Healthcare practitioners' engagement with non-specialists: A scoping review.

Purpose: This study examines management competencies, career attitudes, leadership preferences, and long-term life purpose orientations among Generation Z students in the Indian higher education context. It also explores whether demographic factors influence these dimensions and whether they are interrelated. Methodology: A quantitative and exploratory research design was adopted. Data were collected through a structured online questionnaire from 478 students enrolled in intermediate, undergraduate, and postgraduate programs across India. Descriptive statistics, independent samples t-tests, one-way ANOVA and Chi-square tests were used for data analysis. Findings: The results indicate that Generation Z students report generally high levels of management competencies, particularly in time management and coordination, while adaptability and balancing personal and academic responsibilities were comparatively lower. Selected career attitudes including work–life balance, financial independence, and career stability, differed significantly across schooling background. Family income and academic stream influenced specific management competencies and career attitudes. In terms of leadership, students showed a strong preference for transformational, servant, and autonomy-supportive leadership styles, whereas authoritarian leadership was least preferred. Leadership preferences were largely consistent across demographic groups; however, long-term life purpose orientations varied significantly with family income, highlighting the role of socio-economic background in shaping students aspirations. Practical Implications: The findings suggest that higher education institutions should place greater emphasis on developing adaptability, work–life balance skills, and collaborative competencies, while also considering students’ diverse socio-economic backgrounds in employability and leadership development initiatives. Originality: The study offers a student-centric and context-sensitive perspective by integrating management competencies, career attitudes, and leadership preferences within a single framework in the Indian higher education context.

Neonatal intensive care units (NICUs) concentrate ethically complex decision-making, yet the leadership behaviours supporting nurses' ethical agency remain insufficiently understood, particularly outside Western contexts. To explore how moral leadership is experienced and enacted in shaping ethical decision-making among NICU nurses. Qualitative narrative inquiry, reported in accordance with COREQ and SRQR. Twenty-four registered nurses were recruited through purposive maximum-variation sampling across four Level III NICUs in northern Saudi Arabia. Narrative interviews (52-97min; mean ≈ 74min) were conducted over an eight-month period, from June 2025 to January 2026, and analysed using a narrative analysis approach integrating thematic and structural elements. Trustworthiness was supported through participant review of narrative summaries (14 of 24 participants provided substantive feedback), peer debriefing, reflexive journaling, and inter-coder agreement (κ = 0.83). Five themes and 15 subthemes were identified. Moral recognition was narrated as active, affectively mediated, and culturally embedded. A recurrent gap between moral judgment and moral action was attributed to hierarchical suppression of nursing voice and limited psychological safety. Servant leadership behaviours, empathic listening, moral mentoring, and ethical role modelling, as cumulative relational formation, functioned as moral scaffolding enabling ethical voice and action. Three emergent subthemes extended the framework: ethical role modelling as identity-level formation, spiritually grounded motivation rooted in Islamic accountability, and culturally sanctioned disclosure silence as a source of moral dissonance. Moral leadership in Saudi NICUs is a relational, contextually conditioned practice shaped by leadership behaviours, institutional structures, and cultural frameworks. Strengthening ethical infrastructure through leadership development, nurse-accessible ethics support, and competency frameworks embedding moral leadership as a professional standard is a priority for neonatal nursing in Saudi Arabia and comparable settings. Not applicable.

