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The purpose of this paper is to articulate the shifts in the theoretical conceptualization of, and the practice of leadership in health care in Canada that are happening as a response to challenges of system transformation; and the implications of those shifts for individual leaders, for health services delivery, for research into health system leadership, and for leadership development approaches in university and health agencies.

The paper begins with an analysis of the historical, contemporary, and futuristic context that shapes the conceptualization and practice of leadership now and into the future. The context consists of two parts. First, the need for leadership in health systems in Canada will be established. Second, a conceptual and practical exploration of leadership in health care, beginning with a review of the literature and moving on to exploration of two key projects pertaining to health leadership and health leadership development in Canada, commissioned by senior leaders in health care, will be analyzed for their contribution to defining leadership.

The findings outline key shifts in leadership that must take place to respond to changes in the national health environment and be pro‐active in shaping it. A typology of those shifts in order to show the constituent elements framing the evolution of leadership is outlined.

Further research on different models and approaches to leadership being promulgated in Canada, their impact on health system capacity building for change, and on new models of education for leaders, is needed.

As the speed of change in health service delivery grows, the form of leadership required to steward it in a productive fashion changes. As a lag grows between “old” models of leadership and “new” models, leaders themselves experience frustration at their ability to be effective in creating system change. This has implications for our expectations of, and ability to practice leadership; and for our developmental approaches to developing leadership.

The paper helps to explain what kind of leadership is required to truly transform health systems on a national scale. It also contributes to the international dialogue around health systems transformation, capacity building, and improving health service delivery.

The purpose of this conceptual paper is to provide strategies on how to embed physician leadership development efforts within health organizations.

Findings from our previous research, which include an extensive literature review and analysis of 53 interviews with representatives from healthcare organizations across the globe, are integrated within the context of the Influencer© framework to provide a useful and grounded tool for physician leadership development strategies.

Physician leadership development strategies are identified for each of the six domains within the Influencer© framework.

A number of physician leadership development strategies are provided. They can be used in combination or used independently.

Integrating the knowledge gained from practices in health organizations and from the literature within the Influencer© framework is a unique approach and strengthens the usefulness of the identified physician leadership development strategies.

This paper aims to examine the benefits and challenges of enacting cross‐sector alliances as a strategy to meet the health leadership capacity and capability requirements to effect improvements in health service delivery.

The findings originate from two case studies of cross‐sector alliances in Canada.

Value generated by strategic alliances in health with organisations from public, private and civil sectors is accrued at the inter‐organisational, organisational, group and individual level. Obstacles related to mindsets, operations and governance guiding the partnerships were identified which further an understanding of the advantages and constraints for using cross‐sector alliances as a strategy for large‐scale health leadership development.

Future research could investigate whether other factors influence the overall success of using an alliance strategy which may lead to a more comprehensive understanding of large‐scale health leadership initiatives. Given the universal health care context of this study, the results should be examined for their generalisability to other contexts.

The results urge decision‐makers to develop the mental models, behaviours and processes that support the use of cross‐sector alliances to achieve practical benefits gained through large‐systems health leadership development that may otherwise be unattainable.

This paper responds to the needs of executives by investigating alliances among health, education, business and government as a strategic driver for building the health leadership capacity and capability needed for implementing health reform.

The purpose of this qualitative research study is to gain an understanding of the workplace experiences of individuals, employed in health care organizations, a few months after taking leadership development programming, as they endeavor to put into practice the concepts, ideas, and skills they acquired as part of their leadership development programs.

Four providers of leadership development programs in the health care arena canvassed their recent “graduates” to participate in the study. A total of 54 participant telephone interviews were transcribed and inductively analyzed.

Despite the range of leadership development programs attended, participants were consistent in their enthusiasm for the uptake of leadership knowledge, and the organizations for which they worked were largely consistent in their facilitation of the participants' leadership efforts when they returned to work. Organizational factors that support or impede the practice of effective leadership, and strategies to facilitate supportive organizational responses to aspiring leaders, were identified.

This study cites benefits realized by health care organizations when participants of leadership development programs return to their workplaces; such benefits are based on the participants' self‐report only. Future research could gain third‐party corroboration concerning specific organizational impacts related to employees attending leadership development programs.

There are many practices organizations can implement to ensure that full value is realized from employees who have attended leadership development programs. This study provides organizations with qualitative evidence of what supports and hinders employees in practicing newly learned leadership behaviors.

Little qualitative research exists that provides an overview of the workplace leadership experiences of individuals after taking leadership development programs.

This paper aims to describe the training strategy developed to provide the leadership of a new coordination structure of health centers in Portugal, with managerial competencies adapted to the requirements of their function, in support of primary care reform.

Pre and post‐program questionnaires were exploited. These focused on the perceptions of the new managers of their needs and of the benefits derived from their participation in learning activities during 2008 and 2009.

