COVID again? Health workers' burnout and turnover intentions: possible impacts of coronavirus-induced anxiety and first-level servant leaders.

PURPOSE: Building on social exchange and leader-member exchange theories, this paper aims to propose a model of the impact of coronavirus-induced anxiety on health-care professionals' burnout and turnover intention through the mediation role of servant leadership. DESIGN/METHODOLOGY/APPROACH: This model was examined by adopting partial least square-based structural equation modeling using data collected from 271 health professionals (doctors, nurses, midwives and analysts) from Turkey. FINDINGS: The findings of the research illustrate that coronavirus-induced anxiety is positively associated with burnout and turnover intention. Furthermore, servant leadership mediates the relationship between coronavirus-induced anxiety, burnout and turnover intention. Yet, according to factor loadings, the mediating role of servant leadership is not strong (ß : 0.035 and 0.053, respectively). RESEARCH LIMITATIONS/IMPLICATIONS: First, this study targeted the health-care professionals from Turkey. Therefore, this population may not be able to provide general information on the topic. Thus, this study suggests that the subject be addressed in other populations as well. Second, the data were self-reported by the participants. Although common method bias and social desirability bias were not an issue in this study, it should be known that the results are based on the subjective judgments of the participants. Third, this study was limited to investigating the mediating role of servant leadership only. PRACTICAL IMPLICATIONS: This study gives much beneficial information to both administrators and organizations by mirroring highly stressed workers' inside throughout statistically results. Hence, it is assumed that the findings will help leaders to cope with several difficult situations, especially in crisis moments. As the chaotic circumstances occurred, achieving organizational goals became more and more difficult. To do this, some leaders play critical roles for members like servant leaders by contributing uniquely spiritual dimensions. SOCIAL IMPLICATIONS: Struggling with the COVID-19 pandemic has aggravated the health-care professionals' existing mental health and has loaded more agitation on them. According to Mozes (2021), suicide cases among nurses have doubled the number of women in the general population. Thus, leaders should do something to lower those ratios. This study points out that servant leaders could break down those unwanted issues by decreasing burnout and turnover intention rates of health workers. Barbuto and Wheeler (2006) highlighted this situation by creating a dimension called "The Natural Desire to Serve Others." ORIGINALITY/VALUE: To the best of the authors' knowledge, to date, this study is the first to examine the mediating role of servant leadership in the effect of coronavirus-induced anxiety on burnout and turnover intention. Furthermore, this research reveals that servant leadership may play a role in avoiding burnout and turnover intention in the health sector.

Practice development amidst a pandemic: a pilot programme to develop leadership in infection prevention and control professionals.

PURPOSE: This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme's aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles. DESIGN/METHODOLOGY/APPROACH: The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners' interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences. FINDINGS: The authors' evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another's experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face. RESEARCH LIMITATIONS/IMPLICATIONS: Despite a small sample size, the authors' results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted. PRACTICAL IMPLICATIONS: The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations. ORIGINALITY/VALUE: ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

The evaluation of health care leadership development programmes: a scoping review of reviews.

PURPOSE: The purpose of this paper is to report a scoping review of reviews which investigated HLDP evaluations to determine: how the conceptualisation of leadership development programmes (HLDPs), and despite growing calls for robust evaluations of their pedagogic design, delivery and effectiveness, there are concerns regarding the quality of data associated with their evaluation. This scoping review of reviews investigated the reporting of HLDP evaluations to determine: how the conceptualisation of leadership underpinning HLDPs influence their evaluation; how the pedagogical approaches within HLDPs influence their evaluation; and the evaluation designs and measures used to assess HLDPs. DESIGN/METHODOLOGY/APPROACH: The scoping review was conducted on reviews of HLDPs. Searches were performed on four databases and on the grey literature. Data were extracted and a narrative synthesis was developed. FINDINGS: Thirty-one papers were included in the scoping review of reviews. A great deal of heterogeneity in HLDPs was identified. Evaluations of HLDPs were affected by poor data quality, and there were limitations in the evidence about "what works". Leadership was conceptualised in different ways across HLDPs, and consequently, there was a lack of consistency as to what is being evaluated and the methods used to assess HLDPs. ORIGINALITY/VALUE: This review of reviews summarises the current evidence on the evaluation of HLDPs. Evaluations of HLDPs need to explicitly account for the complexity of health systems, how this complexity impacts on the development and articulation of leadership practice, and how the underlying conceptualisation of leadership and the associated theory of change articulate a set of assumptions about how HLDPs support leaders to affect change within complex systems.

