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Understanding mechanisms and outcomes in multidisciplinary leadership development: a mixed-methods evaluation.
Juliette Catherine Phillipson1, Nicholas Hicks2, Oscar Lyons3,4
1Thrum Leadership Ltd, Oxford, UK ju.phillipson@hotmail.com.
BMJ Leader
|June 30, 2026
Summary
The Health Systems Development Programme improved leadership skills and staff engagement. Key outcomes included enhanced psychological safety, systems-thinking, and positive organizational impacts like increased staff voice.
Area of Science:
- Health Systems Development
- Leadership Training
- Organizational Psychology
Background:
- The Oxford Health: Health Systems Development Programme aimed to enhance multidisciplinary leadership capacity and address staff morale, engagement, and autonomy.
- This study focused on evaluating the program's mechanisms and outcomes.
Purpose of the Study:
- To evaluate the mechanisms and outcomes of the Health Systems Development Programme.
- To assess the impact of the programme on leadership competencies, staff engagement, and organizational functioning.
Main Methods:
- A mixed-methods evaluation using Kirkpatrick's framework.
- Pre- and post-programme self-assessments with the Medical Leadership Competency Framework Questionnaire (MLCFQ) analyzed using Wilcoxon signed-rank tests.
- Qualitative analysis of questionnaires, free-text responses, and reflective essays using reflexive thematic analysis.
Main Results:
- Statistically significant improvements were observed in MLCFQ domains: managing services and setting direction (p=0.02).
- Qualitative data identified psychological safety, legitimised vulnerability, and structured reflection as key change mechanisms.
- Participants reported increased leadership self-efficacy, systems-thinking, confidence in speaking up, and positive organizational impacts such as increased staff voice and team cohesion.
Conclusions:
- The evaluation provides evidence of behavioral transfer and early organizational influence from the programme.
- Further longitudinal evaluation with predefined service-level metrics is needed to assess sustainability and objective impact.
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