| Andersson 2015 [8] |
To analyze the identity challenges that physicians with medical leadership positions face |
Interviews and observations. Participants: physicians (N = 20) including physicians with a managerial role (N = 10), managers (N = 8) and their peers and subordinates (N = 24). Observations (N = 11) occurred during meetings involving physicians and managers. Setting: four hospitals |
Sweden |
| Barrable 1988 [34] |
To explore the role of the physician manager to outline administrative performance |
Surveys and interviews. Participants: physician managers (N = 13) completed the survey. Interviews were held with physician managers (N = 16), the chairman (N = 1) and the president of the medical staff (N = 1) Setting: academic hospital |
Canada |
| Betson & Pedroja 1989 [11] |
To describe the job of physician managers in hospitals |
Survey containing a task inventory. Tasks were rank-ordered according to the frequency and responsibility of the task. Participants: medical directors (N = 502). Setting: hospital (N = unknown) |
USA |
| Buchanan et al. 1997 [12] |
To explore how doctors engage in hospital management processes and consider the implications of current experiences in the next generation of clinical directors |
Interviews. Participants: clinical directors (N = 6) and other hospital management team members, the chief executive, non-clinical directors, business managers and senior nurse managers (N = 19). Setting: general teaching hospital |
UK |
| Dawson et al. 1995 [35] |
To examine the role of clinical directors and their increasing involvement in management and competition |
Interviews and a survey. Participants: clinical directors (N = 50), medical directors (N = 9), executive directors (N = 40), senior executives (N = 45) and clinical directors who participated in a management development program (N = 15). Setting: NHS trusts (N = 21) |
UK |
| Dedman et al. 2011 [13] |
To explore the perceptions of clinical directors and their roles and needed skills in clinical directorates |
Interviews and document analysis. Participants: clinical directors (N = 13), chief executives (N = 3), nursing directors (N = 12), business managers (N = 9), and department heads (N = 2). Setting: public teaching hospitals (N = 3) |
Australia |
| Dine et al. 2010 [36] |
To discover the characteristics associated with effective physician leadership |
Focus groups. Participants: physicians (N = 6), interns (N = 6) residents (N = 7) and nurses (N = 5). Setting: academic hospital |
USA |
| Dwyer 2010 [28] |
To document the roles, perceived skills, attributes and experience required of medical administrators |
Interviews. Participants: directors of medical services (N = 14). Setting: eight metropolitan public hospitals |
Australia |
| Hallier & Forbes 2005 [37] |
To understand how organizational professionals perceive the introduction of managerialism and the incorporation of managing into specialist roles |
Interviews. Participants: clinical directors (N = 18). Setting: NHS acute/district general hospitals (N = unknown) |
Scotland |
| Holmboe et al. 2003 [38] |
To investigate the characteristics and skills of physicians involved in improving quality |
Interviews. Participants: key physicians, nurses, and quality management and administrative staff (N = 45). Setting: eight hospitals |
USA |
| Hopkins et al. 2015 [39] |
To determine the particular competencies demonstrated by effective physician leaders |
Interviews. Participants: physicians who participated in a leadership development program (N = 28). Setting: academic hospital |
USA |
| Kindig & Lastirir-Quiros 1989 [40] |
To understand the nature of the administrative roles currently performed by physician executives and their perceptions of changes in these roles in the future |
Survey. A task inventory was used to rank 33 tasks according to importance. Participants: physician executives (N = 159). Setting: different hospitals |
USA |
| Kippist & Fitzgerald 2009 [31] |
To examine the tensions between hybrid clinical managers' professional values and health care organizations’ management objectives |
Interviews and observations. Participants: physician-managers who participate in a clinical leadership development program (N = 7), their staff (N = 3), the clinical leadership development facilitator (N = 1) and senior managers (N = 3). Observations of interactions between team members at several team meetings. Setting: large teaching hospital |
Australia |
| Kuhlmann et al. 2016 [41] |
To explore the gaps and organizational weaknesses that may constrain new forms of more integrated (or hybrid) clinical management |
Interviews. “Participants: physicians without a management position (N = 6) and physicians with a management position (N = 6) Setting: four departments at one urban hospital and three different hospitals |
Sweden |
| Leigh & Newman 1997 [42] |
To describe the tasks of medical directors and the problems associated with their new role |
Survey. Participants: medical managers (N = 236) including 14 mini case-studies of current job holders and a broad outline of the responsibilities of medical managers. Setting: hospital (N = unknown) |
UK |
| Llewellyn 2001 [43] |
To understand the aspirations and activities of clinical directors |
Interviews. Participants: clinical directors (N = 16). Setting: three hospitals |
UK |
| Meier 2015 [2] |
To explore how leadership is practiced across four different hospital units |
Interviews, observations and document analysis. Participants: physicians (N = 5), nurses (N = 4), and a physiotherapist (N = 1). Setting: four hospital units, in two different hospitals |
Denmark |
| Mo 2008 [44] |
