Community health nurses leadership in advancing health equity.

OBJECTIVE: To describe the solutions community health nurses (CHNs) identify to address health inequities during the COVID-19 pandemic and to explore what leadership competencies enable CHNs to enact these solutions. DESIGN: Online survey, distributed to all members of the Community Health Nurses of Canada and associated provincial and territorial networks. PARTICIPANTS: Inclusion criteria included all nurses who were working during the COVID-19 pandemic in Canada. A total of 245 responses were included in the analysis. MEASUREMENT: The survey included 25 open ended and fixed response questions. Descriptive statistics were used to describe the quantitative data. Framework Analysis was used to analyze the qualitative data. RESULTS: Solutions focused on advancing health equity and expanding community relationships and partnerships were identified as priorities. To enact these solutions system transformation, engaging others, and developing coalitions were identified as the main leadership competencies required by CHNs. CONCLUSION: Participants in this study clearly articulated structural and process solutions to address health inequities among priority populations during the pandemic. CHNs described with practice knowledge and confidence that solutions enacted in system transformation with community partners are necessary to advance health equity.

Surgical Leadership Competencies for Navigating Hospital Network Expansion.

INTRODUCTION: Today, many hospitals are part of a multihospital network, which changes the context in which surgeons are asked to lead. This study explores key leadership competencies that surgical leaders use to navigate this hospital network expansion. METHODS: In this qualitative study, 30 surgical leaders were interviewed. Interviews were coded and analyzed via thematic analysis. RESULTS: We identified three key competencies that leaders felt were important leadership skills to successfully navigate expanding hospital networks. First, leaders must steer the departmental vision within the evolving hospital network landscape. Second, leaders must align the visions of the department and of the hospital network. Third, leaders must build a network-oriented culture within their department. CONCLUSIONS: As networks expand, leaders are tasked with unifying vision in their department. Leaders identified a unique opportunity to leverage their growing influence across the hospital network and invested in the people and culture of their department.

Identifying and developing effective post-2020 conservation bridging leaders.

Effective bridging leaders interact within and outside their group to facilitate collaboration required in multistakeholder contexts. This is particularly crucial to community-based conservation interventions that strive to achieve both ecological and social objectives by actively engaging or devolving decision-making and management authority to local communities. Although a viable approach in many contexts, achieving "unprecedented collaboration" called for by the Post-2020 Global Biodiversity Framework in community-based conservation is problematic given the multiple and diverse actors affecting and affected by these interventions. Therefore, effective leadership becomes crucial to implementing necessary strategies to engage actors and resolve conflict inclusively. Yet, weak leadership commonly constrains these interventions. I reviewed relevant literature and devised a framework of effective bridging leadership characteristics. I then used this framework to appraise bridging leadership in two African coastal-marine community-based conservation cases. I employed social network analysis and semistructured and group interviews in the two cases. Several local leaders emerged as key (potential) bridging leaders. Furthermore, I found that effective bridging leaders require not only legal recognition but also perceived legitimacy resulting from building trust with other actors. Additionally, the inclusive collaboration required multiple sources of emotionally intelligent bridging leaders with the integrity, humility, empathy, and cultural awareness necessary to mitigate elite capture, effectively communicate, and empower and provide support to others. Because emotional intelligence in conservation leadership remains a knowledge gap, particularly in community-based conservation research, insights from this study should be useful to diverse conservation actors.

