Abstract
-
Purpose
Despite growing recognition of the critical importance of physician leadership in delivering safe healthcare, especially in light of the 2023 medical crisis and professional resistance in Korea, existing studies on leadership education have focused predominantly on countries with long-established leadership curricula. This study aims to assess the curricular content of Korean medical schools to provide a quantitative and qualitative baseline of medical leadership training in the undergraduate curriculum.
-
Methods
We conducted a content analysis of undergraduate medical curricula from 19 Korean medical schools using the Medical Leadership Competency Framework (MLCF) as a guiding framework. Survey questionnaires were distributed to designated faculty at each institution, and 270 courses were analyzed, yielding 504 leadership-related codes that were categorized thematically across the five MLCF domains and by academic year.
-
Results
Our analysis revealed that 228 codes (45.2%) fell within “Demonstrating personal qualities” and 75 codes (14.8%) within “Setting direction,” with predominant emphasis on medical ethics and law. Training in systems-based practice, self-awareness, emotional intelligence, and team-based approaches was relatively limited. Substantial institutional variation existed, with only eight of 19 schools offering curricula covering all five MLCF domains. Most leadership content was delivered through isolated, single-semester courses rather than longitudinally integrated programs.
-
Conclusion
While Korean medical schools recognize certain leadership competencies, there is a need for more comprehensive and consistent integration of leadership development, particularly in teamwork and systems-based practice. We recommend longitudinal integration of leadership education across pre-clinical and clinical years to address evolving competencies at different training stages.
-
Key Words: Leadership, Medical education, Professionalism, Republic of Korea
Introduction
Physician leadership in both healthcare and management settings plays a significant role in improving health outcomes, patient satisfaction, and organizational performance [
1-
3]. Physicians have responsibilities wider than any other health professional and therefore are expected to provide intrinsic leadership roles within healthcare services, regardless of specialty and setting. However, owing to their non-managerial background and insufficient training in leadership competence, few are prepared or willing to take up leadership positions [
4-
7].
With the recent coronavirus disease pandemic, the importance of physician leadership in coordinating and delivering safe healthcare has been underlined more than ever before. Given the essential role of physician leadership and clinical independence in medical professionalism and patient-physician relationships, educational institutions worldwide have increasingly prioritized systematic training and competency development in these areas [
5,
8,
9]. In Korea, the medical crisis and professional resistance in South Korea (hereafter Korea), which was ignited over the government’s decision to increase medical school places in 2023, has heightened the awareness of professional autonomy and its role in securing the quality of patient care [
10-
14].
Unfortunately, as compared to other countries where physician leadership is widely recognized as a requirement of all doctors, efforts to define, introduce, and standardize leadership training in Korean medical education have been elementary. Countries such as the United Kingdom, United States, and Canada, through the development and implementation of guidelines and frameworks, have defined physician leadership competencies and guided their implementation in medical school curricula [
15-
17]. The Medical Leadership Competency Framework (MLCF) is one of the most cited of these thematic frameworks on medical leadership, which effectively describes the leadership competencies required to plan, appraise, and deliver health services [
15]. Although the Korean Association of Medical Colleges (KAMC) has published the “Learning outcomes of basic medical education” in 2017 to include numerous leadership-associated competencies as one of the outcomes [
18], there is currently a limited number of studies exploring when and how leadership training is delivered in the Korean medical curricula. This study aims to assess the curricular content of Korean medical schools to provide a quantitative and qualitative baseline of medical leadership training in the undergraduate curriculum.
Methods
1. Study design
The content analysis, applied to analyze the curricular content of Korean medical schools in this study, incorporated codes and thematic categorization aligned with the five domains of MLCF (
Table 1). A list of codes was developed based on MLCF domains and elements. Two authors independently developed the list of codes and subsequently went under iterative discussion to achieve full agreement of codes that did not breach the original evidence base. Such pre-defined codes, classified into categories and themes, were used to analyze the contents of undergraduate medical courses.
MLCF was chosen as the analytic framework of this study because it is the most widely cited evidence-based leadership framework and its structure of domains and elements were intuitively applicable to the methodology of this study. The MLCF describes five leadership competencies, labeled as “domains”, which are: (1) demonstrating personal qualities, (2) working with others, (3) managing services, (4) improving services, and (5) setting direction. Within each domain, there are four elements which are further divided into competency outcomes. Although a formal validation of the translated MLCF was not conducted, the framework was reviewed by experts in medical education to ensure its conceptual relevance to the Korean medical education context. The detailed composition and the evidence base of each element are beyond the scope of this study and are presented elsewhere [
4,
15].
