This study addresses the existing ambiguity in available definitions of clinical informatician, a challenge that complicates academic literature and practical applications in healthcare. The objective of the study is 'How can the role of clinical informaticians be clearly defined to resolve existing ambiguities and support their evolving function within healthcare systems?' Employing a six-step concept definition process, this research synthesises existing literature and expert feedback to develop a comprehensive definition. Through analysing publicly available academic and practitioner literature and 21 semistructured interviews with experts working in clinical informatics, a definition of clinical informaticians is derived. This study derives a formal definition of clinical informaticians: clinical informaticians leverage their dual expertise in technical and clinical domains to optimise health information technologies and data, and their use to enhance patient care across the healthcare system. This refined definition clarifies the professional boundaries and offers a framework for future role development in a rapidly evolving healthcare landscape.

Medical engagement is critical to high-performing organisational cultures in healthcare. However, the current literature on medical engagement is under-theorised and fails to take into account the role and impact of medical professional identities and identification in explaining organisational culture and performance in healthcare. We provide and test an alternative theoretical explanation of medical engagement as professional identity and identification problems, rooted in doctors' responses to changing configurations of institutional logics in healthcare. We conducted a cross-sectional, exploratory survey study comparing two UK National Health Service (NHS) mental health trusts with contrasting Care Quality Commission (CQC) ratings. Senior psychiatrists (n=119) employed at both trusts; 61 (Trust A) and 58 (Trust B) completed the survey (response rate: ~50% in both). Doctors' perceptions of institutional logics, medical professionalism, senior leadership and organisational identification were assessed using a questionnaire previously validated across senior doctors in all specialties in the UK. Organisational identification scores were compared across trusts, and predictors identified using multiple regression. Psychiatrists in the CQC higher-rated trust reported significantly greater acceptance of hybrid (managerial, financial and political) logics in decision-making, higher confidence in medical and managerial leaders and stronger organisational identification (each p<0.05). Multiple regression analysis (R²= 0.662) indicated doctors' identification with their trusts was independently associated with positive views on leadership quality, a balance between clinical and managerial priorities and willingness to integrate evolving definitions of medical professionalism into their identities. Importantly, psychiatrists in the higher-rated trust were also more likely to recommend their employer as a good place to build a medical career (p<0.01), which is a strong indicator of behavioural identification. Medical professional identities and identification with their organisations enable high-performing mental health trusts by encouraging senior psychiatrists to integrate hybrid institutional logics and leadership roles into their professional identities. Leadership quality and organisational culture are also key mechanisms linking identification and performance.

Leadership has become an essential component of medical professionalism; yet, China lacks leadership competency models grounded in physicians' clinical realities. This study aimed to develop a context-specific leadership competency model for Chinese oncologists, aligning international frameworks with local healthcare priorities. A three-round modified Delphi study was conducted between June and October 2024. The process began with a preliminary model comprising 6 domains and 30 competency items, derived from a scoping review and the National Health Service Medical Leadership Competency Framework. 40 oncology-related experts evaluated both the six proposed domains and the 30 competency items in round 1 using 9-point Likert scales and open-ended feedback. In round 2, experts screened the suggestions from round 1 through binary (yes/no) evaluations. The resulting refined list was subjected to a final rating in round 3, again using 9-point Likert scales to establish consensus. Quantitative data (mean scores, SD, percentage agreement) and thematic analysis of qualitative feedback were used to iteratively refine the model across rounds. Experts reached consensus on a final leadership competency model comprising 6 domains and 40 specific competencies. The highest-rated competencies included integrity, continuous personal development, healthcare quality management, learn and apply new technologies and ensur patient safety. New competencies, not present in the initial model, also emerged-such as clear expression, empathy, influence on the public, familiarity with end-of-life care, health economics evaluation and vision building-capturing the evolving expectations of oncologists as communicators, collaborators and system improvers in a rapidly changing healthcare environment. The resulting competency model reflects the multidimensional nature of oncologist leadership, encompassing professionalism, teamwork, service improvement and social responsibility. It offers a practical framework for leadership development and assessment in oncology and provides methodological guidance for building physician leadership competency models in other medical fields.

To use a lived-experience account of stillbirth and subsequent pregnancy to examine how maternity care systems respond to trauma, reveal structural and relational failures in maternal health services and propose principles for more just, compassionate leadership in maternity care. Despite advances in clinical knowledge, maternal outcomes in the UK have plateaued, with widening inequities by ethnicity, deprivation and other intersecting forms of exclusion. Maternal trauma, including stillbirth and miscarriage, is frequently minimised, poorly recognised in policy and measurement frameworks and inadequately supported in routine care. Personal experience of stillbirth and subsequent pregnancy exposes how systems that appear evidence-based and guideline-driven can fail to provide continuity, psychological safety and trauma-informed support at women's most vulnerable moments. This reflective paper integrates first-person narrative of stillbirth, subsequent pregnancy and encounters with maternity and primary care services with professional insight from clinical and leadership roles. The reflection is informed by existing evidence on maternal outcomes, perinatal mental health, intersectionality and global trends in women's health and rights. The narrative is used as an analytic lens to explore how leadership, culture and structures in maternity care shape women's experiences and outcomes. The reflection identifies recurrent gaps: silencing of women's voices, inadequate bereavement and mental health support, fragmentation of care and limited recognition of trauma across the maternity pathway. It highlights structural injustice in maternal health, including inequities by race, poverty and migration status, and the marginalisation of outcomes such as stillbirth and early pregnancy loss in key indicators. It proposes leadership practices that are relational, trauma-informed and equity-focused, including embedding lived experience in governance, investing across the preconception-to-postpartum continuum and prioritising culturally safe, psychologically safe care. Leadership in maternity care must move beyond metrics and guidelines towards models grounded in humility, listening and justice. By centring lived experience, recognising trauma and addressing structural inequities, leaders can begin to rebuild trust, honour loss and reshape maternity systems to better serve women, babies, families and future generations.