Purpose This study aims to investigate how servant leadership (SL) fosters innovative work behavior (IWB) among public service employees, mediated by knowledge sharing (KS) and creative self-efficacy (CSE), and moderated by task autonomy (TA), in a model which integrates relational, cognitive, and structural mechanisms. Design/methodology/approach The study employs a partial least squares structural equation (PLS-SEM) to analyze data collected from 524 public service employees of the Brazilian Federal Police (PF). Findings Results confirm that SL positively influences IWB through dual mediation mechanisms: KS (β = 0.038, p = 0.001) and CSE (β = 0.092, p = 0.003). CSE exerts the strongest significant influence, indicating that employees' confidence in their creative abilities has a greater impact than KS. TA strengthens the link between SL and CSE (β = 0.126, p = 001; f2 = 0.02), moderates the relationship and amplifies the indirect effects on IWB. The model explains 51.6% of IWB variance, indicating both high explanatory and predictive power. Originality/value This study provides empirical evidence that, in rigid public contexts, CSE is the primary mechanism that translates SL into IWB, surpassing the influence of KS. TA is a necessary condition for activating this creative potential. The results empirically contribute to the literature by testing the proposal integrated model and, methodologically, by confirming the predictive and explanatory strength of PLS-SEM in public administration research. The lack of studies on these integrated variables and the specific context – the Brazilian PF – highlights the importance of this research and amplifies empirical understanding of public service innovation.

Community-based medical education and research services (COBMERS) place medical students in primary health care facilities to strengthen their skills in community health service delivery, teamwork, leadership and professional ethics within limited-resource settings. Beyond training, COBMERS enables universities to generate evidence on local disease epidemiology, transmission dynamics, and control practices, resulting in a tangible, contextualized impact on the communities. There is however limited data on disease profile in Teso subregion, with limited epidemiological research in the area. This prospective study aims to profile the disease burden in the Teso subregion through COBMERS, thereby informing community-level interventions and health policy. The study will employ convergent parallel mixed-methods design, integrating quantitative and qualitative approaches. Quantitative components will include cross-sectional surveys to determine prevalence of non-communicable diseases (NCDs), neglected tropical diseases (NTDs), and infectious diseases, complemented by prospective cohort studies to assess temporal trends. Qualitative data will be gathered through focus group discussions and key informant interviews to explore community perceptions, health system capacity, and effectiveness of preventive measures. A community-based participatory research (CBPR) approach will guide all phases, ensuring that research is co-designed with community members, health practitioners, and local authorities. Medical students, under the supervision of faculty and site mentors, will serve as primary data collectors, integrating research with their COBMERS training. The study is expected to provide evidence on the prevalence, trends, and risk factors of major diseases in the Teso subregion, alongside community perspectives on health priorities and barriers to care. Findings will stir up debates to inform tailored interventions, strengthen primary health care, and guide policy formulation. Additionally, embedding research within COBMERS is expected to build local research capacity among site mentors and students, fostering sustainability and continued community-university collaboration. This protocol therefore provides an integrated framework that combines epidemiological surveillance, community engagement, and capacity building. By leveraging COBMERS and CBPR, the study seeks to provide actionable evidence to reduce the burden of NCDs, infectious diseases, and NTDs while promoting health system resilience in Eastern Uganda.

BackgroundClimate change is now regarded as a global health challenge of the 21st century, posing a negative health risk to the population. Sub-Saharan Africa is disproportionately affected more than any other region worldwide. Mapping strategies and responses in Sub-Saharan Africa to address the impact of climate change on health systems is a starting point for understanding evidence-based decision-making and informing best practices.MethodsWe conducted a scoping review to identify health systems strategies and responses to the effects of climate change in Sub-Saharan Africa. Electronic database searches were conducted on African Index Medicus, PubMed, CINAHL, and Scopus. Covidence software was used to remove duplicates, blind study selection, and data extraction. We included peer-reviewed articles (original quantitative and qualitative studies, mixed methods studies, reviews, editorials, and commentaries) published between 2011 and 2025. All book chapters and grey literature publications (dissertations, conference proceedings, abstracts, and reports) that primarily focus on climate change strategies and responses without effects on health systems were excluded. The results were analysed using descriptive thematic analysis.ResultsOut of 11459 articles, 8 studies met our inclusion criteria. Most studies provided strategies and responses centered on service delivery, health workforce, health information, leadership and governance, with few on health financing and medicinal products. No study was identified that had outlined strategies and responses across all of the six World Health Organisation building blocks for the health systems. Implementation challenges identified include inadequate funding, lack of knowledge among health workers on climate change and health, inadequate surveillance and reporting structures, and low prioritization of climate change activities among health workers.ConclusionsThis scoping review has identified some health system strategies and responses to the effects of climate change within the Sub-Saharan African region. The review has revealed that existing strategies and responses are fragmented and hindered by some implementation challenges. As climate change continues to pose health threats to the global population, urgent and effective interventions are required to minimize its impacts. It is essential to understand the unique vulnerabilities of the health systems, particularly those in the Sub-Saharan African region. The time is now to develop strategies and responses that can improve and strengthen health systems as it protects health of the population from the effects of climate change.

