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In these cash‐stricken times, healthcare commissioners are calling for all staff to deliver more for less. In the UK, there is a growing focus on involving junior doctors in this change. This paper seeks to address these issues.

This article considers the barriers in involving doctors in training in change and mentoring future clinical leaders, based on the observations of a junior doctor.

There are many barriers between management and junior doctors, including the invisibility of junior doctor work and the transient nature of their employment. However, the next step is to go beyond a simply audit requirement, to encourage service improvement training as part of the postgraduate curriculum. This will only happen if journals, conference organisers and other agencies incentivise complex service evaluation projects, by providing opportunities for presentation and publication.

It is important to look beyond a four‐month rotation and consider the many years service doctors will give to the NHS. Junior doctors need to be mentored through projects that focus more on the process of change, rather than completion of the audit cycle. This will mentor future leaders, but also give juniors an understanding of their organisational role and the demands of service.

This article provides an interesting perspective on the difficulties faced by a junior and view on steps to improving the links between service and training.

Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in several clinical settings to quantify whether services meet patient expectations. However, work has been limited in the obstetric population. This paper seeks to address these issues.

This study used an adapted SERVQUAL questionnaire to assess a reconfigured antenatal clinic service. The most important care aspects, as rated by patients, were used to construct the SERVQUAL questions. The questionnaire was administered to eligible women in two parts. The first was completed before their first hospital antenatal appointment and the second either at home (a postal-chasing exercise) or while waiting for their next appointment. Only fully completed questionnaires (both parts) were analysed.

Service strengths included staff politeness, patient respect and privacy. Areas for improvement included hand cleanliness, women's involvement in decision making and communicating risk. However, the low variability in patient responses makes concrete conclusions difficult and methodological issues complicate evaluating hand cleanliness. The new antenatal clinic service received low negative weighted and un-weighted overall scores. The SERVQUAL measure was developed from patient feedback and used to further improve services.

The SERVQUAL-based measure allowed an internal evaluation of patient experience and highlighted areas for improvement. However, without validation, the questionnaire cannot be used as an outcome measure and variation between published SERVQUAL questionnaires makes comparisons difficult. This highlights an important balance in patient evaluation measures - between locally responsive and externally comparable.

The SERVQUAL approach allows healthcare teams to evaluate patient experience, while accounting for variation in their expectations and priorities. The study highlights several areas that are important to obstetric patients, where expectation scores are high. However, the similar means and small samples left little difference between excellence and room for improvement.

Life studies are a rich source for further research on the role of the Afro‐American woman in society. They are especially useful to gain a better understanding of the Afro‐American experience and to show the joys, sorrows, needs, and ideals of the Afro‐American woman as she struggles from day to day.

FIGHTING has indeed ceased in Europe and our gratitude, especially in London and its adjacencies, is profound. It is shared by all, of course. War is by no means over and that and the drearier contentions of politics for a month or two, or it may be for years, are likely to act as a brake on many schemes. It is true a substantial Education Act has been achieved during the war but such peace as we have achieved finds none of the great social schemes, other than this, anywhere but in the realm of talk. Older men may well be cynical and more may be sceptical; so, it becomes those who believe a better world is possible to be aware. Hardly a town or county is without a scheme of development of sorts, ranging from entirely new, and always enlarged, central libraries to extended branch schemes. The cold fact is that only in a few cases, if in any, will any building of libraries be permitted yet. That does not mean that scheming is a vain occupation. Librarians realize as other men do that housing needs will overwhelm building resources for a few years and that schools, which are disastrously inadequate to permit the full implementing of the Act of 1944, and hospitals, will be preferred to us. Librarians, however, must be opportunists, too ; they will lose nothing by readiness to seize chances. Let us take what we can get; if, in the many newly‐planned residential centres, satellite towns, or other communities, no elaborate library accommodation is possible, let us reflect that what really matters are a book service and a centre of information, which do not require elaborate buildings, only good librarianship. Then, when the needs of the area are known, an appropriate building may be provided. And, as Mr. Berwick Sayers has suggested, much more temporary buildings than have been erected in late years should be used ; we have too many “good buildings” which are obsolescent—to say the least. It can be assumed now that readers do not need so much inducement to use public libraries as they did formerly, although some do and it is well to insist that temporary buildings are not necessarily unattractive inside or outside.

How can a manager lead an organization or a team in a particularly turbulent time? How can management cope with chaos and uncertainty? Drawing on behavioral strategy theory, this study aims at investigating how hubristic managers can enable organizations to thrive, even over small time periods, in chaotic and uncertain contexts and settings.

This study uses a qualitative methodology to explore the possible positive effects of hubris in a behavioral strategy. In particular, 45 interviews with leaders and followers of particularly high-performing secondary schools have been administered to try to fully understand the origin, process and performance evolution of organizations led by hubristic managers.

The results showed that, in chaotic and uncertain times, hubris can prove to be a trump card for managers in dealing with the pitfalls and uncertainties of the context in which the organization operates. Three major attributes were identified – overconfidence and over-persistence, recklessness and contempt for critical feedback – defining the positive behavioral strategies implemented by hubristic managers during the COVID-19 pandemic.

To the best of the authors’ knowledge, this study is the first to highlight, by means of qualitative methodologies, the positive managerial hubristic-behavioral strategy during turbulent times in the school sector.