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Bridging the gap: using ‘Paired Learning’ to improve clinician/management understanding
  1. Hannah Monaghan,
  2. Connie Swenson,
  3. Joanne Kerins,
  4. Sue Sloan
  1. Medical Education Directorate, NHS Lothian, Edinburgh, UK
  1. Correspondence to Dr Hannah Monaghan, NHS Lothian, Edinburgh EH1 3EG, UK; hannah.monaghan{at}


Background Leadership in the National Health Service (NHS) embraces two distinct groups: managers and clinicians, often arriving with differing backgrounds, skill sets and outlook. ‘Bridging the gap’ between the two, with a relational paired learning (PL) approach, has been run in NHS Lothian for 4 years (three cohorts) to positively impact the organisation and its leadership.

Methods In the initial pilot six doctors and six general managers were paired together. Subsequently cohorts expanded with doctors paired with other senior managers, including the Director of eHealth, a non-executive member of the NHS Lothian Board and shadowing of the Chairman of NHS Lothian. All cohorts used PL ‘Contracts’ for their work together and then engaged in conversation, shadowing and reflection. Preprogramme and postprogramme questionnaires and postprogramme interviews explored the effect of PL on ‘preparedness’ for leadership and an understanding of the role and ethos of the corresponding group, and the running of the programme.

Results The questionnaires and interviews have shown that the programme had a positive impact on preparedness to lead, and participants described a shift in attitudes with increased understanding of the ‘other’ group and increased ability to work collaboratively together in the future. The ‘Trainee Management Forum’ was developed as a result of PL collaborative working and provides regular engagement and learning for junior doctors and managers at all levels of the organisation.

Conclusion NHS Lothian PL has been impactful for those involved and is perceived to add value to the organisation, with further cohorts of doctors and managers continuing to engage with this opportunity.

  • behaviour
  • communication
  • development
  • doctor
  • medical leadership

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  • Contributors HM leads the Clinical Development Fellow programme and wrote the paper. CS and JK took part in the PL and gained and analysed data from other pairs. SS developed and runs PL in NHS Lothian.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The responses to the questionnaires have not been published in full. The non-confidential data are available from SS on request.