Academic literature on the topic 'Self-Efficacy Scale for Clinical Nurse Leaders'

Abstract Evidence regarding the role of nurses-in-leadership and how to engage nurses in policy decisions is minimal in sub-Saharan Africa. The purpose of this study was: (1) to assess the leadership practices of nurses-in-leadership in Uganda (by self-report) and from the perspective of ‘followers’ (direct-report, peers, co-workers, other); and (2) to determine factors (positively) associated with leadership practices. We surveyed 480 nurses, 120 in leadership roles (Response Rate 57%) and 360 ‘followers’ (Response Rate 60%), who were recruited from five hospitals in Kampala, Uganda. We used the Leadership Practice Inventory (Self and Observer), a project-specific demographic questionnaire and Denison’s Organizational Culture Survey (DOCS). Sixty-three per cent of the respondents held a registered nursing certificate; 79% had received formal leadership training; 47% were based in private for-profit (PFP) hospitals, 28% in private not-for-profit (PNFP) and 25% in public hospitals. Among the five leadership practices, nurses-in-leadership used the practice of Model the Way (M = 8.27, SD = 1.30), Challenge the Process (M = 8.12, SD = 1.30) and Encourage the Heart (M = 8.04, SD = 1.51) more frequently (on a 10-point Likert Scale). Inspire a Shared Vision (M = 7.82, SD = 1.57) and Enable Others to Act (M = 7.62, SD = 1.66) practices were used less frequently. The same rank order was true for leadership scores from the perception of followers. However, leadership scores by followers were significantly lower (P < 0.01) than the nurse leader self-reported scores across all sub-scales. Leadership practice scores were higher in public than private hospitals (P < 0.0001). Organizational culture (OC) was associated (P < 0.001) with leadership practices. Although overall leadership practice scores were generally high, the less frequent use of Inspire and Enable practices suggests opportunities for targeted improvement. Moreover, differences between self-reported and leadership scores by followers suggest perception gaps between leaders and their followers. The positive relationship between public hospital settings and self-reported leadership practices among nurses-in-leadership suggests that important nursing leadership practices are possible even in a low-resource clinical setting.

Background: Poverty, poor healthcare infrastructure and geographic location contribute to a total lack of cancer screening for most residents of rural Honduras. Three projects built upon each other to develop, with local leaders, multiorgan screening events that mitigated barriers to screening-based early detection of cancers. Targeted barriers included transportation, cost, community perception and convenience. Aim: To test a novel system of multiorgan screening for feasibility, acceptability and effectiveness. Methods: Leveraging well-known brigade-style medical outreach methods, two large-scale weekend programs for women and one for men over four years in the same rural location screened women for cancers of the cervix, breast, oral cavity, thyroid; and men for cancers of the testes, oral cavity, skin, prostate and colon; and connected participants with follow-up care at a Honduran cancer center. Screening methods ranged from simple throat palpation for thyroid lesions to molecular screening for high risk HPV. Generally, screening began with low-tech methods onsite to triage the participants and identify those at high-risk for cancer who should have more technical follow-up at an equipped clinic. Well-trained Honduran medical students provided screening capacity and community leaders were solely responsible for promoting the screening opportunities. Masking was not possible onsite, but data analysis in the U.S. was anonymized. Results: Participants were accrued to each program's capacity (n=400) in 2013 and 2016 and near capacity in 2017 with high levels of participants completing the screening programs, community engagement with the process, and compliance with referrals for clinical follow-up at a collaborating cancer center located three hours away. Participants identified at the screenings for clinical follow-up included for women: breast 2.7% (2013) and 4.2% (2016), thyroid 1.7% (2016), cervix/positive for high risk HPV 8.2% (2013) and 11.8% (2016); and for men all in 2017: skin 0%, testes 7%, colorectal 1%, oropharynx 1 participant, and prostate 6.7%. The dominant local narrative predicted men would not participate in screening, yet 326 participated and of that group, 239 self-identified as having possible colorectal symptoms based on seeing an advertising flyer with questions about symptoms of constipation, bloody stools, or unintended weight loss. That self-identified subset took the initiative to see the local nurse in advance, obtain a colorectal sample kit, collect three days of stool samples, and bring them to the screening event. Conclusion: With community engagement and attention to planning for organized and rapid throughput, large-scale multiorgan cancer screening may be feasible in low-income rural communities. Funding: The Jornada studies were funded by Norris Cotton Cancer Center at Dartmouth's Geisel School of Medicine and a special grant from Geisel's Munck-Pfefferkorn Fund.

