Service impact of a national clinical leadership development programme: findings from a qualitative study.

AIM: The study reported here was part of a larger study, which evaluated a national clinical leadership development programme with reference to resources, participant experiences, participant outcomes and service impact. The aim of the present study was to evaluate the programme's service impact. BACKGROUND: Clinical leadership development develops competencies that are expressed in context. The outcomes of clinical leadership development occur at individual, departmental and organisational levels. METHODS: The methods used to evaluate the service impact were focus groups, group interviews and individual interviews. Seventy participants provided data in 18 separate qualitative data collection events. RESULTS: The data contained numerous accounts of service development activities, initiated by programme participants, which improved service and/or improved the culture of the work setting. CONCLUSION: Clinical leadership development programmes that incorporate a deliberate service impact element can result in identifiable positive service outcomes. The nuanced relationship between leader development and service development warrants further investigation. IMPLICATIONS FOR NURSING MANAGEMENT: This study demonstrates that clinical leadership development can impact on service in distinct and identifiable ways. Clinical leadership development programmes should focus on the setting in which the leadership competencies will be demonstrated.

Mentoring, coaching and action learning: interventions in a national clinical leadership development programme.

AIMS AND OBJECTIVES: To evaluate mentoring, coaching and action learning interventions used to develop nurses' and midwives' clinical leadership competencies and to describe the programme participants' experiences of the interventions. BACKGROUND: Mentoring, coaching and action learning are effective interventions in clinical leadership development and were used in a new national clinical leadership development programme, introduced in Ireland in 2011. An evaluation of the programme focused on how participants experienced the interventions. DESIGN: A qualitative design, using multiple data sources and multiple data collection methods. METHODS: Methods used to generate data on participant experiences of individual interventions included focus groups, individual interviews and nonparticipant observation. Seventy participants, including 50 programme participants and those providing the interventions, contributed to the data collection. RESULTS: Mentoring, coaching and action learning were positively experienced by participants and contributed to the development of clinical leadership competencies, as attested to by the programme participants and intervention facilitators. CONCLUSIONS: The use of interventions that are action-oriented and focused on service development, such as mentoring, coaching and action learning, should be supported in clinical leadership development programmes. Being quite different to short attendance courses, these interventions require longer-term commitment on the part of both individuals and their organisations. RELEVANCE TO CLINICAL PRACTICE: In using mentoring, coaching and action learning interventions, the focus should be on each participant's current role and everyday practice and on helping the participant to develop and demonstrate clinical leadership skills in these contexts.

Individual-level outcomes from a national clinical leadership development programme.

A national clinical leadership development programme was instituted for Irish nurses and midwives in 2010. Incorporating a development framework and leadership pathway and a range of bespoke interventions for leadership development, including workshops, action-learning sets, mentoring and coaching, the programme was introduced at seven pilot sites in the second half of 2011. The programme pilot was evaluated with reference to structure, process and outcomes elements, including individual-level programme outcomes. Evaluation data were generated through focus groups and group interviews, individual interviews and written submissions. The data provided evidence of nurses' and midwives' clinical leadership development through self and observer-reported behaviours and dispositions including accounts of how the programme participants developed and displayed particular clinical leadership competencies. A key strength of the new programme was that it involved interventions that focussed on specific leadership competencies to be developed within the practice context.

Truths and Lies from the Polysomnography ECG Recording: An Electrophysiologist Perspective.

Polysomnography remains the gold standard for diagnosis of Sleep Apnea (SA) and evaluation of the apnea/hypopnea index (AHI) which is used as the primary index of SA severity. The electrocardiogram (typically a single lead) obtained during the polysomnographic study is usually used to report the association between SA and cardiac rhythm disturbances. These findings help in guiding medical decisions but they could also represent a source for confusion. Electrophysiologists are frequently consulted to determine whether interventions need to be taken. We present 2 cases where the ECG during a polysomnography study required the intervention of an electrophysiologist to help with management.