ABSTRACT Social entrepreneurship research has focused on the importance of ventures that create social value with economic sustainability. However, a comprehensive understanding of the drivers of social entrepreneurial intention (SEI) is less well developed and clearly requires research from the perspective of leadership and personal value orientations. This article addresses this research gap by drawing on the theory of planned behavior and effectuation theory to explore the influence of servant leadership on SEI through the mediating effects of effectuation and the moderating effects of collectivism. An empirical analysis of 287 university students using partial least squares structural equation modeling showed that servant leadership—empowerment, service, and vision—significantly influences SEI. The influence of servant leadership on SEI is partially mediated by effectuation—experimentation, affordable loss, flexibility, and precommitment. Moreover, the results show that collectivism—an internalized value that focuses on interdependence and shared responsibility—positively moderates the relationship between servant leadership and SEI. The findings indicate that collectivism serves as an important boundary condition for translating leadership values into social intent. This research makes theoretical contributions by linking leadership orientation with entrepreneurial cognition and has implications for educators and policy makers interested in developing a new wave of socially responsible entrepreneurs.

BackgroundEffective leadership is crucial for delivering high-quality healthcare, optimizing employee performance, and improving patient outcomes.ObjectiveThis study conducts a bibliometric analysis to examine leadership styles in the healthcare sector, identifying key research trends, influential works, and their impact on work outcomes.MethodsUsing Scopus-indexed publications (2010-2024), this study analyzes eighty-three relevant documents with VOSviewer.ResultsThe findings reveal that various leadership styles, such as transformational, transactional, authentic, collaborative, inclusive, servant, and paternalistic leadership, have a significant impact on both individual and organizational outcomes. Furthermore, transformational leadership is the most studied and influential style, promoting employee engagement, innovation, and better patient care. Transactional leadership ensures structure and efficiency but offers limited long-term benefits. Servant leadership fosters trust, collaboration, and ethical decision-making, while authentic leadership enhances transparency and psychological safety. Additionally, the study highlights a growing focus on healthcare leadership, with Medicine and Business, Management & Accounting as the dominant disciplines.ConclusionThis bibliometric study highlights the critical role of leadership styles in shaping work outcomes in the healthcare sector. Transformational leadership emerges as the most influential, fostering innovation, engagement, and improved patient care.

This action research project aimed at understanding the challenges and barriers that established and emerging lived experience leaders experience in their organisational and community contexts. The study reports on qualitative focus groups/online forum with 31 diverse lived experience leader participants and 14 individual interviews with mental health and community service and sector leaders. The data was thematically analysed using a systems change framework which emphasises challenges and barriers relating to policies, practices and resource flows, relationships and power dynamics, and mental models. Themes revealed that leaders face multiple organisational and system level challenges in seeking policy and organisational change through leadership action. Similar themes were apparent in the perspectives of lived experience leaders and service/sector leaders, on challenges relating to organisational settings, however, lived experience leaders described a wider scope of challenges relating to emotional, relational, organisational and community experience than those of sector leaders.

Servant leadership, job commitment, and resource satisfaction as predictors of teachers' quality of work life in Peruvian basic education.