Primary data on the undergraduate medical curriculum, which in Korea is a 6-year program, were collected through a survey questionnaire distributed to 24 medical schools in Korea in November 2021. The purpose and process of the survey were explained in advance to the deans of medical schools. Of the 24 schools that had agreed to participate and subsequently provided the contact details of the designated survey respondent, 19 schools completed the survey (response rate=79.1%). The survey respondents were mostly faculty in medical schools involved in curriculum management, development, and/or medical education. The survey questionnaire included information regarding the title of courses, course objectives, and target academic year. Course hours were approximated by collecting information on ‘course credit,’ as the Presidential decree of the Higher Education Act of Korea stipulates that one-course credit should be at least 15 hours each semester. The provided information was cross-checked with the information available on official web pages and course catalogs of respective medical schools. A total of 363 courses were initially surveyed, among which 93 were excluded from the final analysis. Exclusion criteria were (1) courses that do not cover any relevant medical leadership themes, (2) courses without detailed course descriptions, and (3) courses not open for the 2021 academic year (e.g., canceled courses). A total of 270 courses were included in the final analysis.
The curricular content of these 270 medical courses was then analyzed independently by two authors to decide on the code that best fit the objective of the course. A single course could be assigned with more than one code, as long as the provided course description precisely included the exact phrases and/or words in our pre-defined coding list. A pilot data analysis was performed to ensure a congruent understanding of the analytic process. During the analytic process, authors communicated regularly to share findings and address any methodological issues that need to be settled, and any discrepancies were resolved through discussion with a third reviewer. The content analysis identified a total of 504 codes in the undergraduate medical curriculum, which were subsequently classified into five themes of MLCF.
3. Statistical analysis
The curricular content coding was performed using Microsoft Excel spreadsheets (Microsoft Corp., Redmond, USA) and the spider chart was produced using Microsoft PowerPoint 2021 (Microsoft Corp.) to plot the availability of leadership themes in undergraduate medical school curricula in Korea, against the MLCF domain in respective axes. The availability of leadership codes and themes were presented by the academic year of study which we grouped into pre-clinical and clinical. The pre-clinical year was defined as grades 1 through 3, during which the medical students mostly engage in basic medical and life sciences, and clinical year was defined as grades 4 through 6 during which the students mostly take clinical courses and hospital clerkships. The heatmap of curricular codes covered in 19 medical schools, by MLCF domains and elements, was produced using Microsoft Excel 2021 (Microsoft Corp.).
4. Ethics statement
In accordance with the Bioethics and Safety Act (Act number 15188) and the Ordinance of the Ministry of Health and Welfare on the Bioethics and Safety Act (Ordinance number 1048) of the Republic of Korea, this study was not subject to ethics review because the study did not involve physical intervention with human subjects or apply personally identifiable information. Nevertheless, informed consent was obtained, and the study was conducted in full accordance with the principles of the Declaration of Helsinki.
Results
The basic characteristics of the undergraduate medical courses is presented (
Table 2). The content analysis of the 270 courses revealed a total of 504 leadership codes in the Korean undergraduate medical curriculum, of which 228 (45.2%) were codes within the first domain, “demonstrating personal qualities” (
Fig. 1). The second most common was “working with others” (n=120; 23.8%). “Managing services” (n=44; 8.7%) and “improving services” (n=37; 7.3%) were relatively infrequent. When analyzed by academic years, “demonstrating personal qualities” and “working with others” were more frequently covered in pre-clinical years, whereas “managing services,” “improving services,” and “setting directions” were mostly covered in clinical years (
Table 3).
Within the first domain (“demonstrating personal qualities”), the most frequent element was “acting with integrity” (n=121; 53.1%) which had marginally higher frequency in pre-clinical years than in clinical years. “Developing self-awareness” (n=56; 24.6%) was the second most frequent, mostly appearing in the pre-clinical curriculum (n=43; 76.8%). In the second domain (“working with others”), “developing networks” (n=54; 45.0%) and “building and maintaining relationships” (n=53; 44.2%) were the most common elements. “Encouraging contribution” (n=7; 5.8%) and “working within teams” (n=6; 5.0%) were relatively infrequent.