Los líderes vinculantes efectivos interactúan dentro y fuera de su grupo para facilitar la colaboración requerida en contextos con múltiples actores. Esto es crucial para las intervenciones de conservación basada en la comunidad que buscan alcanzar objetivos ecológicos y sociales mediante la participación y transferencia de la autoridad gestora y la toma de decisiones a la comunidad local. Aunque es una estrategia viable, es problemático lograr la "colaboración sin precedentes" en la conservación basada en la comunidad que exige el Marco Mundial de Biodiversidad Post-2020 debido a los múltiples y diversos actores que afectan y han sido afectados por estas intervenciones. Por lo tanto, el liderazgo efectivo se vuelve crucial para la implementación de las estrategias necesarias para involucrar a los actores y resolver los conflictos de manera inclusiva. Sin embargo, es común que el liderazgo deficiente limite estas intervenciones. Revisé la literatura relevante y diseñé un marco de trabajo de las características del liderazgo vinculante efectivo. Después usé este marco para valorar el liderazgo vinculante en dos casos de conservación costera-marina basada en la comunidad en África. Analicé las redes sociales y realicé entrevistas grupales y semiestructuradas en ambos casos. Además, descubrí que los líderes vinculantes efectivos requieren no sólo de un reconocimiento legal, sino también de la legitimidad resultante de la construcción de la confianza con otros actores. Asimismo, la colaboración inclusiva requirió de líderes vinculantes de múltiples orígenes con inteligencia emocional y con la integridad, humildad, empatía y conciencia cultural para mitigar la captura elite, comunicar efectivamente y empoderar y proporcionarles apoyo a los demás. Ya que la inteligencia emocional todavía es un vacío de conocimiento en el liderazgo de la conservación, particularmente en la investigación sobre la conservación basada en la comunidad, el conocimiento que brinda este estudio debería ser útil para diversificar a los actores de la conservación.

The role of life skills in developing an authentic leadership attitude in public health students: a multicenter cross-sectional study in Poland.

BACKGROUND: Decision-making skills are considered crucial life skills that condition proper social functioning within groups (i.e., support authentic leadership skills and increasing one's chances of success and wellbeing in life). Nonetheless, the number of scientific papers addressing the role of life skills in developing authentic leadership skills in public health students is limited. The aim of the present study was to develop a theoretical model to determine the role of selected life skills in developing authentic leadership skills in public health students. METHODS: The study was conducted from January 16 through February 28, 2018. In total, 653 students undertaking in-service training in Master's degree programs qualified for the study, and complete data sets were obtained from 329 students (response rate 50.38%). The data were collected by means of a paper questionnaire. Four research tools were used in the study: The Authentic Leadership Self-Assessment Questionnaire, The Moral Foundations Questionnaire, The General Self-Efficacy Scale, and The Youth Leadership Life Skills Development Scale. RESULTS: Two subgroups were identified among the public health students in the study: 1) the extra life skills training group (N = 113) and 2) the no extra life skills training group (N = 216). Both groups of study participants did not differ significantly in terms of age (M (SD): 25.0 (3.89) vs. 25.0 (3.66); t = 0.068, P = 0.946). On the other hand, clear differences were observed in the case of the respondents' participation in voluntary service. The respondents from the extra life skills training group declared participation in voluntary activities less frequently than the respondents from the second identified group (48.7 vs. 31.9%). CONCLUSIONS: A verified theoretical model showed that course aimed at strengthening authentic leadership competences should be modular, should focus on self-improvement and critical reflection, and should be spread over time to enable and encourage each participant to grow and flourish at their own pace.

A mixed-methods systematic review of interventions to improve leadership competencies of managers supervising nurses.

AIM: This study aimed to synthesize evidence on interventions to improve leadership competencies of managers supervising nurses. BACKGROUND: In recent years, numerous interventions have been developed to improve the leadership competencies of managers supervising nurses. However, researchers and nursing leaders are unclear about what aspects of interventions are effective for developing which competencies. METHODS: We conducted a mixed-methods systematic review following the Joanna Briggs Institute (JBI) approach for evidence synthesis. The Medline (Ovid), CINAHL, Embase, Scopus, Nursing and Allied Health Database were reviewed. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: A total of 69 studies (35 quantitative, 22 mixed methods, 12 qualitative) evaluating 68 interventions were included. Studies showed that interventions used modal activities such as lectures, group work and mentoring that generally had positive effects on improving leadership competencies such as supporting, developing and recognizing nurses. Opportunities to interact with peers increased managers' engagement in the interventions; however, many barriers existed for managers to use the competencies in practice including understaffing, insufficient time and lack of support from supervisors and staff. CONCLUSIONS: Leadership interventions were shown to have beneficial effects on developing different competencies. Managers predominately felt positive about participating in leadership interventions; however, they expressed many difficulties applying what they learned in practice. IMPLICATIONS FOR NURSING MANAGEMENT: Leadership interventions should include multimodal activities that give managers opportunities for interaction. When considering interventions for developing the leadership of managers, it is imperative to consider the practice environments for managers to be successful in applying the competencies they learned in practice.

