Table 1

Summary of selected studies reporting level 4 Kirkpatrick impact of physician leader programmes*

Authors	Year of publication (Reference)	Setting	Reported level 4 impact (4A or 4B (see text))
Boyle et al	200416	2 US intensive care units	Enhanced communication skills and problem-solving between nurses and physicians. Specifically, ratings on a Collaborative Skills Simulation activity developed to assess the stages of communication and relationship skills were significantly higher after the development programme than before Perception that quality of care was improved. Specifically, caregivers’ perceptions of the technical quality of care and the ability to meet families’ needs were higher after the programme than before (level 4A)
Dannels et al	200817	Executive leadership programme for US/Canadian women faculty (Associate or Full Professor)	Compared with control groups who did not participate in the leadership programme, participants had higher scores on leadership competencies assessed by survey and by academic rank/position (levels 3A and 4B)
Green et al	200218	US network of community-based providers and physicians participating in a 2-year leader development course (the VHA Coaching and Leadership Initiative)	Many improvement projects worked on by participants achieved clinical improvement. As specific examples, the VHA Coaching and Leadership Initiative was associated with measured clinical improvements, like improvements in spirometry results in children with asthma, reduction in the prevalence of haemoglobin A1C values>8% from 57% to 28% and increased compliance with recommended mammograms from 62% to 83% (level 4B)
Korschun et al	200719	Physician leaders course delivered in a US academic medical centre	Participants reported leadership promotion (level 3B) and enhanced organisational outcomes (eg, patient satisfaction, level 4A)
Richman et al	200120	US women faculty at Associate or Full Professor level engaged in a 1-year leader development programme	Enhanced scores on post-test regarding leadership competencies (eg, strategic planning, financial management, career advancement [levels 3A and 4B)
Stoller et al	200921	10-month leader development course administered at a US academic medical centre	High frequency with which business plan projects proposed by attendees were implemented/had impact (level 4B)

*After Ref.11.