# A Quality Improvement Approach to Sustainable Student-Led Leadership Development in Undergraduate Medical Education

## TL;DR

This paper describes how quality improvement methods were used to enhance a student-led leadership program in medical school, aiming to improve structure and sustainability.

## Contribution

A novel application of PDSA-guided quality improvement to strengthen a student-led leadership program in undergraduate medical education.

## Key findings

- Students identified weaknesses in program clarity, curriculum structure, and organizational consistency.
- Interventions in structural enhancement, sustainability, and professional development were unanimously approved.
- The study proposes a feasible, adaptable model for leadership development in medical education.

## Abstract

Background

Leadership training is increasingly recognized as an important component of medical education, yet programs remain highly variable in delivery. The Leadership in Medicine (LIM) program at the Florida State University College of Medicine is a four-year, student-led leadership development program. As the only of its kind, LIM offers autonomy and hands-on training but faces challenges in consistency and sustainability.

Objective

The objectives of this study are to (1) evaluate LIM program weaknesses through an internal needs assessment and (2) apply plan-do-study-act (PDSA)-guided quality improvement (QI) interventions to address shortcomings. This study focuses on QI design and implementation; future evaluation through follow-up surveys and competency assessments aligned with the emotional and social competency inventory (ESCI) model will determine the effectiveness of these interventions.

Methods

A mixed-methods internal needs assessment (n = 21, 52.5% response rate) evaluated participant perceptions of key program elements. Quantitative data were analyzed using four-point Likert scales, while qualitative themes guided the QI intervention design.

Results

Participants noted deficiencies in program clarity (2.52/4), curriculum structure (2.55/4), and organizational consistency (2.57/4). Students expressed strong interest in poster presentation opportunities (85.7%) and leadership competency certificates (76.1%). Qualitative themes revealed limited curricular visibility, inconsistent transitions, and unclear expectations.

Intervention

Three QI domains were implemented: (1) structural enhancement through voting, a program roadmap, and meeting documentation; (2) sustainability through standardized transitions and annual budgeting; and (3) professional development through poster presentations, microlearning, and outside lectures. All interventions received unanimous approval from the managing cohort and executive board.

Conclusions

This intervention demonstrates how QI principles can be used to address shortcomings in the structure and autonomy of student-led leadership programs in undergraduate medical education. The implemented interventions are aimed at overcoming program areas for improvement and providing a framework for future evaluation. This reform proposes a feasible, adaptable model with the potential to enhance leadership development through evidence-based interventions.