Abstract Introduction Sickle cell disease (SCD) is the most common inherited blood disorder in Jamaica. SCD is associated with significantly shortened lifespans globally. SCD has serious health complications and individuals with SCD often experience poor quality of life (QoL) and high levels of perceived stigma as a result. Stigma acts as a barrier to self-management, and affects morbidity, mortality, and QoL in individuals with SCD. Sources and perceptions of stigma depend largely on culture, society, and environment. The purpose of this study is to describe health-related QoL, perceived stigma, and measure the relationships between these concepts in adults with SCD in Jamaica. Methods Inclusion criteria were >18 years of age and self-reported diagnosis of a SCD genotype. Participants were recruited from the Sickle Cell Unit at The University of the West Indies in Kingston, Jamaica. Participants (n=50) completed interviewer-administered surveys including demographic/clinical characteristics; SCD Health Related Stigma Scale (SCD-HRSS) subscales: family, general public, doctors, nurses (scores range 10-60, total 40-240); the Measure of Sickle Cell Stigma (MoSCS) subscales: disclosure concerns, expected discrimination, social exclusion, internalized stigma (scores range 3-18, 2-12, 3-18, 3-18 respectively; total 11-66); and the Adult Sickle Cell Quality of Life Measurement System (ASCQ-Me) subscales: Emotional Impact, Sleep Impact, Social Functioning Impact, Stiffness Impact, Pain Impact, and Pain Episode Frequency and Severity. ASCQ-Me uses a T-score metric where 50 is the mean of the reference population and 10 is the standard deviation. The value of 50 indicates the health score of the average field test respondent during testing of the ASCQ-Me in the United States. Higher scores indicate healthier status for all subscales except pain episode frequency and severity. Scores were determined by using the online scoring system at Healthmeasures.net as recommended. The MoSCS and SCD-HRSS are both scored by obtaining summing the mean score of the subscales; higher scores indicate higher perceived stigma. Descriptive statistics were used to report scores per subscale. To identify a relationships between QoL and stigma a set of Spearman point-biserial correlation analyses were performed. Results Fifty individuals (average age 34.4 +/- 11.4; 94% Black) were recruited, 22 (44%) males and 28 (56%) females. The majority of the sample reported low disease severity. Participants reported average to healthier status on the ASCQ-Me domain in comparison to the normative United States population. Low to moderate levels of stigma were reported. See Table I for ASCQ-Me, SCD-HRSS, and MoSCS results. There were weak but significant relationships identified between the QoL measures and the stigma scales, according to the lenient p ≤0.10 significance level that was used for this exploratory study. A positive correlation was identified between pain frequency and stigma (SCD-HRSS: r=0.303, p: 0.043; MoSCS: r=0.379 p: 0.008), indicating that individuals who report experiencing more frequent pain may also report higher stigma. Negative correlations were identified between stigma and both emotional impact (SCD-HRSS: r=-0.335, p=0.025; MoSCS: -0.331, p=0.021) and social functioning (MoSCS: r=-0.397; p=0.005); suggesting that individuals who report less emotional impact, as a result of having SCD, and better social functioning also experience less perceived stigma. Conclusion It is important to note that while participants in this Jamaican sample of adults with SCD reported average to healthier status on the QoL measures than the normative population of individuals with SCD, this does not signify better QoL than the general population. A previous study found that in comparison to the general population, individuals with SCD reported QoL levels most similar to those undergoing hemodialysis. Our sample reported low levels of stigma, which is also consistent with also having lower disease severity. Correlational analysis revealed relationships that indicate that greater disease severity (pain frequency) could result in higher stigma levels, while experiencing less psychosocial (social functioning and emotional) impacts could result in lower stigma levels. Disclosures Bulgin: NIH NINR: Research Funding; Jonas Nurse Leaders Scholar Program: Other: Education Funding ; Duke Global Health Institute Field Work Grant: Research Funding. Tanabe:Alliant Health: Consultancy; NIH and AHRQ: Research Funding; Duke University: Employment.