Social ventures operate at the intersection of business and social mission, facing competing institutional logics and scarce resources while striving to generate sustainable social impact. To navigate these challenges, leadership plays a crucial role in enabling team processes that foster creativity and innovation. Building on the resource-based view and the dynamic capabilities framework, this study examines how empowering leadership – characterised by delegation, autonomy and participative decision-making – enhances team creativity and innovation in social ventures. Specifically, we test a sequential mediation model in which empowering leadership influences team innovation through team dynamic capabilities and team creativity, controlling for servant leadership. Data were collected from social ventures operating in Brazil. Results indicate that empowering leadership positively affects team dynamic capabilities. The indirect effects of empowering leadership on both creativity and innovation were also significant. These findings highlight empowering leadership as a critical trigger of adaptive and creative team processes that sustain innovation in social ventures.

The art of balancing behind the Golden Wall: An administrative perspective on civil service leadership The ongoing discussion regarding political-bureaucratic relations illustrates the importance of a refined and balanced approach to civil service leadership, without calling into question the essential premise of political primacy. In this article, we develop an analytical framework for civil service leadership and apply it to the Dutch and the (federal) American prison systems. A plea is made for the emancipation of civil service leadership: it is time for senior civil servants to exercise their leadership duties within the rules of the political-bureaucratic game.

competencies of master teachers in Region I and their implications on teaching effectiveness. Employing a descriptive-correlational research design, the study involved master teachers and teachers in public elementary schools in Region I. Data were gathered using validated survey instruments aligned with instructional leadership constructs, supervision competency domains, and the DepEd RPMS–IPCRF framework for teaching effectiveness. Descriptive statistics were used to describe levels of instructional leadership styles, supervision competencies, and teaching effectiveness, while inferential statistics, particularly Pearson r and Spearman rank correlation, were employed to assess significant relationships among variables. Findings revealed that the instructional leadership styles of master teachers — namely, authoritative, collaborative/participative, coaching/mentoring, transformational, distributed/shared leadership, instructional monitoring and feedback, and servant leadership — were highly evident. Supervision competencies in planning and organizing instructional supervision, classroom observation and feedback, coaching and mentoring, monitoring and evaluating instructional practices, and facilitating professional development activities were highly competent. Teachers’ level of teaching effectiveness based on RPMS–IPCRF indicators was also rated highly effective. Results further showed significant positive relationships between instructional leadership styles and teaching effectiveness, as well as between supervision competencies and teaching effectiveness. Selected profile variables were also significantly related to supervision competencies. These findings underscore the critical role of instructional leadership and effective supervision in enhancing teaching performance. Based on the results, a capacity-building program for master teachers was proposed to strengthen leadership and supervision practices and sustain improvements in teaching effectiveness.

Purpose Knowledge-sharing behavior (KSB) is vital for innovation and collaboration in knowledge-intensive sectors. An employee’s willingness to share is heavily dependent on leadership’s influence and support. The purpose of this study is to examine the distinct effects of entrepreneurial leadership (EL) and servant leadership (SL) on employees’ KSB. It also investigates whether SL explains additional variance in KSB beyond EL. Furthermore, the study explores the mediating role of psychological safety (PS) and assesses the moderating effect of workplace bullying (WB) on the relationship between PS and KSB. Design/methodology/approach Data was collected in a multiwave cross-sectional design using digital and physical distribution methods. The final data set includes 541 personnel from various information technology firms in Bangladesh. Structural equation modeling was used to thoroughly test the hypotheses and compare model performance. Findings The results imply that SL not only has a greater positive influence on KSB but also represents an additive variation in KSB above and beyond EL. Likewise, the research demonstrated that the influence of EL on KSB is more effectively mediated by PS. Moreover, WB was found to weaken the positive PS on KSB. Originality/value This study provides novel empirical insights into the unique and supplementary impact of SL on KSB, surpassing the influence of EL. It significantly extends the literature on EL, SL and knowledge-sharing by demonstrating their distinct contributions to knowledge distribution via intricate mediation and moderation processes.

