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Review of determinants of national medical leadership development
  1. Wouter Keijser1,2,
  2. Max Poorthuis1,
  3. Judith Tweedie3,
  4. Celeste Wilderom1
  1. 1 Faculty of Behavioural, Management and Social Sciences (BMS) Change Management and Organizational Behavior (CMOB), University Twente, Enschede, The Netherlands
  2. 2 Research Department, Dutch Institute of Research and Education in Medical Leadership and Interdisciplinary Teamwork (DIRMInstitute), Utrecht, The Netherlands
  3. 3 Royal College of Physicians, London, UK
  1. Correspondence to Wouter Keijser, Faculty of Behavioural, Management and Social Sciences (BMS), Change Management and Organizational Behavior (CMOB), University Twente, AE Enschede 217 7500, The Netherlands; wouter{at}


Increasingly, physician engagement in management, quality and innovation is being recognised as vital, requiring ‘medical leadership’ (ML) competencies. Besides numerous local institutional efforts and despite the high level of autonomy of the medical profession and the education of its members, in some countries, national level activities are focusing on developing ML competencies to guide physicians in more effectively engaging in these non-medical activities. Up to this date, little is known about effective strategies and tactics for developing ML on a national level. This study investigates existing literature on determinants and interventions for national ML development. We performed a scoping review and subsequent systematic literature review of published reviews, using PubMed, Scopus, Web of Science, Ovid MEDLINE and Science Direct in search for eligible papers between 2011 and 2016. Full-text versions of 43 papers were studied, and a snowballing method was deployed. Data extraction included grounded theory coding, and synthesis of data was done iteratively during data clinics. Analysis of the seven included papers resulted in five discrete categories of determinants of and 10 distinct interventions relevant to national development of ML approaches. None of the papers reported on any specific phasing of national ML development. Our data suggest that local and national level activities in ML development should consider multifaceted and multilevel approaches, taking into account resistance to change and redesign of institutionalised logics that accompany changing positions and reconstruction of professional identities of physicians.

  • medical leadership
  • development
  • competencies
  • professionalism
  • clinical leadership

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