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Racism occurs in many ways and varies across countries, evolving and adapting to sociocultural history, as well as contemporary economic, political and technological changes. This chapter discusses the multilevel dimensions of racism and its diverse manifestations across multiracial societies. It examines how different aspects of racism are mediated interpersonally, and embedded in institutions, social structures and processes, that produce and sustain racial inequities in power, resources and lived experiences. Furthermore, this chapter explores the direct and indirect ways racism is expressed in online and offline platforms and details its impacts on various groups based on their intersecting social and cultural identities. Targets of racism are those who primarily bear the adverse effects. However, racism also affects its perpetrators in many ways, including by limiting their social relations and attachments, and by imposing social and economic costs. This chapter thus analyses the many aspects of racism both from targets and perpetrators' perspectives.

The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT).

A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants’ responses to the question “please tell us about the impact of your overall experience”, which culminated in a combined corpus of 75,053 words.

Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact.

This in-depth qualitative evaluation of participants’ feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice.

Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments.