<Box 2 about here>
We engaged in multiple rounds of discussions via videoconferencing with
memo-generation and collaborative conceptual development using
cloud-based, real-time interactive documents, each session lasting
approximately one-hour in length.
Literature Review &
Synthesis
After refining our initial model, we conducted a focused literature
review. We drew from literature within health systems leadership,
followership and organizational development, contrasting our own newly
formulated conceptualization with other existing models. We engaged in
iterative rounds of revisions. Ultimately, we coalesced our thinking
into one conceptual model (see results section), which we refined
through persona-driven testing (i.e. cognitive simulations with various
types of simulated characters that were used to elucidate each role in
various scenarios) and stakeholder consultation.22,23
Prototype and Persona-based testing of the
model
Next, we simulated personas and stories to test and prototype our
model.22–24 The resulting model with associated
persona-driven vignettes were submitted to a representative sampling of
health system stakeholders (clinicians, administrators, educators and
researchers in healthcare leadership) for review. Feedback from
stakeholder consultation was used to refine the model.
Stakeholder consultations
Similar to stakeholder consultations endorsed by scoping
reviews25 and the Canadian Institutes of Health
Research Knowledge Exchange process26, we sought
formative feedback on our provisional concepts from a range of
educators, experts, and frontline practitioners. This process has been
used previously20. Our inclusion criteria were that
the individual would meet one of the following criteria:
- Personal experience in blended leadership roles across two or more
organizations/units;
- Supervised/led others who bridge across more than one role; or
- Actively engaged in teaching or scholarship about leadership training
and development.
We excluded those who met the above criteria but had no experience
within the North American leadership context. We constructed a simple
survey tool with an embedded video
(https://bit.ly/BridgeLEADsurvey)
and requested that each stakeholder help us to identify the strengths,
weaknesses, and relevance of the conceptual model to their own
leadership-related practice. We subsequently met with each of the
leaders for a one-on-one interview led by our senior author (TC) to
gather feedback from those who volunteered to engage with us to provide
further feedback. A thirty-minute, one-on-one Zoom interview (Zoom
communications, Inc., San Jose, CA) was completed within a one-month
span with any stakeholder who sought to provide verbal feedback about
our model in addition to their survey responses.