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Background: Clinical leadership competencies for effective teamwork differ between Western cultures, where an independent self-construal prevails, and Japanese society, where the self-construal is rooted in interdependence. Although 27 out of 82 Japanese medical schools have 'leadership' as an educational outcome, specific competencies are poorly described, hindering the development of contextually-relevant leadership education. This study aimed to identify clinical leadership competencies and articulate the attributes and skills fundamental to leadership as perceived by Japanese physicians. Methods: The 80 items of the UK clinical leadership competency framework (CLCF) formed the stimulus in a modified Delphi. Participants, comprising 26 Japanese physicians, rated the importance of each item using a 5-point Likert scale with free-text comments regarding the modification of competencies and suggestions for new items. Items were eliminated if the Likert mean was less than 4.0 and if fewer than 70% of participants considered them to be important. Newly described or modified items derived from free-text comments were rated for importance in a second round with reflective thematic analysis of the free-text descriptions. Results: A CLCF of 84 items, reflective of Japanese clinical leadership, was created by eliminating three items describing tasks rarely involving Japanese physician leaders, revising seven items to emphasize understanding of members, and adding seven items to maximize feelings of team comfort. Seven skills and attributes emerged to construct Japanese clinical leadership from thematic analysis. "Humility" was viewed as a fundamental to leadership. Humility-driven "self-discipline" and "attentive listening", "supporting members" and "guiding members" with humility-based compassion, were essential elements to create "psychological safety" for freedom of expression. Achieving "unity" through emotional integration was identified as the overall goal of leadership. Conclusions: The reorganized CLCF has embedded more member-centered behaviors that build rapport and comfort for the members than the original CLCF. Modeling the Confucian virtue of humility and building unity by acting with compassion toward members are characteristics of Japanese clinical leadership that reflect an interdependent social context. These findings are a step toward the development of leadership education aligned with a Japanese context. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Method Results Conclusion Implications for the Profession Impact Patient or Public Contribution What Does This Paper Contribute to the Wider Community? Reporting Method Trial and Protocol Registration This study aims to describe the exercise of clinical leadership by nurses within hospital care units, identify the factors influencing it and explore how nurses perceive its impact.Qualitative multiple case study.The study involved 36 interviews, 120 h of observation and documentary analyses with nurses across various roles within three nursing teams to capture collective leadership. Thematic and cross‐case analyses were also conducted.Nurses' clinical leadership was manifested in five distinct forms, irrespective of their role: (1) initiating actions involving reflective thinking and intervention, (2) influencing others through coaching, (3) actively participating in and mobilising efforts to enhance the quality of care, (4) fostering optimal synergy and team cohesion, and (5) leveraging personal and collaborative capacities. Factors influencing this leadership included clinical, human and material resources, time, a work environment that promotes autonomy and a positive work climate. Nurses perceived their leadership as having a positive impact on patients, themselves, the interdisciplinary team and the organisation. These findings were integrated into a modellisation of the exercise of nurses' clinical leadership based on Le Moigne's (La Théorie du Système Général. Théorie de la Modélisation. Paris: Presses Universitaires de France, 2006) philosophical approach.This study provides a perspective on nurses' collective clinical leadership in hospital care units, emphasising its leverage effect and the achievement of positive impacts. The proposed model serves as a valuable tool for nurse managers to better understand and support the exercise of clinical leadership.The model can guide nurse managers in supporting clinical leadership within teams, assist individual nurses in associating clinical leadership with their practice and assist with mobilising their leadership skills. This study explores how nurses across various roles within a hospital care unit exercise clinical leadership. The findings reveal five active forms of nurses' clinical leadership, perceived by nurses to positively impact patients, the interdisciplinary team and the organisation. Nurses and managers can use these five forms to foster a collective approach to clinical leadership. None. This study introduces an innovative model for understanding and promoting nurses' clinical leadership. It provides insights into the positive impact of this leadership approach and the significance of promoting it. Standards for Reporting Qualitative Research [SRQR] (O'Brien et al. Academic Medicine, 89, 2014 and 1245).Not registered [ABSTRACT FROM AUTHOR]

Background: Nursing homes face a critical need for competent healthcare professionals to deliver high-quality care. Focusing on clinical leadership is crucial for equipping healthcare professionals with the skills necessary to manage complex care needs, collaborate effectively within multidisciplinary teams, and improve care quality in nursing homes. Developing clinical leadership fosters professional growth and enhances healthcare professionals' ability to tackle the challenges unique to the nursing home environment. However, the concept of clinical leadership in nursing homes remains poorly defined and investigated. This study aimed to explore and define influencing factors for the development of clinical leadership within healthcare professionals in nursing homes. Methods: A qualitative study was conducted in Flanders, Belgium, using semi-structured focus group interviews (n = 5) with healthcare professionals (n = 41), including nurse assistants, licensed practical nurses, registered nurses, occupational therapists, recreational therapists, psychologists, and gerontologists. Interviews were audio-taped, transcribed, analysed and interpretated by using a thematic analysis based on descriptive phenomenology. Results: Clinical leadership development within healthcare professionals' hinges on four pivotal themes: (1) Cultivating an empowering working environment that fosters open feedback, encourages peer learning, and champions a stimulating learning climate. (2) Nurturing a supportive leadership style in formal leaders that exemplifies role modeling, accessibility, and a coaching approach. (3) Elevating well-developed professional identity through targeted training, experience, and a talent-oriented work approach. (4) Fostering team dynamics marked by commitment, collaboration, support, and trust. Conclusions: The study's findings on the influencing factors for clinical leadership development should be actively applied in nursing homes and guide the creation of targeted training programs and leadership development initiatives. Awareness of these factors are crucial to optimise and to support the development and implementation of clinical leadership in nursing homes in an attempt to reduce the workforce shortages. [ABSTRACT FROM AUTHOR]

This paper presents a paradigm of leadership within the nursing profession. It argues that it is vitally important to (re)kindle debate about – and, through this process, ascertain the realization of – complementarity between values and competency bases for the leadership profiles of the nursing profession. The article proposes how this clinical leadership may be understood and realized in the organizational and societal context of 2024. Our ambition is to start a necessary debate, focussing on how to strengthen this requisite leadership, in order to ensure quality and development in nursing care, and the professional competence development of nurses. [ABSTRACT FROM AUTHOR]

