BMJ Leader最新文献

{"title":"Allied health professions (AHP) engagement with and leadership towards actionable carbon reduction interventions to meet the NHS net zero agenda: a consensus study.","authors":"Frances Slowie, Linda Hindle, Louise Davey-Hewins, Sarah Cooper, Clare Pettinger","doi":"10.1136/leader-2025-001451","DOIUrl":"https://doi.org/10.1136/leader-2025-001451","url":null,"abstract":"<p><strong>Background: </strong>Climate change is one of the greatest threats to human health. The UK health and care system is responsible for 4%-5% of the country's carbon footprint. Following an ambitious commitment to 'Delivering a Net Zero NHS', there is an ongoing urgent drive to advocate for proactive sustainability measures across the workforce healthcare practice areas. As the third largest workforce within the NHS, allied health professionals (AHPs) are crucial players in this net zero commitment. Implementing suitable carbon reduction strategies requires leadership and more clarity on the practical steps that AHPs can take specific to their unique skill set.</p><p><strong>Objective: </strong>This study aimed to develop a professional consensus on the actionable carbon reduction priorities across a sample of AHP professions.</p><p><strong>Setting: </strong>AHPs working in diverse areas of practice.</p><p><strong>Participants: </strong>n=101 participants from n=10 AHP professional disciplines.</p><p><strong>Methods: </strong>Using an adapted nominal group technique, 10 workshops were run with AHP professional disciplines to discuss practice-related carbon reduction priorities. Within workshops, ideas were discussed, scored and ranked to produce a final consensus on the top (5 or 10) priorities for carbon reduction for each profession.</p><p><strong>Results: </strong>Via thematic analysis, five cross-cutting themes emerged: (a) resource use; (b) preventative healthcare; (c) digital transformation; (d) professional development/training and (e) service efficiency/re-design. Findings align closely with those highlighted in the 'AHPs Deliver' strategic vision to prioritise environmental sustainability across practice areas. They also concur with the urgent call for stronger leadership within healthcare to embed sustainability and planetary health into 'business as usual' function.</p><p><strong>Conclusions: </strong>Despite some inherent limitations (eg, purposive sampling, which might have presented bias) this study provides a solid foundation on which to base future action to reduce carbon emissions within the UK healthcare context. Recommendations are made for AHP practice, advocacy and culture change, and for bold (collaborative) leadership to spearhead and direct transformational change towards greener healthcare across the AHP community.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370103","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":"Understanding mechanisms and outcomes in multidisciplinary leadership development: a mixed-methods evaluation.","authors":"Juliette Catherine Phillipson, Nicholas Hicks, Oscar Lyons","doi":"10.1136/leader-2026-001588","DOIUrl":"https://doi.org/10.1136/leader-2026-001588","url":null,"abstract":"<p><strong>Background: </strong>The Oxford Health: Health Systems Development Programme was co-designed to strengthen multidisciplinary leadership capacity and address staff morale, engagement and autonomy. This study aimed to evaluate the mechanisms and outcomes of the programme.</p><p><strong>Methods: </strong>Twenty-two participants completed the one year programme, which included six full-day workshops. We conducted a mixed-methods evaluation mapped to Kirkpatrick's framework. Pre-programme and post-programme self-assessments using an adapted Medical Leadership Competency Framework Questionnaire (MLCFQ) were analysed using Wilcoxon signed-rank tests with Bonferroni correction. Post-programme questionnaires, free-text responses and reflective essays (n=15) were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Workshops were highly rated for relevance and experience. There were statistically significant improvements in two MLCFQ domains: managing services and setting direction (p=0.02). Psychological safety, legitimised vulnerability and structured reflection were identified in qualitative data as central mechanisms for change. Participants reported increased leadership self-efficacy, systems-thinking and confidence in speaking up. Behavioural transfer included deliberate cultivation of psychological safety and broader ranges of approaches to leadership. Reported organisational impacts included increased staff voice, team cohesion and early service-level improvements.</p><p><strong>Conclusions: </strong>This evaluation demonstrates credible evidence of behavioural transfer and early organisational influence. Strengthened longitudinal evaluation and predefined service-level metrics are required to assess sustainability and objective impact.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362741","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":"Radiographers' readiness for artificial intelligence (AI) leadership: confidence, challenges and role expectations in the UK.","authors":"Gemma Walsh, Janice St John-Matthews, Yiannis Kyratsis, Benard Ohene-Botwe, Amanda Goodall, Christina Malamateniou","doi":"10.1136/leader-2025-001513","DOIUrl":"https://doi.org/10.1136/leader-2025-001513","url":null,"abstract":"<p><strong>Background: </strong>With the rapid implementation of artificial intelligence (AI) in radiographer workflows, leadership roles are necessary for its safe and effective integration into practice. Due to their dual professional identity (encompassing patient-centred care skills and technical skills) radiographers emerge as natural AI leaders within the medical imaging and radiotherapy ecosystems.