The COVID-19 pandemic created significant challenges for human services leaders, including a pivot to technology, as public health restrictions disrupted face-to-face service models. These challenges were exacerbated for social enterprise leaders, whose organizations’ hybrid nature requires balancing social mission and market-driven operational demands. While the human services organizations’ use of technology is documented, less is known about how human services and in particular social enterprise leaders guided technological shifts. Adopting an exploratory qualitative approach, this study draws on semi-structured interviews with ten regional Australian social enterprises leaders and an institutional logics perspective to analyze how they navigated their complex organizational demands and shaped technological choices during the COVID-19 pandemic. The findings reveal heterogeneous responses, where while a minority prioritized a single logic to guide their technological choices of adoption, adaptation, and, in one case, refusal, most were not constrained by the competing demands of their hybrid nature. Instead, the presence of multiple logics served as a framework for action, transforming a disruptive situation of ambiguity into a complex interplay of value-driven technological decisions. By mapping the landscape, the study contributes to a deeper understanding of technological choices and the leadership experience in complex human services settings, particularly within resource-constrained contexts.

Purpose Creativity is a major success factor for marketing organizations, but little is known about the relative impact of different styles of leadership on marketing creativity. The purpose of this study was to study experimentally the distinctive effects of four contemporary leadership styles (servant-, transformational-, transactional- and laissez-faire leadership) on two dimensions of marketing creativity (i.e. originality and relevancy of brand slogans). Design/methodology/approach In this experimental study, the authors use a sample of 526 marketing professionals to test hypotheses on the comparative effects of four leadership styles on the originality and relevancy of 1.733 generated slogans for a new brand, scored by a panel of marketing professionals. To test the hypotheses, the authors use a multi-categorical structural equation modeling technique. Robustness checks suggest that the findings are not sensitive to age, gender, education or culture. Findings The results show that leadership-effects on marketing creativity can be meaningfully tested using an experimental design. Specifically, the findings show that active leadership styles (servant, transformational and transactional) stimulate more creativity than passive leadership (laissez-faire). Among the active leadership styles, the authors find that servant leadership is a stronger predictor of marketing creativity than transformational and transactional leadership styles. Research limitations/implications Randomized experiments make it possible to draw causal conclusions about the relative effect of leadership styles (Podsakoff and Podsakoff, 2019). However, there are also limitations with experimental studies. Inspired by Van Dierendonck et al. (2014) the authors used “imaginative scenarios” to manipulate leadership style. Participants were asked to imagine themselves in the role of an employee reporting to a leader described in the scenario. Compared to real experience of leadership, this is a relatively weak (but precise) manipulation of leadership style. Practical implications Marketing organizations looking for new managers to supervise creative marketing activities should look for candidates with a servant leadership style and avoid laissez-faire leaders. Internal leader programs for marketing managers should enhance servant leadership skills and the ability to stimulate psychological safety. Marketing programs at business schools should develop the same skill sets in students. Theoretical knowledge is not sufficient. Educators need to assist students in developing a serving identity and form personal goals to be a servant leader. Social implications Servant leadership has a positive effect on marketing creativity and this effect is mediated by psychological safety. This means that marketing employees feel more free to use their creative talents when their leader practice servant leadership. This effect of servant leadership is likely correlated with commitment and job satisfaction. Thus, servant leadership contributes to social sustainability of marketing organizations. Originality/value To the best of the authors knowledge, this study is the first to compare the effects of several major leadership styles on marketing creativity using experimental design and experts to rate the originality and relevance of real marketing ideas. For the first time it is shown empirically that servant leadership has a stronger effect on marketing creativity than other major styles of leadership, including transformational leadership.