The United States health care system is facing an unprecedented nursing shortage, increasing complexity of care, and fewer experienced nurse mentors. These factors contribute to a cycle of burnout, turnover, decreased quality and safety, and a worsening financial bottom line. Improving these contributing factors depends on our ability to mitigate the structural causes of burnout and turnover. The clinical nurse specialist role is essential to improving the work environment, advancing evidence-based nursing practice, reducing turnover, and stabilizing the bottom line. [ABSTRACT FROM AUTHOR]

Abstract Background Clinical leadership competencies for effective teamwork differ between Western cultures, where an independent self-construal prevails, and Japanese society, where the self-construal is rooted in interdependence. Although 27 out of 82 Japanese medical schools have ‘leadership’ as an educational outcome, specific competencies are poorly described, hindering the development of contextually-relevant leadership education. This study aimed to identify clinical leadership competencies and articulate the attributes and skills fundamental to leadership as perceived by Japanese physicians. Methods The 80 items of the UK clinical leadership competency framework (CLCF) formed the stimulus in a modified Delphi. Participants, comprising 26 Japanese physicians, rated the importance of each item using a 5-point Likert scale with free-text comments regarding the modification of competencies and suggestions for new items. Items were eliminated if the Likert mean was less than 4.0 and if fewer than 70% of participants considered them to be important. Newly described or modified items derived from free-text comments were rated for importance in a second round with reflective thematic analysis of the free-text descriptions. Results A CLCF of 84 items, reflective of Japanese clinical leadership, was created by eliminating three items describing tasks rarely involving Japanese physician leaders, revising seven items to emphasize understanding of members, and adding seven items to maximize feelings of team comfort. Seven skills and attributes emerged to construct Japanese clinical leadership from thematic analysis. “Humility” was viewed as a fundamental to leadership. Humility-driven “self-discipline” and “attentive listening”, “supporting members” and “guiding members” with humility-based compassion, were essential elements to create “psychological safety” for freedom of expression. Achieving “unity” through emotional integration was identified as the overall goal of leadership. Conclusions The reorganized CLCF has embedded more member-centered behaviors that build rapport and comfort for the members than the original CLCF. Modeling the Confucian virtue of humility and building unity by acting with compassion toward members are characteristics of Japanese clinical leadership that reflect an interdependent social context. These findings are a step toward the development of leadership education aligned with a Japanese context.

Abstract Background Nursing homes face a critical need for competent healthcare professionals to deliver high-quality care. Focusing on clinical leadership is crucial for equipping healthcare professionals with the skills necessary to manage complex care needs, collaborate effectively within multidisciplinary teams, and improve care quality in nursing homes. Developing clinical leadership fosters professional growth and enhances healthcare professionals’ ability to tackle the challenges unique to the nursing home environment. However, the concept of clinical leadership in nursing homes remains poorly defined and investigated. This study aimed to explore and define influencing factors for the development of clinical leadership within healthcare professionals in nursing homes. Methods A qualitative study was conducted in Flanders, Belgium, using semi-structured focus group interviews (n = 5) with healthcare professionals (n = 41), including nurse assistants, licensed practical nurses, registered nurses, occupational therapists, recreational therapists, psychologists, and gerontologists. Interviews were audio-taped, transcribed, analysed and interpretated by using a thematic analysis based on descriptive phenomenology. Results Clinical leadership development within healthcare professionals’ hinges on four pivotal themes: (1) Cultivating an empowering working environment that fosters open feedback, encourages peer learning, and champions a stimulating learning climate. (2) Nurturing a supportive leadership style in formal leaders that exemplifies role modeling, accessibility, and a coaching approach. (3) Elevating well-developed professional identity through targeted training, experience, and a talent-oriented work approach. (4) Fostering team dynamics marked by commitment, collaboration, support, and trust. Conclusions The study’s findings on the influencing factors for clinical leadership development should be actively applied in nursing homes and guide the creation of targeted training programs and leadership development initiatives. Awareness of these factors are crucial to optimise and to support the development and implementation of clinical leadership in nursing homes in an attempt to reduce the workforce shortages.

Health organizations all over the world are presented with numerous challenges due to providing and maintaining the health of society, and their flawless performance depends on their proper management. Moreover, the assessment of the country's healthcare system demonstrates that there is no competent clinical leadership in the country, and it must be radically reformed. The present study aimed to identify the obstacles and solutions to improve clinical leadership competence among Guilan University of Medical Sciences managers. This qualitative research was conducted using the content analysis approach. The sample included the managers of Guilan University of Medical Sciences in 2023. Among this population, 15 senior managers were selected via a purposive sampling approach and entered the study. In order to obtain the reliability and validity of the data, two methods of reviewing the participants and reviewing the experts who did not participate in the research were used. After analyzing and combining the data, the data were categorized into 139 primary concepts, 2 main categories, and 12 sub-themes. The main categories included barriers and solutions. Considering the importance of leadership competence and the complexity of specialized work, the Ministry of Health plays a key role in determining the management perspective, implementation, and monitoring in the whole country to determine the comprehensive health roadmap. Furthermore, at the individual level, apart from training a generation of specialists, it is imperative to train people and equip healthcare managers with effective management tools. [ABSTRACT FROM AUTHOR]

Aim(s): To conceptualise and identify characteristics of clinical leadership in the nursing home setting. Design: A qualitative study using semi‐structured focus group interviews and a thematic analysis. Methods: Five semi‐structured focus group interviews were conducted with 41 healthcare professionals from nursing and other healthcare disciplines working in nursing homes (such as nurse assistants, licensed practical nurses, registered nurses (RNs), occupational therapists, recreational therapists, psychologists and gerontologists). Qualitative thematic content analysis of the gathered data was done. Results: Clinical leaders in nursing homes can be defined as passionate healthcare professionals providing person‐centred care with strong communication skills. They are clinical experts in their field and motivated to engage in lifelong learning. They are team players with informal leadership skills. They are visionary, committed, resilient and responsive. Awareness of the definition and the main characteristics of clinical leadership is necessary to facilitate the identification, support and development of healthcare professionals. Focussing on the development of competencies, training courses and monitoring and assessment methods is necessary to improve the evidence of clinical leadership in nursing homes. [ABSTRACT FROM AUTHOR]