A Qualitative Analysis of Maternal and Child Health Public Health Leadership Institute (MCH PHLI) Leaders: Assessing the Application of Leadership Skills at the "Others" and "Wider Community" Levels of the MCH Leadership Competencies 4.0.

OBJECTIVES: To gain insight into how participants in the Maternal and Child Health Public Health Leadership Institute (MCH PHLI) report applying the leadership skills gained through the program at the "Others" and "Wider Community" levels of the MCH Leadership Competencies 4.0. METHODS: 111 mid- to senior-level MCH leaders participating in the MCH PHLI gave < 5 min oral presentations detailing the impacts resulting from implementation of the skills gained through the leadership development training. Presentations were recorded and transcribed then qualitatively analyzed in reference to the MCH Leadership Competencies 4.0. Impacts were stratified by the "Others" and "Wider Community" levels. RESULTS: Analysis resulted in 1510 separate coded examples, 948 of which were coded as aligning with the MCH Leadership Competency 4.0 areas of "Others", "Wider Community" and with an additional emerging competency. In many examples Participants estimated the numbers of people affected by these leadership activities, which totaled more than 80,773 people across the US. CONCLUSIONS FOR PRACTICE: This analysis suggests that mid-to-senior level intensive leadership development strategies benefit organizations, communities, and systems quite broadly through a virtual "ripple effect" of training. Capturing qualitative data can help elucidate the return on investment for leader development programs in terms of impacts on communities and systems.

A Qualitative Analysis of Individual Leadership Behaviors Among Participants in the Maternal and Child Health Public Health Leadership Institute.

OBJECTIVES: To gain insights into how participants in the Maternal and Child Health Public Health Leadership Institute (MCH PHLI) report applying the personal leadership skills gained through the program at the "Self" level of the MCH Leadership Competencies 4.0. METHODS: 112 mid- to senior-level MCH leaders completed the MCH PHLI, which is a year-long intensive leadership training program. At graduation, 111 participants gave < 5-min oral presentations detailing the actions taken and impact created by implementation of the skills gained through the MCH PHLI training. Presentations were recorded, transcribed and then qualitatively analyzed in reference to the "Self" level of the MCH Leadership Competencies 4.0. RESULTS: Participants reported 562 coded examples of activities in which they implemented skills aligning with each competency in the Self-Level of the MCH Leadership Competencies 4.0 and with three other competency areas that emerged as themes from the data: networking, confidence, and career advancement. CONCLUSIONS FOR PRACTICE: This analysis suggests that intensive leadership development strategies focused on the mid-to-senior level leader benefit the individual and their organizations in broad and strategic ways that can be captured and described. Further, these applications of skills can create a virtual "ripple effect" of the workforce development program, by ultimately impacting a far greater number of people. Finally, this type of reflective assignment can be a valuable addition to intensive workforce development programs.

Building Maryland's health care leadership capacity: The Nurse Leadership Institute at the University of Maryland School of Nursing.

Nurse leadership was identified as essential to the advancement of health care in the State of Maryland. The State's Health Services Cost Review Commission's (HSCRC) committed to building the next generation of nurse leaders as part of its vision for advancing healthcare in Maryland. In 2015, HSCRC approved a $2.5 million, multiyear grant that supported development of the Nurse Leadership Institute (NLI) at the University of Maryland School of Nursing. The NLI designed a leadership development program that prepared nurse faculty and clinicians with critical competencies needed for assuming leadership positions unique to complex adaptive systems, facilitating collaborative partnerships between academia and practice, and ultimately improving health outcomes for Maryland's residents. This article is the first in a series reporting on outcomes of this initiative, which describes the design and implementation of the Nurse Leadership Institute, its Leadership Development Program, and preliminary findings for the first 4 years.

Medical leadership competencies: A comparative study of physicians in public and private sector hospitals in India.

