Linking leadership development programs for physicians with organization-level outcomes: a realist review
Abstract Background Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization’s performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing. Objective To investig...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09811-y |
| _version_ | 1797774320518299648 |
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| author | Maarten Debets Iris Jansen Kiki Lombarts Wietske Kuijer-Siebelink Karen Kruijthof Yvonne Steinert Joost Daams Milou Silkens |
| author_facet | Maarten Debets Iris Jansen Kiki Lombarts Wietske Kuijer-Siebelink Karen Kruijthof Yvonne Steinert Joost Daams Milou Silkens |
| author_sort | Maarten Debets |
| collection | DOAJ |
| description | Abstract Background Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization’s performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing. Objective To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes. Methods We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O). Results In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories ‘culture’, ‘quality improvement’, and ‘the leadership pipeline’: 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes. Conclusions LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes. |
| first_indexed | 2024-03-12T22:19:20Z |
| format | Article |
| id | doaj.art-f1b394f6591348c3961438a573f42d32 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-12T22:19:20Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-f1b394f6591348c3961438a573f42d322023-07-23T11:10:10ZengBMCBMC Health Services Research1472-69632023-07-0123111610.1186/s12913-023-09811-yLinking leadership development programs for physicians with organization-level outcomes: a realist reviewMaarten Debets0Iris Jansen1Kiki Lombarts2Wietske Kuijer-Siebelink3Karen Kruijthof4Yvonne Steinert5Joost Daams6Milou Silkens7Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMCAmsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMCAmsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMCSchool of Education, Research On Responsive Vocational and Professional Education, HAN University of Applied SciencesAmsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public HealthFaculty of Medicine and Health Sciences, Institute of Health Sciences Education, McGill UniversityMedical Library, Amsterdam University Medical CentersDepartment of Health Services Research & Management, City University of LondonAbstract Background Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization’s performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing. Objective To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes. Methods We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O). Results In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories ‘culture’, ‘quality improvement’, and ‘the leadership pipeline’: 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes. Conclusions LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes.https://doi.org/10.1186/s12913-023-09811-yLeadership Development Programs (LDPs)LeadershipPhysiciansRealist reviewMiddle-range program theoryOrganization-level outcomes |
| spellingShingle | Maarten Debets Iris Jansen Kiki Lombarts Wietske Kuijer-Siebelink Karen Kruijthof Yvonne Steinert Joost Daams Milou Silkens Linking leadership development programs for physicians with organization-level outcomes: a realist review BMC Health Services Research Leadership Development Programs (LDPs) Leadership Physicians Realist review Middle-range program theory Organization-level outcomes |
| title | Linking leadership development programs for physicians with organization-level outcomes: a realist review |
| title_full | Linking leadership development programs for physicians with organization-level outcomes: a realist review |
| title_fullStr | Linking leadership development programs for physicians with organization-level outcomes: a realist review |
| title_full_unstemmed | Linking leadership development programs for physicians with organization-level outcomes: a realist review |
| title_short | Linking leadership development programs for physicians with organization-level outcomes: a realist review |
| title_sort | linking leadership development programs for physicians with organization level outcomes a realist review |
| topic | Leadership Development Programs (LDPs) Leadership Physicians Realist review Middle-range program theory Organization-level outcomes |
| url | https://doi.org/10.1186/s12913-023-09811-y |
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