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The leadership behaviors needed to implement clinical genomics at scale: a qualitative study.

ABSTRACT: PURPOSE:To investigate leadership in clinical genomics and identify likely implications of different leadership approaches for future implementation of clinical genomics. METHODS:We undertook 37 interviews in a cross-sectional qualitative study examining implementation of clinical genomics in Australia. Participants were either nongenetic medical specialists working with genomic initiatives (e.g., immunologists, nephrologists) or working at a service/organizational level (e.g., department heads, chief medical officers). We identified participants as genomic migrants (long-established practitioners) and genomic natives (those medical specialists coming into independent practice with genomic technology in situ). Data were analyzed deductively with reference to leadership approach. RESULTS:Leadership approaches were often blended or reported to iteratively support development of another. There was concern at both the absence or the excess of entrepreneurial leadership (i.e., risk-taking). CONCLUSION:Entrepreneurial leadership is needed to promote innovativeness, risk-taking, and proactivity, essential in these early stages of clinical genomics. Shared decision-making is required from a wide range of clinicians, calling for both clinical and distributed leadership. Sharing leadership, and the potential loss of positional status from formal senior positions, may prove challenging to genomics "migrants," who are essential for nurturing genomic "natives." Clinicians will need support from their organizations and professional bodies to manage the transition.

SUBMITTER: Best S

PROVIDER: S-EPMC7394877 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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The leadership behaviors needed to implement clinical genomics at scale: a qualitative study.

Best Stephanie S Stark Zornitza Z Brown Helen H Long Janet C JC Hewage Kushani K Gaff Clara C Braithwaite Jeffrey J Taylor Natalie N

Genetics in medicine : official journal of the American College of Medical Genetics 20200513 8

<h4>Purpose</h4>To investigate leadership in clinical genomics and identify likely implications of different leadership approaches for future implementation of clinical genomics.<h4>Methods</h4>We undertook 37 interviews in a cross-sectional qualitative study examining implementation of clinical genomics in Australia. Participants were either nongenetic medical specialists working with genomic initiatives (e.g., immunologists, nephrologists) or working at a service/organizational level (e.g., de ...[more]

PMID: 32398772

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Project description:OBJECTIVES:Globalisation has increased the opportunities for health professionals working in developed countries to provide clinical and educational support in developing countries. However, how these experiences contribute to the leadership competency of health professionals is unclear; therefore, this study explored this with the objective of analysing the process of developing individual leadership competency. DESIGN:This is a qualitative descriptive study. Qualitative descriptive study is widely used in healthcare research, particularly to describe the nature of various healthcare phenomena. Qualitative descriptive data were collected in face-to-face, semistructured interviews. SETTING:The authors interviewed Japanese health professionals who participated in an international medical cooperation project as part of a multinational medical team between July 2017 and March 2018, and analysed and interpreted the data using a social constructivism paradigm. PARTICIPANTS:The authors interviewed 20 research participants, including 5 nurses, 5 dentists and 10 physicians with an average of 15.3 years of clinical experience. RESULTS:The interviews identified 58 emergent themes related to their leadership competency, 23 of which affected the actual medical care in their own institutions. The authors categorised the 58 emergent themes into seven competency areas: leadership concepts, teambuilding, direction setting, communication, business skills, working with others and self-development. The authors identified the relationships among each competency and identified differences between professions: nurses particularly reflected on their empathic attitudes towards patient after global clinical health experience; dentists tended to reflect on their business skills; physicians tended to reflect on their leadership concepts and teambuilding. CONCLUSIONS:This study clarified the leadership competency gained through short-term global clinical health experience and the process of individual leadership competency development. The findings provide expected learning competency for those considering medical practice in developing or other countries in the future.

Project description:BackgroundActive and protracted conflict settings demonstrate the need to prioritise the peace through health agenda. This can be achieved by reorienting attention toward gender diverse leadership and more effective governance within health systems. This approach may enable women to have a greater voice in the decision-making of health and social interventions, thereby enabling the community led and context specific knowledge required to address the root causes of persistent inequalities and inequities in systems and societies.MethodsWe conducted a qualitative study, which included semi-structured interviews with 25 key informants, two focus group discussions and one workshop with humanitarian workers in local and international non-governmental organisations (NGOs), United Nations (UN) agencies, health practitioners, and academics, from Sub-Saharan Africa, Middle East and North Africa (MENA), and Latin America. Findings were then applied to the peacebuilding pyramid designed by John Paul Lederach which provides a practical framework for mediation and conflict resolution in several conflict-affected settings. The purpose of the framework was to propose an adapted conceptualisation of leadership to include women's leadership in the health system and be more applicable in protracted conflict settings.ResultsFive interrelated themes emerged. First, perceptions of terms such as gender equality, equity, mainstreaming, and leadership varied across participants and contexts. Second, armed conflict is both a barrier and an enabler for advancing women's leadership in health systems. Third, health systems themselves are critical in advancing the nexus between women's leadership, health systems and peacebuilding. Fourth, across all contexts we found strong evidence of an instrumental relationship between women's leadership in health systems in conflict-affected settings and peacebuilding. Lastly, the role of donors emerged as a critical obstacle to advance women's leadership.ConclusionContinuing to empower women against social, cultural, and institutional barriers is crucial, as the emerging correlation between women's leadership, health systems, and peacebuilding is essential for long-term stability, the right to health, and health system responsiveness.

Dataset Information

The leadership behaviors needed to implement clinical genomics at scale: a qualitative study.

Publications

The leadership behaviors needed to implement clinical genomics at scale: a qualitative study.

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