PURPOSE: Indian health care system comprising of public and private sectors needs enhancement of medical leadership capacity to face the growing challenges. Hence, this study was designed to evaluate medical leadership competencies of public and private sector doctors. FINDINGS: A survey questionnaire was developed to assess "self-assessed proficiency levels" as well as "perceived importance of competency levels," to which 532 doctors responded-290 (54.5%) from private sector and 242 (45.5%) from public sector hospitals. Statistically significant "leadership competency gap" was observed for all 30 leadership competencies in both sectors, more so in public sector. The 10 most deficient competencies were mainly in the NHS-MLCF domains of "working with others," "managing services," and "setting direction." The most low-rated competency among public sector doctors was "knowledge of HR, procurement, financial, and contract management" while "ability to influence key decision makers who determine future government policies" was most deficient among private sector physicians. Further, deficiencies related to "time and stress management" and "conducting need analysis, identifying and prioritizing requirements" were confined to public and private sector doctors, respectively. CONCLUSIONS: This study, first from India, highlights a critical need for medical leadership development programs in both sectors for enhancement of medical leadership capacity in the country.

Advancing Leadership Skills: A Multiyear Examination of LEND Trainee Self-Efficacy Growth.

Purpose The current healthcare system requires Maternal and Child Health (MCH) professionals with strong interdisciplinary leadership competence. MCH training programs utilize a conceptual framework for leadership and 12 validated MCH Leadership Competencies. Examining Trainee Perceived Leadership Competence (TPLC) through the competencies has the potential to inform our understanding of leadership development. Description Five cohorts of NH-ME leadership education in neurodevelopmental disabilities trainees (n = 102) completed the MCH Leadership Competencies Self-Assessment at three time points. Paired-sample t tests examined TPLC scores. A one-way analysis of variance tested for statistically significant differences in mean difference scores. A General Linear Model was used to examine the extent to which TPLC scores changed when controlling for specific variables. Assessment Statistically significant differences in mean scores between Time 1 and Time 3 were found. Cohen's d effect sizes fell in the moderate range. A one-way ANOVA demonstrated significant differences between groups in the spheres of self and others. TPLC mean scores between Time 1 and Time 3 in the sphere of wider community had the highest increases in four out of five cohorts. Age, discipline, experience, and relationship to disability did not contribute to the model. Conclusion On average, cohorts began the year with very different evaluations of their leadership competence but finished the year with similar scores. This suggests participation in the NH-ME LEND Program consistently supported the development of leadership self-identity. Small sample sizes limit the ability to draw definitive conclusions from these results. Further study with a larger sample may reveal relationships between cohort characteristics and change scores.

Integrating Family as a Discipline by Providing Parent Led Curricula: Impact on LEND Trainees' Leadership Competency.

Background While the MCH Leadership Competencies and family as a discipline have been required elements of Leadership Education in Neurodevelopmental and related Disabilities (LEND) programs for over a decade, little research has been published on the efficacy of either programmatic component in the development of the next generation of leaders who can advocate and care for Maternal and Child Health (MCH) populations. Objective To test the effectiveness of integrating the family discipline through implementation of parent led curricula on trainees' content knowledge, skills, and leadership development in family-centered care, according to the MCH Leadership Competencies. Methods One hundred and two long-term (≥ 300 h) LEND trainees completed a clinical and leadership training program which featured intensive parent led curricula supported by a full-time family faculty member. Trainees rated themselves on the five Basic and Advanced skill items that comprise MCH Leadership Competency 8: Family-centered Care at the beginning and conclusion of their LEND traineeship. Results When compared to their initial scores, trainees rated themselves significantly higher across all family-centered leadership competency items at the completion of their LEND traineeship. Conclusions The intentional engagement of a full-time family faculty member and parent led curricula that include didactic and experiential components are associated with greater identification and adoption by trainees of family-centered attitudes, skills, and practices. However, the use of the MCH Leadership Competencies as a quantifiable measure of program evaluation, particularly leadership development, is limited.

Landing the job: A guide to successful transition.

Personal development plans (PDPs) guide individuals in personal and professional career enhancement ( Bullock and Jamieson 1998 ). While formats vary, the key component is self-analysis of strengths and weaknesses. This article describes a nurse administrator's successful use of a PDP to progress her career from a mid-level manager position at a small, rural hospital to a senior executive level position at the USA's second largest Veterans Health Administration (VHA) facility. The PDP used VHA's eight core leadership competencies: personal mastery, systems thinking, organisational stewardship, creative thinking, technical skills, interpersonal effectiveness, flexibility, and customer service. These core competencies mirror the VHA's 360° self-assessment tool supported by the National Center for Organization Development ( US Department of Veterans Affairs 2014 ).

