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Purpose The purpose of this study was to explore rapid role shifts at work and to describe the factors that facilitate or inhibit such role shifts, and how these factors affect the employee. Design/methodology/approach A qualitative study was conducted with 12 participants from four public sector organizations. The participants systematically documented their work role shifts over the course of three days. Based on these data, they were interviewed about their shifts in work roles. All data were analyzed thematically. Findings Rapid role shifts do not work without extensive mental preparation and commitment. The role changes were perceived as stimulating if there was clarity about purpose, context and the significance of one’s own role, and if there was time both to switch between different roles and to reflect. Research limitations/implications This study was only performed in public sector organizations, and with a relatively small sample of interviewees. To generalize the results a more comprehensive collection of data would be required, including independence between researchers and subjects. Practical implications Adequate work structures, well-thought-out plans, time set aside for adjustment and reflection, and, not least, well-functioning information technologies are essential to teamwork commitment and satisfaction. As occasional teams, virtual teams and remote work become more common in the future, attention must be paid to rapid work role shifts by governments, policymakers and employers. Originality/value To the best of the authors’ knowledge, this is the first systematic study of the challenges involved in rapid shifts in work roles.

Purpose The purpose of this paper is to examine the possible factors related to transfer of knowledge and skills from two leadership development courses to the work environment and its maintenance for two years post training. Design/methodology/approach A total of 12 leaders in two different types of courses were interviewed at least two years after their participation. Thematic analysis was used to identify patterns within the data that explained if, how and why these leaders used this knowledge and these skills in their leadership practice. Findings The most influential themes identified were personalized feedback in the courses, increased confidence in leadership roles after the courses, the opportunity to use new knowledge and skills at work, employee feedback, management facilitation and continual reflection. Practical implications Leadership development programs should include personalized feedback and reinforce continual reflection on the feedback and course content. The short-term goal of such programs should be to increase leaders’ confidence in their leadership role. The employer must offer opportunities for continual reflection, facilitate dialogue with employees, peers or superiors for long-term maintenance of skills and knowledge. Originality/value Outcome studies of leadership development programs are scarce and long-term follow-up of transfer and maintenance of knowledge, as this one, even more unusual.

Purpose The purpose of this paper is to report on the results of an experiential leader development course titled understanding group-and-leader (UGL). Design/methodology/approach The study sample consisted of 61 course participants (the managers) and 318 subordinate raters. The development leadership questionnaire (DLQ) was used to measure the results of the course. The measurements were made on three occasions: shortly before the course, one month after the course and six months after the course. Findings The managers’ self-evaluations did not change significantly after the course. However, the subordinate raters’ evaluations of their managers indicated a positive trend in the scales of developmental leadership and conventional-positive leadership one month and six months after the course. Research limitations/implications The study was based on a comparatively small sample with a number of drop-outs. The study lacked a control condition. Practical implications From an organizational point of view, it could be argued that it is justifiable to send managers to such a course, as there is a good chance for an improvement in their leadership style as rated by subordinates. Social implications The integration of group processes and leadership behavior in the context of experiential learning seems to be a fruitful path to leader development. Originality/value Longitudinal studies on the results of experiential learning for managers are sparse. This is the first quantitative evaluation of a course that more than 80,000 individuals have taken.

Purpose The purpose of this paper is to understand the influence of leadership programmes on leaders and co-workers, as well as which mechanisms are involved in the process. Design/methodology/approach An analysis was done into 431 free-text answers to questionnaires given to 120 participants in two different leadership programmes and their co-workers six months after their participation, using a grounded theory inspired approach. Findings The result is a model, linking internal psychological and external behavioural aspects, with the central outcome that leaders gained more confidence in their leadership role through theoretical models learned, and reflection. Research limitations/implications The course participants as well as the co-workers seemed to experience a positive leadership development indicating a value of participating in the courses. Practical implications Confidence in leadership role seems important for having positive outcomes of leadership. Although this needs further research, it is something organisations should consider when working with leadership questions. Social implications The co-workers perceived their leaders to be calmer, more open for discussions, and willing both to give and receive feedback post training. There appears to be an increase in trust both in the leader and reciprocally from the leader in the co-workers. Originality/value Until now there has not been any systematic research into the effects on participants and co-workers following the programmes, despite the fact that over 100,000 have participated in the courses.

Purpose The purpose of this study is to investigate the relationship between leadership profiles and differences in managers’ own levels of work stress symptoms and perceptions of work stressors causing stress. Design/methodology/approach Cross-sectional data were used. Healthcare managers (n = 188) rated three dimensions of their leadership behavior and levels of work stressors and stress. Hierarchical cluster analysis was performed to identify leadership profiles based on leadership behaviors. Differences in stress-related outcomes between profiles were assessed using one-way analysis of variance. Findings Four distinct clusters of leadership profiles were found. They discriminated in perception of work stressors and stress: the profile distinguished by the lowest mean in all behavior dimensions, exhibited a pattern with significantly more negative ratings compared to the other profiles. Practical implications This paper proposes that leadership profile is an individual factor involved in the stress process, including work stressors and stress, which may inform targeted health promoting interventions for healthcare managers. Originality/value This is the first study to investigate the relationship between leadership profiles and work stressors and stress in healthcare managers.

Purpose – This paper aims to explore if and how employees in a healthcare organisation perceive changes in their managers’ leadership behaviour over time. Design/methodology/approach – An interview study was conducted with employees whose managers had participated in a two-year leadership development programme offered by their employer, Healthcare Provision Stockholm County. Qualitative content analysis was applied, and the interview discussions focused on areas in which the majority of the informants perceived that a change had occurred over time and their answers were relatively consistent. Findings – The majority of employees did discern changes in their managers’ leadership over time, and, with very few exceptions, these changes were described as improvements. Practical implications – The knowledge that employees perceived changes in their managers’ leadership supports investments in leadership development through courses, programmes or other initiatives. Originality/value – The present findings contribute to a deeper empirical understanding of leadership as it is practised over time in everyday contexts among employees in healthcare organisations.

