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Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

The purpose of this paper is to contribute theoretical ideas of how peer support workers (PSWs) bring added value to interprofessional learning (IPL) in mental health care teamwork. The question is: How can we theoretically understand the value of PSWs’ expertise for IPL in mental health care teamwork?

Initially, the authors formulate a hypothesis. Then, the authors describe the focus and context in IPL and PSWs, respectively, and the PSWs’ and mental health professions’ different roles, expertise and perspectives. The authors also refer to some peer provided programs related to IPL. Finally, the authors construct an outline and apply ideas from Wenger’s Communities of Practice (CoP).

Using CoP, the PSWs as newcomers can by their perspectives change mental health professions’ perspectives and stimulate IPL in teamwork.

The paper gives theoretical insights of how PSWs can facilitate IPL in mental health care teamwork.

Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners.

In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence.

Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal – and technical, and organisational internal and – external competencies.

This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books.

The holistic framework for healthcare leadership competences offers a common understanding of a “fuzzy” concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders.

This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.

The purpose of the study is to identify barriers to collaboration among female administrators at a Ghanaian technical university (TU), based on the social identity theory (SIT).

A mixed-method approach was adopted, integrating qualitative interviews of 15 female administrators and completing structured questionnaires from 117 randomly sampled female administrators. The SIT, as the analytical framework, identified themes emerging from the data on barriers to collaboration among female administrators. While exploratory factor analysis identified measures of factors hindering collaborations, the use of structural equation modeling (SEM) enabled the confirmation of relationships among the barriers to collaboration with female administrators.

There existed statistically significant relationships between four of the barriers: intergroup relations conflict, trust with stakeholders and among females and structural barriers (SBs). For the quantitative analysis, it was found that SBs, intergroup relations, conflict and trust were statistically significant except for weak cultures. For the qualitative, results showed that SBs, lack of trust with stakeholders and among females and intergroup conflict hinder collaboration.

The study has a limited scope in using only one TU and focusing on a particular gender. The implications of this research will enrich the literature on barriers to female administrative collaboration in technical education based on the SIT.

Promoting administrative collaborations in the TU will ensure sustainability and efficient administrative systems.

Institutional policies should include gender inclusivity and equality on networking opportunities and provide mentorship programs for efficient administrative systems.

We used the SIT to determine barriers to collaboration among female administrators in a technical education institution, and the mixed methodology added a unique dimension to the study.

Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions.

We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs.

This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India.

Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries.

This paper aims to critically examine the accounting and information systems literature to understand the changes that are occurring in the management accounting profession. The changes the authors are interested in are linked to technology-driven innovations in managerial decision-making and in organizational structures. In addition, the paper highlights research gaps and opportunities for future research.

The authors adopted a grounded theory literature review method (Wolfswinkel et al., 2013) to achieve the study’s aims.

The authors identified four research themes that describe the changes in the management accounting profession due to technology-driven innovations: structured vs unstructured data, human vs algorithm-driven decision-making, delineated vs blurred functional boundaries and hierarchical vs platform-based organizations. The authors also identified tensions mentioned in the literature for each research theme.

Previous studies display a rather narrow focus on the role of digital technologies in accounting work and new competences that management accountants require in the digital era. By contrast, the authors focus on the broader technology-driven shifts in organizational processes and structures, which vastly change how accounting information is collected, processed and analyzed internally to support managerial decision-making. Hence, the paper focuses on how management accountants can adapt and evolve as their organizations transition toward a digital environment.

Paramedics became nationally registered in 2018 in Australia. Prior to this, there was no central regulation of the profession with reliance on organisational regulation through employers. As paramedics expanded their scope, role and range of employers, especially outside statutory agencies, there was increasing need to engage in professional regulation. Regulation is more than a legal and bureaucratic framework. The purpose of the paper states that the way paramedics interact with their new regulatory environment impacts and is influenced by the professionalisation of the discipline. Regulation also redefines their positionality within the profession.

Two mixed-method surveys were undertaken. A pre-registration survey occurred in the month prior to regulation commencing (N = 419) followed by the second survey 31 months later (N = 407). This paper reports the analysis of qualitative data from the post-registration survey and provides comparison to the pre-registration survey which has been previously reported. Analysis was undertaken using interpretive phenomenological analysis (IPA).

Themes from the pre-registration survey continued however became more nuanced. Participants broadly supported registration and saw it as empowering to the profession. Some supported registration but were disappointed by its outcome, others rejected registration and saw it as divisive and oppressive.

Paramedics are beginning to come to terms with increasing professionalisation, of which regulation is one component. Changes can be seen in professional identity and engagement with professional practice; however, this is nascent and is deserving of additional research to track the profession as it continues to evolve.

This study explores the extent of undergraduate students' engagement in interdisciplinary learning experiences across their academic journey and its potential correlation with elevated levels of self-efficacy in learning. Furthermore, the research investigates how the clarity of career decisions and future goals contributes to the perception of relevance, value and alignment of interdisciplinary learning experiences among undergraduate students.

Data were collected using a self-report questionnaire in a longitudinal survey administered annually to undergraduate students at a university in northern Taiwan over four waves from 2018 to 2021. The sample analyzed for this study consisted of 123 undergraduate students who willingly and continuously participated in the research throughout the specified period.

The results showed that self-efficacy within interdisciplinary learning experiences could be classified into three clusters: high efficacy, moderate efficacy and fluctuating efficacy. The determinants influencing these clusters include career decisions and years spent in university. Undergraduate students who have determined their career decisions and are in their latter two years of undergraduate studies demonstrate higher self-efficacy in interdisciplinary learning. Conversely, students who have yet to determine their career decisions exhibit a fluctuating pattern of self-efficacy across the three interdisciplinary learning categories.

Two key limitations of this research include a small sample size and a confined university-specific context, potentially constraining the applicability of the results to a broader population.

This study contributes to the interdisciplinary learning experience in higher education by explaining the significance of undergraduates' self-efficacy and career-related factors. Whereas most research has focused on the effects of self-efficacy, this study investigated the factors that influence undergraduates' self-efficacy.

This study aims to explore the effects of expertise diversity on project efficiency and creativity in health-care project teams.

This study analyzes hierarchical linear models using multi-source data from 50 project teams in a large health-care organization in the USA. This data set includes self-reported survey responses from 274 team members and human resource information for all 515 members across the 50 teams. Expertise diversity is operationalized by professional diversity and positional diversity reflecting two dimensions, domain and level, of the concept of expertise.

This study reveals that professional diversity is negatively related to project efficiency and project creativity, whereas positional diversity is positively related to project efficiency.

Successfully managing a project team of experts within a limited time frame is a challenge for organizations. This study advances the understanding of the double-edged sword effect of expertise diversity on project teams, focusing on professional and positional diversity. It provides important insights for human resource development in terms of the composition of project teams regarding members’ expertise.

During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.