Leadership Positions In Health Care Research Articles

Intersectionality and Feminist Theory: A Framework for Understanding and Teaching Social Construct and Healthcare Policy

The continuing nursing shortage throughout the United States has affected all aspects of the healthcare sector, particularly nursing leadership. As the Baby Boomer generation of nurses retires, the profession is primed to need more experience, advocacy, and leadership. This leaves a critical gap for leaders who identify with and are wise to the factors that influence the dynamic power relationships inherent to American history. As the country continues to become increasingly diverse, women and minorities in leadership continue to be underrepresented. In one of the most significant threats to women’s health, the recent overturning of the Supreme Court landmark case, Roe v. Wade, has highlighted the marginalization of women and people of color that is deeply embedded in the nation’s history. The lack of women and minorities in leadership positions in healthcare that has resulted from vast power imbalances, gender stereotyping, discrimination, and patriarchal structures must be addressed. Intersectionality theory offers a lens through which to understand these factors of power for all nurses. Nurse leaders can understand complex social constructs and be prepared to address power relationships that inform healthcare policy.

Recommendations for Recovery of the COVID-19 Pandemic-related Diagnostic, Screening, and Procedure Backlog in Ontario: A Survey of Healthcare Leaders.

The COVID-19 pandemic has resulted in a significant diagnostic, screening, and procedure backlog in Ontario. Engagement of key stakeholders in healthcare leadership positions is urgently needed to inform a comprehensive provincial recovery strategy. A list of 20 policy recommendations addressing the diagnostic, screening and procedure backlog in Ontario were transformed into a national online survey. Policy recommendations were rated on a 7-point Likert scale (strongly agree to strongly disagree) and organized into those retained (≥75% strongly agree to somewhat agree), discarded (≥80% somewhat disagree to strongly disagree), and no consensus reached. Survey participants included a diverse sample of healthcare leaders with the potential to impact policy reform. Of 56 healthcare leaders invited to participate, there were 34 unique responses (61% response rate). Participants were from diverse clinical backgrounds, including surgical subspecialties, medicine, nursing, and healthcare administration and held institutional or provincial leadership positions. A total of 11 of 20 policy recommendations reached the threshold for consensus agreement with the remaining 9 having no consensus reached. Consensus agreement was reached among Canadian healthcare leaders on 11 policy recommendations to address the diagnostic, screening, and procedure backlog in Ontario. Recommendations included strategies to address patient information needs on expected wait times, expand health and human resource capacity, and streamline efficiencies to increase operating room output. No consensus was reached on the optimal funding strategy within the public system in Ontario or the appropriateness of implementing private funding models.

Mixed-method Study on Gender Disparity in Healthcare Leadership Positions in Southern Ethiopia

Gender disparity in healthcare leadership positions is a multifactorial phenomenon based primarily on how society has been socialised according to gender roles and defined how women and men progress in the workplace, including healthcare. The purpose of this mixed-method study was based on the theory of hostile and benevolent sexism as applied in organisations and explored gender disparity in healthcare leadership positions. Quantitative survey data were collected using a structured questionnaire from 414 healthcare professionals, and qualitative data were collected from 21 healthcare professionals using a semi-structured interview guide containing open questions. Quantitative data were analysed using SPSS version 25. A descriptive phenomenology using Colaizzi’s (1978) approach was used for the qualitative strand. The findings show a noticeable increase in women’s promotion to low-level leadership positions. The quantitative results were corroborated by the qualitative findings, which confirmed that healthcare workers faced several challenges in getting promoted and that cultural bias persists. Participants of both genders reported that female promotions are negatively impacted by gender roles, inherent gender bias, and family responsibilities. This study documents changes in the way men view women’s abilities in the workplace. Although there are noticeable improvements in low-level leadership positions, serious issues persist, such as the lack of support for female healthcare workers with young families and limited recognition of women’s abilities to perform at the level of their male counterparts. It is crucial to establish gender-sensitive recovery interventions that facilitate women’s progress in leadership positions. Further research and empowerment programmes are necessary to enhance women’s self-assurance.

