The Meaning of Leadership in Medical Education in the Pan American Health Organization Member States: A Stakeholder Analysis and Interviews

Abstract Background The well-being and health of people are the primary goals of health systems and services (HSS). Education and training (E&T) in leadership within undergraduate medical education (UME), the health workforce (HWF), and other professions are important for having resilient HSS that promote societal changes and transformations. The member states of the Pan American Health Organization (PAHO/MS) have not explored the conceptualization of leadership based on a robust methodology that provides guidelines for evidence-based leadership development in the Americas. Methods The aim was to conceptualize leadership in UME in PAHO/MS. Stakeholders who worked in a PAHO/MS were interviewed, and three steps were followed to identify them: Kammi Schmeer’s guide for stakeholder analysis, networking by the authors, and snowballing by the stakeholders. Semi-structured interviews were done in Spanish or English and each one was transcribed into English. Authors used inductive content analysis and a member checking process to achieve agreement on the themes and codes. Results Thirty-four stakeholders were interviewed. Health-promoting leadership and expanding the borders of medicine are the central concepts for E&T in leadership as they focus on achieving people’s well-being and health. Leading and leadership antonyms, models of our own: Leadership signature in the Americas, and challenges: health, public health, and HSS are the peripheral domains that aim to differentiate leadership from other concepts and the target audience, which includes UME, other professions, and individuals without a profession. Furthermore, the distinctive mark of leadership in the Americas and the challenges that will be faced through leadership were highlighted. Conclusions We encourage PAHO/MS to consider this research as foundation for leadership E&T to strengthen capacities in UME and related fields. E&T should begin with a conceptualizing leadership exercise that focuses on developing leadership competencies aimed at enhancing the well-being and health of both humans and our ecosystem.