The influence of political disagreements and corruption on state health leader turnover during the COVID-19 pandemic in Brazil.

PURPOSE: Governments faced formidable challenges in coordinating public health responses to the COVID-19 pandemic. This study aims to enhance the understanding of effective organizational leadership during crises by investigating the factors influencing the turnover of health leaders during the COVID-19 pandemic in Brazil. DESIGN/METHODOLOGY/APPROACH: Using primary data encompassing all appointments and dismissals of federal and state health secretaries, this paper conducted a quantitative analysis of the relational and reputational factors that contributed to leader turnover during the COVID-19 pandemic. This paper also examined whether leaders' management and public health experience increase the duration of tenure. FINDINGS: States encountered significant challenges in retaining experienced and effective leadership during the health emergency, primarily due to political conflicts in policymaking and, to a lesser extent, allegations of corruption. Furthermore, leaders with expertise in public health were found to be less likely to be removed from office. However, managerial experience did not prolong the tenure of state health secretaries during the emergency. RESEARCH LIMITATIONS/IMPLICATIONS: Since most health leaders have public health and management experience, the contributions of each factor to the duration of a secretary's tenure are difficult to separate and analyze separately. PRACTICAL IMPLICATIONS: This study provides empirical insights into what factors drive health leader turnover during major health emergencies. SOCIAL IMPLICATIONS: During major health emergencies, health leaders often strongly disagree with elected officials on the response. This paper test how crisis leadership theories help explain state health leaders' duration in one of the world's largest public health systems during the COVID-19 pandemic. This paper find that policy disagreements contributed to significant turnover. ORIGINALITY/VALUE: To the best of the authors' knowledge, this paper is the first that are aware of that uses novel primary data on public health executive leader characteristics and turnover causes in the context of the COVID-19 pandemic. It provides empirical evidence contributing to the crisis leadership literature by examining health leader turnover in one of the world's largest public health systems.

Predictors of Leadership Competencies Among Nurse Executives in the Kingdom of Saudi Arabia.

Background: Awareness and development of nurse executives' leadership competencies has been considered a key strategy for the success of healthcare organizations. However, only a few studies about nurse executives' leadership competencies are available in the literature, and no study has been conducted about the topic within Saudi Arabian context. The aim of this study was to assess the leadership competencies of nurse executives and the predictors of these competencies. Methods: This quantitative study used a descriptive, cross-sectional, and correlational design. The study recruited a total convenience sample of 136 nurse executives who voluntarily consented to participate. The respondents self-rated the online survey, "Leadership Competency Assessment Tool: Self-Assessment." Data collection was conducted between September 2022 and November 2022. Test of correlation and multiple regression analyses were conducted. Results: The overall mean score of nurse executives' leadership competencies was 3.38 out of 5.0, which was below the level of having excellent leadership competencies. Four dimensions had mean scores below the level of having excellent leadership competencies, namely, communication and relationship building (3.48), knowledge of the healthcare environment (3.29), leadership (3.45), and business skills (3.15), while nurse executives had excellent leadership competencies only in the professionalism dimension (3.51). Age (p=0.04), highest educational attainment (p=0.01), current role (p<0.01) and length of experience (p=0.02) as nurse executive, monthly salary (p=0.03), nationality (p=0.04), and having seminars/trainings in leadership and management (p=0.01) were considered predictors of the leadership competencies of nurse executives. Conclusion: Nurse executives reported a low level of leadership competencies, thus implying necessary actions for improvement. There were personal factors that influenced the level of nurse executives' leadership competencies. To achieve quality outcomes and maintain a high level of nursing care in hospital organizations, these findings must be considered in planning strategies related to the improvement of the leadership competencies of nurse executives.

Leadership Development in Pharmacy Students: A Literature Review.

