Benefits Of Peer Support Research Articles

A narrative review of peer support barriers and facilitators in kidney care.

IntroductionPatients with chronic kidney disease often experience emotional/mental challenges and benefit from peer support, as it provides insight/information from others with the same condition. Previous studies show it is effective in improving health outcomes and aids in treatment decisions.Literature ReviewThere is low peer support uptake among patients with chronic kidney disease in the United Kingdom and staff do not utilise peer support services fully. Few studies within the United Kingdom have focused on peer support barriers/facilitators, so this narrative review aimed to understand them from staff and patient perspectives.Materials and MethodsA comprehensive search strategy and inclusion/exclusion criteria were applied with a two‐step process of article selection employed using two reviewers. Thematic analysis was applied.ResultsFive articles were included and six themes emerged. Low referrals and difficulty matching were staff barriers; concern regarding the relationship dynamic and the format/delivery were patient barriers. Promotion of the service aided the uptake from staff, while patients valued inclusivity.DiscussionIncreased promotion of peer support benefits through training/awareness may improve staff referrals and there should be greater exposure nationally. A flexible format is essential to ensure ample opportunity for access.ConclusionThis review highlights the current literature on peer support barriers/facilitators. Further study is needed to evidence which approaches best overcome staff‐ and patient‐barriers.

Healing Our Own: A Randomized Trial to Assess Benefits of Peer Support.

This study aimed to develop and evaluate a structured peer support program to address the needs of providers involved in obstetric adverse outcomes. In this pilot randomized controlled trial, participants were providers who experienced an obstetric-related adverse outcome. Providers were randomly assigned to routine support (no further follow-up) or enhanced support (follow-up with a trained peer supporter). Participants completed surveys at baseline, 3 months, and 6 months. The primary outcome was the use of resources and the perception of their helpfulness. Secondary outcomes were the effect on the recovery stages and the duration of use of peer support. Fifty participants were enrolled and randomly assigned 1:1 to each group; 42 completed the program (enhanced, 23; routine, 19). The 2 groups were not significantly different with respect to event type, demographics, or baseline stage; in both groups, most participants started at the stage 6 thriving path. Most participants required less than 3 months of support: 65.2% did not need follow-up after the first contact, and 91.3% did not need follow-up after the second contact. Participants who transitioned from an early stage of recovery (stages 1-3) to the stage 6 thriving path reported that they most often sought support from peers (P = 0.02) and departmental leadership (P = 0.07). Those in the enhanced support group were significantly more likely to consider departmental leadership as one of the most helpful resources (P = 0.02). For supporting health care providers involved in adverse outcomes, structured peer support is a practicable intervention that can be initiated with limited resources.

Patient support groups: A survey of United Kingdom practice, purpose and performance.

Critical care survivors face physical, psychological and socio-economic burdens. Peer support is acknowledged as a way individuals can face, accept and overcome the challenges arising from a stressful event. We sought to examine the provision and benefits of peer support to critical care survivors in the UK. We distributed a survey, devised by the patients and relatives committee of the Intensive Care Society and ICUsteps, to contacts in 163 UK Trusts/hospitals with critical care departments. The benefit to individuals was assessed by seeking the views of attendees of two support groups. A response was received from 91 (56%) of the critical care departments. Of these, 46 (48% of respondents) have patient support groups. Our analysis of comments from 30 people is that support groups greatly benefit service users and staff. Attendees of patient support groups gave highly positive comments about the service yet provision of patient support groups in the UK is not universal. We make a series of recommendations for consideration by UK health care providers.

A framework for interconnected benefits of peer support for family members of people with disability

AbstractPeer support describes the process of giving and receiving support between people who share similar life experiences. It is commonly used by family members of people with disability, with positive outcomes. However, existing research tends to assume it has separate and discrete benefits, neglecting the subtleties of how the different outcomes may be interconnected and mutually reinforcing. An account of these broader connections between benefits is needed. Drawing on Australian data from 24 parents and siblings of people with disability, this paper identifies benefits of peer support, including exchange of information, benefiting from experience and problem solving; motivation/encouragement and self‐confidence/personal development; social interaction and friendship; understanding, perspective and belonging/community; working together for change; and resilience and well‐being. The paper then proposes a framework to understand these benefits in an interconnected manner, where they are either transactional (giving and receiving practical and social‐emotional resources) or integrative (assimilating what is given and received into one's own experience and actions). The implications for practice and for families are discussed.