</p><p><strong>Aim: </strong>To examine how UK radiographers perceive their readiness, confidence and potential roles in AI leadership, and to identify the barriers and enablers for their engagement within the AI-ecosystem.</p><p><strong>Methods: </strong>A UK-wide, cross-sectional, online survey of radiographers and students (n=273) combined demographic questions, AI knowledge and experience questions, Likert-type assessments of preparedness and free text responses. Quantitative data were analysed using descriptive statistics and Mann-Whitney U tests; qualitative data underwent thematic content analysis.</p><p><strong>Results: </strong>Most respondents reported limited AI literacy and minimal hands-on experience, citing insufficient education, protected time and managerial support as key barriers to leadership readiness. Confidence varied: women and those with little AI exposure, expressed statistically significant lower confidence to lead in AI-enabled environments. Respondents felt more comfortable taking on leadership responsibilities once AI systems were already in place than leading their implementation. Qualitative findings indicated that in this predominantly frontline sample, radiographers described AI leadership mainly as operational, practice-based work. Motivations for leadership focused on improving workflows, supporting colleagues and ensuring safe practice.</p><p><strong>Discussion/conclusions: </strong>Radiographers recognise the relevance of AI leadership but understand it as practice-proximal, operational-focused responsibilities, due to limited AI exposure, uneven confidence and the absence of defined leadership pathways in national policy. Role ambiguity and limited experiential learning constrain radiographers' ability to envision strategic or organisation-wide AI leadership. Profession-specific education, structured experiential opportunities and organisational support are essential for enabling radiographers to participate equitably and effectively in AI-enabled service transformation.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362792","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":"Relative importance of senior leaders compared with direct supervisors in clinician burnout.","authors":"Daniel Marchalik, Alberta Tran, Nate C Apathy","doi":"10.1136/leader-2025-001414","DOIUrl":"https://doi.org/10.1136/leader-2025-001414","url":null,"abstract":"<p><strong>Background: </strong>Clinician well-being has been linked to leadership assessment, yet the relative impact of satisfaction with direct supervisors versus senior leadership remains underexplored. Understanding these relationships can inform leadership development and organisational strategies to mitigate burnout.</p><p><strong>Methods: </strong>We administered a well-being survey to all frontline clinicians at a large US health system in Spring 2023 (response rate 24.5%). Independent variables included satisfaction with immediate supervisors and senior leadership, operationalised from five-point Likert items. Burnout was assessed using the Professional Fulfillment Index. Linear probability models estimated the association of leadership satisfaction with burnout, adjusting for clinician type and gender. Stratified analyses examined differences across nurses, advanced practice providers, physician trainees and attending physicians.</p><p><strong>Results: </strong>Among 3707 respondents, 36.3% met criteria for burnout. Satisfaction with senior leadership was associated with an 83.7% lower probability of burnout (B=-0.304, p<0.001), compared with 32.2% for direct supervisors (B=-0.117, p<0.001). Findings were consistent across clinician groups, with senior leadership satisfaction demonstrating the largest effect, particularly among nurses.</p><p><strong>Conclusions: </strong>Satisfaction with senior leadership exerts a stronger influence on burnout than satisfaction with immediate supervisors. Interventions that support senior leadership development may yield significant benefits for frontline healthcare worker well-being and retention.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354042","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":"Contemporary diversity trends among matched ophthalmology residents in the USA.","authors":"Camryn Thompson, Pratap Challa, Sandra S Stinnett, Sharon Fekrat","doi":"10.1136/leader-2024-001204","DOIUrl":"10.1136/leader-2024-001204","url":null,"abstract":"<p><strong>Background: </strong>Ophthalmology remains one of the least diverse medical specialties, despite ongoing efforts to promote inclusion. To address the gap in recent literature and understand the demographic trajectory of this specialty, this study analyses current demographic trends among ophthalmology residents in the USA.</p><p><strong>Methods: </strong>US ophthalmology residents enrolled with the Accreditation Council for Graduate Medical Education between 2008 and 2022 were included. Racial trends were analysed over the period of 2012-2022, and sex trends were analysed across 2008-2022, according to data availability.</p><p><strong>Results: </strong>Over the study period, the percentage of female ophthalmology residents remained stable from 41% in 2008 to 41.8% in 2022 (compared with 54.6% of US medical students). The least represented racial group from 2012 to 2022 was American Indian/Alaskan Native (ranging 0%-0.35%) followed by black/African American (ranging 1.42%-3.01%) and Hispanic/Latin/Spanish origin (ranging 2.05%-7.50%). The year with the greatest proportion of under-represented in medicine (URiM) ophthalmology residents was 2021-2022, with 10.5% URiM residents (0% American Indian/Alaskan Native, 3.01% black/African American, 7.50% Hispanic/Latin/Spanish). The summed proportions of URiM ophthalmology residents were significantly less before 202 (5.4%) compared with after (10%) (p<0.001).