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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.

Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the effects of the public hospital unions (PHUs), which were a result of Decree Law No. 663, on the efficiency and productivity of public hospitals.

Data envelopment analysis (DEA) and DEA-based Malmquist total factor productivity (TFP) index were used from 2011 to 2016. Raw materials and supply expenses, salaries and fringe benefits, other service costs, general administrative expenses, total number of beds, number of specialists, number of residents, number of general practitioners, number of nurses and midwives and other medical officials were used as input variables. Working capital turnover, number of inpatients, number of outpatients and number of surgical operations for Groups A, B and C were used as output variables.

According to the DEA scores, the percentage of efficient hospitals showed a declining trend from 2011 to 2016. The TFP results also showed a decreasing trend from 2011 to 2016.

Providing administrative and financial autonomy to public hospital managers may cause efficiency and productivity losses, which is contrary to expectations.

This study is the first to reveal the impact of decentralization of public healthcare providers on their performance levels in Turkey.

With global migration, the number of ethnic minority and migrant women receiving maternity health care in dominantly Anglo-European societies has increased significantly but they consistently have among the worst pregnancy and maternal outcomes. This paper aims to analyse gaps in structural (migration-related inequalities) and cultural (responsiveness to ethno-cultural practices) competencies among maternal health practitioners in Aotearoa New Zealand (NZ).

Using a semi-structured interview guide, in-depth interviews were conducted with 13 maternal health practitioners in NZ. Data were analysed using a thematic analysis framework.

The results highlight significant barriers around language and communication, cultural stereotyping by professionals, ethnic women’s own constraints around family and cultural expectations and their lack of knowledge about reproductive health. In addition, practitioners’ own ethnic differences are inseparable from their approach to structural and cultural competencies; there were instances of ‘over-’ or ‘under-’ reading of culture, practitioner constructions of ideal pregnancies and anti-racism concerns that shaped maternal care practices that were sensitive to, but also marginalised, ethnic migrant women who attended maternity services.

To the best of the authors’ knowledge, this is the only study in NZ that examines the impact of complex dynamics of migration and culture on knowledge, beliefs and values of practitioners, in context of their own personal biographies. Identifying strategies to improve the way diversity is practiced in hospital settings can be transformational in improving maternal outcomes for ethnic migrant women in NZ.

The purpose of this systematic review was to explore the benefits and challenges in the implementation of simulation-based education (SBE) in the classroom and clinical settings in sub-Saharan Africa. The objectives of this systematic review were to identify the benefits of utilising SBE in the classroom and clinical practice in sub-Saharan Africa and to assess the challenges in the implementation of SBE in the classroom and clinical practice in sub-Saharan Africa.

Five databases were searched for existing English literature (Medline, CINAHL and Science Direct), including grey literature on the subject. Out of 26 eligible studies conducted in sub-Saharan Africa between 2014 and 2021, six studies that used mixed-methods design were included. Hawker et al.’s framework was used to assess the quality of the studies. Quantitative data were presented using descriptive and inferential statistics in the form of means and standard deviations while qualitative data were analysed and presented thematically.

Quantitative findings showed that participants rated SBE highly in terms of teaching (93.2%), learning (91.4%) and skill acquisition (88.6%). SBE improved the clinical skill competency from 30% at baseline to 75% at the end. On the other hand, qualitative findings yielded themes namely: improved confidence and competence; knowledge acquisition and critical thinking; motivation and supervision; independent, self-paced learning; simulation equipment and work schedules; and planning and delivery of simulation activity. Pedagogical skills, competence and confidence are some of the elements that determine the feasibility of implementing SBE in the classroom and clinical settings.

SBE could help to bridge the gap between theory and practice and improve the quality of care provided by nurses. Simulation-based training is effective in improving the clinical skills of midwives and increasing their confidence in providing care. However, SBE trainees require motivation and close supervision in classroom settings if simulation is to be successfully implemented in sub-Saharan Africa. Furthermore, careful planning of scenarios, students briefing and reading of content prior to implementation facilitate effective simulation.

While there may be a lack of literature on the use of SBE for training nurses and midwives in the developing world, there is growing evidence that it can be an effective way to improve clinical skills and quality of care. However, there are also significant challenges to implementing simulation-based training in resource-limited settings, and more research is needed to understand how best to address these challenges. This study fills this gap in the literature.

Despite the long-established importance of infant mental health, internationally this has not been mirrored in the provision of infant mental health services. Within Scotland in the UK, there has been significant recent government investment in developing infant mental health services. However, existing research identifies a massive knowledge and skills gap that could create barriers to implementation. This study aims to use qualitative methods to consider the views of relevant professional stakeholders on education and training within infant mental health.

The authors completed semi-structured interviews with 14 professional stakeholders working in a health board in Scotland. This study used purposive sampling to include a broad range of professionals across health and social care services and analysed the resulting data using Braun and Clarke’s (2006) methodology. This study adopted a reflexive stance throughout, including the research team interviewing each other as part of the process.

Within the theme of education and training, we identified four sub-themes. These included roles for public health and societal education, training for parents, training for professionals and increasing professionals’ experience of infant mental health.

The issues identified are relevant in any area of the UK or internationally in considering the role of education and training in developing and maintaining new infant mental health services. Further research with families and with wider groups of professional stakeholders would be of further benefit.

Poetic inquiry is an approach that promotes alternate perspectives about what research means and speaks to more diverse audiences than traditional forms of research. Across academia, there is increasing attention to decolonising research. This reflects a shift towards research methods that recognise, acknowledge and appreciate diverse ways of knowing, being and doing. The purpose of this paper is to explore the different ways in which poetic inquiry communicates parallax to further decolonise knowledge production and dissemination and centre First Nations’ ways of knowing, being and doing.