How hospital top managers reason about the central leadership task of balancing quality of patient care, economy and professionals' engagement: an interview study.

PURPOSE: This study aims to deepen the understanding of how top managers reason about handling the relationships between quality of patient care, economy and professionals' engagement. DESIGN/METHODOLOGY/APPROACH: Qualitative design. Individual in-depth interviews with all members of the executive management team at an emergency hospital in Norway were analysed using reflexive thematic method. FINDINGS: The top managers had the intention to balance between quality of patient care, economy and professionals' engagement. This became increasingly difficult in times of high internal or external pressures. Then top management acted as if economy was the most important focus. PRACTICAL IMPLICATIONS: For health-care top managers to lead the pursuit towards increased sustainability in health care, there is a need to balance between quality of patient care, economy and professionals' engagement. This study shows that this balancing act is not an anomaly top-managers can eradicate. Instead, they need to recognize, accept and deliberately act with that in mind, which can create virtuous development spirals where managers and health-professional communicate and collaborate, benefitting quality of patient care, economy and professionals' engagement. However, this study builds on a limited number of participants. More research is needed. ORIGINALITY/VALUE: Sustainable health care needs to balance quality of patient care and economy while at the same time ensure professionals' engagement. Even though this is a central leadership task for managers at all levels, there is limited knowledge about how top managers reason about this.

Human Capital Creation: A Collective Psychological, Social, Organizational and Religious Perspective.

Psychological, social, cultural, emotional, and organizational perspectives consistently highlight human capital's importance in the literature. We argue that the collective view of different capitals with self-notion is essential for establishing impression, image, and self-esteem. According to the review findings, religious capital could predict context-specific psychological, cultural, social, emotional, and organizational capital. This acknowledgment can assist academics in better understanding how religion, social psychology, and other capitals co-create value in human capital development. This study includes several possible future paths and notes remarkable qualities that can enhance human capital value development research.

CQI approaches for evaluating management development programs: A case study with health service managers from geographically remote settings.

Health systems are known for being complex. Yet, there is a paucity of evidence about programs that successfully develop competent frontline managers to navigate these complex systems. There is even less evidence about developing frontline managers in areas of contextual complexity such as geographically remote and isolated health services. This study used a customised management development program containing continuous quality improvement (CQI) approaches to determine whether additional levels of evaluation could provide evidence for program impact. Generalisability is limited by the small sample size; however, the findings suggest that continuous improvement approaches, such as action learning workplace-based CQI projects not only provide for real-world application of the manager's learning; they can potentially produce the type of data needed to conduct evaluations for organisational impact and cost-benefits. The case study contributes to the literature in an area where there is a scarcity of empirical research. Further, this study proposes a pragmatic method for using CQI approaches with existing management development programs to generate the type of data needed for multi-level evaluation.

Leadership development in health care in low and middle-income countries: Is there another way?

Leadership and management capacity is an important factor in the health care systems of low and middle-income countries (LMICs) due to resource scarcity and a high burden of disease. The paper identifies the key concerns of health care policy-makers and health care leaders and managers in LMICs and, in the case of the latter, what is led and managed. It examines the two major education and training approaches adopted to develop such capacity and the cultural context against which development takes place, noting that leadership and management development in LMICs needs to reflect local cultures. From this consideration, it is proposed that action learning (which already has a track-record of application in LMICs) would be a practical way forward.

Peer-to-peer shadowing as a technique for the development of nurse middle managers clinical leadership.