</p><p><strong>Conclusions: </strong>Overall, female and URiM residents are under-represented in ophthalmology. The proportion of female residents remained constant between 2008 and 2022, highlighting a need for additional recruitment efforts. The proportion of URiM residents increased over the same period, highlighting a time period of interest for future research on recruitment strategies.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"179-182"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555240","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":"Learning to lead by listening: an autoethnographic reflection from my early months as a health and social care CEO.","authors":"Paul Newman","doi":"10.1136/leader-2025-001424","DOIUrl":"10.1136/leader-2025-001424","url":null,"abstract":"<p><strong>Background: </strong>Transitioning into a new chief executive role within a large national health and social care provider prompted a period of systematic observation and deliberate reflection. Drawing on Schön's concept of the reflective practitioner, I kept a journal during my first months to capture critical moments that tested my assumptions and revealed how organisational culture shapes leadership behaviour.</p><p><strong>Reflection: </strong>This autoethnographic account integrates observation, intentional listening and reflective journaling to explore how leadership meaning is constructed in everyday practice. Six anonymised vignettes are presented, spanning board discussions, governance meetings and frontline encounters. Each vignette illustrates tensions such as silence vs intervention, urgency vs empathy and authority vs collaboration, analysed through frameworks including adaptive, situational and collective leadership, as well as psychological safety, motivation and organisational culture.</p><p><strong>Conclusion: </strong>The reflections show that leadership is not confined to formal authority but emerges in presence, tone and everyday interactions. They demonstrate how listening, humility and adaptive behaviour foster psychological safety and collective leadership. While situated in health and social care, the insights are transferable to leaders at all levels and across sectors facing complexity and uncertainty.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"229-231"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655857","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":"Succession planning in nursing management: a scoping review.","authors":"Mohammadsaeed Mirzaee, Tahmine Salehi, Mansoureh Ashghali-Farahani","doi":"10.1136/leader-2025-001227","DOIUrl":"10.1136/leader-2025-001227","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this review article is to comprehensively examine and analyse the studies and research conducted in the field of succession planning in nursing management.</p><p><strong>Introduction: </strong>Succession planning, through the identification and appointment of qualified managers to key leadership positions, helps improve the quality of nursing services.</p><p><strong>Methods: </strong>The present study is a scoping review that was conducted using Arksey and O'Malley's framework. We used English-language databases such as Web of Science, PubMed, Scopus, ProQuest and the Google Scholar search engine. Additionally, for searching Persian-language sources, databases such as the Islamic World Science Citation Center, the Jihad University Journals Bank, Iran-Doc, Elm-Net and the Ministry of Health's of Iran Theses System were employed.</p><p><strong>Results: </strong>30 documents were selected based on the evaluation for data extraction, aligning with the objectives of the study. The results of the data analysis identified six main categories related to succession planning: barriers, facilitators, requirements, contextualisation, cyclical succession planning and potential succession planner organisation.</p><p><strong>Conclusion: </strong>Based on the importance of succession planning in nursing management, we recommend using the study's findings to plan and carry out thorough and practical research, formulate guidelines and managerial policies, define hospital goals and missions, and shape the organisational vision.</p>","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"117-122"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving beyond net-zero to a nature-positive healthcare sector.","authors":"Sara Soraya Eriksen, David Vernon Brasfield, Ola Løkken Nordrum, Trond Heir","doi":"10.1136/leader-2025-001252","DOIUrl":"10.1136/leader-2025-001252","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"198-199"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972631","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":"Redefining the primary role of healthcare boards: to advance careful and kind care.","authors":"Leonard Berry, Dominique Allwood, Sheila Delaney Moroney, Maggie Breslin, Richard M Levy, Donald M Berwick, Victor M Montori","doi":"10.1136/leader-2024-001208","DOIUrl":"10.1136/leader-2024-001208","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"192-197"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070978","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":"Burning to the edge: healthcare leadership in a time of climate-driven wildfires.","authors":"Dana Mathew, Attila J Hertelendy, Gregory R Ciottone","doi":"10.1136/leader-2025-001308","DOIUrl":"10.1136/leader-2025-001308","url":null,"abstract":"","PeriodicalId":36677,"journal":{"name":"BMJ Leader","volume":" ","pages":"187-191"},"PeriodicalIF":2.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253096","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}