Frontline doctors' clinical leadership (CL) is key to addressing healthcare sustainability challenges. Research shows CL requires professional learning. Significant investments into CL development notwithstanding, little evidence exists of how frontline clinicians learn leadership, highlighting an educational sustainability challenge. We propose a fundamental constitutive step towards understanding CL professional development (PD) through theorising and analysing CL-learning mechanisms and their association with clinicians' leadership competences required for sustainable healthcare development. This mixed-methods study developed a concept of leadership learning patterns to assess doctors' learning processes associated with sustained innovation. It analysed a post-course dataset of past participants of a CL-PD course (N = 150) and a pre-post dataset of an online CL-PD (N = 34). EFA demonstrated a reasonable factor model for the Leadership Learning Inventory, measuring two dimensions of doctors' leadership learning patterns: Meaning-oriented and Problematic learning. Qualitative and quantitative analyses showed that Meaning-oriented learning increased significantly during CL-PD and is linked with sustainable leadership competences. This study suggests that the concept of leadership learning patterns is useful for evaluating the quality of clinical leadership learning processes during PD. It offers a conceptually and empirically sound way to assess clinical leadership learning involved in sustainable healthcare improvement, and the sustainability of educational interventions to support it. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the importance of effective nursing leadership in clinical practice • To understand the factors that affect early career nurses’ motivation to develop leadership skills • To consider the approaches that organisations could use to encourage nurses to adopt leadership roles. Effective nursing leadership has been shown to improve patient outcomes, but there has been little exploration of the factors that influence early career nurses to develop their leadership skills and adopt leadership roles. This article presents a rapid review of the literature on these factors, integrating data from 25 articles. Findings suggest that improving leadership confidence and self-efficacy, particularly in relation to system leadership, can increase nurses’ motivation for adopting leadership roles. Supportive organisations that value leadership and give nurses opportunities to exercise it are equally important. Training and education, preceptorship, peer-to-peer shadowing, modelling and mentoring can all be useful in improving leadership skills and inspiring the next generation of nurse leaders. [ABSTRACT FROM AUTHOR]

Aim: To identify strategies that develop clinical nursing leadership competencies among staff nurses, and to explain the contextual elements and mechanisms that underpin the development of clinical nursing leadership competencies. Design: Realist review according to the Realist and Meta-narrative Evidence Syntheses—Evolving Standards (RAMESES). Data Sources: PubMed, Embase, CINAHL, Web of Science, Wiley Online Library, PsycInfo and ProQuest were searched from January 2000 until October 2022. Review Methods: Three iterative phases: (1) development of initial programme theory, (2) structured searches for relevant published and grey literature and (3) data synthesis and interpretation by researchers and theory triangulation, and discussions within the research group. Results: Multiple context–mechanism–outcome configurations were extracted from 10 reports that explain how, under what circumstances and why strategies can facilitate (or discourage) staff nurses to act as clinical leaders. Reports were both quantitative and qualitative in design, originating from English-speaking countries only. Conclusions: A logic model was developed and suggests four contexts and five mechanisms underlying the development of clinical nursing leadership. Growth in clinical nursing leadership was mainly experienced through experiential learning, which was enhanced by a supportive relationship with a coach or mentor, the use of reflective practices and modelling from other leaders. Furthermore, a supportive work environment triggers ownership, confidence and motivation, and thereby growth in clinical nursing leadership competencies. Impact: Fostering competencies for clinical leadership among staff nurses requires multifaceted strategies. Strategies are successful if, and only if, they combine learning by doing, by knowing and by observing, and establish a responsive work environment. Hospital policy should ensure that staff nurses have access to reciprocal relationships with role models or a coach. In order to grow as clinical nurse leader, ownership and self-reflection on own leadership behaviour need to be facilitated. [ABSTRACT FROM AUTHOR]

This paper raises and addresses issues to do with leadership and child psychotherapy, beginning with a report on a systematic review of papers about leadership in the Journal of Child Psychotherapy (JCP). The authors establish that leadership is expressed implicitly rather than as an important issue in its own right with relevance to clinical work, service development and the ongoing viability of psychoanalytic child psychotherapy. When reviewing the limited literature available, the authors classify them into five types of article: tribute to leaders past; clinical leadership; threat to survival and call to action; organisational leadership; and exemplary papers describing professional leadership. The authors query why the leadership literature is sparse and inexplicit and respond by using the theme of 'dual citizenship' to explore the issue from a psychoanalytic and organisational perspective. The psychoanalytic perspective explores tensions and barriers that may be profession-specific in relation to leadership. The organisational perspective explores the wider literature on leadership, starting with the concept of 'wicked problems and clumsy solutions'. The authors introduce and describe a 'leadership stance' that is compatible with psychoanalytic practice in context. This requires opening up leadership activity to the same scrutiny and reflective practice as clinical work, which provides ways of containing organisational and career anxieties and perplexing clinical problems. This paper is a call to action in regard to integrating leadership into the training and the profession. [ABSTRACT FROM AUTHOR]

Background: Postgraduate leadership education is an evolving field. Locally we have an established ‘Chief Residency’ programme where centres have two to four senior trainees completing leadership duties alongside clinical workload, supported by local directors of medical education. This is twinned with a 4-day central training programme and peer-support network. Methods: To assess perspectives of the CR role, we adopted a qualitative case-study design using an electronic questionnaire delivered to previous chief residents between 2020 and 2023. Results were analysed using thematic analysis. Results: Trainees valued involvement within quality improvement and trainee support, demonstrating successful multi-departmental projects. Leadership education was viewed ubiquitously positively but participants felt further work is needed to address role legitimacy locally. A proposed solution was junior doctor leadership teams to address workload and emotional challenges. Conclusion: This model provides further evidence of the value in investing in trainee leadership positions, demonstrating organisational impact. Future work will research hospital peer leadership teams.

Abstract Aim(s) To conceptualise and identify characteristics of clinical leadership in the nursing home setting. Design A qualitative study using semi‐structured focus group interviews and a thematic analysis. Methods Five semi‐structured focus group interviews were conducted with 41 healthcare professionals from nursing and other healthcare disciplines working in nursing homes (such as nurse assistants, licensed practical nurses, registered nurses (RNs), occupational therapists, recreational therapists, psychologists and gerontologists). Qualitative thematic content analysis of the gathered data was done. Results Clinical leaders in nursing homes can be defined as passionate healthcare professionals providing person‐centred care with strong communication skills. They are clinical experts in their field and motivated to engage in lifelong learning. They are team players with informal leadership skills. They are visionary, committed, resilient and responsive. Awareness of the definition and the main characteristics of clinical leadership is necessary to facilitate the identification, support and development of healthcare professionals. Focussing on the development of competencies, training courses and monitoring and assessment methods is necessary to improve the evidence of clinical leadership in nursing homes.

