Enhanced model for leadership development for trainees and early career health professionals: insights from a national survey of UK clinical scientists.

INTRODUCTION: The importance of shared or distributed leadership in healthcare is recognised; however, trainees, early career professionals and others for whom the exercise of leadership is a recent development report being underprepared for leadership roles. Trainee clinical scientists exemplify such groups, being both early in their career and in a profession for which clinical leadership is less well established. Their insights can inform understanding of appropriate forms of leadership development for health professionals. METHODS: We explored perceptions of leadership and its development for trainee clinical scientists on the UK preregistration Scientist Training Programme through semi-structured interviews with trainees, training officers, academic educators and lead healthcare scientists; and through an online questionnaire based on the UK multiprofessional Clinical Leadership Competency Framework (CLCF). Responses were analysed statistically or thematically as appropriate. RESULTS: Forty interviews were undertaken and 267 valid questionnaire responses received. Stakeholders recognised clinical expertise as integral to leadership; otherwise their perceptions aligned with CLCF domains and 'shared leadership' philosophy. They consider learning by 'doing' real tasks (leadership activities) key to competency acquisition, with leadership education (eg, observation and theory) complementing these. Workplace affordances, such as quality of departmental leadership, training officer engagement and degree of patient contact affect trainees' ability to undertake leadership activities. CONCLUSIONS: From our research, we have developed an enhanced model for leadership development for trainee and early career clinical scientists that may have wider applicability to other health professions and groups not traditionally associated with clinical leadership. To foster their leadership, we argue that improving workplace affordances is more important than improving leadership education.

Clinical scientists' early career choices and progression: an exploratory mixed methods study.

BACKGROUND: Understanding the influences on healthcare professionals' career choices and progression can inform interventions to improve workforce retention. Retention of health professionals is a high priority worldwide, in order to maintain expertise and meet the needs of national populations. In the UK, investment in clinical scientists' pre-registration education is high and the need to retain motivated scientists recognised. METHODS: We conducted a mixed methods study to investigate the career choices and progression of early career clinical scientists. First job sector and salary of trainees who completed the UK pre-registration Scientist Training Programme (STP) between 2014 and 2019 were analysed using descriptive statistics and Chi-Squared tests. Semi-structured interviews conducted with volunteer practising clinical scientists who completed the programme in 2015 or 2016 were analysed thematically and reviewed for alignment with theories for understanding career choice and workforce retention. RESULTS: Most scientists who completed the STP between 2014 and 2019 obtained a post in the UK National Health Service (NHS) and achieved the expected starting salary. Life scientists were more likely to work in non-NHS healthcare settings than other scientific divisions; and physiological scientists less likely to achieve the expected starting salary. Experiences during training influenced career choice and progression 0-3 years post qualification, as did level of integration of training places with workforce planning. Specialty norms, staff turnover, organisational uncertainty and geographical preferences influenced choices in both the short (0-3 years) and longer term (5 + years). Interviewees reported a strong commitment to public service; and some could foresee that these priorities would influence future decisions about applying for management positions. These factors aligned with the components of job embeddedness theory, particularly that of 'fit'. CONCLUSIONS: Training experiences, personal values, specialty norms and organisational factors all influence UK clinical scientists' early career choices and progression. Job embeddedness theory provides a useful lens through which to explore career choice and progression; and suggests types of intervention that can enhance the careers of this essential group. Interventions need to take account of variations between different scientific specialties.