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The purpose of this paper is to report on the dynamics of “identity leadership” with a quality improvement project undertaken by an International Medical Graduate (IMG) from Sri Lanka, on a two year Medical Training Initiative (MTI) placement in the National Health Service (NHS) [Academy of Medical Royal Colleges (AoMRC), 2017]. A combined MTI rotation with an integrated Fellowship in Quality Improvement (Subedi et al., 2019) provided the driver to implement the HEART score (HS) in an NHS Emergency Department (ED) in the UK. The project was undertaken across ED, Acute Medicine and Cardiology at the hospital, with stakeholders emphasizing different and conflicting priorities to improve the pathway for chest pain patients.

A social identity approach to leadership provided a framework to understand the insider/outsider approach to leadership which helped RH to negotiate and navigate the conflicting priorities from each departments’ perspective. A staff survey tool was undertaken to identify reasons for the lack of implementation of a clinical protocol for chest pain patients, specifically with reference to the use of the HS. A consensus was reached to develop and implement the pathway for multi-disciplinary use of the HS and a quality improvement methodology (with the use of plan do study act (PDSA) cycles) was used over a period of nine months.

The results demonstrated significant improvements in the reduction (60%) of waiting time by chronic chest pain patients in the ED. The use of the HS as a stratified risk assessment tool resulted in a more efficient and safe way to manage patients. There are specific leadership challenges faced by an MTI doctor when they arrive in the NHS, as the MTI doctor is considered an outsider to the NHS, with reduced influence. Drawing upon the Social Identity Theory of Leadership, NHS Trusts can introduce inclusion strategies to enable greater alignment in social identity with doctors from overseas.

More than one third of doctors (40%) in the English NHS are IMGs and identify as black and minority ethnic (GMC, 2019a) a trend that sees no sign of abating as the NHS continues its international medical workforce recruitment strategy for its survival (NHS England, 2019; Beech et al., 2019). IMGs can provide significant value to improving the NHS using skills developed from their own health-care system. This paper recommends a need for reciprocal learning from low to medium income countries by UK doctors to encourage the development of an inclusive global medical social identity.

This quality improvement research combined with identity leadership provides new insights into how overseas doctors can successfully lead sustainable improvement across different departments within one hospital in the NHS.

This study aimed to investigate the effects of accessibility, quality perception, and price perception on consumer satisfaction with imported fruit, specifically imported Asian pears. The moderating role of the country image was also assessed.

A total of 413 Americans aged over 19 years who had purchased imported Asian pears were surveyed through an online questionnaire. Structural equation modeling and multiple group analysis were conducted to test the hypotheses.

Accessibility, quality perception, and price perception exhibited a significant impact on consumer satisfaction with imported Asian pears and influenced behavioral intention through satisfaction. Multiple group analysis results revealed a moderating effect of the country image on these relationships. Accessibility had a significant impact on consumer satisfaction of consumers with a high country image of Korea, whereas prices had no significant impact on them. In contrast, price was determined as a key satisfaction factor for consumers with a low country image of Korea, whereas accessibility did not have a significant impact.

This study contributes to the literature on imported fruits and provides practical implications for promoting the consumption of imported Asian pears in the US.

This paper aims to add further evidence to adoption criteria for “revolutionary” business techniques.

Adoption criteria for business techniques with a high degree of novelty have been developed earlier. The case of exchange-traded funds supports the earlier findings. The methodology applied is explicative.

The analysis supports findings that an effective response to a problem, the availability of a controllable procedure, the means to apply the procedure easily and the hardware jointly explain adopting “revolutionary” business techniques.

The results of case studies, in general, do not permit induction. More research might identify additional adoption criteria or falsify the presently obtained results. Therefore, further research is invited.

Managers seeking or being introduced to new techniques in business administration might use the criteria outlined here for their evaluation.

The author believes this paper corroborates earlier findings on adopting “revolutionary” business techniques that draw on theoretically developed technologies.

This phenomenological study aims to explore how media promote and should promote wheelchair rugby.

Semi-structured interviews were conducted with 31 athletes at National Wheelchair Rugby Championship. In using a reflective thematical analysis approach, three themes were identified – media coverage: the promise of an unknown quantity; the battle of inspiration and athleticism; and leverage marketing and promote the “wow”.

Lacking fair representation from media resulting in the perception and reception gap between the general public and spectators was identified and explained by most of the athletes. Besides urging increased coverage with a shifting focus on athleticism, the important role of marketing was highlighted.

In short, the “wow” factor of the sport is its aggressiveness which can be its bestselling feature and used by stakeholders for maximum impact when marketing wheelchair rugby.