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The purpose of this paper is to conceptualise a research study to examine leadership as a relational concept between leaders and followers. The context is within surgical practice examining how motivated consultant surgeons are to lead junior doctors and which type of leadership style they use. From a follower perspective, the motivation of junior doctors will be explored, and their leadership preferences will be correlated with those of the actual style of consultant surgeons.

In this paper, the authors provide a detailed description of the methods for an international quantitative research study, exploring sequentially how motivated consultant surgeons are to lead and how leadership styles impact on the motivation of junior doctors. The objectives, method and data collection of this study are explained, and the justification for each method is described.

The findings for this outline study illustrate how critical it is to redefine leadership as a relational concept of leader and follower to ensure adequate support is provided to the next generation of consultant surgeons. Without consideration of the relational model of leadership, attrition will continue to be a critical issue in the medical workforce.

The research limitations are that this is a proposed quantitative study due to the need to collect a large sample of data from surgeons across the UK, Egypt and Germany. This research will have immense implications in developing new knowledge of leadership as a relational concept in medicine and healthcare. This study additionally will impact on how leadership is conceptualised in the curriculum for specialist surgical practice.

The practical implications are that relational leadership is supportive of generating a supportive leadership culture in the workplace and generating more effective teamwork.

To the best of the authors’ knowledge, this is the first study of its kind to look at a relational model of leadership in surgical practice between consultant surgeons and surgical trainees. This study will also identify any specific country differences between the UK, Germany and Egypt.

The purpose of this paper is to illuminate the ethical concerns associated with the use of artificial intelligence (AI) in the medical sector and to provide solutions that allow deriving maximum benefits from this technology without compromising ethical principles.

This paper provides a comprehensive overview of AI in medicine, exploring its technical capabilities, practical applications, and ethical implications. Based on our expertise, we offer insights from both technical and practical perspectives.

The study identifies several advantages of AI in medicine, including its ability to improve diagnostic accuracy, enhance surgical outcomes, and optimize healthcare delivery. However, there are pending ethical issues such as algorithmic bias, lack of transparency, data privacy issues, and the potential for AI to deskill healthcare professionals and erode humanistic values in patient care. Therefore, it is important to address these issues as promptly as possible to make sure that we benefit from the AI’s implementation without causing any serious drawbacks.

This paper gains its value from the combined practical experience of Professor Elhassan gained through his practice at top hospitals worldwide, and the theoretical expertise of Dr. Arabi acquired from international institutes. The shared experiences of the authors provide valuable insights that are beneficial for raising awareness and guiding action in addressing the ethical concerns associated with the integration of artificial intelligence in medicine.

The consolidation process and morphology evolution in ceramics-based additive manufacturing (AM) are still not well-understood. As a way to better understand the ceramic selective laser sintering (SLS), a dynamic three-dimensional computational model was developed to forecast thermal behavior of hydroxyapatite (HA) bioceramic.

AM has revolutionized automotive, biomedical and aerospace industries, among many others. AM provides design and geometric freedom, rapid product customization and manufacturing flexibility through its layer-by-layer technique. However, a very limited number of materials are printable because of rapid melting and solidification hysteresis. Melting-solidification dynamics in powder bed fusion are usually correlated with welding, often ignoring the intrinsic properties of the laser irradiation; unsurprisingly, the printable materials are mostly the well-known weldable materials.

The consolidation mechanism of HA was identified during its processing in a ceramic SLS device, then the effect of the laser energy density was studied to see how it affects the processing window. Premature sintering and sintering regimes were revealed and elaborated in detail. The full consolidation beyond sintering was also revealed along with its interaction to baseplate.

These findings provide important insight into the consolidation mechanism of HA ceramics, which will be the cornerstone for extending the range of materials in laser powder bed fusion of ceramics.

Three-dimensional (3D) printing is highly dependent on printing process parameters for achieving high mechanical strength. It is a time-consuming and expensive operation to experiment with different printing settings. The current study aims to propose a regression-based machine learning model to predict the mechanical behavior of ulna bone plates.

The bone plates were formed using fused deposition modeling (FDM) technique, with printing attributes being varied. The machine learning models such as linear regression, AdaBoost regression, gradient boosting regression (GBR), random forest, decision trees and k-nearest neighbors were trained for predicting tensile strength and flexural strength. Model performance was assessed using root mean square error (RMSE), coefficient of determination (R²) and mean absolute error (MAE).

Traditional experimentation with various settings is both time-consuming and expensive, emphasizing the need for alternative approaches. Among the models tested, GBR model demonstrated the best performance in predicting both tensile and flexural strength and achieved the lowest RMSE, highest R2 and lowest MAE, which are 1.4778 ± 0.4336 MPa, 0.9213 ± 0.0589 and 1.2555 ± 0.3799 MPa, respectively, and 3.0337 ± 0.3725 MPa, 0.9269 ± 0.0293 and 2.3815 ± 0.2915 MPa, respectively. The findings open up opportunities for doctors and surgeons to use GBR as a reliable tool for fabricating patient-specific bone plates, without the need for extensive trial experiments.

The current study is limited to the usage of a few models. Other machine learning-based models can be used for prediction-based study.