To determine the role of physician-managers after unitary management reforms |
Interviews. Participants: medical managers (N = 10). Setting: university hospital |
Norway |
| Ong 1998 [32] |
To examine the way in which clinicians and their clinical teams are developing their understanding of the new role |
Interviews. Participants: clinical directors (N = 2), their managing pairs (N = unknown) and the executive team (N = unknown). Setting: two directorates in a general hospital |
UK |
| Palmer at al. 2009 [45] |
To explore the perceptions of junior doctors of the most important leadership competencies |
Survey. One on competencies and one on leadership styles (ranking). Participants: year-2 physicians (N = 196). Setting: nine hospitals |
UK |
| Quinn & Perelli 2016 [46] |
To understand how physician leaders construe their roles |
Interviews. Participants: full-time physician administrators (N = 6), physicians who are either department chairs or presidents of staff (N = 12) and physician leaders without a formal leadership role (N = 6). Setting: four hospitals |
USA |
| Pepermans et al. 2001 [47] |
To determine the job tasks of medical directors and head nurses in intensive care units |
Interviews, observations and focus groups. Participants: medical directors (N = unknown), observational units of activities (N = 235), focus groups (N = unknown) and medical directors and head nurses (N = 3–6) Setting: six hospital IC units |
Belgium, Denmark, Portugal, Switzerland, Netherlands |
| Robinson et al. 2013 [48] |
To determine the personal and professional characteristics of medical leaders in urology compared to other specialties |
Survey (listing of duties and skills). Participants: program directors and department heads of urology (N = 13) and other specialties (N = 88). Setting: hospital (N = unknown) |
Canada |
| Rotar et al. 2016 [49] |
To explore the formal managerial roles of doctor managers in hospitals and to determine the association between the level of their involvement in hospital management and the level of implementation of quality management systems |
Survey and interviews. Participants: (1) country experts (N = 19) in the OECD's health care quality indicator program and (2) physicians that have a formal or informal leading role (N = 1,670). Setting: 188 hospitals |
Europe, Israel, Japan, Singapore, South Korea, Turkey |
| Spehar et al. 2015 [50] |
To investigate how clinicians' professional background influences their transition into the managerial role and identity as clinical managers |
Interviews and observations. Participants: physicians (N = 13), nurses (N = 16) and a clinician with another healthcare background (N = 1). Setting: four public hospitals |
Norway |
| Spyridonidis et al. 2015 [51] |
To understand how physicians assume a 'hybrid' role and identity processes as they take on managerial responsibilities |
Interviews pre -and post, observations and document analysis. Participants: physician managers (N = 62), pre -and post project (total N = 124 interviews), and CLAHRC senior members (total N = 210 interviews). Setting: hospital (N = unknown) |
UK |
| Taylor et al. 2008 [52] |
To explore the required leadership qualities, knowledge and skills among medical leaders in an academic hospital setting |
Interviews. Participants: physicians who followed a leadership program (N = 10) and course and clerkship directors, program directors and department chairs (N = 8), and division directors and academic deans (N = 7). Setting: academic hospital |
USA |
| Thorne 1997a [53] |
To discover how clinicians became clinical directors, how they perceived and enacted their role and its impact on themselves and others |
Interviews and observations. Participants: clinical directors (N = unknown). Observations at management board meetings and 'being around' in both formal and informal settings. Setting: Large provincial teaching hospitals trust |
UK |
| Thorne 1997b [54] |
To identify the perspectives of doctors in management and managers of the clinical director role |
Interviews and observations. Participants: clinical directors (N = 14). Setting: 14 directorates within one NHS trust |
UK |
| Vinot 2014 [9] |
To explore the managerial roles of doctors after major hospital management reforms |
Interviews and document analysis. Participants: At each hospital two interviews were held: one with a hospital director and one with a medical manager (total N = 10). Setting: three public and two university hospitals |
France |
| Willcocks 1995 [30] |
To suggest a possible framework for examining the effectiveness of individual directors |
Interviews and document analysis. Participants: clinical directors and managers (N = unknown). Setting: NHS trust hospital |
UK |
| Williams 2001 [10] |
To indentify the skills and knowledge required for effective medical leadership |
Survey containing a list of skills and knowledge, which was rank-ordered. Participants: physicians in executive or senior management positions (N = 111). Setting: hospital (N = unknown) |
USA |
| Williams & Ewell 1996 [55] |
To assess hospital medical staff governance and leadership characteristics |
Survey (3 types). Participants: Two surveys were completed by the medical staff specialists, office managers or coordinators, and one by the chiefs of staff. Setting: 65 hospitals |
USA |
| Witman et al. 2010 [6] |
To obtain insights regarding the day-to-day practices of medical leaders |
Interviews, observations, focus groups in small learning groups (N = 26, in 33 groups). Participants: department heads (N = 6), their colleagues, residents and non-medical managers (N = 23). Setting: three departments in a university hospital |
NL |
