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Workplace silence impedes productivity, job satisfaction and retention, key issues for the hospital workforce worldwide. It can have a negative effect on patient outcomes and safety and human resources in healthcare organisations. This study aims to examine factors that influence workplace silence among hospital doctors in Ireland.

A national, cross-sectional, online survey of hospital doctors in Ireland was conducted in October–November 2019; 1,070 hospital doctors responded. This paper focuses on responses to the question “If you had concerns about your working conditions, would you raise them?”. In total, 227 hospital doctor respondents (25%) stated that they would not raise concerns about their working conditions. Qualitative thematic analysis was carried out on free-text responses to explore why these doctors choose to opt for silence regarding their working conditions.

Reputational risk, lack of energy and time, a perceived inability to effect change and cultural norms all discourage doctors from raising concerns about working conditions. Apathy arose as change to working conditions was perceived as highly unlikely. In turn, this had scope to lead to neglect and exit. Voice was seen as risky for some respondents, who feared that complaining could damage their career prospects and workplace relationships.

This study highlights the systemic, cultural and practical issues that pressure hospital doctors in Ireland to opt for silence around working conditions. It adds to the literature on workplace silence and voice within the medical profession and provides a framework for comparative analysis of doctors' silence and voice in other settings.

Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.

Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.

We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.

Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.

Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.

Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.

The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.

Important research once thought unassailable has failed to replicate. Not just in economics, but in all science. The problem is therefore not in dispute nor are some of the causes, like low power, selective reporting, the file drawer effect, publicly unavailable data and so forth. Some partially worthy solutions have already been offered, like pre-registering hypotheses and data analysis plans.

This is a review paper on the replication crisis, which is by now very well known.

This study offers another partial solution, which is to remind researchers that correlation does not logically imply causation. The effect of this reminder is to eschew “significance” testing, whether in frequentist or Bayesian form (like Bayes factors) and to report models in predictive form, so that anybody can check the veracity of any model. In effect, all papers could undergo replication testing.

The author argues that this, or any solution, will never eliminate all errors.

This paper aims to investigate the relationships between participative decision-making, ethical leadership and leadership performance, which might make school leaders quit autocratic behavior and enhance their performance at private K12 schools in Iraq.

The researchers collected data through a questionnaire using a stratified sampling methodology from 207 educators of 10 institutions. The research methodology included demographic analysis, factor analysis, structural equation modeling and mediation analysis.

The participative decision-making affected moral, knowledge and attitude that contributed to leadership performance. Besides, the only attitude mediated the relationship between participative decision-making and leadership performance.

The study is limited to private K12 schools in Iraq. Therefore, the findings cannot be generalized. It might guide educational institutes to change their management style.

The study delivers a unique insight into education in Iraq.

This research evaluates (1) work situations prompting participants to recall memories of a wilderness-based leadership training program, (2) the content of such memories, and (3) the leadership attitudes and behaviors inspired by those memories.

A qualitative content analysis of semi-structured interviews was performed with 36 leaders who had participated in a wilderness leadership transformation program in the past (on average six years before).

The findings suggest that, at moments with emotional pressure and psychological stress, episodic memories of wilderness experiences have a positive influence on actual leadership style. Memories involved moments of solitude, a deep connection with nature, and peer-to-peer counseling. The interviewees regularly relived their emotion-laden wilderness experiences, acquiring direction and guidance. Simultaneously, episodic memories of nature immersion promoted an enduring transformation of their leadership styles.

The findings cannot be blindly generalized as referring to all leaders. The leaders in this study are a subset of leaders who are inclined towards personal growth and leadership development. It is challenging to motivate leaders unkeen on changing to achieve better leadership.

This study indicates that the inclusion of emotional concepts to address the root causes of learning among leaders might be the most promising way to innovate leadership development.

The present study makes a novel contribution to relevant literature by examining leadership transformation through episodic remembrance of leaders' experiences in nature.