Purpose The purpose of this study was to explore the experiences and impact of peer-to-peer shadowing as a technique to develop nurse middle managers' clinical leadership practices. Design/methodology/approach A qualitative descriptive study was conducted to gain insight into the experiences of nurse middle managers using semi-structured interviews. Data were analysed into codes using constant comparison and similar codes were grouped under sub-themes and then into four broader themes. Findings Peer-to-peer shadowing facilitates collective reflection-in-action and enhances an "investigate stance" while acting. Nurse middle managers begin to curb the caring disposition that unreflectively urges them to act, to answer the call for help in the here and now, focus on ad hoc "doings", and make quick judgements. Seeing a shadowee act produces, via a process of social comparison, a behavioural repertoire of postponing reactions and refraining from judging. Balancing the act of stepping in and doing something or just observing as well as giving or withholding feedback are important practices that are difficult to develop. Originality/value Peer-to-peer shadowing facilitates curbing the caring disposition, which is essential for clinical leadership development through unlocking a behavioural repertoire that is not easy to reveal because it is, unreflectively, closely knit to the professional background of the nurse managers. Unlike most leadership development programmes, that are quite introspective and detached from context, peer-to-peer shadowing does have the potential to promote collective learning while acting, which is an important process.

Municipal solid waste development phases: Evidence from EU27.

Many countries in the European Union (EU) have very developed waste management systems. Some of its members have managed to reduce their landfilled waste to values close to zero during the last decade. Thus, European Union legislation is very stringent regarding waste management for their members and candidate countries, too. This raises the following questions: Is it possible for developing and developed countries to comply with the European Union waste legislation, and under what conditions? How did waste management develop in relation to the economic development in the countries of the European Union? The correlation between waste management practices and economic development was analysed for 27 of the European Union Member States for the time period between 1995 and 2007. In addition, a regression analysis was performed to estimate landfilling of waste in relation to gross domestic product for every country. The results showed a strong correlation between the waste management variables and the gross domestic product of the EU27 members. The definition of the municipal solid waste management development phases followed a closer analysis of the relation between gross domestic product and landfilled waste. The municipal solid waste management phases are characterised by high landfilling rates at low gross domestic product levels, and landfilling rates near zero at high gross domestic product levels. Hence the results emphasize the importance of wider understanding of what is required for developing countries to comply with the European Union initiatives, and highlight the importance of allowing developing countries to make their own paths of waste management development.

Preparing academic medical department physicians to successfully lead.

PURPOSE: The purpose of this paper is to present a case study which details the successful development, design and deployment of a leadership course for academic medical department chairs. The course provides a needed local and contextual alternative to the lengthy and often theoretical MBA/MHA. DESIGN/METHODOLOGY/APPROACH: Faculty developers used a multi-tiered methodology for developing the physician leadership course. The methodology consisted of literature findings, needs assessment, stakeholder input and structured interviews with administrative leaders. FINDINGS: The research, stakeholder input and interviews revealed an increasing number of physician leaders with a general lack of fundamental administrative leadership skills. These shortfalls are largely because of underexposure to core management competencies during medical school and limited contextual knowledge outside their organization. There is an urgent need for leadership development opportunities aimed at current and future academic medical department chairs. RESEARCH LIMITATIONS/IMPLICATIONS: This research is limited by the assumptions that the curriculum meets the ever-changing needs of health-care leaders, the course's focus on academic medical department chairs within the Texas Medical Center and the lack of long range follow-up data to substantiate the effectiveness of the curriculum content and course structure. PRACTICAL IMPLICATIONS: The Academic Medical Department Leadership course offers valuable management skills training which complements standard medical training. Much of the course structure and content is adaptable to physician administrative and leadership positions in all settings. ORIGINALITY/VALUE: Although the Academic Medical Department Leadership course is a response to a local concern, the study offers a generalizable approach to addressing the demand for skilled physician leaders.

Women chairs in academic medicine: engendering strategic intuition.