“Managing services” was not an actively integrated theme in the curriculum and “improving services” was the domain least frequently covered, comprising only 7.3% of the total leadership codes identified. All elements within the “managing services” and “improving services” domains were more frequently covered in the clinical years compared to the pre-clinical years. In the final domain “setting direction,” “identifying the contexts for change” (n=63; 84.0%) was the most frequently covered element. Some elements did not appear in any of the surveyed courses (e.g., “facilitating transformation,” “making decisions,” and “evaluating impact”).
When analyzed using an alternative grade grouping (grades 1–2 vs. grades 3–6), the domains of “demonstrating personal qualities” and “working with others” were more frequently represented in grades 3–6, whereas patterns observed in the “managing services” and “improving services” domains were largely consistent with those identified in the initial grade grouping (
Supplement 1). Selected examples of course titles coded and classified within the domains of the MLCF show various detailed course titles mostly within the first two domains (
Supplement 2).
The heatmap of leadership codes in the undergraduate medical school curriculum of 19 medical schools showed that the domains “demonstrating personal qualities” and “working with others” were more frequently covered compared to other domains, correlating to the results presented in
Fig. 1 and
Table 3 (
Fig. 2). It also revealed the most saturated element was “1.4 Acting with integrity” and “5.1 Identifying the contexts for change,” which were integrated into the curriculum of all 19 schools surveyed. The heatmap also confirmed some differences in leadership education among schools. There are six schools (A, L, M, O, P, and Q) that have one MLCF domain that is entirely not covered, and five schools (B, E, K, N, and S) that have two domains that are not covered in their undergraduate curriculum. In contrast, a total of eight schools (C, D, F, G, H, I, J, and R) had an undergraduate medical curriculum that covered all five domains of MLCF. Two schools (D and R) had more than 60 leadership codes identified in their curriculum and three schools (B, E, and M) had less than 15.
Discussion
The results of this study indicate that, although some leadership training exists in Korean undergraduate medical curricula, considerable variation remains in both its extent and content. This finding is particularly meaningful in light of the recent legislative conflict over medical school expansion, which exposed underlying deficiencies in leadership within the medical profession, including gaps in proactive communication, inadequate capacity to uphold professional ethics, and limited ability to reconcile competing interests. This has consequently heightened awareness of the need for structured leadership education to better prepare physicians for future challenges and safeguard patient care [
10-
12].
Among the 20 elements within five MLCF domains, the most saturated were “1.4 Acting with integrity” and “5.1 Identifying the contexts for change,” which were integrated into the curriculum of all 19 schools surveyed as shown through the heatmap. The most frequently covered themes in these two elements were “medical ethics” and “medical law,” revealing that the Korean medical schools widely recognized the significance of medical law and ethics in their curricula, consistent with previous studies [
19]. This is partly attributable to the structure of the Korean Medical Licensing Examination, which designates medical law and ethics as one of its major disciplines [
20]. However, previous studies have highlighted that education on medical law and ethics in Korean medical schools faces challenges and requires enhanced pedagogical approaches to foster ethical and legal reasoning among students [
21-
23].
Whereas themes associated with the social accountability of physicians (e.g., “social accountability,” “physician responsibilities”) were frequently covered, themes associated with self-awareness and emotional intelligence were not frequently covered. In this regard, it is noteworthy that the Korean medical curriculum emphasize more on the social value (e.g., how the “society” sees “doctors” or “what the society expects of doctors”) as compared to the personal value of an individual medical student (e.g., how “I” see “myself” as a doctor-to-be) [
19,
24]. Although the KAMC has defined self-awareness as one of the Learning Outcomes of Basic Medical Education earlier in 2017, further efforts should be made to more actively incorporate self-awareness into the undergraduate medical curriculum in Korea. Self-awareness and emotional intelligence has been discussed as an essential component of interactive leader-follower relationships in various leadership theories including the leader-member exchange theory and the vertical dyadic theory [
4,
25], as the starting point of reflective practice in leadership development such as feedback seeking and introspection [
4], and thus should be more actively emphasized in the undergraduate medical curricula [
26,
27]. In addition to such personal and social perspectives, broader cultural and organizational factors—such as hierarchical structures and groupthink—may influence leadership development and curricular implementation in Korean medical schools. These factors could affect students’ willingness to express opinions and participate actively in team-based learning [
11,
13,
14,
19].