Exploring perceived barriers for advancement to leadership positions in healthcare: a thematic synthesis of women's experiences

PurposeThis paper aims to explore the voices of women describing the perceived barriers for advancing to leadership positions in healthcare.Design/methodology/approachA systematic search was conducted through Elton B Stephans Company (EBSCO) host research platform using the databases Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Medical Literature Analysis and Retrieval System Online (MEDLINE) Complete and American Psychological Association (APA) PsycInfo. Nine papers were selected for this review. Thomas and Harden's (2008) method of thematic synthesis was used drawing from eight qualitative papers and one mixed methods paper describing women's lived experiences in, or advancing to, leadership positions in the healthcare sector. Analysis was conducted using three steps of thematic synthesis: the inductive coding of the text, the development of descriptive themes and the generation of analytical themes.FindingsThrough the method of thematic synthesis, six descriptive themes (barriers) emerged: internalised feelings, work–life balance, lack of support, stereotypes, discriminatory behaviours and organisational culture. From these, three analytical themes were identified: personal, interpersonal and organisational.Research limitations/implicationsThis review looked at nine papers and documented women's voices. However, the women were in disparate geographical areas across the world and did not consider the specific cultural context in which the women were located. The healthcare sector is very large, and therefore, whilst there are shared commonalities, the disparateness could be a limitation.Practical implicationsBarriers were categorised as either structural barriers or attitudinal barriers to determine the policy and practice.Originality/valueThis research is crucial to better understanding what remedies need to be implemented to address gender disparity in the sector.

Gender stereotyping: Women's challenges when seeking healthcare leadership

This paper will discuss attributions, stereotyping, the relationship between them, and the challenges it creates for women seeking leadership positions in health care. Our paper presents different theories and models of stereotyping and some new controversies on gender stereotyping. It also introduces some strategies for managers to use when working with young women interested in pursuing leadership roles in the healthcare field. Gender and gender stereotyping discussed in this paper points out the root of gender inequality in society and organizations.

Experiences of Organizational Practices That Advance Women in Health Care Leadership

Women are underrepresented in health care leadership positions. Organizational practices and culture play a key role in mitigating this disparity. To explore the experiences of women in leadership roles and inform how health care organizations can support the advancement of women into leadership. This qualitative study used a constructivist grounded theory approach applied over a 1-year period (May 1, 2021, to May 31, 2022) in a large private health care network in Australia. Women were eligible if they had been in leadership positions for more than 5 years. Purposive and theoretical sampling guided recruitment of 28 women, representing medical, nursing, and allied health specialties. Interviews lasted 1 hour, producing 500 pages of transcripts for analysis. The primary outcome was a model of organizational practices and conditions that advance women in health care leadership, extrapolated from the collective experiences of women in leadership. Key elements pertained to organizational patterns of interaction and group norms and behaviors that contributed toward women's experiences of career advancement. Overall, 28 women (23 [82%] White; 3 [11%] Southeast Asian) participated in the study, 10 (36%) of whom were in nursing, 9 (32%) of whom were in allied health, and 9 (32%) of whom were in medical disciplines. Organizational practices that advance women in health care leadership were highly dependent on conducive organizational culture enhancing women's credibility and capability as leaders. Four interrelated elements were identified that create the necessary conditions for an organizational culture to advance women in health care leadership, including (1) identifying and actively addressing systemic barriers, (2) challenging gendered assumptions and expectations of leadership behaviors, (3) providing mentorship to shape career opportunities, and (4) determining how these conditions all contribute toward raising women's credibility to enable internalizing a leadership identity. For women, advancing to leadership involved organizations moving away from ad hoc, inconsistent applications of gender equity practices and generating supportive practices that reinforced a workforce culture of credibility, collaboration, and continuous improvement to support women. In light of persisting inequity in health care leadership, women's experiences were captured in this qualitative study to identify organizational practices that support their advancement. Insights into factors that influence efficacy of these practices, including building a supportive culture and mentoring, are discussed. This research informs a National Health and Medical Research Council initiative with international collaborators to support organizations in advancing women in health care leadership.