Background: A deeper understanding of leadership competencies and development of these competencies in pharmacy students are essential to enable future pharmacists to take a more advanced role in patient care and serve as interdisciplinary team members and leaders. Such efforts are also needed to help guide succession planning. Objective: To identify and describe the competencies and experiences involved in leadership development for pharmacy students. Data Sources: A literature review was conducted using the MEDLINE, PubMed, and Google Scholar databases (from inception to November 2023), as well as syllabi from pharmacy leadership courses. Study Selection and Data Extraction: Articles discussing leadership competencies in a health care setting and during pharmacy education and training were included. Competencies and experiences related to leadership development were extracted and organized into categories, with each category given a single descriptor. Data Synthesis: A total of 34 resources were included in the analysis, which revealed the following 7 leadership competencies: leadership knowledge, self-awareness, collaboration, leading change, business skills, systems thinking, and lifelong learning. Conclusions: Pharmacy students can develop their leadership abilities through a variety of experiences and activities aligned with the core leadership competencies identified here. Pharmacy schools in Canada can design and offer leadership placements to help enhance students' leadership skills. This study has highlighted activities that may help prepare pharmacy students for leadership roles in the changing landscape of pharmacy practice.

Contexte: Une compréhension plus approfondie des compétences en leadership et le développement de celles-ci chez les étudiants en pharmacie sont essentiels pour permettre aux futurs pharmaciens de jouer un rôle plus avancé dans les soins aux patients et de servir de membres et de chefs d'équipes interdisciplinaires. De tels efforts sont également nécessaires pour aider à orienter la planification de la relève. Objectif: Identifier et décrire les compétences et les expériences à l'œuvre dans le développement du leadership pour les étudiants en pharmacie. Sources des données: Un examen de la littérature a été réalisé à l'aide des bases de données MEDLINE, PubMed et Google Scholar (depuis leur création jusqu'en novembre 2023), ainsi que des programmes de cours de leadership en pharmacie. Sélection des études et extraction des données: Des articles traitant des compétences en leadership dans un contexte de soins de santé et pendant la formation en pharmacie ont été inclus. Les compétences et les expériences liées au développement du leadership ont été extraites et organisées en catégories, chaque catégorie étant dotée d'un seul descripteur. Synthèse des données: Au total, 34 ressources ont été incluses dans l'analyse, qui a révélé les 7 compétences de leadership suivantes: connaissances en leadership, conscience de soi, collaboration, conduite du changement, compétences commerciales, pensée systémique et apprentissage continu. Conclusions: Les étudiants en pharmacie peuvent développer leurs capacités en matière de leadership grâce à différentes expériences et activités alignées sur les compétences de base en leadership recensées ici. Les écoles de pharmacie au Canada peuvent concevoir et offrir des stages de leadership pour aider à améliorer les compétences des étudiants en la matière. Cette étude a mis en évidence des activités qui peuvent aider à préparer les étudiants en pharmacie à des rôles de leadership dans le paysage changeant de la pratique pharmaceutique.

Suggesting a holistic framework for understanding healthcare services leadership competence - a critical interpretive synthesis.

PURPOSE: Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners. DESIGN/METHODOLOGY/APPROACH: In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence. FINDINGS: Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal - and technical, and organisational internal and - external competencies. RESEARCH LIMITATIONS/IMPLICATIONS: This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books. PRACTICAL IMPLICATIONS: The holistic framework for healthcare leadership competences offers a common understanding of a "fuzzy" concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders. ORIGINALITY/VALUE: This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

A case study of a pilot leadership skills program to clarify professional fulfillment sources for academic physicians.

PURPOSE: In this case study, the authors aimed to investigate the usefulness of five interactive workshops on leadership skills relevant to academic physicians for their professional fulfillment. Workshops were led by experts in finance, negotiation, business administration and digital tools and enhanced a practical understanding of skills in 1) financial investment; 2) growing clout on social media; 3) negotiation; 4) navigating institutional culture as a woman; and 5) conflict management. DESIGN/METHODOLOGY/APPROACH: Workshops were deployed to faculty in the departments of Radiology and Psychiatry. Attendance at seminars was captured, categorized as in-person (when offered), virtual-live or virtual-recording views post hoc. The authors also collected responses to a brief, 5-question survey which assessed faculty familiarity with the topic pre-and post-seminar and evaluated the perceived relevance of the topic to professional fulfillment. FINDINGS: The highest attendance was for the seminar on financial investments, and the lowest attendance was for that on conflict management. The seminar that the highest proportion of respondents deemed important as a leadership skill was on the topic of navigating institutional culture as a woman in the workplace. The seminar that focused on cultivating clout on social media was the seminar that the highest proportion of respondents deemed worth attending. ORIGINALITY/VALUE: From this case study, the authors learned that financial literacy, discerning institutional culture, managing conflicts, negotiating and using digital tools are topics which have relevance to physician professional fulfillment. Such topics could be valuable as the building blocks for future programs which provide leadership training to physicians.