Value of study groups: Why we should stick together.

Fellowship examinations are a potentially stressful part of clinical training. While they may feel at the time to be a test of academic fortitude and endurance, they also establish the foundation knowledge essential for a career in paediatrics. We reflect on the important role of the study group in this process, and the far-reaching benefits of peer support and sticking together, for the exam and beyond.

30 Does Peer Support Facilitate Social Integration Following Burn Injury?

Abstract Introduction Facilitating access to one-to-one peer support is an important criterion in providing aftercare for individuals with a burn injury. Although there is an increase in understanding of the perceived benefits of peer support, there are not many studies examining peer support as an intervention to promote community re-entry. This comparative study aims to examine if there is a difference in physical and mental health outcomes, including social reintegration between a group that received one-to-one peer support (PS) and a group that did not receive the peer support (NPS). Methods Subjects include adults (>=18y) with a major burn injury who received treatment at a major burn center and consented to participate in a longitudinal national database at discharge from hospital, 6-, 12-, and 24-months post injury. The physical and mental health outcomes were measured using the SF-12 Health Questionnaire – Physical (PCS) and Mental (MCS) component (50 is the average score or norm); the Satisfaction with Life Scale, and Social Integration (SI) was measured by the Community Integration Questionnaire Social Component Scale (score range 0–12; 0 is no community integration and 12 is excellent community integration). The PS program offered at the burn center is a standardized program that includes an 8-hour peer volunteer training. Independent Samples t Tests were conducted to see if there were significant differences in health outcomes between the group that received PS and the group that did not receive PS (NPS). Results Over a period of 5 years, 228 subjects consented to participate in the database. Subjects were predominantly male (70%) and White (72%), with a mean age of 44 years and the mean total body surface area was 24.8%. Sixty-three (28%) subjects received peer visits during their stay in the hospital. Compared to the NPS group, the social integration score for the PS group was higher at all time points, although it was statistically significant only at 24 months (PS= 8.22, NPS=7.13, p< .01). The PS group scored significantly higher in satisfaction with life at 6 months (p< .01) and at 12 months (p< .05). There were significant differences found in TBSA %burn (PS = 31%, NPS = 22%; p< .001), average length of acute hospital stay (PS= 52 days, NPS = 31 days; p< .01), and average length of in-patient rehabilitation stay (PS= 12 days, NPS = 5 days; p< .05). Conclusions The social integration and satisfaction with life scores of the PS group was higher when compared to those of the NPS group. The study highlights the profile of patients who seek peer support visits and has implications for delivery and utilization of burn aftercare programs. Applicability of Research to Practice The study findings highlight the emerging need for providing burn survivors with resources such as peer support to facilitate successful community reentry, and examine the effects of such interventions on health outcomes.

Exploring citizenship and belonging with two college music students of marginalised identities

ABSTRACTIn this study, I explore the experiences of two college music students of colour who founded and led an organisation for underrepresented music students by employing a theoretical framework of citizenship (Osler and Starkey 2005). According to Osler and Starkey (2005), citizenship refers to the practices and statuses of membership within an institution as well as to the affective dimensions of belonging. Findings include the benefits of peer support and identity-based coursework for music students of colour and the negative effects of peers’ pernicious attitudes as well as other threats to safety influenced by the campus climate. Citizenship provided a framework for centreing underrepresented students’ feelings of belonging and problematising the relationship between an institution of higher education and its stakeholders. Finally, I explore the implications of student organisations like Elevate, the group founded by the participants, for supporting music students of underrepresented identities.

Is Peer Support in Group Clinics as Effective as Traditional Individual Appointments? The First Study in Patients With Celiac Disease.

INTRODUCTION:Celiac disease (CD) is common, affecting approximately 1% of the population. The cornerstone of management is a gluten-free diet, with dietetic advice being the key to aiding implementation. The aim of the study was to assess group clinics in comparison with traditional individual appointments.METHODS:Patients with a new diagnosis of CD, confirmed histologically, were prospectively recruited over 18 months in Sheffield, United Kingdom. Patients received either a group clinic or traditional one-to-one appointment, led by a dietitian. Quality-of-life questionnaires were completed at baseline, as well as biochemical parameters being recorded. Patients were followed up at 3 months, where adherence scores were assessed as well as biochemical parameters and quality of life questionnaires being completed.RESULTS:Sixty patients with CD were prospectively recruited and received either an individual (n = 30) or group clinic (n = 30). A statistically significant reduction in tissue transglutaminase was noted following group clinics (mean 58.5, SD 43.4 U/mL vs mean 13.2, SD 5.7 U/mL, P < 0.01). No significant differences in baseline and follow-up biochemical parameters between one-to-one and group clinics were noted. At follow-up, there was no statistically significant difference between mean gluten-free diet adherence scores (mean 3.1, SD 0.4 vs mean 3.1, SD 0.7, P = 0.66) between one-to-one and group clinics.DISCUSSION:This first study assessing group clinics in CD demonstrates they are as effective as traditional one-to-one clinics, with the added benefits of peer support and greater efficiency, with an estimated 54% reduction of dietetic resources.