The domain showing the second highest frequency was “working with others.” A detailed exploration of “communication,” the most frequently covered theme in this domain, reveals that Korean undergraduate medical curricula primarily focus on patient communication (e.g., patient-doctor relationships, empathy, patient-centered communication). In contrast, as shown in the low frequency of “encouraging contribution (n=7; 6.2%)” and “working within teams (n=6; 5.2%)”, communication with colleagues and/or within multidisciplinary teams was not actively covered. Collaboration and team approach is essential for safe and patient-centered health care [
15-
18,
28] and involves understanding the role of others and respecting team decisions. However, this study found that Korean undergraduate medical curricula do not actively address these areas, which is consistent with previous findings [
14,
23,
29]. This is in contrast to the wide recognition and integration of team communication in medical education in the United States [
29,
30] and the United Kingdom [
7].
This study also indicates that education on systems-based practice is relatively weak, with no valid themes identified under “making decisions” and “Evaluating impact,” consistent with findings from numerous previous studies [
7,
19,
30]. It is speculated that the professional background of doctors, mostly their non-managerial background and strong technical expertise, are often making them unwilling or incompetent to take up managerial leadership positions [
4]. As all physicians will have to demonstrate managerial and organizational leadership at some point in their careers, medical schools should promote more active integration of this leadership competency at the undergraduate level.
Analysis by academic year of study reveals that “demonstrating personal qualities and “working with others” were more frequently covered in the pre-clinical years, compared to “managing services” and “improving services” which were more actively covered in the clinical years. Despite the limited scope of leadership education within Korean undergraduate medical curricula, these findings indicate that early medical training places an emphasis on establishing foundational elements of person-centered leadership, including ethical conduct, and basic interpersonal competencies. In contrast, the greater emphasis on the “managing services” and “improving services” during the clinical years suggests a shift toward more complex leadership roles, including healthcare system navigation and patient safety. Results from the alternative grade grouping analysis further support this trajectory pattern, as grade 3 showed a high representation of intermediate competencies that reflect a transition from individual- to team-oriented leadership, such as “developing networks.” However, as most of the courses under these domains were isolated courses within a single academic semester, longitudinal integration of leadership courses spanning both pre-clinical and clinical years is necessary to tune into the competing leadership needs at different stages of medical education [
29,
30].
Established leadership models provide a useful framework for addressing the identified gaps in leadership education. Transformational Leadership Model and its emphasis on motivating others and fostering innovation [
9,
26] align with the need to cultivate self-awareness, reflective practice, and effective team leadership among medical students in Korea. Servant Leadership, prioritizes ethical conduct, service to others, and the growth and well-being of both patients and colleagues [
27]. As these values are particularly relevant in healthcare, integrating principles from both transformational and servant leadership into the undergraduate curriculum could strengthen the development of both personal and organizational leadership competencies. For instance, pre-clinical education could focus on self-reflection and personal integrity, whereas clinical years could provide longitudinal experiences that reinforce team engagement and systems-based practice. This would support a progressive transition from individual-centered to team- and system-oriented leadership, preparing students to assume sound leadership roles throughout their medical careers.
This study has several limitations. First, analyzing curricula solely based on the frequency of code occurrence may not fully capture the depth and content of leadership education and may overlook the fact that leadership competencies can be taught through diverse pedagogical methods. We attempted to minimize this subjectivity by pre-defining codes and categorizing content according to an established leadership framework. Second, because information on leadership courses was collected through a designated survey respondent, the responses may not fully reflect the perspectives of faculty directly responsible for the implementation of leadership education. We mitigated this limitation by cross-checking the collected information against course descriptions on official websites and institutional catalogs. Third, although the MLCF provides a structured approach to examining leadership education, some of its components may not align with the Korean context, where leadership is often hierarchical and associated with authority. In addition, the MLCF may not capture informal or hidden leadership learning that occurs through clinical practice, thus providing an incomplete picture of leadership education when analyzing curricula. Lastly, the participation of only 19 out of the 24 invited universities may not fully represent all 40 medical schools in Korea, which warrants careful interpretation of the findings.
This study examined medical leadership training in Korea and found that while ethics and law were emphasized, systems-based practice, emotional intelligence, and team leadership were underdeveloped. Wide variation existed across schools in both content and implementation. Despite the convenience of isolated courses, longitudinal integration of leadership education should be promoted. Future studies with larger and more representative samples could examine institutional characteristics, such as ownership type or geographic location, to further examine contextual factors influencing the implementation of leadership education.
Supplementary materials
Supplement 1.
