Health leadership education programs, best practices, and impact on learners’ knowledge, skills, attitudes, and behaviors and system change: A literature review

Abstract

Background: A review of the literature was undertaken by the Canadian Interprofessional Health Leadership Collaborative to investigate the content and competencies of health education programs that teach collaborative leadership and to inform the development of an international collaborative leadership curriculum. Methods: A PubMed and Google Scholar search identified the frequency of key leadership education program terms and was adjusted for six major databases. From the 2,119 references, 250 were selected in a double-blinded manner. A descriptive statistical analysis was performed to determine the patterns, types, learners, models, and competencies addressed. Cross-tabulation and analysis of correlation identified best practices and impacts on learners’ knowledge, skills, attitudes/behaviors, and on health system change. Results: Four types of leadership models were formally identified, ie, traditional leadership, transformational leadership, clinical leadership, and collaborative leadership. The most identified competencies were interprofessional communication, knowledge on how to work in teams and across disciplines, and financial knowledge. The least addressed topics were social accountability and community engagement. Only 6.8% of the articles reviewed assessed the effectiveness of their program based on patient-centered outcomes and 3.6% on system change. Conclusion: This literature review focused on 250 health leadership education programs reported in peer-reviewed journals to address important questions about the competencies, best practices taught, and evaluation of effectiveness of health system change in health leadership educational programs. This review provides information that may encourage the development, implementation, and evaluation of new collaborative leadership programs. The Lancet Commission report in 2010 called for a new breed of collaborative health leader who can work across health professions in community, hospital, and primary care settings. Collaborative leaders must lead change in the face of uncertainty and ambiguity, and must strengthen and build relationships to navigate complex systems. Existing leadership programs do not adequately address the key competencies to prepare future health leaders to rise to these challenges.