Global research trends in nursing leadership from 1985 to 2022: a bibliometric analysis.

PURPOSE: Developing nursing leadership has become a key policy priority to achieve universal health coverage. This study aims to explore the current status, developing trends and research frontiers in the field of nursing leadership. DESIGN/METHODOLOGY/APPROACH: In total, 1,137 articles and reviews on nursing leadership from 1985 to 2022 were retrieved from the Web of Science Core Collection database. Trends of publications, journals, countries/regions, institutions, documents and keywords were visualized and analyzed using Microsoft Excel and CiteSpace software. FINDINGS: Nursing leadership research showed an overall increase in number despite slight fluctuations in annual publications. The USA was the leading country in nursing leadership research, and the University of Alberta was the most productive institution. The Journal of Nursing Management was the most widely published journal that focused on nursing leadership, followed by the Journal of Nursing Administration. Keyword analysis showed that the main research hotspots of nursing leadership are improvement, practice and impact of nursing leadership. ORIGINALITY/VALUE: This article summarizes the current state and frontiers of nursing leadership for researchers, managers and policy makers, as well as follow-up, development and implementation of nursing leadership. More research is needed that focuses on the improvement, practice and impact of nursing leadership, which are cyclical, complementary and mutually reinforcing. Longitudinal and intervention studies of nursing leadership, especially on patient prognosis, are also particularly needed.

Leadership academy for excellence in disability services: evaluation of outcomes for state employees.

As the United States' first disability-specific leadership academy in state government, the Leadership Academy for Excellence in Disability Services is a year-long competency-based training experience designed for employees who manage programs that impact the lives of Tennesseans with intellectual and developmental disabilities and their families. The Tennessee Department of Human Resources, in collaboration with the Tennessee Council on Developmental Disabilities, began implementing this program in 2017. The lasting impact of such a training experience on the practices of state employees once they complete the program is not known; this was the aim of the study. A follow-up survey examining graduate perceptions and outcomes was sent to 71 graduates; 48 completed the measure. The results reveal an increase in knowledge of disability service systems and a perceived ability to lead and advocate for others. Leadership competencies deemed most important to graduates' current efforts in state government included developing direct reports, managing diversity, organizational agility, and innovation management. Graduates' written comments cited the variety of subject matter experts, networking opportunities, and small group projects as fundamental in breaking down barriers to cross-agency collaboration in their disability work. The impact of this experience continues to be seen years after completing the leadership academy.

Leadership dynamics in nursing: a comparative study of paternalistic approaches in China and Pakistan.

PURPOSE: This study aims to examine the impact of nurses' paternalistic leadership style on performance, in the presence of underlying mechanisms, i.e. self-efficacy as a mediator in the high-power distance societies, namely, China and Pakistan, based on social exchange theory. Both healthcare sectors have seen several behavioral advancements in recent years. To improve things, even more, behavioral elements such as the influence of leadership styles, personality traits and so on have become more important. However, leadership styles, particularly paternalistic leadership, have received little attention in this field and need to be highlighted along with the mediating and moderating effects. DESIGN/METHODOLOGY/APPROACH: Data were collected from public and private sector hospitals in China and Pakistan using a 6-week time lag technique. Firstly, 356 Chinese and 411 Pakistani nurses were surveyed about their perceptions of power distance, self-efficacy and paternalistic leadership. Their managers were called six weeks later for a dyadic response to provide feedback on nurses' performance. For confirmatory factor analysis, AMOS 22 and for regression analysis, SPSS 22 was used. FINDINGS: According to the study's findings, nurses in both countries perform well when led by a paternalistic leader. Furthermore, self-efficacy explains the relationship between paternalistic leaders and nurses' performance. The moderated-mediation result also supported the importance of power distance. ORIGINALITY/VALUE: This study highlights the kind of nursing leadership which is beneficial in high-power-distance societies and leads to better performance. According to this research, paternalistic leadership improves nurses' performance in both China and Pakistan. As a result, this study will be useful in high-power-distance societies, where hospital administrators can ensure that paternalism is implemented in leadership, thereby improving nurse performance.