This study uses machine learning to predict the mechanical properties of FDM-based distal ulna bone plate, replacing traditional design of experiments methods with machine learning to streamline the production of orthopedic implants. It helps medical professionals, such as physicians and surgeons, make informed decisions when fabricating customized bone plates for their patients while reducing the need for time-consuming experimentation, thereby addressing a common limitation of 3D printing medical implants.

Surgical services are settings where resilient performance (RP) is necessary to cope with a wide range of variabilities. Although RP can benefit from a supportive built environment (BE), prior studies have focused on the operating room, giving scant attention to support areas. This study takes a broader perspective, aiming at developing BE design knowledge supportive of RP at the surgical service as a whole.

Seven BE design prescriptions developed in a previous work in the context of internal logistics of hospitals, and thus addressing interactions between workspaces, were used as a point of departure. The prescriptions were used as a data analysis framework in a case study of the surgical service of a medium-sized private hospital. The scope of the study included surgical and support areas, in addition to workflows involving patients and family members, staff, equipment, sterile instruments and materials, supplies, and waste. Data collection included document analysis, observations, interviews, and meetings with hospital staff.

Results identified 60 examples of using the prescriptions, 77% of which were related to areas other than the operating rooms. The developed design knowledge is framed as a set of prescriptions, examples, and their association to workflows and areas, indicating where it should be applied.

The design knowledge is new in surgical services and offers guidance to both BE and logistics designers.

This study aims to examine the applicability of Hartmann et al.’s (2018) service ecosystem framework to the day-to-day management of the modern sales force. The authors provide a review of the framework, acknowledging its strengths, while also indicating areas for advancement. The authors conclude with recommendations to the framework and indicate opportunities where future research could advance sales theory.

A review of the theoretical underpinnings of the service ecosystem framework is weighed against the established roles and responsibilities of the modern sales force in the literature.

The ability of the framework to capture the multi-level, multi-actor and dynamic aspects of sales represents an improvement in the conceptualization of selling is critical. Suggestions around the refinement for meso-level sales interactions and a more pliant application of service dominant-logic are offered.

The suggested extensions of the framework continue the advancement of novel theorization for the field of sales. Priorities for future research include consideration of ethical implications of the framework and formulations of new management strategies reflective of the broad and dynamic properties of the ecosystem conceptualization.

This paper provides managerial guidelines and implications tied specifically to the thick and thin crossing points and how they may impact employee decision-making.

To the best of the authors’ knowledge, this study is the first to pointedly examine the service ecosystem framework with respect to established principles of managing a modern sales force.

Assessing the research performance of researchers offers inducement toward excellence in research. This study aims to analyze the research productivity of the most prolific authors of Pakistan considering their trends toward publications, citations and collaboration.

Top 100 authors from the top 10 Pakistani universities from Web of Science over the 10 years with the rigorous data cleaning process were selected. Scientometric analysis techniques were carried out to evaluate the research profile of these authors.

The findings revealed that majority of the productive authors were male working in the position of Professor in the physical sciences area. The publications and citations gradually increase with time. They preferred to collaborate for their publications, while first authorship publications were found less in number. Moreover, the propensity to collaborate at the international level increases double-fold from the first five years to the next five years period. In addition, the position of the authors was explored among different performance metrics. The finding exhibits variation in the ranking of authors among them. The impact of numbers of authors, funding status, publication of articles, presence of collaboration and international collaboration on the dependent variable and citation count was insignificant. However, the publication of review papers has a significant impact on the citation counts.

Findings have significant implications for policymakers to make maximum opportunities for researchers to strengthen linkages for collaboration and increase the funding prospects.

Studies on this topic are scarce, and therefore, this study provides useful recommendations to researchers and institutes to improve research productivity.

Clinician engagement in research has positive impacts for healthcare, but is often difficult for healthcare organisations to support in light of limited resources. This scoping review aimed to describe the literature on health service-administered strategies for increasing research engagement by medical practitioners.

Medline, EMBASE and Web of Science databases were searched from 2000 to 2021 and two independent reviewers screened each record for inclusion. Inclusion criteria were that studies sampled medically qualified clinicians; reported empirical data; investigated effectiveness of an intervention in improving research engagement and addressed interventions implemented by an individual health service/hospital.

Of the 11,084 unique records, 257 studies were included. Most (78.2%) studies were conducted in the USA, and were targeted at residents (63.0%). Outcomes were measured in a variety of ways, most commonly publication-related outcomes (77.4%), though many studies used more than one outcome measure (70.4%). Pre-post (38.8%) and post-only (28.7%) study designs were the most common, while those using a contemporaneous control group were uncommon (11.5%). The most commonly reported interventions included Resident Research Programs (RRPs), protected time, mentorship and education programs. Many articles did not report key information needed for data extraction (e.g. sample size).

This scoping review demonstrated that, despite a large volume of research, issues like poor reporting, infrequent use of robust study designs and heterogeneous outcome measures limited application. The most compelling available evidence pointed to RRPs, protected time and mentorship as effective interventions. Further high-quality evidence is needed to guide healthcare organisations on increasing medical research engagement.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.