Student mental health in the healthcare professions: exploring the benefits of peer support through the Bridge Network

Purpose Student mental health is a major challenge for higher education in the twenty-first century. Students undertaking healthcare professionally affiliated courses can experience additional pressures that negatively impact on their well-being and can make it more difficult to access support. The paper aims to discuss this issue. Design/methodology/approach To address some of these challenges, the Bridge Network was established in one healthcare school in a higher education institution. It is a peer support network co-produced with students studying on healthcare courses to provide group-based support to promote mental well-being. Student peer group facilitators draw on their own lived experience of mental health challenges or of being a carer. The groups provide a safe space for students who may experience mental health difficulties to share, gain support and connect with each other. This paper explores the journey of setting up the Bridge Network. Findings Although the group has been well received and various factors have supported its establishment, there are several difficulties that the network has faced. Power imbalances between students and academic staff have been challenging for the co-produced design, alongside enabling positive and safe discloser for healthcare students. However, the network has raised the profile of mental well-being for healthcare students and encouraged supportive conversations about the issue as well as providing enriching volunteer opportunities. Practical implications The Bridge Network is an innovative development reflecting best practice within mental healthcare. However, to ensure spread and sustainability, alignment with organisational strategy is required. Originality/value The paper explores the strengths and challenges of establishing peer support for students undertaking vocational healthcare courses.

Perioperative peer support and surgical preparedness in women undergoing reconstructive pelvic surgery

The benefits of peer support for pelvic floor disorders are unclear. We hypothesize that perioperative peer support might be associated with greater preoperative preparedness compared with usual care in women undergoing pelvic reconstruction. A multicenter prospective cohort study of women undergoing pelvic reconstruction compared peer support (group or one-to-one) with usual care. The primary outcome was preparedness, measured by a Preoperative Preparedness Questionnaire at baseline and before surgery. Assuming 48% preparedness in usual care preoperatively, 44 women per group (Group, One-to-One, or Usual care) would detect a 30% difference in preparedness (alpha = 0.05, 80% power). Chi-squared or Fisher's exact test compared categorical variables, t test and analysis of variance compared continuous variables, independent sample tests compared changes in mean or composite scores, and multiple logistic regression estimated the effect. One hundred and sixty-eight patients were included (113 with peer support, 55 undergoing usual care). A greater proportion of women in peer support had college or higher education versus usual care (78 vs 58%, P = 0.02). After the intervention, the proportion of women feeling prepared was not different between groups (66 vs 63%, P = 0.9). However, a greater proportion in peer support reported improved preparedness from baseline compared with usual care (71 vs 44%, P = 0.001). Peer support was associated with improved preparedness on multiple regression adjusting for age, study site, education, and surgery type (OR 4.14, 95% CI 1.69, 10.14). Peer support was associated with improved preoperative preparedness compared with usual care, but did not result in a greater proportion of women feeling prepared before surgery.

Information Needs for Treatment Decision-making of Hematopoietic Cell Transplant Patients 65Years or Older and Caregivers.

Hematopoietic cell transplantation (HCT) is a complex and potentially life-threatening treatment option for patients with hematologic malignant and non-malignant diseases. Advances have made HCT a potentially curative treatment option for patients 65years of age and older (older patients), and patient education resources should be adapted to meet their needs. To better understand the information needs of older patients and their caregivers for HCT treatment decision-making, the National Marrow Donor Program® (NMDP)/Be The Match® conducted a qualitative comprehensive needs assessment. Focus groups, offered in person or by phone, were conducted with older HCT patients and primary caregivers of older HCT patients at three transplant centers in the USA that were selected based on the number of older adults treated and geographic diversity. The one-hour, semi-structured discussions were recorded and transcribed verbatim. The analysis was performed with the NVivo 10 software for identification of conceptual themes. Five telephone and six in person focus groups of patients (n = 35) and caregivers (n = 10) were conducted. Themes that emerged included the following: (1) the need for tailored resources with age-specific recovery expectations; (2) the need for the right amount of information at the right times; and (3) the benefit of peer support. Effective patient education supports learning and treatment decision-making. As HCT increasingly becomes a treatment option for older patients, tailored educational resources are needed. These focus group results can inform and guide the development of new educational resources for older adults with hematologic diseases considering and planning for HCT.