Purpose To develop a model of clinical leadership that encompasses the specialized technical skills and leadership behaviors exhibited by clinical radiography leaders. Methods During this quantitative study, 432 clinical radiography leaders completed the Clinical Radiography Leadership Survey, which measured the technical skills and leadership behaviors aligned with clinical leadership in radiography. Data analysis included a correlational analysis to examine the relationships between the dimensions measuring technical skills and dimensions measuring leadership behaviors when defining clinical radiography leaders. Results Participant responses were correlated individually and aggregated by dimension, with Pearson values greater than 0.3 indicating a moderate or strong relationship. The highest interdimensional correlation existed between dimensions 1 (patient care skills) and 2 (technical and radiographic skills) (P = .715), while exhibiting weak correlations to dimensions associated with clinical leadership behaviors. The confirmatory factor analysis revealed that a more global view of clinical leadership behaviors, in addition to patient care and technical skills, informed participants' view of clinical radiography leadership. Discussion Participants viewed the technical aspect of their practice as the most salient, and survey items related to professional communication and using sound clinical decision-making skills correlated highly with the leadership behaviors exhibited and valued by clinical radiography leaders. Conclusion By defining the clinical expertise, technical skills, and commonly practiced leadership behaviors that clinical radiography leaders encompass, other health care professionals will recognize the unique contribution that the radiologic science profession provides. [ABSTRACT FROM AUTHOR]

Clinical leadership is necessary to improve the performance of large public hospitals. Trainee medical officers (TMOs) are important stakeholders in organisation-wide initiatives that affect the medical workforce and support clinician engagement. This case study describes the development of a representative body known as the ‘TMO Forum’ within the Central Adelaide Local Health Network as a mechanism to promote engagement between medical trainees and the hospital executive to facilitate escalation and discussion of system-based issues. Over the past 8 years, this group has evolved into a community of practice with steady and sustained growth since inception. Trainees have fostered relationships with the executive, and have engaged in leadership and quality improvement initiatives. Here we explore the evolution, value and barriers to success of the TMO Forum. Our discussion is supplemented with findings from anonymous online evaluation surveys of both the TMO and executive stakeholder groups. We propose that initiatives such as the described may offer reciprocal benefits to both constituent groups regarding communication, and that the development of a dedicated community of practice will enhance engagement of TMOs in health service improvement initiatives and advocacy. However, there are obstacles to overcome in order to attract a greater number of trainees and maximise the benefits from this initiative. [ABSTRACT FROM AUTHOR]

Forensic mental health (FMH) inpatient settings are complex working environments at times due to a number of factors including the presence of challenging behaviours that may include violence and aggression, restrictions related to legislation, extended length of stay and the impact of trauma. Nurse unit managers (NUMs) play an important role in managing the unit environment and clinical standards of care to achieve better outcomes for consumers and staff. However, the role of NUMs in an FMH setting is poorly understood. The overall aim of this study was to explore the role of NUMs working within an FMH setting in Victoria, Australia. To our knowledge, this is the first study that has examined the subject. Data were collected via focus groups from n = 32 participants which included NUMs, their managers, staff who work alongside the NUMs and the staff the NUMs manage. Data were analysed using thematic analysis and four themes were interpreted from the data, (i) lack of role clarity, (ii) the importance of clinical Leadership and forensic mental health knowledge, (iii) step up in responsibility and step down in pay and (iv) seeing the difference you make. The role of the NUM within a forensic mental health setting comes with a number of challenges, but also opportunities to enact change. An ongoing effort to better support those employed within the NUM role and make the role desirable for aspiring staff is critical to the sustainability of a skilled clinical workforce and quality of care in this complex setting. [ABSTRACT FROM AUTHOR]

Abstract Aim To understand the current application and benefits of coaching practice in nursing and identify potential areas for future research. Design An integrative literature review was conducted using Whittemore and Knalf integrative review methods. Data sources A search of the literature from Medline (PubMed) and CINHAL platform for abstracts and/or full‐text articles from 2012 to 2022. Methods A systematic approach was used to screen and analyse the literature. Inclusion and exclusion criteria were applied, a quality appraisal of the literature was undertaken and summarised into themes. Eighteen articles were selected, two articles were different aspects of the same studies. Coaching was found to have benefits to the individual related to performance, role effectiveness, role transitions and confidence in performing in the role. The outcomes for individuals add to the overall organisational benefits with performance, support, teamwork, communication and culture. Results This literature review sought to understand the current use of coaching in nursing and identify any gaps in the application of coaching within the discipline. Supporting, developing staff knowledge and skills and nurturing nursing staff into the profession has occurred in several ways and evolved to include coaching. Coaching provides capabilities to enhance nursing leadership, performance improvement and to provide support to staff. The findings from this literature review found a need to conceptually define coaching in nursing and the opportunity to explore the use of coaching to support both the clinical and managerial workforce (job satisfaction, intention to stay and building resilience). The benefits of coaching in nursing extend beyond the leadership level and there is opportunity to extend the operationalisation of coaching practice and coaching training within the discipline of nursing. This integrative review explains how coaching has been utilised in nursing to be a valuable tool in developing nurse leaders and clinical staff.

Using the balanced scorecard approach, Strategic Management Initiative (SMI) driven Key Performance Indicators (KPIs) have allowed measurable data regarding various clinical, medical, patient and logistic outputs for healthcare leadership to manage an ongoing improvement system in real-time. We underwent a comprehensive search to have 168 articles with the keywords "Balanced Scorecard in healthcare". We applied filters for the last ten years only. We shortlisted 14 studies. The study highlighted various KPIs utilised in different healthcare settings, with most authors favouring BSC methodology as a comprehensive strategy to deal with multi-dimensional hospital processes. The most utilised KPIs included service quality, patient safety, increased healthcare literacy, empowering patients, developing the empathic attitude and social skills in medical staff, professional human resource management and financial management and interests of stakeholders. In short, the BSC strategy is suggested for implementation to improve healthcare-related processes.