This manuscript presents two First Nations’ perspectives on a methodological approach that is decolonial and aligns with Indigenous ways of knowing, being and doing. In trying to frame this diversity through Indigenous standpoint theory (Foley, 2003), the authors present two First Nation’s women's autoethnographic perspectives through standpoint and poetics on the role of poetic inquiry and parallax in public pedagogy and decolonising research (Fredericks et al., 2019; Moreton-Robinson, 2000).

The key to understanding poetic inquiry is parallax, the shift in an object, perspective or thinking that comes with a change in the observer's position or perspective. Challenging dominant research paradigms is essential for the continued evolution of research methodologies and to challenge the legacy that researchers have left in colonised countries. The poetic is often invisible/unrecognised in the broader Indigenist research agenda; however, it is a powerful tool in decolonial research in the way it disrupts core assumptions about and within research and can effectively engage with those paradoxes that decolonising research tends to uncover.

Poetic inquiry is not readily accepted in academia; however, it is a medium that is well suited to communicating diverse ways of knowing and has a history of being embraced by First Nations peoples in Australia. Embracing poetic inquiry in qualitative research offers a unique approach to decolonising knowledge and making space for Indigenous ways of knowing, being and doing.

Poetic inquiry offers a unique approach to centring First Nations voices, perspectives and experiences to reduce hegemonic assumptions in qualitative research.

Writing about poetic inquiry and decolonisation from a First Nations’ perspective using poetry is a novel and nuanced approach to discussions around First Nations ways of knowing, being and doing.

Policing requires atypical work hours. The present study examined associations between shiftwork and pregnancy loss among female police officers.

Participants were 91 female officers with a prior history of at least one pregnancy. Shiftwork information was assessed using daily electronic payroll work records. Any prior pregnancy loss (due to miscarriage) was self-reported. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for main associations.

On average, the officers were 42 years old, had 14 years of service, and 56% reported a prior pregnancy loss. Officers who worked dominantly on the afternoon or night shift during their career had 96% greater odds of pregnancy loss compared to those on day shift (OR = 1.96, 95% CI:0.71–5.42), but the result was not statistically significant. A 25% increase in percent of hours worked on night shift was associated with 87% increased odds of pregnancy loss (OR = 1.87, 95% CI:1.01–3.47). Associations were adjusted for demographic and lifestyle factors. Objective assessment of shiftwork via electronic records strengthened the study. Limitations include small sample size, cross-sectional design and lack of details on pregnancy loss or the timing of pregnancy loss with regard to shiftwork.

The present study is preliminary and cross-sectional.

With considerable further inquiry and findings into this topic, results may have an impact on police policy affecting shift work and pregnant police officers.

Implication on the health and welfare of police officers.

To our knowledge, there are no empirical studies which associate shiftwork and pregnancy loss among police officers. This preliminary study suggested an association between shiftwork and increased odds of pregnancy loss and points out the need for further study.

This study aims to present a comprehensive integrative review of capitation payment for primary healthcare (PHC) in the Indonesian national health insurance (Jaminan Kesehatan Nasional,JKN).

Whittemore and Knafl’s integrative review method is used within this review and analysis framework. Multiple types of academic literature were included in this review, including all studies related to capitation payment in the JKN from 2014 until 2022.

This review found that several practices of capitation payments in the JKN in Indonesia deviate from basic economic concept of capitation. It does not yet incentivize PHC to create a competitive environment in attracting members and it does not incentivize health promotion and prevention. Moreover, the capitation model uses the same scope of primary care services for all PHC throughout the country – which in fact has disparities in providing 155 medical conditions as required competencies for PHC. The authors recommend that the JKN apply bottom-up costing and pricing methods to set market prices of capitation rates.

This is the first study that reviews theory-practice gap of the capitation payment model using an integrative review that covers academic literature, journal articles and regulations in Indonesia.

Access to professional interpreter services is a critical facilitator of positive health-care experiences when health-care professionals and women accessing maternity care are not proficient in a shared language. Understanding interpreter demand is essential for the provision of professional interpreter services. This study aims to characterise interpreter requirements among women from nonrefugee and refugee non-English-speaking migrant backgrounds in Australian maternity hospitals.

This study analysed administrative data from four public maternity hospitals in Victoria, Australia. The primary outcome was the proportion of women from non-English speaking migrant backgrounds who required an interpreter during their maternity care, both overall and stratified by refugee and nonrefugee background. Adjusted logistic regression was used to estimate the association between migrant background and interpreter requirements.

Among the 6,771 women from non-English speaking migrant backgrounds included in analyses, 1,344 (19.8%) required an interpreter during their maternity care. The odds of requiring an interpreter were fivefold higher among women from refugee backgrounds compared to migrant women from nonrefugee backgrounds [adjusted odds ratio (aOR): 4.83; 95% confidence interval (CI): 4.13–5.65].

The study highlights the diversity in cultural backgrounds and migration experiences of women accessing maternity care within metropolitan public hospitals. The high interpreter requirements, particularly among women from refugee backgrounds, underscores the need for comprehensive and woman-centred interpreter services to attenuate disparities in hospital maternity care.

To the best of the authors’ knowledge, this study is the first to quantify the interpreter requirements of women from non-English-speaking migrant backgrounds in maternity hospital settings and make women comparisons between women from refugee and nonrefugee backgrounds.