Relationship of peer specialists to mental health outcomes in South Florida

BackgroundIn recent years the use of peer specialists in the delivery of mental health of care across the US has increased. Although data on the benefits of using peer specialists is limited and/or equivocal, states are making policy and funding decisions to support the expansion of peer specialist services. This data is even more limited in the state of Florida where no studies were found to document the effect of peer specialists on mental health care outcomes. The purpose of this study was to assess whether local decisions to use peer specialists can be supported through the measurement of outcomes of service utilization and mental health functioning when peer specialists are involved in the treatment of individuals living with serious mental illness.MethodsThe study was conducted using service data collected by South Florida Behavioral Health Network (SFBHN). SFBHN is the Managing Entity for publicly funded mental health and substance abuse services in Miami-Dade and Monroe Counties in Florida. We compared mental health outcomes and service utilization between individuals who received peer specialist services (n = 367) and a treatment as usual group (n = 1468) matched on gender, age and severity of diagnosis in the period July 2013 and June 2015. Multilevel models were used to evaluate the functioning outcomes between the groups. Service utilization was assessed using negative binomial regression.ResultsIndividuals in the treatment group receiving peer specialist services utilized more ambulatory/lower levels of care services and had more frequent crisis stabilization unit admissions. Those in the treatment group also displayed more functional difficulties with a variety of practical activities, employment and housing and violent temper, hostility, threatening behaviors.ConclusionsThe findings of the study further support existing evidence documenting the mixed benefits of using peer services compared to treatment as usual care. Policy makers and other stakeholders are encouraged to advance mental health recovery by examining outcomes more comprehensively. Future research should include examination of the subjective benefits of peer support for recipients, understanding the impact on service utilization and a better definition of the roles, supervision and expectations of peer support programs.

Peer support for people with advanced cancer: a systematically constructed scoping review of quantitative and qualitative evidence.

The number of people living with advanced cancer is increasing, and appropriate support to this population is essential. Peer support is increasingly advocated as a component of care, but little is known about how to provide this in the context of advanced cancer. This review describes the experience and impact of different forms of peer support for people with advanced cancer. Data from 22 articles were reviewed, primarily descriptive studies. They describe three forms of peer support (one-to-one, group, and online), reaching primarily those who are women, middle-aged, and well educated. Only two studies focused on support to people with advanced cancer, but those with advanced cancer were frequent users of all forms of peer support. Benefits of peer support were described, but no data were presented to allow a determination of the best form of support for people with advanced cancer. Practitioners can be assured that peer support is likely to be beneficial and provide care that complements that of clinicians. However, there is a need for a comprehensive programme of high-quality evaluative research of peer support for people with advanced cancer.

Positive Health Benefits of Peer Support and Connections for College Students With Type 1 Diabetes Mellitus.

Purpose The purpose of this study is to examine the characteristics and health outcomes of college students with type 1 diabetes mellitus (T1DM) as it relates to membership in a local university-based diabetes student organization. Methods This descriptive, correlational research design is a secondary analysis of data. The sample consisted of nationally representative young adults in college (n = 317) between 18 and 30 years of age who were diagnosed with T1DM. Data were collected during April 2017 using a secure electronic diabetes management survey to inquire about self-reported barriers to diabetes management, hypoglycemia, and diabetic ketoacidosis of members of a diabetes organization. Results Students were evenly distributed from freshman to senior year of college with a slight decrease at the graduate level. Students who were affiliated members of a student-led diabetes student organization were less likely to report increased levels of isolation, depressive symptoms, and anxiety related to their diabetes than were general members. Conclusion Participation in a university-based diabetes student organization on campus and connecting with other college students with diabetes may have health benefits. In conclusion, the current study underscores the potential importance of peer-led, diabetes-specific support for adolescents emerging into adulthood.

