Leadership in healthcare: a bibliometric analysis of 100 most influential publications

Leadership Development Strategies in Interprofessional Healthcare Collaboration: A Rapid Review

Background

Contemporary healthcare practitioners require leadership skills for a variety of professional roles related to improved patient/client outcomes, heightened personal and professional development, as well as strengthened interprofessional collaboration and teamwork.

Objective/Aim

The aim of this study is to systematically catalogue literature on leadership in healthcare practice and education to highlight the leadership characteristics and skills required by healthcare practitioners for collaborative interprofessional service delivery and the leadership development strategies found to be effective.

Methods/Design

A rapid review was conducted. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) diagram shows that the 11 databases, yielded 465 records. A total of 147 records were removed during the initial screening phase. The remaining 318 records were uploaded onto Rayyan, an online collaborative review platform. Following abstract level screening, a further 236 records were removed with 82 records meeting the eligibility criteria at full text level, of which 42 were included in the data extraction. The Mixed Methods Appraisal Tool (MMAT) was used for quality appraisal.

Results

Results showed variability in methodologies used, representing various healthcare disciplines with a range in population size (n = 6 to n = 537). Almost half of the results reported on new programs, with interprofessional collaboration and teamwork being the most frequently mentioned strategies. The training content, strategies used as well as the length of training varied. There were five outcomes which showed positive change, namely skills, knowledge, confidence, attitudes, and satisfaction.

Conclusion

This rapid review provided an evidence-base, highlighted by qualitative, quantitative, and mixed methods research, which presents distinct opportunities for curriculum development by focusing on both content and the methods needed for leadership programs. Anchoring this evidence-base within a systematic search of the extant literature provides increased precision for curriculum development.

Sticky Floor and Glass Ceilings in Academic Medicine: Analysis of Race and Gender

Purpose This paper examines the changes in the representation of women and racial minorities in academic medicine, compares the proportion of minorities in medicine and the general United States (US) population, and discusses potential explanations for observed trends. Methods A retrospective cross-sectional analysis of the Association of American Medical Colleges (AAMC) database was done and used to collect data on the gender and race of physicians in academic medicine. Data was collected for instructors, assistant professors, associate professors, full professors, and chairpersons from 2007 to 2018, and trends were presented. Results White physicians represented most academic physicians at every academic level, peaking in proportion at 82.74% of chairpersons and were lowest at the level of instructor at 59.30%. A similar distribution existed when gender was compared, with men comprising 84.67% of chairpersons and forming the majority at levels of full, associate, and assistant professors. However, most physicians at the level of instructors are women at 55.44%. Conclusions Though women and racial minorities have gained greater representation in academic medicine over the past decade, high-level academic positions are not as accessible to them. Existing efforts of advocacy for women and minority races have proven fruitful over the past decade, but much more work needs to be done.

Leadership gender disparity in the fifty highest ranking North American universities: Thematic analysis under a theoretical lens

BACKGROUND

Despite changes in the discourse around gender distributions within academic leadership, women continue to be under-represented in academia. Our study aims to identify the extent of gender disparity in the academic leadership in the top 50 North American universities and to critically analyse the contributing factors through a comprehensive theoretical framework.

METHODS

We adopted the theoretical framework of leadership continuum model. A retrospective analysis of the gender of the leadership ranks was conducted between December 2018 and March 2019 for the top 50 universities in North America (2019 Quacquarelli Symonds World University Ranking system). The leadership hierarchy was classified into six tiers.

RESULTS

A total of 5806 faculty members from 45 US and five Canadian universities were included. Women were overall less likely to be in a senior leadership role than men (48.7% vs 51.3%; p value=0.05). Women accounted for fewer positions than men for resident/chancellor (23.8% vs 76.2%; p value<0.001), vice-president/vice-chancellor (36.3% vs 63.7%; p value<0.001), vice provost (42.7% vs 57.3%; p value=0.06), dean (38.5% vs 61.5%; p value<0.001) and associate dean (48.2% vs 51.8%; p-value=0.05). Women however were in a greater proportion in the assistant dean positions (63.8% vs 36.2%; p value<0.001).

CONCLUSION

Leadership gender imbalance is trans-organisational and transnational within the top 50 universities of North America and progressively widens towards the top leadership pyramid. This correlates with the lack of women leadership progress and sustainability in later cycles of the leadership continuum model (beyond assistant dean).