The LEADS framework is well known across the Canadian health care landscape and is used as the basis for numerous leadership development programs; it has more specificity than the Leader Role identified in the 2015 CanMEDS Physician Competency Framework.43,44 After review of existing models, we felt that although the LEADS framework mapped the capabilities of health care leaders, it was not clearly adaptable to situation in which a leader has multiple organizational roles. The LEADS framework does not explicitly account for the context nor experience of an AHC leader who has multiple synchronous roles of mixed-seniority. Similar to other outcome-frameworks in health care, the LEADS framework describes the capabilities of the ideal leader. Complimentary to the LEADS framework, Kegan’s adult development model focuses on an individual’s cognitive development without any specific attention leadership capabilities. Prior work by Kegan and colleagues has described various ways in which individuals develop and assume various orders of consciousness, engage in constructive-development (despite an innate resistance to change), and create cultures that support all members of an organization.19,45,46 As such, we felt that a “remix” of these two frameworks might be most informative for AHC leaders.