Linking leadership development programs for physicians with organization-level outcomes: a realist review

Area of Science:

• Healthcare Management
• Organizational Psychology
• Medical Education

Background:

• Hospitals invest in physician Leadership Development Programs (LDPs) assuming organizational benefits.
• Existing research lacks clarity on the specific mechanisms and contexts through which LDPs achieve organization-level outcomes.

Purpose of the Study:

• To investigate the 'how,' 'why,' and 'under which circumstances' physician LDPs impact organization-level outcomes.
• To develop a middle-range program theory (MRPT) explaining these impacts.

Main Methods:

• A realist review adhering to RAMESES guidelines was conducted.
• Searched scientific and grey literature (2010-2021) on LDPs for physicians in hospitals.
• Developed Context-Mechanism-Outcome (CMO) configurations for the MRPT.

Main Results:

• 38 documents informed the MRPT, detailing five CMO configurations.
• LDPs impact 'culture,' 'quality improvement,' and 'leadership pipeline' outcomes.
• Key mechanisms include self-insight, networking, quality improvement project support, tailored content, and valuing physician leaders within a leadership ecosystem.

Conclusions:

• Physician LDPs drive organization-level outcomes via multiple mechanisms.
• Realizing these outcomes necessitates appropriate contexts, resource investment, and physician support.
• The MRPT can guide LDP development for specific organizational goals.