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The concept of quality culture has gained increased attention in health professions education, drawing on insights that quality management processes and positive work-related attitudes of staff in synergy lead to continuous improvement. However, the directions that guide institutions from quality culture theory to educational practice have been missing so far. A prospective qualitative case study of three health professions education programmes was conducted to explore how a quality culture can be enhanced according to the experiences and perspectives of educational leaders. The data collection was structured by an appreciative inquiry approach, supported with vignette-based interviews. A total of 25 participants (a selection of course coordinators, bachelor coordinators and directors of education) reflected on quality culture themes to learn about the best of what is (Discover), envision positive future developments (Dream), identify actions to reach the desired future (Design), and determine how to support and sustain improvement actions (Destiny) within their own educational setting. The results are presented as themes subsumed under these four phases. The experiences and perspectives of educational leaders reveal that peer learning in teams and communities, attention to professional development, and embedding support- and innovation networks, are at the heart of quality culture enhancement. An emphasis on human resources, (inter)relations and contextual awareness of leaders stood out as quality culture catalysts. Educational leaders are therefore encouraged to especially fuel their networking, communication, coalition building, and reflection competencies.

To this date, research on the interplay between organisational structure/managerial and organisational value/psychological elements which impact on educational quality is scarce and fragmented. As a consequence of a lack of knowledge in this area, institutions often address these elements in isolation, moving past integral approaches, which reinforce the organisations' quality culture. In order to examine interrelationships between context characteristics, work-related psychological attitudes of staff and enhancement practices, a path analysis was performed on data collected from academics with teaching coordination roles. The findings highlight the paramount importance of a 'human relation' value orientation; this orientation influences empowerment, commitment and communication satisfaction. Rational goal values and ownership are positively related to quality enhancement practices. It is advocated that institutional policies and strategies directed at educational quality enhancement should leave discretionary space for the availing of academics' expertise. Nurturing collaborative teaching/learning communities with explicit concern for morale, involvement and development, deserves further cultivation.

There is a growing belief that higher education institutions should nurture a "quality culture" in which structural/managerial and cultural/psychological elements act in synergy to continuously improve education. Notwithstanding the positive connotation of the "quality culture" concept, its exact configuration remains subject to debate. A realist review was conducted to identify inhibiting and promoting organisational context elements impacting quality culture, its working mechanisms and associated outcomes. Leadership and communication were identified as being of key importance in binding structural/managerial and cultural/psychological elements. Leaders are central "drivers" of quality culture development through their ability to influence resource allocation, clarify roles and responsibilities, create partnerships and optimise people and process management. Adequate communication is considered a prerequisite to diffuse quality strategies and policies, evaluate results and identify staff values and beliefs. It is proposed that the working mechanisms of quality culture comprise increased staff commitment, shared ownership, empowerment and knowledge. Associated outcomes related to these mechanisms are positive effects on staff and student satisfaction, continuous improvement of the teaching--learning process and student and teacher learning and development. Institutions striving for the development of a quality culture should best operate from a contingency approach, i.e. make use of quality management intervention approaches which are tailored to the organisational context.

To this date, research on the interplay between organisational structure/managerial and organisational value/psychological elements which impact on educational quality is scarce and fragmented. As a consequence of a lack of knowledge in this area, institutions often address these elements in isolation, moving past integral approaches, which reinforce the organisations' quality culture. In order to examine interrelationships between context characteristics, work-related psychological attitudes of staff and enhancement practices, a path analysis was performed on data collected from academics with teaching coordination roles. The findings highlight the paramount importance of a 'human relation' value orientation; this orientation influences empowerment, commitment and communication satisfaction. Rational goal values and ownership are positively related to quality enhancement practices. It is advocated that institutional policies and strategies directed at educational quality enhancement should leave discretionary space for the availing of academics' expertise. Nurturing collaborative teaching/learning communities with explicit concern for morale, involvement and development, deserves further cultivation. [ABSTRACT FROM AUTHOR]