Peer support to improve diabetes care: an implementation evaluation of the Australasian Peers for Progress Diabetes Program

BackgroundSeveral studies have now demonstrated the benefits of peer support in promoting diabetes control. The aim of this study is to evaluate the implementation of a cluster randomised controlled trial of a group-based, peer support program to improve diabetes self-management and thereby, diabetes control in people with Type 2 Diabetes in Victoria, Australia.MethodsThe intervention program was designed to address four key peer support functions i.e. 1) assistance in daily management, 2) social and emotional support, 3) regular linkage to clinical care, and 4) ongoing and sustained support to assist with the lifelong needs of diabetes self-care management. The intervention participants attended monthly group meetings facilitated by a trained peer leader for 12 months. Data was collected on the intervention’s reach, participation, implementation fidelity, groups’ effectiveness and participants’ perceived support and satisfaction with the intervention. The RE-AIM and PIPE frameworks were used to guide this evaluation.ResultsThe trial reached a high proportion (79%) of its target population through mailed invitations.Out of a total of 441 eligible individuals, 273 (61.9%) were willing to participate. The intervention fidelity was high (92.7%). The proportion of successful participants who demonstrated a reduction in 5 years cardiovascular disease risk score was 65.1 and 44.8% in the intervention and control arm respectively. Ninety-four percent (94%) of the intervention participants stated that the program helped them manage their diabetes on a day to day basis. Overall, attending monthly group meetings provided ‘a lot of support’ to 57% and ‘moderate’ support to 34% of the participants.ConclusionPeer support programs are feasible, acceptable and can be used to supplement treatment for patients motivated to improve behaviours related to diabetes. However, program planners need to focus on the participation component in designing future programs. The use of two evaluation frameworks allowed a comprehensive evaluation of the trial from the provider-, participant- and public health perspective. The learnings gained from this evaluation will guide and improve future implementation by improving program feasibility for adoption and acceptability among participants, and will ultimately increase the likelihood of program effectiveness for the participants.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000469213. Registered 16 June 2009.

Negotiating barriers: prisoner and staff perspectives on mental wellbeing in the open prison setting

PurposeThe purpose of this paper is to explore the perspectives of prisoners and prison staff in relation to mental wellbeing and the negotiation of barriers to accessing and providing support. This small-scale study includes the experiences of 11 prison staff and 9 prisoners within a Category D male prison.Design/methodology/approachA focus group was conducted with the prisoners and interviews with prison staff. Thematic analysis identified three core themes: “context enabling factors”, “barriers to accessing support for mental wellbeing” and “peer support roles”.FindingsPrisoners conveyed a reluctance in reporting mental health issues due to the fear of being transferred to closed conditions. All staff indicated the benefits of peer support roles.Research limitations/implicationsFurther research is required on a wider scale, as it is acknowledged that the findings of this study are from one prison and may not apply to other settings. Although there are barriers that may impact the reporting of mental wellbeing issues, there may be small relational steps that can be taken to address these.Originality/valueFew studies exist that explore the nuances and barriers within open prisons, perhaps due to the overwhelming need within closed conditions. A context-specific approach considering early prevention strategies to support a safer prison system and successful rehabilitation is explored. The combination of prisoner and staff experiences is of value to both academia and policymakers.

‘I am not alone’ – an ethnographic research on the peer support among northern-Finnish children with hearing loss

ABSTRACTThis study focused on the peer support group activities organized in two northern-Finnish places for children with hearing loss and their experiences of it. This was an ethnographic child research, in which the research participants were 16 (12 girls, 4 boys, aged 7-17 years) northern-Finnish children with hearing loss. The main research data consisted of the researcher’s field notes and diaries, and focus group interviews among the research participants. Additional research data consisted of various questionnaires and background information. Peer support group activities provided children with hearing loss social, functional, cognitive, and emotional peer support. The benefits of peer support were:(1) peer support group activities provided information and coping skills for the children’ daily lives;(2) participation in group activities and group discussions strengthened the children’s social competence; and (2) peer support group activities empowered the participants. The importance of social relationships is discussed based on the findings.

Peer advice giving from posttreatment to newly diagnosed esophageal cancer patients.