Closing the Gender Gap in Healthcare Leadership: Can Administrative Fellowships Play a Role?

Although women make up most of the healthcare workforce, they are underrepresented in higher levels of leadership positions. Leadership development programs for early careerists, such as administrative fellowships, have been suggested as one strategy for accelerating gender equity in leadership roles. However, the potential impact of these programs has not yet been the subject of systematic evaluation. In this study, we examined the (1) benefits of administrative fellowship programs on career attainment and (2) differences in attainment by gender. We completed this study using a data set involving alumni from a consortium of 11 graduate healthcare management programs whose students frequently pursue administrative fellowships. Our data included individual-level demographic and career attainment data for graduating classes from 5, 10, and 20 years prior to the reference year. Using multiple regression analysis, we tested the relationship of three independent variables-graduation year, gender, and completion of a fellowship-on career attainment. This analysis enabled us to determine differences in overall career attainment by gender, evaluate the role of fellowships in career attainment, and consider the differential impact of fellowships on attainment by gender. Our findings suggest that fellowship programs accelerate leadership career paths for individual leaders, but that the effect is stronger for males than their female counterparts. These findings not only support the value of administrative fellowships for early careerist leadership development but also suggest that closing the gender disparity gap in leadership may require additional and focused career-supportive strategies. We provide recommendations for healthcare organizations in developing their administrative fellowship programs to help minimize the gender disparity in healthcare leadership positions. Furthermore, we discuss research implications and future areas of research in administrative fellowships.

Think Like an MBA: Development, Implementation, and Evaluation of an Academic Radiology Business Series (ARBS) for Radiology Trainees

To address existing educational gaps in the business of radiology and medicine, we developed, implemented, and evaluated an Academic Radiology Business Series (ARBS) as part of a longitudinal noninterpretive skills curriculum in our radiology residency program. Mixed lecture- and discussion-based sessions were prepared and taught by content experts and radiologist-leaders at our institution in the style of a typical MBA curriculum, drawing on five core pillars: strategy, management, operations, finance, and health policy and economics. The series concluded with an interactive discussion of a Harvard Business School case study. To study the effectiveness of the curriculum, Wilcoxon rank-sum test was used to compare survey results before and after the curriculum. Nearly 80% of the pre-curriculum survey respondents were not satisfied with the current training offered in the business of medicine. Although 94% of trainees were interested in pursuing leadership positions in healthcare, they have self-reported knowledge gaps in the fundamentals of the business of medicine. There were significant improvements in satisfaction with their training in the business of medicine and perceived improvements in knowledge of important concepts in the business of medicine after participating in the curriculum (p < 0.001). Radiology trainees have strong interest in the business of radiology and appreciate its importance yet feel inadequately prepared during training. Intentional training incorporated into residency education in the form of an innovative educational initiative that brings radiology trainees together and utilizes an institution's own leaders to teach is feasible and effective.

Professional Discernment:: Discover the Leader in You!

An appealing characteristic of nursing as a professional career is the broad spectrum of tiered career path choices spanning diverse settings, geography, and specialties, which call for the specific body of knowledge, artful and scientific ways of thinking, and unique composites of experience acquired by nurses. Often, nurses aspire to assume leadership positions in health care. Purposefully developed professional discernment can illuminate the path to self-knowledge, which is an essential precursor to identifying a well-fit influential leadership role to pursue. In this article, the concept of professional discernment is expounded on as a powerful facilitator of self-assessment and decision support. An appealing characteristic of nursing as a professional career is the broad spectrum of tiered career path choices spanning diverse settings, geography, and specialties, which call for the specific body of knowledge, artful and scientific ways of thinking, and unique composites of experience acquired by nurses. Often, nurses aspire to assume leadership positions in health care. Purposefully developed professional discernment can illuminate the path to self-knowledge, which is an essential precursor to identifying a well-fit influential leadership role to pursue. In this article, the concept of professional discernment is expounded on as a powerful facilitator of self-assessment and decision support. Carol Tuttas, PhD, RN, is the Chief Learning Officer at CGFNS International Inc. in Philadelphia, PA. She can be reached at [email protected] .

