the teaching–learning module and they enjoyed their learning experience. This learning experience increased their motivation in learning. They felt that this module introduced in their initial phase will help them to become competent transformation leaders as they will get time to modify themselves.

The following are qualities a good leader should have as per opinion of more than 80% students:

  • A leader should allow each and every member of the team to express his/her own opinion and then take a decision regarding any problem and should be gentle, polite, and soft-spoken to other team members.
  • A leader is someone who can see how things can be improved and who motivates others to move toward that vision. Leaders can work toward transforming their vision to a reality while putting people first.
  • A leader is someone who knows how to motivate others, encourage them to believe in themselves and give their best. Motivational leaders provide opportunities to others and lead them. They should be focused and have a clear vision.
  • A good leader should be flexible, good in communication, intelligent, a good learner and innovative person.
  • A leader must take decisions to analyze the situation and also receive the opinions from others.
  • As a leader one must constantly be influencing other team members in a positive way. The first and fore most quality should be clarity of mind and have to stay disciplined so that other people can follow this.
  • A leader should approachable to his/her team mates and have good communication skills.
  • A leader should never be biased. A leader should stay calm and take decision after thinking about situation and should never humiliate weaker team members but rather encourage and help them to overcome weakness.



  Discussion Top


In the present study conducted among 137 first-phase MBBS students, increased mental health literacy and decreased perceived stress levels were two causes of improved Leadership skill test scores. Students were satisfied with the leadership skills taught to them and this teaching–learning module increased their awareness about mental health and leadership skills. The students were able to know of their personality types, their weakness and strengths and this may help them to become transformational leaders in future. Males and females had comparable PSSs, mental health literacy scores, and leadership skills.

The students of today will become Indian Medical graduated in near future and doctors of primary contact. They have to play roles as competent Clinicians, Communicators, Professionals, Lifelong learners, and Leaders. The importance of leadership qualities in managing patients has long been realized but teaching leadership was a part of the hidden curriculum. In the new competency-based curriculum AETCOM module has been introduced in 2019. The medical curriculum is vast and there still remains a challenge to include leadership training in the curriculum as time management poses a huge problem. One potential solution may be to utilize a module-based system in which the learning is more self-paced throughout undergraduate medical education. In the present study, we could motivate first-phase MBBS students to learn leadership skills.

Medical students suffer from mental health issues as they many a time fail to efficiently manage personal and professional problems. Depression is one of the commonest mental health issues among medical students worldwide due to the high intensity of training. Systematic reviews and meta-analyses have indicated that the prevalence of depression among medical students worldwide is around 28%, and suicidal ideation was 11.1%.[7],[8],[10] In the present study, DASS 21 scores were as follows: Depression: 11.45 ± 4.03; Anxiety: 12.3 ± 4.35; Stress: 15.1 ± 3.29.

A cross-sectional study was conducted on medical students in Vietnam[8] from November 2015 to January 2016 by Pham T et al.[11] Among 494 participants, the prevalence of self-reported depression was 15.2%. To estimate the prevalence of depression, depressive symptoms, and suicidal ideation a systematic review was conducted by Rotenstein LS et al. in 2016.[10] Depression prevalence data were extracted from 167 cross-sectional studies and 16 longitudinal studies across 43 countries. The overall pooled crude prevalence of depression was 27.2% and that of suicidal ideation was 11.1%.

Many studies have found significantly high-stress levels among medical students and this high stress has been reported across multiple countries, spanning several continents. This indicates to a certain extent that high stress among medical students is a phenomenon that transcends socio-cultural factors, economic status, course patterns, and the like. Indian studies have also demonstrated significant morbidity with stress in medical students. Self-rated depression is also found to be significantly higher in Indian medical students.[12],[13],[14],[15] The aim of a study by Garg K et al.[16] was to assess stress among medical students and the relationship of stress to the year of study and gender. Worry about future endurance and capacity were rated the highest by the final year students while faculty shortcomings and insufficient feedback were rated highest by the second-year students and financial concerns the highest by the first-year students. In the present study also, students reported high-stress levels and this was associated with mental health literacy. Leadership skill scores also decreased with increased stress scores and decreased mental health literacy scores.

The early sensitization program to mental health issues and the introduction of stress management programs in the present study may increase the mental strength of students and help them to become more mentally stable in hours of crisis which is an essential criterion of a good leader. We included both PSS and DASS-21 to increase the validity and reliability of the present study as these are both self-rated questionnaires.

The leadership qualities learned by the students may motivate them to become transformational leaders in the near future and help in better management (as team leaders) of patients in long run.

Strengths and limitations and future scope

In the present study, we could sensitize young medical students about mental health issues and leadership skills. They could realize their strengths and weakness and become aware of the qualities a good leader needs to possess. This was a cross-sectional study and longitudinal follow-up is essential to help the students strengthen their leadership skills. We are continuously providing the students with feedback regarding their mental health status and motivating them to develop self-directed learning skills. In the second phase, we are planning to implement a new module on leadership to help the students to become transformational leaders.


  Conclusions Top


Increased mental health literacy and decreased perceived stress levels were two causes of improved leadership skill test scores in the present study. Students were satisfied with the leadership skills taught to them and this study increased awareness about mental health and leadership among first-phase MBBS students.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2]



 

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