The benefits of peer support in cancer care include the sharing of information and experience, supporting adjustment by providing an illness trajectory which cancer patients can use to prepare for their own cancer journey. Information from peers is prioritized by esophageal cancer patients, yet the content of this experiential information is not well understood. The purpose of this study is to understand the content of peer advice giving from posttreatment to newly diagnosed esophageal cancer patients. Esophageal cancer survivors (n =23) at median 67-months postdiagnosis completed a single open-ended survey item which asked for advice they would give to individuals newly diagnosed with esophageal cancer on how to cope emotionally with the cancer journey (including adjusting to life after treatment). Transcripts were assessed using qualitative content analysis, with five categories of advice identified: social support, psychological approach, realistic expectations, support from healthcare professionals and self-care. The categories of advice reported were distinct from information needs prioritized by clinicians. This study demonstrates that experiential information is accessible and has the potential to identify neglected information and supportive care needs, and may have a potential use in delivery of psychological support to newly diagnosed patients.

Influence of Peer-Based Needle Exchange Programs on Mental Health Status in People Who Inject Drugs: A Nationwide New Zealand Study.

Alleviating the personal and social burden associated with substance use disorders requires the implementation of a comprehensive strategy, including outreach, education, community interventions, psychiatric treatment, and access to needle exchange programs (NEP), where peer support may be available. Given that substantial research underscores the potential benefits of peer support in psychiatric interventions, we aimed to conduct a national survey to examine key domains of mental health status in people who inject drugs (PWID) in New Zealand. PWID were recruited from 24 pharmacies and 16 dedicated peer-based needle exchanges (PBNEs) across the country. We focused on two mental health outcomes: (1) affective dysregulation, across the three emotional domains of the Depression Anxiety Stress Scale, due to its role in the maintenance of continued drug use, and (2) positive cognition and effective health- and drug-related information exchange with the provider, using the Satisfaction with Life Scale and an ad hoc questionnaire, respectively, in view of their association with improved mental health outcomes. We hypothesized that access to peer support would be associated with mental health benefits for PWIDs. Remarkably, the results of a multistep regression analysis revealed that irrespective of sex, age, ethnicity, main drug used, length of drug use, and frequency of visits to the NEP, the exclusive or preferential use of PBNEs predicted significantly lower depression and anxiety scores, greater satisfaction with life, and increased health-related information exchange with the service provider. These findings demonstrate for the first time an association between access to peer support at PBNEs and positive indices of mental health, lending strong support to the effective integration of such peer-delivered NEP services into the network of mental health services for PWID worldwide.

Leading the health service into the future: transforming the NHS through transforming ourselves

Abstract Background: Leadership development impacts on quality of care and workplace cultures for staff. Clinical Leadership embracing transformational and other collective leadership approaches are key enablers to developing effective workplace cultures at the micro-systems level. Following the development of a shared purpose and values framework, an internal, inter-professional clinical leadership programme was set up to grow a critical community of transformational leaders across one NHS organisation in England. This programme had previously been unsuccessful in engaging medical doctors. Aims and Objectives: This paper shares how a dedicated practice development based clinical leadership programme set out to support medical doctors across one organisation with their leadership journey, equipping them to become both transformational and collective leaders and facilitators with the skills to begin to develop and sustain effective workplace cultures, that are person centred, safe and effective. Methods: Practice development methodology with its collaborative, inclusive and participative approach for developing person centred cultures combined with clinical leadership strategies, formed the basis of the programme which emphasised the use of active and action learning drawing on the workplace as the main resource for learning, development and improvement. Self-assessment and co-creation of insights about clinical leadership together with collaborative analysis of evaluation data led to the syntheses of insights through the use of reflection and action planning. Findings/Results: Findings are presented at two levels: 1) Five individual authentic reflections by authors to illustrate their leadership journeys which also demonstrate how a range of tools were used and their impact from reflections. Insights and learning include recognition of the benefits of peer support and networking; development of a disciplined approach to learning and self-management; 2) A collaborative reflection and critique that embraced the feeling of a sense of team ethos and community cohesion, for the first time in a safe environment; as well as, a sense of collective shared purpose and values. Conclusions: We conclude that the programme helped to identify the impact of leadership on workplace cultures and to begin to embed ways of working that are collaborative, inclusive, participative and celebratory. This unique approach by one organisation to leadership development has enabled a journey of self-transformation for medical clinical leaders to commence. Practical implications arising from our learning: • An internal model grows clinical leadership capacity across the organisation through peer support and networking and collective leadership. • Investing in a safe confidential space for clinical leads and other staff groups is a strategy for leadership development practice. • There is need to develop more skilled critical companions to support leadership, improvement and development activities • Clinical leadership development, informed by practice development methodology, demonstrates potential for enabling transformative and collective leadership for achieving person-centred cultures in the workplace. Keywords: Clinical leadership, collective leadership, critical companionship, micro-systems, transformational leadership, workplace culture