Improving Healthcare Disparities of African American Males through Healthcare Leadership

The success rate for African American male students has surged as it relates to educational reform initiatives that not only challenge traditional structures of education but also mandate that policymakers, administrators, and educators craft new models to ensure success [1]. According to the US Department of Education, African American males constitute only 18% of the nation’s total student population enrolled in public schools. The Kaiser Foundation found that there is a link between socioeconomic status and health. The study found that on average, individuals with more education have more income and tend to have better access to health care and better health outcomes than those with less education and income. The study also found that 38% of African American men between the ages of 16-24 with a high school diploma were enrolled in college compared to 67% of Asians and nonwhites. Of the percentage of African American men enrolling in college only a few enroll in healthcare programs. The shortage of African American males pursuing careers in healthcare could be directly related to the disparate number of African American males enrolled in college. Therefore, continued efforts must be made to first, increase the college enrollment for African American men, and second, increase the number of African American men enrolling in healthcare programs which will in-turn increase the number of African American males in healthcare leadership positions. An increase in the number of African American men in healthcare leadership positions will aid in addressing health disparities such as hypertension, diabetes, and cardiovascular health in African American men by bringing a cultural awareness of how to get other African American men better access to healthcare. To assist with improving the number of African American men in healthcare leadership positions, focus needs to be placed on developing programs designed to attract and prepare African American males for healthcare leadership positions [2].

Challenges in Translation: Lessons from Using Business Pedagogy to Teach Leadership in Undergraduate Medicine

ABSTRACTProblem: Leadership is increasingly recognized as a core physician competency required for quality patient care, continual system improvement, and optimal healthcare team performance. Consequently, integration of leadership into medical school curriculum is becoming a priority. This raises the question of the appropriate context, timing, and pedagogy for conveying this competency to medical students. Intervention: Our program introduced a 1-week leadership course grounded in business pedagogy to Year 1 medical students. The curriculum centred on four themes: (a) Understanding Change, (b) Effective Teamwork, (c) Leading in Patient Safety, and (d) Leadership in Action. Post-curriculum qualitative student feedback was analyzed for insight into student satisfaction and attitude towards the leadership course content. Context: The Undergraduate Medical Education program of the Schulich School of Medicine & Dentistry, Western University, is delivered over 4 years across 2 campuses in London and Windsor, Ontario, Canada. Course structure moved from traditional passive lectures to established business pedagogy, which involves active engagement in modules, case-based discussions, insights from guest speakers, and personal reflection. Outcome: A student-led survey evaluated student opinion regarding the leadership course content. Students valued career development reading materials and insights from guest speakers working in healthcare teams. Students did not relate to messages from speakers in senior healthcare leadership positions. Course scheduling late in the second semester was viewed negatively. Overall student opinion suggested that the 1-week course was suboptimal for establishing leadership principles and translated business pedagogy was ineffective in this context. Lessons Learned: Leadership curriculum in Undergraduate Medical Education should be grounded in a healthcare context relevant to the student's stage of training. Student engagement may be better supported if leadership is framed as a competency throughout their career. Schools considering such innovations could draw lessons from other professional schools and utilize material and faculty that resonate with students.

