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Although the need for cultural competence in clinical care has been well articulated for over four decades, the goal of integrating and addressing cultural issues in care remains elusive. The challenges can be attributed to a lack of clarity on definitions and a lack of understanding of what constitutes cultural competence. What to know and what to do are questions that are frequently raised in discussions of cultural competence. Previous literature has described cultural competence in terms of affective, behavioural, and cognitive domains. The purpose of this paper is to build on this discourse by discussing key attributes within each domain and extending the framework to highlight the dynamics of difference, clarify the goal of equity, and recognise the importance of practice environments in the development of cultural competence in clinical care.

This exploratory study aims to examine female Muslim immigrant patients’ expectations of physicians’ religious competence during clinical interactions.

In total, 101 female Muslim immigrants in Ottawa, Canada, completed an eight-item survey measuring patients’ expectations of physicians’ religious competence during clinical communication.

Results from the independent samples t-tests and one-way ANOVA suggested that female Muslim immigrant patients in this study expected their doctors to be aware of Islam as a religion and be sensitive to their religious needs, especially food/dietary practices during clinical communication. Although the participants did not differ in their expectations of physicians’ religious competence based on age, educational level, employment status and income level, they differed based on their frequencies of visiting doctors and their ethnic/cultural origin.

This study fills a gap in the literature by advancing understanding of religious competence during clinical interactions from female Muslim immigrant patients’ perspective. The findings can contribute to developing religiously competent and accessible health-care services for religiously diverse populations.

The purpose of the article is to analyze how physicians and nurses, as the two major health care professions, experience psychological empowerment for managerial work.

The study was designed as a qualitative interview study at four primary care centers (PCCs) in Sweden. In total, 47 interviews were conducted, mainly with physicians and nurses. The first inductive analysis led us to the concept of psychological empowerment, which was used in the next deductive step of the analysis.

The study showed that both professions experienced self-determination for managerial work, but that nurses were more dependent on structural empowerment. Nurses experienced that they had competence for managerial work, whereas physicians were more ignorant of such competence. Nurses used managerial work to create impact on the conditions for their clinical work, whereas physicians experienced impact independently. Both nurses and physicians experienced managerial work as meaningful, but less meaningful than nurses and physicians' clinical work.

For an effective health care system, structural changes in terms of positions, roles, and responsibilities can be an important route for especially nurses' psychological empowerment.

The qualitative method provided a complementary understanding of psychological empowerment on how psychological empowerment interacted with other factors. One such aspect was nurses' higher dependence on structural empowerment, but the most important aspect was that both physicians and nurses experienced that managerial work was less meaningful than clinical work. This implies that psychological empowerment for managerial work may only make a difference if psychological empowerment does not compete with physicians' and nurses' clinical work.

The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment. Health-care leaders and managers in this study were both nursing and physician managers. Competence was assessed by evaluating the knowledge, skills, attitudes and abilities that enable management and leadership tasks.

A systematic literature review was performed to find articles that identify and describe the characteristics of management and leadership competence. Searches of electronic databases were conducted using set criteria for article selection. Altogether, 13 papers underwent an inductive content analysis.

The characteristics of management and leadership competence were categorized into the following groups: health-care-context-related, operational and general.

One limitation of the study is that only 13 articles were found in the literature regarding the characteristics of management and leadership competence. However, the search terms were relevant, and the search process was endorsed by an information specialist. The study findings imply the need to shift away from the individual approach to leadership and management competence. Management and leadership need to be assessed more frequently from a holistic perspective, and not merely on the basis of position in the organizational hierarchy or of profession in health care.

The authors’ evaluation of the characteristics of management and leadership competence without a concentrated profession-based approach is original.

The purpose of this paper is to provide a summary of a research and consultation project being undertaken by the NHS Institute for Innovation and Improvement and The Academy of Medical Royal Colleges to develop an integrated medical management and leadership competency framework. This will apply to all doctors in training at undergraduate and postgraduate levels and post‐registration.

A literature review and consultation approach has been adopted. By interviewing appropriate stakeholders from medical professional, educational, service and regulatory bodies, a high level of awareness and engagement has been realised. This should pay dividends at the implementation phase.

Whilst some management and leadership is included within current curricula, it is highly variable both in terms of its coverage and relevance. At undergraduate level, it is often covered within professional development modules. At postgraduate level, some exciting initiatives are offered for some doctors but no integrated, systematic and coherent framework exists. Findings from the research are influencing the design and content of the emerging competency framework.

The approach used has provided a good range of information however, neither an exhaustive set of views or a full literature review has been obtained.

Introduction of the Medical Leadership Competency Framework will have a significant impact on how doctors are trained. To be deemed an effective and safe doctor in the future, competence in both clinical and wider non‐clinical competences including management and leadership will be required.

This paper will raise awareness of this important initiative and offer a methodology for other clinical professional groups, nationally and internationally.

The purpose of this paper is to analyse existing clinical supervision frameworks to develop a supervision meta-model.

