BMJ Leader最新文献

{"title":"Embracing artificial intelligence in surgical training: a clinical leadership perspective.","authors":"Patrick Cook, Atef Hassan, Ryan Kerstein, Mohamed A Imam","doi":"10.1136/leader-2025-001258","DOIUrl":"10.1136/leader-2025-001258","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"315-318"},"PeriodicalIF":2.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity in US medical school department chairs: 45-year retrospective analysis.","authors":"Milin Patel, Nachiket Patel, Jeffrey Ding, Shaheer Mujahid, Nancy D Spector, Sophia Kamran, Javed Siddiqi, Faisal Khosa","doi":"10.1136/leader-2025-001283","DOIUrl":"10.1136/leader-2025-001283","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the trends in sex and race/ethnicity demographics of department chairs at US medical schools over 45 years.</p><p><strong>Design: </strong>This was a longitudinal retrospective analysis of the Association of American Medical Colleges database.</p><p><strong>Setting: </strong>The study analysed the sex and race/ethnicity of department chairs in US medical schools.</p><p><strong>Participants: </strong>Department chairs were classified by sex and self-reported race/ethnicity. Data from 1977 to 2022 were used to evaluate changes in the demographic composition of leadership roles over time.</p><p><strong>Exposure: </strong>Identifying as female and/or as part of an under-represented in medicine group.</p><p><strong>Main outcomes and measures: </strong>The outcome measures were demographic (ie, sex, race and ethnicity) trends among department chairs.</p><p><strong>Results: </strong>The analysis depicted under-representation of women and racial minorities in department chairs. A notable increase was noted in the number of Asian, Black or African American, and Hispanic or Latino department chairs. However, this was outnumbered by the number of white individuals in leadership positions.</p><p><strong>Conclusion and relevance: </strong>The end of affirmative action is expected to jeopardise the progress made and has the potential to perpetuate the lack of diversity in the department chair positions.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"285-291"},"PeriodicalIF":2.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demand as the echo of conditions: a leadership lens for understanding system pressure.","authors":"Philip Whatling","doi":"10.1136/leader-2026-001668","DOIUrl":"https://doi.org/10.1136/leader-2026-001668","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with job satisfaction among government-employed doctors in Sabah, Malaysia: the role of supervisor support and scheduling flexibility.","authors":"Samsul Tuah Ag Tuah, Abdul Rahman Ramdzan, Mohd Fadhli Mohd Fauzi, Nur Adibah Mat Saruan, Apriningsih Apriningsih","doi":"10.1136/leader-2026-001701","DOIUrl":"https://doi.org/10.1136/leader-2026-001701","url":null,"abstract":"<p><strong>Background: </strong>Job satisfaction among doctors is a workforce signal, not merely an individual attitude. In geographically dispersed and resource-constrained health systems, dissatisfaction may reflect organisational strain, weak supervisory support and limited control over work schedules. This study examined the association between scheduling flexibility, supervisor support and job satisfaction among government-employed doctors in Sabah, Malaysia.</p><p><strong>Methods: </strong>A cross-sectional analytical study was conducted from September to October 2025 among government-employed doctors in selected government hospitals in Sabah. Hospitals were selected using stratified random sampling according to hospital type and geographical setting, followed by random selection of eligible medical officers within participating hospitals. House officers, specialists, resident specialists and doctors with less than 6 months of service were excluded to maintain a more homogeneous medical officer population. Data were collected using a self-administered questionnaire. Job satisfaction, flexible working hours and supportive supervision were measured and analysed as binary variables. Univariable and multivariable logistic regression analyses were performed.</p><p><strong>Results: </strong>A total of 141 doctors were included. Overall, 60 doctors reported job satisfaction, giving a satisfaction proportion of 42.6%. In multivariable analysis, doctors satisfied with flexible working hours had substantially higher odds of job satisfaction than those not satisfied (adjusted OR (AOR) 10.25; 95% CI 4.07 to 25.85; p<0.001). Doctors satisfied with supportive supervision also had higher odds of job satisfaction (AOR 8.99; 95% CI 3.37 to 23.98; p<0.001). Married doctors had higher odds of job satisfaction than single doctors (AOR 2.12; 95% CI 1.03 to 4.37; p=0.041). Other demographic, professional and institutional variables were not statistically significant after adjustment.</p><p><strong>Conclusion: </strong>Fewer than half of doctors reported job satisfaction. The strongest associations were organisational rather than demographic or institutional: flexible working hours and supportive supervision. These findings identify scheduling flexibility and supportive supervision as potentially modifiable organisational factors associated with doctors' work experience and relevant to workforce sustainability in resource-constrained public hospitals.