Leadership Themes in Korean Undergraduate Medical School Curricula, by Domains of the Medical Leadership Competency Framework, Using an Alternative Grade Grouping (Grades 1–2 vs. Grades 3–6).
Supplement 2.
Selected Examples of Korean Undergraduate Medical Course Titles Coded and Classified within the Domains of the Medical Leadership Competency Framework.
Data sharing statement
Please contact the corresponding author for data availability.
Acknowledgements
None.
Funding
This study was supported by the research fund of Dankook University.
Conflicts of interest
No potential conflict of interest relevant to this article was reported.
Author contributions
Conceptualization: YJ. Data curation: YHL. Formal analysis: YJ, SWG. Funding acquisition: YJ. Validation and visualization: YJ, SWG. Writing–original draft: YJ. Writing–review and editing: YJ, SWG, YHL, YC. Final approval of the version to be published.
Fig. 1.Availability of leadership themes in Korean undergraduate medical school curricula, by academic years. Pre-clinical: grades 1 through 3 (students mostly engage in basic medical and life sciences (e.g., biology, biochemistry, physiology, anatomy); Clinical: grades 4 through 6 (students mostly take clinical courses and hospital clerkships); The undergraduate medical curriculum in Korea is a 6-year program.
Fig. 2.Heatmap of leadership codes in undergraduate medical school curriculum of 19 medical schools in Korea, by domains and elements of the Medical Leadership Competency Framework. Rows: 19 medical schools in Korea participating in the survey, expressed respectively as alphabets A to S; columns: Domains and elements of the Medical Leadership Competency Framework. 1. Developing personal qualities (1.1. Developing self-awareness, 1.2 Managing yourself, 1.3 Continuing personal development, 1.4 Acting with integrity), 2. Working with others (2.1 Developing networks, 2.2 Building and maintaining relationships, 2.3 Encouraging contribution, 2.4 Working within teams), 3. Managing service (3.1 Planning, 3.2 Managing resources, 3.3 Managing people, 3.4 Managing performance), 4. Improving services (4.1 Ensuring patient safety, 4.2 Critically evaluating, 4.3 Encouraging improvement and innovation, 4.4 Facilitating transformation), 5. Setting direction (5.1 Identifying the contexts for change, 5.2 Applying knowledge and evidence, 5.3 Making decisions, 5.4 Evaluating impact). The color key indicates number of codes identified within each domains and elements.
Table 1.Undergraduate Medical Leadership Curricular Themes Coded and Organized according to the Medical Leadership Competency Framework
Table 1.
|
Themes |
Category |
Codes |
|
1. Demonstrating personal qualities |
1.1 Developing self-awareness |
Values and principles; Self-awareness; Self-reflection; Strengths and weaknesses |
|
1.2 Managing yourself |
Emotional management; Stress management; Flexibility; Self-care; Work planning; Work-life balance; Responsibilities and commitments |
|
1.3 Continuing personal development |
Continuing professional development; Personal development; Behavior change based on feedback; Learning from mistakes |
|
1.4 Acting with integrity |
Ethics; Equality; Diversity; Human rights; Culture and beliefs; Appreciating individual backgrounds |
|
2. Working with others |
2.1 Developing networks |
Networking; Working with colleagues; Sharing information and resources; Patient participation; Working with patients |
|
2.2 Building and maintaining relationships |
Building relationships; Communication skills; Different perspectives; Empathy; Needs and feelings of others |
|
2.3 Encouraging contribution |
Encouraging contribution; Brainstorming; Building consensus; Facilitating conflict management |
|
2.4 Working within teams |
Teams; Teamwork; Team approach; Team decisions; Team diversity; Leading a team; Interdisciplinary teams; Understanding roles within a team |
|
3. Managing services |
3.1 Planning |
Planning and organization; Gathering feedback from patients and users; Patient-centeredness; Value-based healthcare |
|
3.2 Managing resources |
Resources management; Hospital management |
|
3.3 Managing people |
Human resources management; Guidance and direction; Mentoring; Coaching; Motivation |
|
3.4 Managing performance |
Accountability and taking responsibility; Performance management and analysis |
|
4. Improving services |
4.1 Ensuring patient safety |
Patient safety; Risk analysis; Monitoring change |
|
4.2 Critically evaluating |
Analytical thinking; Critical evaluation; Appraise-plan-action-evaluate |
|
4.3 Encouraging improvement and innovation |
Quality in healthcare; Quality improvement; Innovation; Solutions |
|
4.4 Facilitating transformation |
Facilitating change; Systems redesign |
|
5. Setting direction |
5.1 Identifying the contexts for change |
Healthcare context (political, social, technical, organizational, professional, historical etc.); Legislation; Law and accountability; Best practices |
|
5.2 Applying knowledge and evidence |
Evidence-based service improvement; Applying data and information |
|
5.3 Making decisions |
Organizational decision-making and values; Decision-making process; Contributing a clinical perspective |
|
5.4 Evaluating impact |
Measuring outcomes; Corrective action; New approaches; Barriers to change; Disseminating good practice |
Table 2.Basic Characteristics of Undergraduate Medical Courses Included in the Final Analysis
Table 2.