Five Ideas for the Development of Successful Physician Leaders

An increasing number of physicians are embarking on a pathway from clinical practice to senior healthcare leadership positions that historically have been held by seasoned nonmedical or allied health professionals. Successful medical practitioners who are energetic, have a breadth of interests, and desire a broader range of influence are logical candidates for promotion to leadership positions in healthcare and are the ones most likely to put themselves forward for consideration in such roles.These individuals are chosen because of the characteristics that made them good clinicians or leaders of other physicians rather than deep experience in the larger world of healthcare administration. The resulting potential for mismatch of skill sets is widely believed to be a primary cause of failure in the role. Regardless of whether this assumption is a self-fulfilling prophecy promoted by those who seek to avoid disruption of the status quo, senior leaders who value the entrance of this new group of leaders must take great care in preparing them for success in interacting with unfamiliar constituencies, such as senior administrative leaders in nursing or finance, in the complex and continually evolving healthcare landscape.This column presents five key ideas that might inform the successful development of physician leaders.CONSIDERATIONS FOR DEVELOPMENT OF PHYSICIAN LEADERS: FIVE IDEASIdea 1: Prepare Physicians for Specific New Leadership Roles Rather Than an Undefined Future RolePhysician leader candidates share responsibility with senior leaders for thoughtful promotion on the basis of their (1) natural potential for the intended role and (2) preparation in areas where technical knowledge or new leadership skills are required. Both parties must understand the need to identify appropriate roles and the means for intentional professional development to fulfill leadership duties. Attention to career planning and leadership development and the alignment of a physician leader's talents, energies, and key motivators with the role help ensure a higher likelihood of success. A list of personal qualities deemed critical to success in a leadership position could be developed and compared with candidates' qualities. One way to determine key personal qualities is through the Birkman Method, which applies metrics to the following areas (Birkman International, 2016):* Usual behavior* Underlying needs* Stress behavior* Interests* Occupation* Management styles* Work environmentMany organizations have established structured programs, such as my institution's R. Timothy Stack Piedmont Leadership Academy, to develop their own physician talent. Master's degree programs in hospital or business administration are other common pathways for leadership development. The caveat to using such programs is that they typically provide broad-based leadership training rather than goal-based training. They rarely seek to define the specific roles that potential leaders might one day occupy, and they tend to offer no explicit plan for movement of individuals into such positions.On the other hand, the cultivation of new leaders at General Electric (GE) under Jack Welch, as described in Jack: Straight From the Gut, is a remarkable example of purposeful leadership development (Welch & Byrne, 2003). At GE, aspiring leaders study formal curricula, but they also are assigned to work in various defined roles in GE's five companies in both domestic and foreign offices under the tutelage of a variety of managers. A formal, semiquantitative evaluation process is used for determining advancement. The Boeing Company, Microsoft, and other global organizations take a similar approach to developing high-potential leaders.Of course, extrapolating the GE model to the development of physician leaders is difficult. Most healthcare organizations are not multinational corporations with large numbers of management positions, and physicians are not highly mobile. …

A call for SCAI members to become physician leaders.