This research involved a thematic analysis of existing supervision frameworks used to support allied health practitioners working in rural or remote settings in Australia to identify key domains of supervision which could form the basis of supervision framework in this context. A three-tiered sampling approach of the selection of supervision frameworks ensured the direct relevance of the final domains identified to Australian rural allied health practitioners, allied health practitioners generally and to the wider area of health supervision. Thematic analysis was undertaken by Framework analysis methodology using Mindmapping software. The results were organised into a new conceptual model which places the practitioner at the centre of supervision.

The review included 17 supervision frameworks, encompassing 13 domains of supervision: definitions; purpose and function; supervision models; contexts; content; Modes of engagement; Supervisor attributes; supervisory relationships; supervisor responsibilities; supervisee responsibilities; structures/process for supervision and support; facilitators and barriers; outcomes. The authors developed a reflective, supervision and support framework “Connecting Practice” that is practitioner centred, recognises the tacit and explicit knowledge that staff bring to the relationship, and enables them to identify their own goals and support networks within the context in which they work.

This is a thematic analysis of the literature which was argely based on an analysis of grey literature.

The resulting core domains of supervision provide an evidence-based foundation for the development of clinical supervision models which can be adapted to a range of contexts.

An outcome of this paper is a framework called Connecting Practice which organises the domains of supervision in a temporal way, separating those domains that can be modified to improve the supervision framework, from those which are less easily modifiable. This approach is important to help embed the implementation of supervision and support into organisational practice. This paper adds to the existing growing body of work around supervision by helping understand the domains or components that make up the supervisory experience.

Connecting Practice replaces traditional, more hierarchical models of supervision to put the practitioner at the centre of a personalised supervision and support network.

The purpose of this paper is to consider the benefits of service users contributing to university teaching and having opportunities to present at a conference, both for student learning and clinical development objectives as well as for the service users themselves.

With reference to current policies and good practice guidelines, the article reflects on the experiences of both the students and the service users in relation to the literature and the events that led to the People in Control Conference.

Students valued the experience in terms of developing knowledge and insight into different techniques to facilitate both receptive and expressive communication. Students also had opportunities to think about their own perceptions of disability. Service users have gained in communication confidence and competence as well as getting opportunities to have their voices heard.

Increased opportunities for service users have cultural and clinical benefits for all involved.

The perpose of this paper is to analyse recent changes in the management of French public hospitals, following a reform enacted in 2009 and aimed at bolstering the managerial roles of doctors.

The paper is exploratory and is based on both the analysis of French literature dealing with the results of the 2009 reform, and ten semi-directed interviews with clinical managers and top leaders in the public hospital sector.

The author reports on the major hospital management reforms of 2009 and analyse the implications for the medical profession and management. The author shows that the involvement of the classical clinical leaders has become less regulated as the units no longer have a clear legal basis. The governance of the newly introduced “medical poles” appears to be shaped by various factors: there is high correlation between centrality, prestige and “clan involvement”, which suggests that professionals holding new responsibilities obtain power and legitimacy by consolidating pre-existing networks. While it is often argued that high-quality clinical leadership is a key factor of organisational success, the findings suggest that the performance of clinical managers relies on this network and legitimacy acquired from it.

Drawing on the “sociology of translation” and actor-network theory (Callon and Latour, 1991), this paper provides a new conceptual framework for the analysis of the transformation of the role of clinical leaders, arguing that this transformation depends highly on their abilities to build and use networks. The findings challenge the French tradition of public management that presupposes a clear division of power between doctors and administrative staff.

Teachers at the tertiary level play an essential role in the expansion of quality in higher education. The issue of competence and its development has particular importance in creating the new landscape of the twenty-first century. Therefore, the purpose of this paper is to develop validated inventory identifying future-oriented competences required for the teaching profession in the changing environment of higher education institutions (HEIs).

In the study, teacher competences and related teacher’s behavior were theoretically defined and underwent principal factor analysis. The survey was carried out among teachers, students and graduates of HEIs in India.

The analysis revealed future-oriented teacher competences resulting from the globalization process of the teaching profession. Testing the inventory indicated that there was a high Cronbach’s α reliability. Results show that the inventory enjoyed proper internal consistency for four dimensions as general teaching competences. The inventory with 66 items and four factors explained 47.279 percent of the total variance and indicated a strong factor model.

Teacher competence inventory (TCI) can be used to modernize study programs of teacher education and shift focus toward future-oriented competences required for the teaching profession in HEIs in India. Therefore, TCI could be essential to prepare teachers for the changing environment of teaching.

This study is an essential step in reorienting the process of teacher education toward professional development aimed at developing future-oriented competences in the teaching profession. It proposes to develop an instrument measuring teacher competences areas and related teacher behavior.

There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs).

The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed.

The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations.

In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities.

Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring.

This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public policy making. A better understanding of ISs in general, and in healthcare in particular, may provide the basis for designing and evaluating innovation policy.