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Background: Executive leaders at academic medical institutions face challenges that previously involved maintaining scholarship and patient care to advance and deal with crises. However, leading aims are broadly described, and limited reports describe the critical requirements of skills executive leaders use to deal effectively with academic challenges and crises. Purpose: This study aimed to describe the aims and skills of effective leadership among executive leaders in academic medical institutions when contending with challenges and crises. Methods: This study builds on a challenge and crisis management framework for executive leaders in healthcare. In this framework I developed, executive leaders who use skills that support healthcare organizations and individual career development. A descriptive qualitative study was conducted using the critical incident technique, which explores the critical requirements for the most effective outcome. The critical requirements are the most important aspects of achieving the aims of a phenomenon. A questionnaire were sent to presidents’ of all medical schools and participants of a NIH executive leadership program. One questionnaire addressing the aims of effective leadership was collected from medical school leaders and one questionnaire addressing critical incidents of effective behaviors was collected from leadership program participants. Twenty-seven responses were categorized using open coding, making connections among categories with axial coding, and selective coding to perform network analysis for taxonomy development with Atlas.ti qualitative data analysis software. Results: Open coding resulted in aims grouped into two categories: strengthening and suppressing segments of challenges and crises for executive leaders. Further categorization of responses with axial coding revealed that the most effective skill was Leadership Communication. Leadership Communication was required for improving institutional scholarship. Decision Leadership and Leadership Communication were skills required for resolving crises. Selective coding resulted in a radial network visualization that showed Leadership Communication and Decision Leadership as endpoints. These endpoints were in the path to how effective leadership occurs by executive leaders in academic medical institutions to deal with academic challenges and crises. Conclusion: The challenge and crisis management framework now expands to include strengthening academic medical institutions with improving scholarship utilizing leadership communication, stimulating innovation, and leading teams for improved patient care. The model now also includes developing a resilient academic medical institution by lowering costs, balancing budgets, and resolving crises utilizing leadership communication and decision leadership as strategies for effective leadership. These newly identified skills may support faculty developers, new leaders, and institutional assessment teams in creating and assessing strategies for new areas of learning for executive leaders in academic medical institutions.



Executive Leadership, Strategy, Academic Medicine