In 2010 Robert Kocher MD painted a grim view of two possible futures 1. Both included accountable care organizations (ACOs) as key players in the United States health care system. In one version of the future, physicians took responsibility for leading ACOs, and consequently set the policies by which ACOs operated. Physicians were key decision-makers, advocated for excellent patient care, and reaped the economic benefits of efficient care rendered in the ACOs. In the other, very different vision of the future, physicians ceded control of ACOs to hospital administrators who operated their ACOs to benefit hospitals. In this vision, physicians dwindled in status, influence, and economic well-being, and patient care suffered. Kocher's message is clear: take a seat at the leadership table, or be on the menu. This paper is a call for interventional cardiologists to step up to positions of leadership to make sure that Kocher's second vision of the future does not come true. One theory of leadership holds that good leaders are good leaders because they have certain inborn traits 2. The opposing theory holds that good leadership is learned. Both are partly true. Either way, the drive and ambition required to be an interventional cardiologist makes us particularly well-suited for leadership. Most interventional cardiologists have many traits of “natural” leaders. We know how to set goals, make decisions under stress, learn and rebound from failure, and lead and inspire teams. All of these are important for successful leaders. Some leadership skills must be acquired through study, including business and financial savvy, negotiation, and knowledge of organizational behavior. But if they can be mastered by college business majors they can also be learned by physicians. Other qualities such as emotional intelligence and relationship-building, if not learned through medical or interventional cardiology training, can be picked up by aspiring leaders through hard work and a measure of humility. Interventional cardiologists are used to mastering new skills and techniques on the job; if we can learn new structural heart disease procedures we can learn how to read a financial statement or develop a strategic plan. Interventional cardiologists need to take leadership positions in health care for two reasons. The first is the welfare of our patients. As payment systems transition to “value-based”, and as health systems seek ways to make health care more efficient, no group is as well-positioned to understand threats to patients from health care reform, or to guard the interests of patients, as are physicians. Physicians have a moral obligation to lead health care organizations at all levels so as to protect the interests of their patients 2. The second reason for physicians to learn leadership is to retain control of their own fate. If you aren't leading, someone less competent may be leading you. If you aren't leading, someone with a non-patient-oriented viewpoint may lead your organization. If you aren't leading, someone else may lead you down a path of professional dissatisfaction. Academic physicians 4, surgeons 5, family practitioners 6 and heart failure physicians 7 have issued calls for their colleagues to become physician leaders. This is your call to leadership. Not only do interventional cardiologists have the same reasons as other specialists to become leaders, but interventional cardiologists are particularly well-suited to do it. Colleagues – answer this challenge, prepare yourself for leadership, and step up to leadership positions in your organizations. Thanks for critique and contribution to this article by Jeff Adams MBA, Susan Frye MBA, and Mary Stark MFA.

The Leadership Gap: Ensuring Effective Healthcare Leadership Requires Inclusion of Women at the Top

This paper argues that successful transformation of the healthcare system requires inclusion of women at the top. Women are missing in top leadership roles in healthcare at a time when the US healthcare system faces daunting challenges. There is a documented need for diverse leadership teams with transformational leadership skills to successfully lead organizations, yet women who comprise three fourths of the healthcare workforce are sparsely represented in board rooms and in the senior executive suite. Through a review the literature the authors explain why this leadership gap persists and recommend strategies to increase gender diversity in leadership ranks of the healthcare industry. Studies from other business sectors are also examined for application in healthcare. A lack of focus on female career development and succession planning, often based on persistent stereotypes about women leaders is a major deterrent to advancing women in top leadership positions. A compelling case is made for immediate remediation of this issue and implementing strategies to fill the leadership gap with talented women leaders. There is a demand to increase the number of women in top leadership positions in healthcare to assist in overcoming the current crises facing the industry.

Leadership Development and Succession Planning in Case Management

The director of case management is one of health care's leadership positions most frequently in demand. The lack of qualified and effective case management leaders will continue to be an issue for organizations for years to come, influenced by increasing pressures on health care reimbursement and the aging case management workforce. Organizations have an opportunity to create a program to develop future case management leaders from their internal talent. The proposed strategies are designed for the acute care hospital but also have applicability in other health care settings where there are case managers and a need for case management leadership. The business community offers leadership research and leadership development models with relevance to case management. Identifying and developing internal talent for leadership roles has been proven to be effective in preparation for advanced responsibilities, has a positive effect on staff morale, and minimizes the impact of vacant leadership positions during recruitment and onboarding activities. Creating a case management leadership development program for an organization can be an alternative to the process of external recruitment for case management department leaders. Such a program can be undertaken even in today's budget conscious environment by accessing existing resources in an organization in a creative and organized manner. The authors outline an approach for case management leaders to accept responsibility for succession planning and for case managers to accept responsibility for promoting their own career development through creation of a leadership development program.

View from Above

Five radiologists who have attained prominent leadership positions in health care, academia, and industry discuss the looming cultural, economic, and political obstacles facing radiology—and how they can be converted into opportunities.

