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Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues.

This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement.

Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods.

There is widespread inclusion of MLM in UK medical schools’ curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students’ desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these.

This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.

Given the definition for traffic safety culture (proposed in the first chapter) as the shared beliefs of a group which affect behaviors related to traffic safety, this chapter provides practical guidance on ways to measure traffic safety culture, analyze collected data, and use the analysis to inform interventions. The proposed definition of “shared beliefs” used a behavioral model to inform specifically what beliefs may influence intentional behaviors involved with either reducing or improving traffic safety. This behavioral model provides a framework to guide measurement. Analyses include examining the prevalence of beliefs and behaviors, the relationships between beliefs and behaviors, and identifying “gaps” in beliefs that may be important to address in interventions. Finally, an example of a traffic safety culture program which includes a collecting of strategies working across the social ecology to improve traffic safety is introduced (in this case, seat belt use).

Our commitment to the goal of zero traffic fatalities and serious injuries requires consideration of innovative traffic safety thinking. There is growing recognition that this goal requires a change in our culture as it relates to traffic safety (traffic safety culture). And yet, there is no consensus about a definition for traffic safety culture, no explicit theory-based model to predict the effect of traffic safety culture, and no practical guidance for applying these models to develop effective culture-based strategies. This chapter seeks to address these omissions from both an academic and practitioner perspective.

This chapter proposes a standard definition of traffic safety culture based on a model that integrates relevant theories of willful and intentional behavior. Importantly, a set of 10 principles are identified that provide the context and foundation from which the definition and model are derived. An understanding of these principles provides the logic and purpose for developing strategies that can transform traffic safety culture:

• (1)

  Traffic crashes are a significant public health concern.

• (2)

  Most traffic crashes are caused by human behavior, not the roadway, vehicle, or environment (e.g., weather).

• (3)

  Human behavior is influenced by beliefs.

• (4)

  Beliefs develop based on experience (actual and vicarious) and socialization.

• (5)

  Socialization is the process whereby an individual develops beliefs which align with the culture of a group with which the individual identifies (social identity).

• (6)

  Individuals can form an identity with many different groups in their social environment, each with a different degree of bonding.

• (7)

  A stronger bond results in greater conformity and motivation to abide with the group culture.

• (8)

  The shared beliefs of a group that affect behaviors related to traffic safety are called traffic safety culture.

• (9)

  The traffic safety culture of a group emerges from actions taken by stakeholders across the social ecology.

• (10)

  Traffic safety culture strategies increase actions by stakeholders across the social ecology to improve traffic safety culture among various groups.

Traffic crashes are a significant public health concern.

Most traffic crashes are caused by human behavior, not the roadway, vehicle, or environment (e.g., weather).

Human behavior is influenced by beliefs.

Beliefs develop based on experience (actual and vicarious) and socialization.

Socialization is the process whereby an individual develops beliefs which align with the culture of a group with which the individual identifies (social identity).

Individuals can form an identity with many different groups in their social environment, each with a different degree of bonding.

A stronger bond results in greater conformity and motivation to abide with the group culture.

The shared beliefs of a group that affect behaviors related to traffic safety are called traffic safety culture.

The traffic safety culture of a group emerges from actions taken by stakeholders across the social ecology.

Traffic safety culture strategies increase actions by stakeholders across the social ecology to improve traffic safety culture among various groups.

For the academic, these principles can also serve as hypotheses that can be explored to expand our knowledge about traffic safety culture. For the practitioner, these principles represent the basic logic and impetus for transforming traffic safety culture. By effectively communicating these principles and their connecting logic, we can express the importance of traffic safety culture and the need for supporting resources with other stakeholders.

Drawing upon the Traffic Safety Culture (TSC) perspective, this chapter outlines the reinforcing and transforming functions of advertising and illustrates such approaches by drawing upon examples from Australian road safety advertising campaigns. The argument put forth is that road safety advertising can be a robust tool; it can reinforce other countermeasures (enforcement) as well as transform community expectations and values and thus ultimately contribute to social as well as behavioral change.

The purpose of this chapter is to outline the rationale for and approach to enhancing community participation in traffic safety initiatives. It describes a process that practitioners can use to engage members of the public in the development of community-based solutions to traffic safety problems. The approach used draws on contemporary social theory, historical antecedents, and demonstrated best practices for effective engagement efforts.

The implications of the ideas developed in this chapter include the need for traffic safety and related agencies to develop and deploy new or expanded capacities as they implement community-level traffic safety initiatives. One such capacity is the development of greater interdisciplinary understanding of sociopolitical dynamics that support and/or inhibit the effectiveness of behavior change efforts. Another is the ability to employ practical participatory processes that engage community members so as to draw out the tacit but critical knowledge about barriers to and avenues for supporting behavior change strategies. These increase the likelihood of developing traffic safety strategies that are effective within the specific and unique culture of each community.

Building a culture of safety in transportation is not dissimilar from building a culture of safety in health. Public health is widely known for protecting the public from diseases through milk pasteurization and chlorination of drinking water, and from injuries by implementing environmental and occupational safeguards and fostering behavioral change. Lifestyle and environmental changes that have contributed to the reductions in smoking and heart disease can also help change driving, walking and cycling behaviors, and environments. Stimulating a culture of safety on the road means providing safe and accessible transportation for all. The vision for a culture of traffic safety is to change the public’s attitude about the unacceptable toll from traffic injuries and to implement a systems approach to traffic injury prevention as a means for improving public health and public safety. Framing the motor vehicle injury problem in this way provides an opportunity for partnerships between highway safety and public health to improve the culture of safety.

The purpose of this chapter is to describe the rationale for and structure of organizational networks in support of traffic safety programming. It outlines the operational considerations and approaches important to both understanding network-based partnerships and improving their functionality. The chapter draws on conceptual and empirical studies of organizational networks in order to enhance the effectiveness of networks and integrate network-based approaches with the cultural orientation already present in traffic safety research and practice.

This chapter proceeds from the premise that, increasingly, efforts to impact traffic safety behaviors will be interconnected with other concerns, and that traffic safety initiatives will require engagement with organizations focused on concerns other than traffic safety. The implication of the ideas examined in this chapter is that traffic safety agencies will need to focus not just on traffic-related behaviors, but also on the strategic and operational coordination with other organizations. Doing so has the potential to create synergies that would be unachievable if agencies operation in isolation.

The chapter defines social capital and explains its relationship to the broader concept of traffic safety culture. It lays out the conceptual case for a causal connection between social capital and positive traffic safety outcomes and describes recent work that has examined that connection. Implications for the practitioner include current policy options based on existing research results and promising new directions that require further exploration.