PURPOSE: Because stereotypically masculine behaviors are required for effective leadership, examining female chairs' leadership in academic medicine can provide insight into the complex ways in which gender impacts on their leadership practices. The paper aims to discuss this issue. DESIGN/METHODOLOGY/APPROACH: The author interviewed three female clinical chairs and compared the findings to interviews with 28 of their faculty. Grounded theory analysis of the subsequent text gathered comprehensive, systematic, and in-depth information about this case of interest at a US top-tier academic medical center. FINDINGS: Four of five themes from the faculty were consistent with the chair's narrative with modifications: Prior Environment (Motivated by Excellence), Tough, Direct, Transparent (Developing Trust), Communal Actions (Creating Diversity of Opinion), and Building Power through Consensus (an "Artful Exercise") with an additional theme, the Significance (and Insignificance) of a Female Chair. While faculty members were acutely aware of the chair's gender, the chairs paradoxically vacillated between gender being a "non-issue" and noting that male chairs "don't do laundry." All three female chairs in this study independently and explicitly stated that gender was not a barrier, yet intuitively used successful strategies derived from the research literature. ORIGINALITY/VALUE: This study suggests that while their gender was highlighted by faculty, these women dismissed gender as a "non-issue." The duality of gender for these three female leaders was both minimized and subtly affirmed.

Changes in commitment to change among leaders in home help services.

PURPOSE: The purpose of the this study was to explore the development of commitment to change among leaders in the home help services during organizational change and to study this development in relation to workload and stress. During organizational change initiatives, commitment to change among leaders is important to ensure the implementation of the change. However, little is known of development of commitment of change over time. DESIGN/METHODOLOGY/APPROACH: The study used a qualitative design with semi-structured interviews with ten leaders by the time an organizational change initiative was launched and follow-up one year later. Thematic content analysis was used to analyze the interviews. FINDINGS: Commitment to change is not static, but seems to develop over time and during organizational change. At the first interview, leaders had a varied pattern reflecting different dimensions of commitment to change. One year later, the differences between leaders' commitment to change was less obvious. Differences in commitment to change had no apparent relationship with workload or stress. RESEARCH LIMITATIONS/IMPLICATIONS: The data were collected from one organization, and the number of participants were small which could affect the results on workload and stress in relation to commitment to change. PRACTICAL IMPLICATIONS: It is important to support leaders during organizational change initiatives to maintain their commitment. One way to accomplish this is to use management team meetings to monitor how leaders perceive their situation. ORIGINALITY/VALUE: Qualitative, longitudinal and leader studies on commitment to change are all unusual, and taken together, this study shows new aspects of commitment.

Diálogos com a liderança através do Sociodrama e da Socioantropologia: das cenas temidas ao desenvolvimento de competências / Dialogue with the leadership through the sociodrama: from feared scenes to the development of competencies

Este artigo apresenta uma intervenção processual implementada em uma empresa do setor Petrolífero com base na sinergia entre o psicodrama e a abordagem socioantropológica da liderança. Teve como objetivo identificar e reduzir a distância entre as competências desejadas para supervisores/gerentes e as competências constatadas no desempenho real do papel no contexto organizacional. O dispositivo grupal elaborado é inovador, pois facilita a alternância entre vivências sociodramáticas das cenas temidas e a abordagem cognitiva conceitual in situ e imediata da temática emergente. Toda a dimensão comportamental foi manejada por meio do sociodrama e do role-playing com base nas dimensões de aproximação intuitiva, afetiva, conceitual e funcional como preconiza a pedagogia do drama.

This paper presents an organizational intervention implemented in an oil sector company, based on the synergy between psychodrama and a social anthropological approach to leadership. Its goal was to identify the gap between the desired skills of supervisors and managers and the actual skills demonstrated in the real role performance within the organizational context. The suggested group approach is innovative, as it facilitates the switching between sociodramatic experiences of feared scenes and the 'in situ' and immediate cognitive conceptual approach of the emerging theme. The entire behavioral dimension was managed through Sociodrama and Role-playing, through the use of intuitive, affective, conceptual and functional approaches as recommended by the pedagogy of drama.