PurposeThis study aims to describe implementation of simulator‐based medical team training and the effect of this programme on inter‐professional working in an intensive care unit (ICU).Design/methodology/approachOver a period of two years, 90 percent (n=152) of the staff of the general ICU at Karolinska University Hospital, Huddinge, Sweden, received inter‐professional team training in a fully equipped patient room in their own workplace. A case study method was used to describe and explain the planning, formation, and results of the training programme.FindingsIn interviews, the participants reported that the training had increased their awareness of the importance of effective communication for patient safety. The intervention had even had an indirect impact by creating a need to talk, not only about how to communicate efficaciously, but also concerning difficult care situations in general. This, in turn, had led to regular reflection meetings for nurses held three times a week. Examples of better communication in acute situations were also reported. However, the findings indicate that the observed improvements will not last, unless organisational features such as staffing rotas and scheduling of rounds and meetings can be changed to enable use of the learned behaviours in everyday work. Other threats to sustainability include shortage of staff, overtime for staff, demands for hospital beds, budget cuts, and poor staff communication due to separate meetings for nurses and physicians.Originality/valueThe present results broaden our understanding of how to create and sustain an organizational system that supports medical team training.

PurposeThe purpose of this study is to describe the perceptions of registered nurses (RNs), enrolled nurses (ENs), and leaders (i.e. the first‐line nurse manager, F‐LNM and the substitute F‐LNM) as to what characterises an excellent work environment in a palliative care unit and the involvement of leadership in that environment.Design/methodology/approachData were collected using two separate instruments: a questionnaire, group interviews with nurses and leaders, and documents at a palliative care unit. Qualitative content analysis was used to analyse the material.FindingsAccording to the participants, the most important component at the palliative care unit was to accomplish the vision of good palliative care. Congruence in leadership, mature group functioning, adequate organisational structures and resources, and comprehensive and shared meaningfulness were all identified as essential components for fulfilling the vision.Originality/valueThis study indicates that fulfilling the vision of good palliative care may function as a buffer against stress in such a workplace

PurposeThe purpose of this paper is to examine the aspects of being a physician that such medical professionals mention in dialogue groups when given the opportunity to choose their own topics of discussion.Design/methodology/approachOver a period of two years, 60 physicians participated in eight dialogue groups at one of the main hospitals in Stockholm, Sweden. Five focus group interviews were performed after the final dialogue group session.FindingsQualitative content analysis showed that three themes dominated in the physicians' perceptions of their role: hierarchy and subgroups; understanding of learning and knowledge; clinical work. Very little time in the dialogue groups was spent discussing the third theme, i.e. problems or issues related to patients or their families. The hierarchy among doctors seemed to influence many aspects of the role of these individuals, their healthcare organisation and their work environment. The methodology in the dialogue groups challenged the prevailing hierarchical structures and seemed to improve the relations between different groups of doctors in the hierarchy. For some of the physicians, this also resulted in a new way of perceiving and acting in their professional role.Research limitations/implicationsThe results of this study represent only one hospital.Practical implicationsThe findings may help healthcare managers understand physicians' conceptions of their role.Originality/valueFew intervention studies have considered management programmes directed towards physicians. The present investigation is the first qualitative analysis of the use of dialogue groups within a healthcare setting.

PurposeThe purpose of this article is to study the impact of two leadership programmes for healthcare managers regarding their attitudes to, and views on, their leadership.Design/methodology/approachA total of 53 managers participated in two different leadership programmes i.e. one‐week (OW‐DGL) intensive leadership course and long‐term support groups. Of those, 39 (74 per cent) responded to the Wheel Questionnaire, both soon before and six months after the end of their respective leadership programmes. Overall, eight focus group interviews were conducted, and the data were analysed through content analysis.FindingsBoth leadership programmes seem to have strengthened the managers in their leadership roles. The OW‐DGL course supported the managers in learning about group dynamics and relationship‐orientated leadership. The programmes' methods differed, but the conclusion is that they complemented each other. The long‐term support groups helped the managers to structure and cope with everyday leadership situations in their occupational environment.Practical implicationsThe OW‐DGL course was found to be good for inexperienced managers and the long‐term support groups for more experienced managers.Originality/valueThere is a lack of intervention studies regarding the efficacy of leadership programmes directed toward managers in health care. Two different approaches to leadership training are compared in this paper, using both quantitative and qualitative methods.

PurposeThe purpose of this study is to evaluate whether dialogue groups for physicians can improve their psychosocial work environment.Design/methodology/approachThe study assessed the impact of eight dialogue groups, which involved 60 physicians at a children's clinic in one of the main hospitals in Stockholm. Psychosocial work environment measures were collected through a validated instrument sent to all physicians (n=68) in 1999, 2001 and 2003. Follow‐up data were collected after the termination of the groups.FindingsThe overall score of organizational and staff wellbeing, as assessed by the physicians at the clinic, deteriorated from 1999 until 2003 and then improved 2004. This shift in the trend coincided with the intervention. No other factors which might explain this shift could be identified.Research limitations/implicationsIn a naturalistic study of this kind it is not possible to prove any causal relationships. A controlled survey of management programmes concerning the work environment among physicians would be of interest for further research.Practical implicationsThe results suggest that dialogue groups may be one way to improve the psychosocial work environment for physicians.Originality/valueThere is a lack of intervention studies regarding the efficacy of management programmes directed toward physicians, concerning the effects on professional and personal wellbeing. This is the first time dialogue groups have been studied within a health care setting.