Early identification and follow-up of sub-acute and acute functional decline in older persons living with multimorbidity at home require integrated and proactive care by interdisciplinary health personnel. Yet, in the context of the task-oriented and fragmented home healthcare services, early identification is challenging. Therefore, the aim of this study was to identify preconditions for the success of a proactive and interdisciplinary follow-up of older recipients of home healthcare. We conducted a qualitative secondary analysis of data from 6 focus group interviews with registered nurses and nurse leaders. In addition, we performed and analyzed data from 2 new focus group interviews with general practitioners and RNs who had a role as super users in a developmental project which introduced a clinical instrument for early identification of sub-acute and acute functional decline (sub-acute functional decline in the elderly—SAFE). Their experiences with using SAFE constituted the backdrop for the study. In total, 41 representatives of the interprofessional primary care staff of 3 city districts participated. Having a common goal, sharing tasks and having reciprocal understanding of each health profession's contribution, systems and tools and clinical leadership were all seen as important factors for succeeding in the proactive and interdisciplinary follow-up of older recipients of home healthcare. Clinical leadership was deemed the strongest precondition, and clear leadership which promotes integrative and proactive care by facilitating interdisciplinary collaboration appears to be the main key for success. [ABSTRACT FROM AUTHOR]

Nurses Improving Care for Healthsystem Elders (NICHE), a program of NYU Rory Meyers College of Nursing, is a national quality and safety program that enhances clinical nursing in the care of older adults. Hospitals, long-term care, and hospice organizations adopt the NICHE practice model to advance professional practice, improve quality of care, and expand capacity to meet the growing demand for age-friendly care. In this month's column, I highlight three clinical improvement projects that were developed during the NICHE Leadership Training Program. These projects represent the range of nurse-led services and clinical interventions that are the foundation of the NICHE philosophy and practice model. [ABSTRACT FROM AUTHOR]

Aim: To understand the current application and benefits of coaching practice in nursing and identify potential areas for future research. Design: An integrative literature review was conducted using Whittemore and Knalf integrative review methods. Data sources: A search of the literature from Medline (PubMed) and CINHAL platform for abstracts and/or full‐text articles from 2012 to 2022. Methods: A systematic approach was used to screen and analyse the literature. Inclusion and exclusion criteria were applied, a quality appraisal of the literature was undertaken and summarised into themes. Eighteen articles were selected, two articles were different aspects of the same studies. Coaching was found to have benefits to the individual related to performance, role effectiveness, role transitions and confidence in performing in the role. The outcomes for individuals add to the overall organisational benefits with performance, support, teamwork, communication and culture. Results: This literature review sought to understand the current use of coaching in nursing and identify any gaps in the application of coaching within the discipline. Supporting, developing staff knowledge and skills and nurturing nursing staff into the profession has occurred in several ways and evolved to include coaching. Coaching provides capabilities to enhance nursing leadership, performance improvement and to provide support to staff. The findings from this literature review found a need to conceptually define coaching in nursing and the opportunity to explore the use of coaching to support both the clinical and managerial workforce (job satisfaction, intention to stay and building resilience). The benefits of coaching in nursing extend beyond the leadership level and there is opportunity to extend the operationalisation of coaching practice and coaching training within the discipline of nursing. This integrative review explains how coaching has been utilised in nursing to be a valuable tool in developing nurse leaders and clinical staff. [ABSTRACT FROM AUTHOR]

Background In this study, we explore how doctors in training perceive mentorship and leadership and whether they believed that mentoring influences the development of leadership skills. The study also addressed whether certain leadership styles lend themselves better to mentoring. Methods A qualitative research method was employed in this study and ethical approval was granted by the Research Ethics Committee (REC) at King Faisal Specialist Hospital and Research Centre (KFSH&RC), after which twelve hospital residents were recruited using purposive sampling. Semi-structured interviews were conducted by the authors and thematic data analysis was performed. Results Three themes emerged and were later refined, using Braun and Clarke’s 2006 thematic analysis method: 1. Purpose of mentorship, with sub themes: a. Expectations, b. Perception of mentorship as supervision, and c. The role of mentorship, including informal mentoring in leadership development 2. Role of mentorship in leadership development. 3. Perceptions of a leader, with sub-themes: a. The leader as a manager, b. The leader as a role model, and c. The merits of different leadership styles. Discussion Most of the residents (doctors in training) viewed mentorship in a positive way. However, when the mentor was perceived more as a supervisor, the usefulness of mentoring was less clear. However, they found that informal mentoring would contribute to leadership skills and would inspire them to become leaders themselves. They were likely to be influenced positively when they saw the leader as a role model, rather than a manager.

The landmark 2021 Resolution on Oral Health by the 74th World Health Assembly has elevated the importance of oral health into the global health policy agenda. This has led to the development and adoption of the World Health Organization (WHO) Global Strategy on Oral Health in 2022. It acknowledged the need to integrate oral health as part of universal health coverage (UHC), which is supported by national clinical leadership for oral health. Although Australia is a signatory WHO member state, it is yet to appoint a Commonwealth Chief Dental Officer to provide national clinical leadership. This commentary provides a background on the current issues on population oral health in Australia, an insight into the Australian oral healthcare system, and explores some of the challenges and learnings related to previous Commonwealth dental programs. This paper highlights why expertise in dental public health is required to steer national oral health policy that is focused on prevention and early intervention. A population oral health approach for UHC should be informed by evidence, prioritise and address oral health inequities, and be co-ordinated by national clinical leadership for oral health. What is known about the topic? Many countries, including Australia, currently do not provide universal access to affordable oral healthcare. There are significant oral health inequities that exist in Australia, particularly for priority populations who are at higher risk for oral diseases. What does this paper add? National clinical leadership on oral health is needed to implement evidence-based oral health policy. This commentary provides justification for the Australian Government to appoint a Commonwealth Chief Dental Officer. What are the implications for practitioners? Strengthening advocacy efforts by the public health practitioners and other stakeholders is important to promote oral health as a critical health issue for urgent action. [ABSTRACT FROM AUTHOR]

Leading inpatient teams is a foundational clinical responsibility of resident physicians and leadership is a core competency for inpatient physicians, yet few training programs have formal leadership curricula to realize this clinical skill. We implemented a 4-module curriculum for PGY1 internal medicine residents. The program focused on the managerial skills necessary for daily clinical leadership, followed by clinical coaching. Interns were first introduced to foundational concepts and then given the opportunity to apply those concepts to real-world practice followed by clinical coaching. Using direct-observations and a previously published checklist for rounds leadership, this study sought to evaluate the workplace behavior change for novice residents leading inpatient teams for the first time. We conducted a prospective cohort study (March 2016 and August 2018) of internal medicine residents at a large tertiary academic medical center in Boston, MA. Trained faculty raters performed direct observations of clinical rounding experiences using the checklist and compared the findings to historical and internal controls. Questionnaires were distributed pre- and post- curriculum to assess satisfaction and readiness to lead a team. We trained 65 PGY1 residents and raters conducted 140 direct observations − 36 in the intervention group and 104 among historical controls. The unadjusted mean score in rounds leadership skills for the intervention group was 19.0 (SD = 5.1) compared to 16.2 (SD = 6.2) for historical controls. Adjusting for repeated measures, we found significant improvement in mean scores for behaviors linked to the curricular objectives (p = 0.008) but not for general behaviors not covered by the curriculum (p = 0.2). A formal curriculum to train residents as leaders led to behavior change in the workplace in domains essential to rounds leadership. We also found that the curriculum was highly regarded in that all interns indicated they would recommend the curriculum to a peer. Moreover, the program may have assuaged some anxiety during the transition to junior year as 90% of interns surveyed felt more ready to start PGY2 year than historical trainings. We learned that while a robust, multi-faceted modular curriculum and clinical coaching successfully resulted in behavior change, the resources required to manage this program are significant and difficult to sustain. Future iterations could include asynchronous material and potentially peer-observation of rounds leadership to reduce the burden on faculty and program curricular time. [ABSTRACT FROM AUTHOR]