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joining the team midstream: practical behaviours for adaptive clinical practice.","authors":"Ian McCoog, Rose Barham, Andrea DiMattia, Brytanie Marshall","doi":"10.1136/leader-2026-001626","DOIUrl":"https://doi.org/10.1136/leader-2026-001626","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When patients bring AI into the consultation: implications for clinical leadership.","authors":"Muhammad Mohsin","doi":"10.1136/leader-2026-001687","DOIUrl":"https://doi.org/10.1136/leader-2026-001687","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing organisational commitment and readiness through the DANMM project: a mixed-methods study.","authors":"Troy Pietsch, Jessica Biles, Bradley Christian, Brett Biles, Judith Anderson, Shanna Fealy, Angela Damm, Nicolle Dawson, Grant Sara","doi":"10.1136/leader-2026-001545","DOIUrl":"https://doi.org/10.1136/leader-2026-001545","url":null,"abstract":"<p><strong>Background: </strong>Low representation and retention of Aboriginal and Torres Strait Islander nurses and midwives remain a persistent challenge for Australian health systems, constraining delivery of culturally safe, person-centred care. Building and sustaining this workforce is essential to addressing entrenched systemic health inequity.</p><p><strong>Aim: </strong>This study evaluated the impact of implementing the Deadly Aboriginal Nursing and Midwifery Mentoring (DANMM) programme on health leaders' perceptions of organisational capability at individual and organisational levels.</p><p><strong>Design: </strong>An exploratory, mixed-methods study SETTING: Senior health leaders across four local health districts in New South Wales METHODS: Using snowball recruitment, the Organisational Commitment and Health Professional Program Readiness Assessment Compass (OCHPPRAC) was administered before and after DANMM implementation, alongside qualitative yarns. Quantitative data were analysed using SPSS, while qualitative data were examined inductively using Braun and Clarke's thematic analysis framework.</p><p><strong>Outcome measures: </strong>The primary outcome was change in OCHPPRAC organisational success factors pre and post implementation. Secondary outcomes included leaders' qualitative reflections on mentoring, relationships and cultural safety. Leaders from two local health districts participated.</p><p><strong>Results: </strong>Eight participants completed the OCHPPRAC. No statistically significant differences were identified across organisational success factors between pre and post implementation. Qualitative findings from five participants generated three themes: mentoring confidence and engagement; building enduring connections to support programme success; and fostering cultural safety.</p><p><strong>Conclusions: </strong>This exploratory study examined the influence of the DANMM programme on perceptions of organisational cultural capability within participating local health districts. While quantitative findings demonstrated no significant organisational level change, qualitative insights revealed meaningful shifts in leadership attitudes, relationships and culturally safe practice. These findings suggest culturally informed mentoring programmes can strengthen relational leadership dimensions supporting Aboriginal and Torres Strait Islander nursing and midwifery workforce sustainability. Longer term implementation and evaluation are required to demonstrate measurable organisational change across diverse health service contexts nationally settings.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eco-affective health as a missing pillar of planetary health leadership.","authors":"Lucas Murrins Marques","doi":"10.1136/leader-2025-001520","DOIUrl":"https://doi.org/10.1136/leader-2025-001520","url":null,"abstract":"<p><p>Planetary health leadership increasingly depends on the capacity to sustain engagement, legitimacy and long-term action under accelerating environmental change. While leadership frameworks in planetary health have advanced in addressing governance, systems transformation and sustainability practices, they have largely overlooked a foundational dimension through which environmental change is experienced and acted on: affect. This commentary introduces an eco-affective health-informed leadership perspective, arguing that emotional responses to environmental change, such as distress, fatigue, loss and hope, are not peripheral or individual-level phenomena but system-level signals that shape policy acceptance, institutional endurance and behavioural persistence within health systems. Drawing on evidence from sustainability science, public health and affective research, the paper reframes eco-affective dynamics as sources of strategic insight rather than obstacles to be managed or medicalised. A concise leadership-oriented framework is presented to support planetary health leaders in recognising, interpreting and responding to eco-affective signals across institutions, communities and policy environments, with practical implications for governance, decision-making and health system resilience. By integrating eco-affective health into planetary health leadership, this commentary advances a human-centred approach to leading through environmental disruption, positioning lived experience as central to the durability, legitimacy and effectiveness of planetary health action.