|
Characteristic |
No. (%) |
|
No. of courses, surveyed |
363 |
|
No. of courses, excluded from the final analysis |
93 |
|
No. of courses, included in the final analysis |
270 |
|
Required/elective |
|
|
Required |
221 (81.9) |
|
Elective |
49 (18.1) |
|
By year of study |
|
|
Year 1 (premed) |
97 (35.9) |
|
Year 2 (premed) |
91 (33.7) |
|
Year 3 |
40 (14.8) |
|
Year 4 |
31 (11.5) |
|
Year 5 |
4 (1.5) |
|
Year 6 |
4 (1.5) |
|
Not specified |
3 (1.1) |
|
Course credit |
|
|
0.5 |
6 (2.2) |
|
1 |
143 (52.9) |
|
1.5 |
6 (2.2) |
|
2 |
83 (30.7) |
|
3 |
18 (6.7) |
|
Not specified |
14 (5.2) |
Table 3.Leadership Themes in Korean Undergraduate Medical School Curricula, by Domains of the Medical Leadership Competency Framework
Table 3.
|
Domains and elements of Medical Leadership Competency Frameworka)
|
By academic year of studyb)
|
|
Pre-clinical (grades 1–3) |
Clinical (grades 4–6) |
|
1. Demonstrating personal qualities (n=228) |
138 (60.5) |
90 (39.5) |
|
1.1 Developing self-awareness (n=56; 24.6%) |
43 (76.8) |
13 (23.2) |
|
1.2 Managing yourself (n=30; 13.2%) |
19 (62.1) |
11 (37.9) |
|
1.3 Continuing personal development (n=21; 9.6%) |
10 (47.6) |
11 (52.4) |
|
1.4 Acting with integrity (n=121; 53.1%) |
66 (54.5) |
55 (45.5) |
|
2. Working with others (n=120) |
69 (57.5) |
51 (42.5) |
|
2.1 Developing networks (n=54; 45.0%) |
32 (59.3) |
22 (40.7) |
|
2.2 Building and maintaining relationships (n=53; 44.2%) |
31 (58.5) |
22 (41.5) |
|
2.3 Encouraging contribution (n=7; 5.8%) |
3 (42.9) |
4 (57.1) |
|
2.4 Working within teams (n=6; 5.0%) |
3 (50.0) |
3 (50.0) |
|
3. Managing services (n=44) |
10 (22.7) |
34 (77.3) |
|
3.1 Planning (n=13; 29.5%) |
1 (4.3) |
12 (92.3) |
|
3.2 Managing resources (n=13; 29.5%) |
2 (15.4) |
11 (84.6) |
|
3.3 Managing people (n=2; 4.5%) |
0 (0.0) |
2 (100.0) |
|
3.4 Managing performance (n=16; 36.5%) |
7 (43.8) |
9 (56.3) |
|
4. Improving services (n=37) |
7 (18.9) |
30 (81.1) |
|
4.1 Ensuring patient safety (n=16; 43.2%) |
3 (18.8) |
13 (81.3) |
|
4.2 Critically evaluating (n=10; 27.1%) |
3 (30.0) |
7 (70.0) |
|
4.3 Encouraging improvement and innovation (n=11; 29.7%) |
1 (9.1) |
10 (90.9) |
|
4.4 Facilitating transformation (n=0) |
0 |
0 |
|
5. Setting direction (n=75) |
31 (41.3) |
44 (58.7) |
|
5.1 Identifying the contexts for change (n=63; 84.0%) |
20 (31.7) |
43 (68.3) |
|
5.2 Applying knowledge and evidence (n=12; 16.0%) |
11 (91.7) |
1 (8.3) |
|
5.3 Making decisions (n=0) |
0 |
0 |
|
5.4 Evaluating impact (n=0) |
0 |
0 |
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