Management and Leadership in Healthcare: Expectations, Conditions, Skills, and Reflections Across a Leadership Development Program

First- and Second-Line Healthcare Managers' Expectations, Skills, and Conditions for Practicing Management and Leadership Before, During, and After Participation in a Leadership Development Program, and Their Reflections on the Program

This study follows first- and second-line healthcare managers who take part in an established leadership development program in a Swedish healthcare region. The study examines managers' expectations of the program and how they describe their skills and conditions for practicing management and leadership before, during, and after participation. It also explores their reflections on the program, including learning, new insights, application in everyday management practice, and conditions for taking part.

Participants complete questionnaires before the program, immediately after it ends, and one year later. During the program, they record reflections in structured diaries. After the program, participants are invited to focus group interviews to discuss their experiences in greater depth. The questionnaire, diary, and interview findings will be combined to provide a broader understanding of managers' development and experiences of the program.

Study Overview

• Status: Not yet recruiting
• Conditions: Management and Leadership in Healthcare
• Intervention / Treatment: Behavioral: Leadership Development Program

Detailed Description

The aim of this study is to describe and compare first- and second-line managers' expectations, skills, and conditions for practicing management and leadership before, during, and after participation in a leadership development program, as well as their reflections on the program.

Approximately 50 first- and second-line healthcare managers participating in a leadership development program will be followed from autumn 2026. Data will be collected through questionnaires, diary entries, and focus group interviews.

A web-based questionnaire will be administered before the program, immediately after completion, and one year after completion. The questionnaire will collect demographic information and data on the managers' self-rated management and leadership using the Leadership and Management Inventory, LaMI-II, and on thriving, understood as flourishing and developing positively, using the Thriving Scale. Study-specific questions will also address whether participants have considered leaving or have left their current management position.

During the leadership development program, participants will be asked to use diaries to describe their expectations of the program and to reflect on learning, insights, application, conditions for participating in the program, and conditions for practicing management and leadership.

After completion of the leadership development program, focus group interviews will be conducted with 5-7 participants in each group. The interviews will be based on the participants' collective descriptions in the diary entries.

Questionnaire data will be compared longitudinally using statistical tests appropriate to the level and distribution of the data. Diary entries and focus group interviews will be analyzed using qualitative content analysis. The quantitative and qualitative results will then be integrated to provide a deeper understanding of the managers' development, experiences, and conditions before, during, and after participation in the leadership development program.

• Study Type: Observational
• Enrollment (Estimated): 50

Contacts and Locations

• Study Contact: Name: Karin Lundin, PhD; Phone Number: +46 737892236; Email: karin.lundin@hig.se

Study Locations

• Sweden
  • Kronoberg County
    • Vaxjo, Kronoberg County, Sweden, 351 88
      • Region Kronoberg
      • Contact: Karin Lundin, PhD; Phone Number: +46 737892236; Email: karin.lundin@hig.se

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of approximately 50 first- and second-line healthcare managers employed in Region Kronoberg who have been selected by the healthcare organization to participate in the leadership development program starting in September 2026. Selection for the program takes place independently of the research study. Managers who consent to participate in the study are followed from before the start of the program until one year after program completion.

Description

Inclusion Criteria:

• Employed as a first- or second-line healthcare manager in Region Kronoberg and selected by the healthcare organization to participate in the leadership development program starting in September 2026.

Exclusion Criteria:

• Not employed as a first- or second-line healthcare manager

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Healthcare Managers Participating in a Leadership Development Program; First- and second-line healthcare managers who have been selected by the healthcare organization to participate in its established leadership development program. Selection and admission to the program occur independently of the research study. Participants who consent to the study are followed from before the program begins until one year after program completion.

Behavioral: Leadership Development Program; An established leadership development program provided annually by a Swedish healthcare region for first- and second-line managers. The program includes planned learning activities, reflection, and interaction intended to support participants in developing their management and leadership practice. The healthcare organization selects participants and provides the program independently of the research study. The research team does not assign participants to the program or determine its content or delivery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-rated management and leadership performance	Self-rated management and leadership performance will be assessed using the Leadership and Management Inventory-II (LaMI-II). The instrument consists of 25 items divided into two factors: management and leadership. Each item is rated on a five-point scale ranging from 1 (not at all) to 5 (to a very large extent). Scores will be calculated for the management factor, the leadership factor, and the total scale. Raw scores will be transformed to values ranging from 20 to 100 by dividing the sum of the item scores by the highest possible score and multiplying by 100. Higher scores indicate more desirable self-rated management and leadership performance. Changes in management, leadership, and total scores will be examined over time. Scores may also be compared within the study group according to demographic and work-related characteristics and whether participants have considered leaving or have left their current management position.	Before the leadership development program, immediately after program completion, and 12 months after program completion
Thriving at work	Thriving at work will be assessed using the 10-item Thriving Scale. The scale consists of two factors: learning and vitality, with five items representing each factor. Each item is rated on a seven-point scale ranging from 1 (totally disagree) to 7 (totally agree). Mean scores will be calculated for the learning factor, the vitality factor, and the total scale. Higher scores indicate a higher degree of thriving at work, understood as the joint experience of learning and vitality. Changes in learning, vitality, and total thriving scores will be examined over time. Scores may also be compared within the study group according to demographic and work-related characteristics and whether participants have considered leaving or have left their current management position.	Before the leadership development program, immediately after program completion, and 12 months after program completion.
Healthcare Managers' Reflections on the Leadership Development Program	Participants' reflections on the leadership development program will be explored through structured diary entries completed during the program and through focus group interviews conducted after program completion. The diary entries will address participants' expectations of the program and their reflections on learning, insights, application of program content, conditions for participating in the program, and conditions for practicing management and leadership. The focus group interviews will explore these areas in greater depth and will be informed by the participants' collective diary reflections. Diary entries and transcribed focus group interviews will be analyzed using qualitative content analysis. The outcome will consist of categories describing participants' expectations, experiences, learning, application, and perceived conditions related to the leadership development program and their management and leadership practice.	From the beginning of the leadership development program until completion of the focus group interviews, approximately September 2026 to September 2027

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intention to Leave or Having Left the Current Management Position	Participants will be asked whether they have considered leaving their current management position or have left the position. The study-specific questionnaire responses will be described and may also be used to compare self-rated management and leadership and thriving scores within the study group.	Immediately after completion of the leadership development program and 12 months after program completion

Collaborators and Investigators

• Sponsor: Kronoberg County Council

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): June 1, 2028
• Study Completion (Estimated): July 1, 2028

Study Registration Dates

• First Submitted: June 25, 2026
• First Submitted That Met QC Criteria: June 25, 2026
• First Posted (Actual): July 1, 2026

Study Record Updates

• Last Update Posted (Actual): July 1, 2026
• Last Update Submitted That Met QC Criteria: June 25, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Longitudinal Studies; Questionnaires; Healthcare Managers; Leadership Development Program; Thriving at Work; Diary Method; Focus Group Interviews; Intention to Leave; Leadership and Management Performance
• Other Study ID Numbers: 2026-00139-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared outside the research group because the study involves a small and well-defined group of healthcare managers within one organization. The dataset includes longitudinal questionnaire responses, diary entries, and focus group interview data. Even after removal of direct identifiers, combining information across data sources and time points could create a risk of indirect identification. Data will therefore be handled in accordance with the approved ethical application and applicable data protection requirements. Aggregated and anonymized study results will be reported in publications.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No