Elizabeth A Fradgley,1,2 Kate Booth,1 Christine Paul,1,2 Nicholas Zdenkowski,1 Nicole M Rankin3 1School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; 2Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; 3Faculty of Medicine and Health Sciences, University of Sydney, Camperdown, New South Wales, AustraliaCorrespondence: Christine Paul Level 4 West, HMRI Building, Callaghan, New South Wales, 2308, AustraliaTel +61 2 4042 0693Email chris.paul@newcastle.edu.auAim: Multidisciplinary team meetings (MDMs) are a critical element of quality care for people diagnosed with cancer. The MDM Chairperson plays a significant role in facilitating these meetings, which are often time-poor environments for clinical decision making. This study examines the perceptions of MDM Chairpersons including their role and the factors that determine the quality of a Chair, as well as the Chairperson’s perception of the value of personally attending meetings.Methods: This qualitative study used telephone interviews to explore the experiences of MDM Chairpersons from metropolitan and regional New South Wales, Australia. Using a state-wide register, 43 clinicians who chaired lung, genitourinary, gastrointestinal, and breast cancer meetings were approached to participate. Thematic data analysis was used to develop and organise themes.Results: Themes from the 16 interviews identified the perceived need for an expert and efficient MDM Chairperson with emphasis on personal rather than technical skills. The remaining themes related to the benefits of meetings to ensure quality and consistency of care; improve inter-professional relationships; and provide communication with and reassurance for patients.Conclusion: The role of the MDM Chairperson requires expert management and leadership skills to ensure meetings support quality patient-centred care. MDMs are perceived to provide multiple benefits to both clinicians and patients. Efforts to train Chairs and to maximise clinician and patient benefits may be warranted given the costly and time-consuming nature of MDMs.Keywords: multidisciplinary care, oncology, quality outcomes, cancer, clinical leadership

This paper presents a study from Sierra Leone that explored the experiences of doctors as they endeavored to improve the health care systems in which they worked. Twenty-eight interviews were conducted with doctors in Sierra Leone, complemented by long-standing experience of national health provision and research by the authors. Drawing on Hirschman's theory of ‘exit, voice and loyalty’, the paper's framework analysis elaborates the doctor's career decisions and choices under systematic political and economic constraints, and in particular, the specter of retribution, including posting to undesirable jobs and withholding of salaries. This retribution was considered a driver of exit by doctors from the system, and few examples were given of doctors successfully advocating for change through advocacy (‘voice’). We suggest that the relevance of Hirschman's theory to this setting is in drawing attention to the critical themes of retribution, opportunity, loyalties, and partial exits, ones often neglected in efforts to reduce emigration of doctors and strengthen their leadership. Ultimately, this paper critiques the overemphasis of mechanistic ‘capacity building’ in global health and recommends that health system strengthening must be viewed as a jointly political as well as technical exercise.

Background: Clinical leadership is the process of improving different organizational and patient care processes that achieve high‐quality and safety of care outcomes. Clinical leadership is about having the appropriate skills and attributes to manage clinical settings. Nurses need to develop managerial and leadership skills; thus, nurses clinical leadership skills should be developed in all clinical settings. The clinical leadership needs of nurses received limited focus; the concept is still not fully understood. Aim: This study aimed to assess the correlates and predictors of nurses' clinical leadership needs in Jordan. Materials and Methods: Using a cross‐sectional research design utilizing a purposive sample of 349 nurses were recruited from different hospitals. Pearson correlation coefficients standard multiple linear regressions were mainly used to analyze the data. Results: The "leadership and clinical practice" was the highest mean score of the subscales, while the "financial and service management" was the lowest. At an alpha of 0.05, significant positive moderate correlations were found between nurses' clinical leadership needs and: level of education, age, years of experience in nursing, years of experience in leadership, number of employees under the direct supervision of the leader, and type of the hospitals. At an alpha of 0.01, significant positive weak correlations were found between nurses' clinical leadership needs and: marital status, title, and unit/ward organizational structure. Marital status‐separated/divorced/widowed, and years of nursing‐4 years or less predicted negatively affect nurses' clinical leadership needs. Discussion and Conclusion: Meeting the clinical leadership needs of nurses will positively contribute to various clinical settings outcomes. Leadership training is needed to enhance nurses' clinical leadership skills and competencies. Key points: The recent literature about clinical leadership in nursing was limited. The clinical leadership needs of nurses received limited focus, and the concept is still not fully understood; this study bridge this gap of knowledge and skills.Promoting the clinical leadership needs of nurses will positively contribute to various clinical settings outcomes.Meeting the clinical leadership needs of nurses will positively contribute to various clinical settings outcomes.Leadership training is needed to enhance nurses' clinical leadership skills and competencies. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your knowledge of leadership styles, traits and characteristics • To refine your competence in supporting colleagues to become confident leaders • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Leadership is not expected solely of managers. At any stage of their career, nurses are expected to be able to demonstrate leadership in their day-to-day role. However, newly qualified nurses, who often experience a challenging transition from nursing student to registered nurse, may lack the confidence to demonstrate leadership. Nurse managers can support junior nurses to develop their leadership skills, notably through training, mentoring, reflection and action learning. By guiding newly qualified nurses in the use of different leadership approaches, experienced nurses can contribute to enhancing the quality of patient care. This article discusses how nurse managers can support newly qualified nurses to develop their leadership skills. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to analyse nurses' perceptions of clinical leadership needs and compare their differences based on the sample's characteristics. Also, it aimed to compare nurses' perceptions of clinical leadership needs between nurses and nurse managers. Background: Various professional organisations have identified the need to develop clinical leaders. Clinical leadership is about having clinical expertise in specialised fields and having professionals involved in clinical care. However, worldwide, little emphasis is placed on the clinical leadership needs of nurses. Methods: Using STROBE (https://www.strobe‐statement.org/index.php?id=available‐checklists), a cross‐sectional study was conducted in 2020 using a purposive sample of 349 Jordanian nurses who were surveyed using the CLeeNA instrument. Different descriptive and inferential statistics were used to analyse the data. The response rate in the current study was 69.8%. Results: The 7‐point CleeNa scale was reduced into 3 categories 1 = "not important (1–3)," 2 = "Neutral (4)" and 3 = "highly important (5–7)." The total mean score of perceived CleeNa was 2.61(SD = 0.50) indicating "very important." The highest perceived mean score of the subscales was for "leadership and clinical practice." In contrast, the lowest perceived mean score of the subscales was "financial and service management." The total mean scores of perceived CleeNa were higher among married nurses, nurse managers, those who have a master degree or more, aged 35 years or more, had more than 4 years of nursing experience or/and more than 4 years of leadership experience, supervised more than 10 employees and were working in teaching hospitals. The total mean scores of perceived CleeNa scale and subscales of staff and team development, patient safety and risk management, and perceived standards of care were higher among nurse managers when compared with nurses. Conclusion and relevance to clinical practice: Results indicated that innovative clinical leaders are needed. A paucity of research identifies the extent to which clinical leadership is enacted in clinical nursing practice. Developing a clinical leadership programme is warranted to contribute positively to nurses' leadership roles and outcomes, patients' outcomes, and in turn, organisational outcomes. [ABSTRACT FROM AUTHOR]

