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Lighting consultants are in little doubt about why they exist: ‘Electrical consulting engineers tend to consider the subject of lighting as a quantitative engineering issue as opposed to the qualitative visual subject it clearly is,’ states Lighting Design Partnership (LDP) in its company brochure. The net result is that most artificial lighting in this country is an unimaginative and depressing compromise which results from the lack of a common language between architect and engineer.

This paper aims to evaluate the longer-term impact of the 12-month Welsh clinical leadership fellowship.

Semi-structured interviews with 10 out of 14 trainee doctors who were fellows between 2013-2016, exploring how leadership knowledge and skills were used in clinical practice, impact on patient care and influence on careers. Data, gathered in 2017 when participants had completed the fellowship between 1-3 years, were analysed thematically.

All found the fellowship rewarding. The experience was felt to advantage them in consultant interviews. They gained insight into the wider influence on organisations and the complexity of issues facing senior clinicians. Although subtle, the impact was significant, equipping fellows with negotiation skills, enabling them to better influence change. Indirect impact on clinical practice was evidenced by enhanced confidence, teamworking skills and progression of improvement projects. However, the use of skills was limited by lack of seniority within teams, demands of medical training and examinations. The negativity of others towards management and leadership was also noted by some.

Small participant numbers limit generalisability.

The fellowship is designed to equip participants with skills to lead improvements in healthcare delivery. Those more advanced in their medical training had greater opportunity and seniority to lead change and were better placed to apply the learning. This has implications for whom the training should be targeted.

A rare study exploring the longer-term impact of a leadership programme on later clinical practice, which adds to the body of knowledge of impact and efficacy of leadership training programmes in healthcare environments.

This article aims to hypothesize a model of trust in both senses of the word – a model, as in something to emulate, and a model as in a structural framework that describes its components. Almost all business people agree that winning and keeping the trust of customers, investors, employees and other stakeholders is critical to business success. There is also broad agreement that trust in business and government has been in serious decline over the past few decades, as documented in a number of studies. Ironically, however, there is little agreement on the nature of trust. Researchers and strategists use the word loosely, without a common definition of its components and with no clear understanding of the process by which it is built, nurtured – and lost.

Based on syndicated research and the more than three-decades experience in public relations, the author suggests that trust has both rational and emotional components that arise from stakeholders’ perception of their own affinity with a brand, company or individual, as well as their judgments of its competencies and purpose. Stakeholder perceptions along these dimensions can be displayed within a three-dimensional matrix, which can explain a range of rational/emotional reactions ranging from simple disappointment and begrudging respect to complete distrust and unquestioned trust.

The model of trust is useful for analyzing a brand, company or individual’s present trust position. It will also enable strategists to design a thoughtful, balanced approach to maintaining or improving stakeholder trust. The model allows strategists to articulate a set of actions and behaviors that will build on strengths, fill voids and correct past errors.

This is a theoretical hypothesis that still needs to be tested, but it appears to present a useful approach to considering issues of trust.

The new model builds on existing research to address an issue that has become even more critical to organizations and individuals in a world of instant communication and everyman publishing. Applying the model to business decision-making will protect firms from inadvertently losing stakeholder trust and enhance their ability to build even stronger stakeholder relationships.

The purpose of the study is to evaluate the first cohort of the Royal College of Physicians' (RCP) Chief Registrar programme in 2016/7. Chief Registrars provide medical leadership capacity through leadership development posts.

The study adopted a mixed methods design, comprising a monthly survey of the 21 Chief Registrars in the first cohort, interviews with Chief Registrars, and six cases studies where Chief Registrars and colleagues were interviewed.

Chief Registrars enjoyed high levels of practical, professional, and leadership support from their employing organisations, the RCP, and the Faculty of Medical Leadership and Management. They had high degrees of autonomy in their roles. As a result, roles were enacted in different ways, making direct comparative evaluation problematic. In particular, we identified variation on two dimensions: first, the focus on medical leadership generally, or quality improvement more specifically, and second, the focus on personal development or organisational leadership capacity.

The data are limited and drawn from the first cohort's experience. The Chief Registrar scheme, unlike many other leadership fellowships, maintains a high level of clinical practice (with a minimum 40 per cent leadership work). This suggests a clearer preparation for future hybrid leadership roles.

This paper may offer some support and guidance for Chief Registrars and those who work with and support them.

This study adds to the literature on leadership development for doctors in hybrid roles, and highlights the distinctiveness of the scheme compared with other schemes.

