Management and Leadership in Healthcare: Expectations, Conditions, Skills, and Reflections in a Leadership 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.

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.

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