A career ladder for nurses, including several levels of nursing practice and specific roles for advanced practice nurses, was introduced in Hong Kong around the start of the 21st century. To date no studies have distinguished the practices of advanced practice nurses in Hong Kong. This cross‐sectional study, conducted between November 2020 and March 2021, aims to identify and differentiate the practice patterns of advanced practice nurses by utilizing the Advanced Practice Role Delineation tool. A total of 191 responses were obtained. Three roles were identified: nurse consultant, advanced practice nurse, and advanced practice nurse in management. Among the five advanced practice nursing domains, nurses were most frequently involved in Education and in Direct Comprehensive Care activities, while least active in Research and in Publication and Professional Leadership. Identifying activities in various nursing roles helps to differentiate their responsibilities and provides new insights for role utilization and support. Although the role characteristics are shaped by country contexts, research evidence on practice patterns may be used to support international discussion and efforts to promote role clarity and effective role introduction and optimization. [ABSTRACT FROM AUTHOR]

Background: Despite efforts to advance equity, diversity and inclusion, women face gender-based barriers in research, including in neurology. Compared with men, women are less likely to hold leadership positions and be senior authors. Gender disparities in grant funding within neurology have yet to be investigated. We examine gender disparities in Canadian Institutes of Health Research (CIHR) funding for Canadian neurology divisions and departments., Methods: Data on CIHR grant recipients and metrics (grant contribution, duration and quantity) within Canadian neurology divisions and departments between 2008 and 2022 were acquired from the CIHR Funding Decisions Database. Gender identity was determined by a validated application programming interface. Gender-based differences in CIHR grant contribution amount, duration and prevalence within neurology were calculated. Subgroup analysis was conducted for Canadian-licensed neurologists and Project Grant awards., Results: 1604 grants were awarded to Canadian neurology divisions and departments between 2008 and 2022. Compared with men, women received less funding (p<0.0001), shorter grant durations (p<0.0001) and fewer grants (41.5%) annually. Women comprised the minority of recipients (45.5%) and were less likely to be awarded grants (p<0.001) annually relative to men. Differences were consistent in subgroup analyses, except for equal grant durations observed across genders in Project Grant awards., Conclusion: We report gender disparities in CIHR grant funding to Canadian neurology divisions and departments. Women receive lower contribution amounts, shorter grant durations and fewer grants than men. Future recommendations include addressing gender differences and continuing to evaluate CIHR funding to provide equal opportunities for women in research and funding., Competing Interests: Competing interests: FK is the recipient of the Vancouver Medical, Dental and Allied Staff Association Scientific Achievement Award (2024) and Michael Smith Health Research BC Award (2023–2028)., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Ten advanced practice nurses are already working at the Guillaume-Régnier hospital in Rennes. As part of an internship at this facility, students in the second year of the IPA master's degree in psychiatry and mental health at the University of Rennes were interested in the dynamics surrounding this still recent profession, the diversity of the missions performed, and inter-professional collaboration. An online survey was distributed to IPAs, and four interviews were conducted with healthcare professionals working with them., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Women often face the challenge of balancing professional growth with societal expectations around family and household responsibilities. Conversely, men encounter limitations due to restrictive paternity leave policies, often receiving undue praise for basic parenting duties. Through the lens of the Chief Pharmaceutical Officer's clinical fellows 2023/24, we explore the question: 'Can you have it all?', Methods: We explore stereotypical gender norms alongside the challenges and expectations faced by individuals of all genders on their leadership journeys. Through personal reflections, literature review and informal conversations with senior leaders, we explore how societal expectations and gendered norms shape the professional and personal lives of women in leadership roles., Results: Commitment to reflection provides opportunities to pause and assess our journeys. Peer support networks are invaluable for professional development, helping to break down barriers and hierarchies. Coaching and mentoring offer significant support and guidance to aspiring leaders from underrepresented backgrounds providing new perspectives., Conclusion: Balancing leadership and family responsibilities is challenging but achievable with the right support systems and a shift in workplace culture. However, we recognise, through all of this, self-care and prioritisation of mental well-being must be at the forefront to sustain a healthy balance. As clinical fellows, we have had the unique opportunity to share the complexities faced in the workplace. Through collective effort, we aim to foster environments that empower individuals on their leadership journeys, illustrating that, with the right support and conditions, it is possible to truly 'have it all'., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Paediatric professional scarcity and uneven distribution is acute in underdeveloped regions, exacerbated by COVID-19's workload surge and burnout, highlighting the need for strengthened prevention and response measures., Aim: Propose an effective talent management model to address the challenge of paediatric medical personnel shortage and lack of management experience in Underdeveloped cities of developing countries., Methods: A crisis management plan has been implemented in a paediatric hospital in Henan, China, with a talent framework to ensure a skilled, stable workforce., Results: An advanced talent management system is vital to address paediatric talent scarcity. Leveraging the national Children's Regional Medical Center, fostering international cooperation, sharing knowledge and harnessing regional policies are key to effective paediatric talent management through leveraging, promotion, and driving initiatives., Conclusions: Efficient talent management methods have a significant positive impact on addressing the paediatric talent crisis, enabling departments and institutions to effectively manage medical talent through scientific strategies, ultimately contributing to the alleviation of medical resource deficiencies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Rationale and Key Points: This article explains how to implement compassionate leadership in nursing teams. Compassionate leadership is an approach that aims to empower and support staff through four main behavioural principles - attending, understanding, empathising and helping. • Compassionate leadership can be practised by all nurses, irrespective of their role or position, and with individuals or groups. • For the nurse, understanding and reflecting on their own leadership style is the starting point for compassionate leadership, after which nurses may consider leading others. • Implementing compassionate leadership can empower teams, enhancing team members' performance, motivation and well-being. • Compassionate leadership can also support improved outcomes for patients, since motivated nurses are more likely to provide high-quality care. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might help you to introduce compassionate leadership into your nursing team. • How you could use this article to educate nursing colleagues and students about the role of compassionate leadership in nursing teams., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Objective: Effective clinical leadership is crucial for the delivery of high-quality medical care. However, the extent to which current leadership development effectively enhances leadership competencies for junior doctors remains uncertain., Methods: This study aimed to investigate the utilisation of quality improvement projects (QIPs) to enhance leadership skills among junior doctors in a District General Hospital. Additionally, the feasibility of implementing a leadership programme in a smaller District General Hospital alongside didactic learning, reflection and stakeholder engagement was assessed. The Medical Leadership Competency Framework Self-Evaluation Tool was used to assess current leadership qualities and develop personal action plans., Results: While the majority of junior doctors completed QIPs, only a few engaged in reflective practice. Moreover, limited participation in formal leadership programmes was observed., Conclusion: The study suggests that effective interpersonal development combined with long-term leadership training can be a resource-intensive yet valuable approach to adequately prepare future leaders even within District General Hospitals. The findings highlight the need for a structured leadership curricula utilising longitudinal project-based learning., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Interprofessional leadership is essential to sustain the National Health Service (NHS) in pressured times, which should include the NHS's third largest clinical workforce in England: allied health professionals (AHPs) (AHPs as defined by NHS England: Art therapists; Dramatherapists; Music therapists; Dietitians; Occupational therapists; Operating department practitioners; Orthoptists; Osteopaths; Paramedics; Physiotherapists; Podiatrists, Prosthetists and Orthotists; Radiographers; Speech and language therapists). Therefore, a feasibility study was undertaken, to explore the views of AHPs working in early to mid-career positions, regarding the barriers and opportunities they encounter, in both leadership and career development., Methods: Twenty-seven participants, representing 8 of the 14 AHP professions across England, were interviewed across 10 focus groups., Results: Thematic analysis (TA) generated four themes, including the barriers and opportunities for AHP leadership development and career progression. Further TA identified three overarching themes: equitable and interprofessional leadership development; an equitable and structured AHP career pathway; and having AHP leaders at a strategical and/or very senior level. These overarching themes were subsumed under the umbrella category: equity of opportunity and voice. The AHPs, who were interviewed, reported inequitable access to both career and leadership development, compared with other professions, such as nurses, doctors and pharmacists., Discussion: Further work is needed to ensure that interprofessional representation, within senior leadership levels, includes AHPs; which the data suggests would directly benefit all AHPs' leadership and career development. Recommendations for organisations to facilitate leadership and career development were developed from the TA and at a system-wide level. Further research would be beneficial to gather the views of the six AHP professions not interviewed in this study and from other organisations, such as independent practice. However, this feasibility study does attempt to represent the voices of AHPs, which can be lacking in both organisations and research., Competing Interests: Competing interests: Leadership Faculty, Postgraduate Medical and Dental Education, HEE YH: Payment towards MSc dissertation module (no award/grant number); HEE continuing professional development funds, via Sheffield Teaching Hospitals NHS Trust: Payment towards MSc dissertation module (no award/grant number); Minor grant fund, Royal College of Speech and Language Therapy: Payment towards MSc dissertation module (no award/grant number); Personal funding: Payment towards MSc dissertation module., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Aims and Background: The COVID-19 pandemic has had adverse effects on nurses, impacting them physically, mentally and psychosocially. These effects stem from heightened workloads, fears of contracting a life-threatening illness due to inadequate protective equipment and concerns about transmitting the disease to their families. This study assessed the impact of COVID-19 on the quality of life of nurses working on the frontlines, aiming to provide insights for future crisis responses., Methods: A descriptive-analytic study included 288 nurses from hospitals affiliated with Çukurova University, Southern Turkey using a stratified sampling method. Data on quality of life and demographics were collected using the WHO Quality of Life-BREF scale and a questionnaire. Data analysis was conducted using SPSS V.25, employing descriptive and analytic measures at a significance level of p<0.05., Results: Overall perceived quality of life was moderate (mean score: 3.31; SD: 0.56), with the highest scores in social relationships, psychological well-being and environmental factors. Positive correlations were found with gender, education, salary, vaccination status and living alone. Negative correlations were observed with alcohol consumption and longer working hours., Conclusions: To strengthen future crisis responses, health authorities should prioritise workload reduction, gender diversity promotion, support for nurses residing with family, better income opportunities, alcohol abstinence encouragement and ensuring vaccination for frontline nurses., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Academic medical centres (AMCs) have the tripartite mission of performing research to advance healthcare delivery, educating future clinicians and providing healthcare services. This study investigates the criteria associated with being promoted in a Singaporean AMC., Methods: Using a dataset of 255 candidates for promotion at the studied AMC, we employ logistic regression to determine if these factors are associated with the likelihood of promotion. Further, we use interaction effects to test if the relationship between the H-index and likelihood of promotion differs across the academic levels of the candidates., Results: The logistic regression results based on the best of our three tested models suggest that the H-index is positively associated with promotion for those applying to become clinical associate professors (OR=1.43, p=0.01). Moreover, candidates who provide well-developed education portfolios (OR=3.61, p=0.02) and who have held service/leadership roles (OR=6.72, p<0.001) are more likely to be promoted., Conclusions: This study affirms the correlation between promotion and the advancement criteria outlined by the AMC. This is important for transparency and trust between the AMC and its faculty in their applications for promotion and success in an academic career. Further, our study is one of the few empirical studies linking promotion criteria to promotion outcomes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Competing interests: None declared.