A distinction must be drawn between a dismissal on the one hand, and on the other a repudiation of a contract of employment as a result of a breach of a fundamental term of that contract. When such a repudiation has been accepted by the innocent party then a termination of employment takes place. Such termination does not constitute dismissal (see London v. James Laidlaw & Sons Ltd (1974) IRLR 136 and Gannon v. J. C. Firth (1976) IRLR 415 EAT).

The purpose of this study is to investigate how physical therapists make meaning of their professional role identity when transitioning from clinician to leadership positions. Despite the importance of professional role identity in the transition from health-care provider to health-care leader, research on this topic in physical therapy remains almost nonexistent.

A qualitative, phenomenological research approach was used in this study. Data was collected through a three-part, semistructured interview process. An open coding to focused coding process was used to analyze data and develop themes which answered the research question.

Physical therapists in this study engaged in identity work, making meaning of their professional role identity by referencing a professional role identity focused on more than clinical skills, accepting the role of discomfort, focusing on relationships, exercising agency over the construction of their leader identity, recognizing consistency between clinical and leader roles and establishing a professional role identity informed but no longer bound by their physical therapist identity.

To the best of the author’s knowledge, this study is the first to investigate how physical therapists make meaning of their professional role identity when transitioning into leadership positions. The findings of this study highlight uniquities in the physical therapy professional role identity and the manner in which physical therapists navigate this work role transition.

UK fellowship schemes have been set up to address low-level engagement of doctors with leadership roles. Established in 2013, the Welsh Clinical Leadership Fellowship (WCLF) programme aims to recruit aspiring future clinical leaders and equip them with knowledge and skills to lead improvements in healthcare delivery. This paper aims to evaluate the 12-month WCLF programme in its first two years of operation.

Focused on the participants (n = 8), the authors explored expectations of the programme, reactions to academic components (provided by Academi Wales) and learning from workplace projects and other opportunities. The authors adopted a qualitative approach, collecting data from four focus groups, 20 individual face-to-face or telephone interviews with fellows and project supervisors and observation of Academi Wales training days.

Although from diverse specialties and stages in training, all participants reported that the Fellowship met expectations. Fellows learned leadership theory, developing understanding of leadership and teamwork in complex organisations. Through workplace projects, they applied their knowledge, learning from both success and failure. The quality of communication with fellows distinguished the better supervisors and impacted on project success.

Small participant numbers limit generalisability. The authors did not evaluate longer-term impact.

Doctors are required to be both clinically proficient and influence service delivery and improve patient care. The WCLF programme addresses both the need for leadership theory (through the Academi Wales training) and the application of learning through the performance of leadership roles in the projects.

This work represents an evaluation of the only leadership programme in Wales, and outcomes have led to improvements.

In the desire to improve outcomes for children in care, the issue of those individuals placed by local authorities in residential establishments run by external agencies has become especially salient. In addition to questions of quality and value for money, there are concerns about children becoming detached from local services, especially as many of the placements selected are outside the local authorities' geographical boundaries. This study looks at 262 children so placed in eight English local authorities. It was found that although there were common presenting problems, such as a need for specialist therapy or to reduce difficult behaviour, the children's circumstances varied and four distinct groups of children with common needs were identified. The use of such placements also varied across the authorities and did not mirror their numbers of children in care. The factors associated with the use of externally purchased residential placements and differences between those placed internally and externally are explored. A framework for developing new approaches for difficult adolescents and suggestions about fruitful service development are offered.

Purpose – Are members of socially dominant groups aware of the privileges they enjoy? We address this question by applying the notion of hypocognition to social privilege. Hypocognition is defined as lacking a rich cognitive or linguistic representation (i.e., a schema) of a concept in question. By social privilege, we refer to advantages that members of dominant social groups enjoy because of their group membership. We argue that such group members are hypocognitive of the privilege they enjoy. They have little cognitive representation of it. As a consequence, their social advantage is invisible to them.

Approach – We provide a narrative review of recent empirical work demonstrating and explaining this lack of expertise and knowledge in socially dominant groups (e.g., White People, men) about discrimination and disadvantage encountered by other groups (e.g., Black People, Asian Americans, women), relative what members of those other groups know.

Findings – This lack of expertise or knowledge is revealed by classic cognitive psychological measures. Relative to members of other groups, social dominant group members generate fewer examples of discrimination that other groups confront, remember fewer instances after being presented a list of them, and are slower to respond when classifying whether these examples are discriminatory.

Social Implications – These classic measures of cognitive expertise about social privilege predict social attitude differences between social groups, specifically whether people perceive the existence of social privilege as well as believe discrimination still exists in contemporary society. Hypocognition of social privilege also carries implications for informal interventions (e.g., acting “colorblind”) that are popularly discussed.