ABSTRACT This study examines the factors driving the use of performance measurement in homeless service networks, where service delivery is complex and multidimensional. While existing literature acknowledges the importance of performance measurement in public and nonprofit sectors, little is known about its application to collaboration in homeless services. Using data from a national survey of Continuum of Care (CoC) networks that serve people experiencing homelessness in the US, this study investigates how leadership style, shared accountability, and governance structure influence the use of performance measurement. Findings reveal that transformational leadership and shared accountability significantly enhance performance measurement use. This research advances our understanding of performance measurement use in services for individuals experiencing homelessness and offers insights for service leaders seeking to implement data-driven decision-making in collaborative homeless service networks.

Professional advancement of the CT workforce: A UK modified e-Delphi study of competency and capability requirements beyond threshold practice and comparison with international CT practices.

Purpose The nursing profession faces a critical shortage and a need for practice-ready leaders to navigate the complex healthcare landscape. This article describes the design, implementation and initial outcomes of the four-year Harper Nursing Scholars Program (HNSP) to prepare ethical, innovative and reflective leaders through experiential, competency-based education (CBE). Design/methodology/approach The HNSP supports 30 direct-entry BSN students across four cohorts and is grounded in authentic and servant leadership theories. Students are competitively selected, receiving annual scholarships and funding for experiential learning. Findings Scholar participants reported positive early outcomes, including self-awareness, evolving leadership concepts, community formation and reflective practice. Faculty report renewed teaching engagement. Originality/value This novel, replicable model, addresses the need for the development of practice-ready, ethical nurse leaders. The program uniquely blends two leadership theories with CBE, offering a distinct path for cultivating the next generation of nurse leaders.

In the UK, a range of services provide same day, urgent and emergency care (UEC). Urgent medical needs can be addressed through pharmacy services, same day general practice (GP) appointments, phone or online triage services, out-of-hours GP appointments and urgent treatment centres (or equivalents). For emergency medical needs, patients can access emergency departments (EDs) and ambulance services. These services are highly vulnerable to excessive strain due to rising, unpredictable demand and limitations in patient flow across the system. The workforce operates in time-critical situations, often with limited resources, which can lead to staff burnout, low job satisfaction and retention and poor health. The organisation of services and their workforce continues to evolve in response to local and national pressures and varies considerably across the UK, where there are four distinct, publicly funded healthcare systems managed separately in each country. This makes it difficult to describe and compare services within and across regions and understand the impact of workforce organisation on service delivery, staff well-being and patient care. This study aims to develop a comprehensive understanding of the range and types of UK UEC services, the relative experiences of the workforce and the available workforce data. This mixed-methods study includes two components, integrated through an explanatory sequential design. Study 1 will use data on NHS service availability and direct enquiry to map UEC services and populate a structured database, which will facilitate the generation of a UEC typology of the range and types of services and regional variation across the UK. Multiple case studies will be conducted in a subset of services using qualitative interviews (n=136-220) with service leaders (n=3-5), workforce (n=10-12), and patients or carers (n=4-5), as well as document analysis where relevant, in each service of interest (n=8-10). Study 2 will create a metadata catalogue of workforce data and produce descriptive summaries of key metrics (eg, staffing levels and skill mix). The study will be supported by our Community Inclusion and Engagement (CIE) panel and Patient and Public Advisory Group (PPAG) to ensure relevance, inclusivity and impact. This study received ethical approval from Yorkshire and The Humber - Sheffield Research Ethics Committee (04/08/2025, IRAS ID: 357276, REC Reference: 25/YH/0125) and HRA and Health and Care Research Wales approval (12/08/2025). Data collection poses minimal risk, informed consent will be obtained, and participants may withdraw at any time. Dissemination will follow knowledge mobilisation principles to maximise impact. We will build on our existing networks and work with our CIE panel and PPAG to tailor study outputs to different audiences. The outputs will improve understanding of the variation in how UEC services and workforces are organised across the UK, as well as the type and format of available workforce data, and provide benchmarks for future research. Research Registry (REF: researchregistry11555; https://www.researchregistry.com/register-now/%23home/registrationdetails/68d402672341e502cd0ce888/).