Background: Clinical handover between emergency medical services (EMS) and the hospital trauma team can be subject to errors that may negatively affect patient care. Thus far, there has been limited evaluation of the quality of EMS handover. As such, we sought to characterize handover practices from EMS to the trauma team, identify areas for improvement, and determine if there is a need for standardization of current handover practices. Aim Statement: Identify areas for improvement in handover from EMS to the trauma team, specifically examining handover content, structure, and discordances between different team members regarding handover expectations. Measures & Design: Data were prospectively collected over a nine week period by a trained observer at Canada's largest level one trauma centre. A randomized scheduled was used to capture a representative breadth of handovers. Data collected included outcome measures such as duration of handover, structure of the handover, and information shared, process measures such as questions and interruptions from the trauma team, and perceptions of the handover from nurses, trauma team leaders (TTLs) and EMS according to a bidirectional Likert scale. Evaluation/Results: Of 410 trauma team activations, 79 verbal handovers were observed. Information was often missing regarding airway (present 22%), breathing (54%), medications (59%), and allergies (54%). Handover structure lacked consistency beyond the order of identification and mechanism of injury. Only 28% of handovers had a dedicated question and answer period. Of all questions asked, 35% were questioning previously given information. EMS returned to categories of information unprompted in 84% of handovers. The majority of handovers (61%) involved parallel conversations between team members while EMS was speaking, which was associated with a greater number of interrupting questions from the trauma team (3.15 vs. 1.82, p =.001). There was a statistically significant disparity between the self-evaluation of EMS handovers and the perceived quality determined by nurses and trauma team leaders. Discussion/Impact: At our trauma centre, we have identified the need for handover standardization due to poor information content, a lack of structure and active listening, significant information repetition, and discordant expectations between EMS, nurses, and TTLs. We intend to use our results to guide the development of a co-constructed framework integrating the perspectives of all team members on the trauma team.

Shiftwork nurses experience physical and psychological health problems related to shift work. This study aimed to examine the effects of Meridian acupressure on stress, fatigue, anxiety, and self-efficacy of shiftwork nurses in South Korea. A quasi-experimental pretest-posttest control group design was employed. Study participants were a total of 59 shiftwork nurses (intervention group: n = 29, control group: n = 30) in S hospital, Seoul, South Korea. The study was conducted at nurse stations in S hospital. Meridian acupressure as intervention was conducted for a total of 15 min on six Meridian acupressure points (GV 20, GB 12, GB 21, LI 11, SI 3, KI 1), 2 min 30 s (10 times for 15 s at a time) on each Meridian point. Measures were the stress scale, fatigue scale, State Anxiety Inventory, and self-efficacy scale, in Korean. Data were collected from July to August 2018. There were significant differences in the degrees of stress, fatigue, and anxiety of shiftwork nurses between the two groups. Meridian acupressure significantly decreased stress, fatigue, and anxiety of shiftwork nurses. This study provides preliminary evidence that Meridian acupressure was an effective intervention. Meridian acupressure could be applied to shiftwork nurses in various clinical situations.

Enhancing communicative competence of healthcare providers (HCPs) is a critical initiative for improving the healthcare experience of sexual and gender minority (SGM) cancer patients. This study presents the development, implementation, and preliminary efficacy of a new training curriculum for improving oncology HCPs’ skills in providing a safe and welcoming environment for SGM cancer patients (SGM Comskil training). Thirty-three (N = 33) oncology HCPs including nurses, nurse leaders, and nurse practitioners participated in a 4.25-hour SGM Comskil Training between July and August 2019. Overall, participants reported highly favorable evaluations of the training, with more than 80% of the participants reacting positively to 12 of the 15 evaluation items assessing engagement and reflectiveness for experiential role-plays with lesbian, gay, bisexual (LGB) and transgender standardized patients (SPs), respectively. Participants also demonstrated significant improvements in SGM healthcare knowledge, self-efficacy, beliefs toward LGB and transgender persons, and SGM-sensitive language use skills following the training. Encouraged by the feasibility of conducting this experiential training with busy cancer care HCPs and the initial favorable participant evaluation of the SGM Comskil training, results clearly indicate that this training can be rolled out into clinical settings to ensure its translational potential. The next steps should assess observable changes in communication skills and SGM-sensitive language skills with SGM patients and improvements in SGM patients’ healthcare experience.