Effective leadership is critical to the success of complex multidisciplinary healthcare organisations. As the organisation emerged from the global pandemic, Mayo Clinic recognised a need to transform its traditional, linear care model into a dynamic, platform-based approach to support its strategy. This required a new leadership model that could support and equip leaders with the skills needed to drive patient-centred healthcare transformation from within. To develop and validate a new leadership competency framework capable of supporting future-ready leadership. A multiphase, evidence-based approach was employed: (1) a visionary interview, goal setting and literature review; (2) focus groups with 23 leaders from across the organisation; (3) iterative competency framework development; and (4) a validation study involving a stratified sample of 129 physician leaders who rated competencies on importance and differentiation, and a qualitative verification by key stakeholders. Five core competencies with 23 behaviours were identified. The validation analysis established all behaviours as important for differentiating leadership performance. Stakeholder review confirmed the competencies were actionable and applicable across leadership roles at all levels. The Leads Self, Leads Others, Inspires Others, Forward Thinking and Engages Others (abbreviated LLIFE) competency model positions a healthcare organisation to advance leadership excellence in a rapidly evolving healthcare environment that requires comprehensive transformation. It aligns with strategic goals, embeds values-based behaviours and supports continuous development, establishing a model that other healthcare institutions may learn from and adapt.

Leadership education is increasingly recognised as essential for preparing healthcare students to navigate complexity and drive change. Yet practice-based learning (placements) focusing on leadership in the Allied Health Professions remains underexplored and is often perceived as less relevant than those in clinical settings. This article presents a reflective account from a mature physiotherapy student from a minoritised ethnic background, whose cultural upbringing initially positioned education and leadership as inaccessible. The student undertook a 6-week leadership-focused placement during her second year of study. Entering with apprehension and uncertainty about its value, she engaged in structured activities, including weekly presentations designed to reflect on learning from the previous weeks and to discuss progress on the placement's central project. Drawing on personal experiences of navigating cultural and gender norms, the placement provided opportunities for significant personal and professional growth, including increased confidence, resilience and development of transferable skills in communication, digital literacy and teamworking. It enabled the student to challenge internalised limitations shaped by cultural expectations and recognise leadership as an integral aspect of physiotherapy practice. The impact of this leadership journey was demonstrated through a university leadership award and the opportunity to influence others via a national online presentation for the Chartered Society of Physiotherapy. This article illustrates how leadership-focused placements can be transformative by fostering inclusion, self-belief and professional adaptability. These placements align with workforce transformation goals and highlight the need to embed leadership as a core component of healthcare education.

Coaching is increasingly used to benefit doctors' professional development. This scoping review summarises the current state of the evidence relating to workplace leadership coaching for qualified doctors. A rapid scoping review was conducted, informed by Joanna Briggs' Institute guidelines, with protocol designed a priori. Medline, Embase and APA PsycInfo were searched for relevant articles. Search results were screened for inclusion in duplicate. Data were synthesised descriptively and thematically, mapping the existing research and identifying knowledge gaps. A total of 5307 articles were screened, and 94 met the inclusion criteria. 15 (16%) articles were classified under 'leadership training needs assessments', 15 (16%) under 'evaluations of leadership development interventions with coaching', 18 (19%) under 'evaluations of leadership coaching interventions', 1 (1%) specifically evaluated a team leader coaching training programme, 37 (40%) were commentaries, 1 (1%) was a research protocol and 7 (7%) were reviews.The studies were positive about the role of coaching in medical leadership development and as a skill for doctors to develop. The use of the term 'coaching' was often conflated with the term 'mentoring'. Most intervention articles mentioned coaches' qualifications or training. Only three used coaches with internationally recognised accreditation qualifications, and the majority used 'faculty coaches'. Most of the coaching components of leadership interventions, reviews and commentaries included in our review were considered successful. Coaching appears to be increasingly requested as an intervention for leadership development and identified as a training need for medical leaders.

For the National Health Service (NHS) in England to reach the target of Net Zero by 2040, transformation of the attitudes and behaviours of healthcare staff across all levels to promote systematic change is required. An understanding of current attitudes and barriers to change is vital for healthcare leaders and sustainability professionals to identify how they can support and encourage staff to adopt these changes. We invited staff from an NHS trust in England to participate in an online survey conducted between December 2024 and March 2025, to investigate NHS healthcare professionals' attitudes towards environmental sustainability, current behaviours and perceived barriers to sustainable healthcare practices. We received 154 responses from healthcare staff across all pay bands and grades, representing an array of disciplines. 94.8% of staff were concerned about climate change and the environment; 95.5% and 93.5% believe that NHS staff have a responsibility to be aware of, and minimise the impact of their work respectively; and over 80% were willing to make changes to their personal practice or engage in education and training. The most predominant perceived barrier to sustainable healthcare practices was found to be cost (72.1% of responses), with both time and staff attitudes being reported as perceived barriers by 69.5% of respondents. Our results suggest that among the staff surveyed, while there is a high level of willingness to change practice, increased funding is needed to support these changes, especially where sustainability initiatives have longer term cost-savings. There is a desire for more education to encourage and empower staff, and to make changes to NHS practice and policy. There is also a need for more direct leadership to facilitate change and integrate sustainability into the everyday work of healthcare professionals, rather than placing it as an additional burden on already overstretched staff.