The leadership behaviors needed to implement clinical genomics at scale: a qualitative study
The leadership behaviors needed to implement clinical genomics at scale: a qualitative study
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DOI：
10.1038/s41436-020-0818-1
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发表时间：
2020-05-13
影响因子：
8.8
通讯作者：
Taylor, Natalie
中科院分区：
文献类型：
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作者：
Best, Stephanie;Stark, Zornitza;Taylor, Natalie
目的 调查临床基因组学的领导力，并确定不同领导方法对临床基因组学未来实施的可能影响。方法 我们在一项横断面定性研究中进行了 37 次访谈，考察了澳大利亚临床基因组学的实施情况。参与者要么是从事基因组研究的非遗传医学专家（例如免疫学家、肾病学家），要么是服务/组织层面的工作人员（例如部门负责人、首席医疗官）。我们将参与者确定为基因组移民（历史悠久的从业者）和基因组本地人（那些利用基因组技术就地进行独立实践的医学专家）。参考领导方法对数据进行演绎分析。结果 领导方法经常被混合或报告以迭代地支持另一种方法的发展。人们对企业家领导力的缺乏或过多（即冒险）感到担忧。结论 需要创业领导力来促进创新性、冒险精神和主动性，这在临床基因组学的早期阶段至关重要。需要广泛的临床医生共同决策，需要临床领导和分布式领导。共享领导权以及可能失去正式高级职位的地位可能对基因组学“移民”构成挑战，而基因组学“移民”对于培养基因组“本地人”至关重要。临床医生需要来自其组织和专业机构的支持来管理过渡。
Purpose To investigate leadership in clinical genomics and identify likely implications of different leadership approaches for future implementation of clinical genomics. Methods We undertook 37 interviews in a cross-sectional qualitative study examining implementation of clinical genomics in Australia. Participants were either nongenetic medical specialists working with genomic initiatives (e.g., immunologists, nephrologists) or working at a service/organizational level (e.g., department heads, chief medical officers). We identified participants as genomic migrants (long-established practitioners) and genomic natives (those medical specialists coming into independent practice with genomic technology in situ). Data were analyzed deductively with reference to leadership approach. Results Leadership approaches were often blended or reported to iteratively support development of another. There was concern at both the absence or the excess of entrepreneurial leadership (i.e., risk-taking). Conclusion Entrepreneurial leadership is needed to promote innovativeness, risk-taking, and proactivity, essential in these early stages of clinical genomics. Shared decision-making is required from a wide range of clinicians, calling for both clinical and distributed leadership. Sharing leadership, and the potential loss of positional status from formal senior positions, may prove challenging to genomics "migrants," who are essential for nurturing genomic "natives." Clinicians will need support from their organizations and professional bodies to manage the transition.