Extending Dietetics Training beyond Traditional Leadership Roles in Health Care

Text: Healthcare management is a field serving one of the largest and most essential industries in the United States. According to the U.S. Department of Labor, “employment of medical and health services managers is expected to grow 16 percent from 2006 to 2016, faster than the average for all occupations.”1 An estimated 43,000 new jobs will need to be filled to provide the leadership needed in health care, providing opportunities in hospitals, and other types of health care organizations. 1 Dietitians are uniquely positioned by training and experience to fill these leadership positions, not only in dietetics management, but in non-dietetics roles as well. Many of the competencies required to pass the Registration Examination for Dietitians2 prepare an individual for leadership, and are not required in other health care professions at entry level, but rather are acquired during graduate studies. 3-6 Exam competencies geared toward health care leadership include: human physiology, the human life span (Domain I), critical thinking, information synthesis, problem solving (Domain II), effective communication (Domain III), inventory management, sanitation, safety, facility planning, and systems development (Domain IV), and management competencies (Domain V). Individuals studying these competencies in coursework and exam preparation may be better prepared than their counterparts in Nursing and allied health professions to assume health care leadership positions which provide not only tangible rewards such as better salary and benefits packages, but also intangible rewards from the opportunities to improve patient care. Registered Dietitians should consider these leadership options when making decisions about career development.

The nurse manager's work in the hospital environment during the 1990s and 2000s: responsibility, accountability and expertise in nursing leadership

The aim of the study was to describe and compare the characteristics of the nurse manager's work in different hospital environments and at different times. Business values and pressures for cost efficiency have become a reality in health care. The data comprised the diaries of 155 nurse managers working in one Finnish health district's hospitals in the 1990s and 2000s. In addition, focus group interviews were used as a data source. The data were subjected to qualitative and quantitative content analysis. The nurse manager's work comprises responsibility activities, accountability activities, and traditional bedside nursing. They also described the recognition of the underlying premises of their work and outcome orientation. Their descriptions of work varied between university and rural hospitals, between psychiatric and somatic nursing and between different wards. The work changed in the 2000s as the nurse manager's role changed from nurse to nurse leader. It appears that nurse managers have succeeded in integrating different leadership models into their daily work pattern. A new leadership model was devised based on an emerging nursing framework. Nurse leaders should assess who can assume leadership positions in health care and on what grounds.

Libyan Medical Education: Time to Move Forward

Libyan Medical Education: Time to Move Forward

Americans' view of cancer.

This paper presents the concept of the town hall meeting and discusses how it can be used as a forum for those who have been touched by cancer. It can be a platform for people to express their views about cancer, not only in the community but also nationally. Empowerment is the hallmark of a town hall meeting. Those who are in leadership positions in health care and elected officials and community leaders are given the opportunity to hear the opinions of people who represent a broad-based constituency of individuals affected by cancer. The idea of holding a town hall meeting was first introduced in the cancer community by the National Coalition for Cancer Survivorship NCCS) as a means of identifying issues, exchanging information and considering creative solutions to problems. The first town hall meeting was held in 1994 in conjunction with the NCCS annual assembly. Since then, utilizing the guidelines set forth by the NCCS, 30 or more town hall meetings have been held across the United States. Cancer survivors have, by and large, been responsible for garnering the necessary support for conducting a town hall in their local area. Organizations such as the American Cancer Society, the Leukemia Society of America, hospitals, clinics, pharmaceutical and healthcare companies and also noncancer groups, such as the YMCA, churches, and radio/T.V. stations, join with the cancer survivors in organizing the meeting, planning related displays, and advertising the event. In 1998, seven town hall meetings were sponsored jointly by OnCare and NCCS in advance and support of the upcoming THE MARCH- Coming Together To Conquer Cancer, a national rally held in Washington, D.C. in September 1998. Attendees at the meetings included not only cancer survivors and their families, but also healthcare professionals, local and state legislators, community leaders and the media. Results of the 1998 town hall meetings are discussed and compared with the topics identified during the meetings held in 1994-1996. Town hall participants were outspoken about what is needed in America if cancer is truly to become the nation's healthcare priority. They are asking for equal access to quality care, increases in financial backing for research, and more support for cancer advocacy efforts. Benefits of holding town hall meetings are identified.