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A learner-driven, longitudinal model for high-value care education: early outcomes from the STARS program.","authors":"Christopher Moriates, September Wallingford, Victoria Valencia, William K Silverstein, Karen Born, Brian M Wong, Andrea Smeraglio, Micah Prochaska, Vineet M Arora","doi":"10.1136/leader-2026-001625","DOIUrl":"https://doi.org/10.1136/leader-2026-001625","url":null,"abstract":"<p><strong>Introduction: </strong>Attitudes and clinical norms are shaped during medical training. Evidence from high-value care education suggests early exposure influences long-term practice patterns, making it an ideal target for curricula interventions. STARS (Students and Trainees Advocating for Resource Stewardship) is a learner-driven programme developed by Choosing Wisely Canada in 2015 and subsequently adopted in the USA. It exposes medical students to high-value care principles and activates them as change agents. We evaluated perceived sustained influence of the US STARS programme on attitudes, behaviours and professional development among medical students.</p><p><strong>Methods: </strong>We conducted a mixed-methods programme evaluation of approximately 20% of participants from the first six U.S. cohorts (n=579; 2018-2023). Participants completed an anonymous retrospective pre-post survey assessing familiarity with healthcare value concepts and STARS' perceived influence. They also submitted annotated CVs reviewed for scholarly activities attributed to programme participation. Survey data were analysed using descriptive statistics.</p><p><strong>Results: </strong>Ninety-four of 118 invited participants (80% response rate) completed both components. Participants reported that STARS influenced how they consider healthcare costs in clinical decision-making, discuss medical overuse with peers and appreciate the impact of costs on patients. Many attributed subsequent leadership activities and scholarly output to their participation, including quality improvement projects, peer-reviewed publications and locally implemented educational initiatives.</p><p><strong>Conclusion: </strong>This evaluation highlights the potential of learner-driven, longitudinal models such as STARS to foster durable engagement with high-value care education and catalyse professional development among medical trainees.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing leadership through talk: how small group reflections can enhance leadership competence.","authors":"Ida Liebe Felsted, Stephanie Noëlle Elisabeth Meeuwissen","doi":"10.1136/leader-2025-001344","DOIUrl":"https://doi.org/10.1136/leader-2025-001344","url":null,"abstract":"<p><strong>Introduction: </strong>Competency-based medical education in postgraduate medical education (PGME) prioritises developing holistic physicians, including leadership competence. The leadership competence encompasses self-management, working effectively in teams, considering organisational and societal demands and navigating complex situations. Although group reflection has proven valuable for leadership development in other professional fields, its role in PGME remains underexplored. This qualitative study investigated how small group reflection can support the development of leadership competence among PGME residents.</p><p><strong>Method: </strong>Using a constructivist grounded theory approach, a purposive sample of seven residents and seven counsellors from three Danish psychiatric hospitals were interviewed. Data analysis followed an iterative process of open, axial and selective coding, eventually constructing three themes.</p><p><strong>Results: </strong>Three central themes related to leadership development were constructed: (1) community and safety, (2) perspective taking and (3) engagement. Residents valued a sense of community, which enabled open dialogues and a willingness to express vulnerability. This safe and supportive environment supported small group discussions. Exposure to diverse perspectives through group reflection broadened residents' understanding of leadership and helped them identify their strengths, areas for improvement and opportunities for action. Group reflection reinforced learning and facilitated further planning of leadership development.</p><p><strong>Conclusions: </strong>These findings show that group reflection is perceived as a valuable method for residents to develop leadership competence, supported by a sense of community and psychological safety. These insights can inform the design of new learning activities using group reflection as an educational tool, fostering leadership competences in PGME.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}