The findings outline that although the program created opportunities for executive directors to identify and analyze planning and management problems and to share potential solutions with colleagues, a training program is not sufficient to create the conditions that facilitate change.

More research is required to better understand the impact of the program on executive directors' attitudes and behaviors. More research on measuring the impact of leadership training is needed to provide policy‐makers with strategies to support their reforms.

The PACES training program was designed to develop and strengthen the managerial capacities of a group of managers of a new administrative structure in the health sector; it could be also applicable to other sectors like education, environment, etc.

If a reform process is to be effective, policy‐makers need to address, in addition to building individual capacities, organizational and institutional capacity needs, and design mechanisms to support managers on a continuing basis.

This paper describes the development of a new program focused on management and leadership to fit the needs of a reform in primary‐care.

This paper aims to describe the educational philosophy and practice underpinning the Royal Australasian College of Medical Administrators (RACMA) program and how it is aligned with the needs of the Australian and New Zealand health care systems. Preparing future doctors as medical leaders requires keeping pace with developments in medical education and increased sophistication on the part of teaching and supervising faculty.

This paper is a descriptive case study. The data are complemented by workforce data and excerpts from the RACMA Management and Leadership Curriculum.

The RACMA has developed a program informed by current best practices in medical education. The educational underpinnings and instructional practices of the RACMA emphasize leadership as a collaborative social process and the importance of relational leadership in successful modern day practice. The ongoing development of the program has a focus on setting of clear learning objectives, regular and continuous feedback to trainees and reflective practice facilitated by the close relationship between trainees and their preceptor.

Although a site-specific case study, the application of relational models of teaching can be applied in other settings.

The application of relational models of teaching can be applied in other settings.

This paper fulfils a social need to describe successful competency models used for medical leadership development.

This paper fulfils an identified need to define competency models used as a foundation for medical leadership development.

The purpose of this paper is to call for strong medical co-leadership in transforming the Australian health system. The paper discusses how Health LEADS Australia, the Australian health leadership framework, offers an opportunity to engage medical clinicians and doctors in the leadership of health services.

The paper first discusses the nature of medical leadership and its associated challenges. The paper argues that medical leaders have a key role in the design, implementation and evaluation of healthcare reforms, and in translating these reforms for their colleagues. Second, this paper describes the origins and nature of Health LEADS Australia. Third, this paper discusses the importance of the goal of Health LEADS Australia and suggests the evidence-base underpinning the five foci in shaping medical leadership education and professional development. This paper concludes with suggestions on how Health LEADS Australia might be evaluated.

For the well-being of the Australian health system, doctors need to play an important role in the kind of leadership that makes measurable differences in the retention of clinical professions; improves organisational cultures; enhances the engagement of consumers and their careers; is associated with better patient and public health outcomes; effectively addresses health inequalities; balances cost effectiveness with improved quality and safety; and is sustainable.

This is the first article addressing Health LEADS Australia and medical leadership. Australia is actively engaging in a national approach to health leadership. Discussions about the mechanisms and intentions of this are valuable in both national and global health leadership discourses.

This paper aims to explore President Obama's leadership style during passage of this major and controversial piece of legislation. Specifically it addresses the historical development of healthcare reform in the USA, and provides an ethical analysis of President Obama's leadership in pursuing the health reform initiative.

Based on a review of the literature, speeches, and application of leadership and ethical theory, an analysis was done of President Obama's leadership and ethical approach to healthcare reform.

This analysis revealed that Obama's behavior was consistent with the full‐range leadership model articulated by Bass and Avolio. Moreover, his personal and strategic ethical approach to promulgating healthcare reform incorporated both deontological and teleological ethical principles.

This paper provides a current look at President Obama's leadership style and demonstrates how incorporating different ethical theories can result in the same outcome.

The purpose of this case study was to gather participants' perceptions of the impact of Memorial Healthcare System's Pillars of Leadership Academy's leadership development programs on an individual, professional and organizational level.

Through a mixture of in‐person and telephone structured interviews, the researchers collected and analyzed qualitative data to explore the experiences of participants from the leadership development programs.

The major themes that interviewees mentioned as impacts of their participation in the mentoring programs closely parallel the foundations of transformational leadership. This suggests that the goals of the Pillars of Leadership Academy have been successful in developing leaders, which provides the basis for improved organizational as well as individual performance.

Developing leaders has been identified as one of the most pressing challenges for the future. Memorial Healthcare System (MHS) demonstrates that theory‐ and competency‐based leadership development programs can contribute to the performance and success of individuals as well as health services organizations.

The success of MHS overall and the contributions of the Pillars of Leadership Academy to the organizational culture and leadership provides a best practice that other organizations can follow regarding the implementation of a success leadership development program.