Context: Nurses act as patients' first caregivers who help them manage their physical needs, control, and treat health conditions through their early nursing interventions and critical decision-making. The critical factor for nurses that help to raise their feeling of confidence is self-efficacy. Psychiatric nurses as long as they are protected, they will become more productive, creative, and supported. Aim: This study aimed to identify the relation between job stress and self- efficacy among nurses working in psychiatric and addiction hospital. Methods: A descriptive-correlational design was utilized. The study was conducted at Al-Amal Psychiatric and Addiction Hospital in Jeddah, Saudi Arabia. A convenience sample of 133 nurses voluntarily participated. Data were collected by using two tools; psychiatric nurse job stress scale used to assess nurses' socio-demographic data and clinical experiences, besides, to measure psychiatry nurses' job stress. General self-efficacy scale to assess self-beliefs to cope with stressful life events and capture individuals' general beliefs about their capabilities to handle different situations. Results: The results showed that about half of the participants (47%) have high job stress, and approximately three-quarters of participants (74.44%) have high self-efficacy. Middle-aged nurses had less job stress than young nurses. It was found that non-Saudi were experience job stress less than Saudi. Conclusion: The analysis of the collected data revealed that there is a statistically significant negative relationship between overall job stress and self-efficacy. Nurses need to be trained in coping strategies to deal with job stress. Workshops regarding stress management, communication skills are a must for those nurses working in a psychiatric hospital. Develop training programs on self-efficacy to help nurses heighten their stress management capability and also increase their job achievements.

BackgroundPain affects most people approaching the end of life and can be severe for some. Opioid analgesia is effective, but evidence is needed about how best to support patients in managing these medicines.ObjectivesTo develop a self-management support toolkit (SMST) and delivery strategy and to test the feasibility of evaluating this intervention in a future definitive trial.DesignPhase I – evidence synthesis and qualitative interviews with patients and carers. Phase II – qualitative semistructured focus groups and interviews with patients, carers and specialist palliative care health professionals. Phase III – multicentre mixed-methods single-arm pre–post observational feasibility study.ParticipantsPhase I – six patients and carers. Phase II – 15 patients, four carers and 19 professionals. Phase III – 19 patients recruited to intervention that experienced pain, living at home and were treated with strong opioid analgesia. Process evaluation interviews with 13 patients, seven carers and 11 study nurses.InterventionSelf-Management of Analgesia and Related Treatments at the end of life (SMART) intervention comprising a SMST and a four-step educational delivery approach by clinical nurse specialists in palliative care over 6 weeks.Main outcome measuresRecruitment rate, treatment fidelity, treatment acceptability, patient-reported outcomes (such as scores on the Brief Pain Inventory, Self-Efficacy for Managing Chronic Disease Scale, Edmonton Symptom Assessment Scale, EuroQol-5 Dimensions, Satisfaction with Information about Medicines Scale, and feasibility of collecting data on health-care resource use for economic evaluation).ResultsPhase I – key themes on supported self-management were identified from evidence synthesis and qualitative interviews. Phase II – the SMST was developed and refined. The delivery approach was nested within a nurse–patient consultation. Phase III – intervention was delivered to 17 (89%) patients, follow-up data at 6 weeks were available on 15 patients. Overall, the intervention was viewed as acceptable and valued. Descriptive analysis of patient-reported outcomes suggested that interference from pain and self-efficacy were likely to be candidates for primary outcomes in a future trial. No adverse events related to the intervention were reported. The health economic analysis suggested that SMART could be cost-effective. We identified key limitations and considerations for a future trial: improve recruitment through widening eligibility criteria, refine the SMST resources content, enhance fidelity of intervention delivery, secure research nurse support at recruiting sites, refine trial procedures (including withdrawal process and data collection frequency), and consider a cluster randomised design with nurse as cluster unit.Limitations(1) The recruitment rate was lower than anticipated. (2) The content of the intervention was focused on strong opioids only. (3) The fidelity of intervention delivery was limited by the need for ongoing training and support. (4) Recruitment sites where clinical research nurse support was not secured had lower recruitment rates. (5) The process for recording withdrawal was not sufficiently detailed. (6) The number of follow-up visits was considered burdensome for some participants. (7) The feasibility trial did not have a control arm or assess randomisation processes.ConclusionsA future randomised controlled trial is feasible and acceptable.Study and trial registrationThis study is registered as PROSPERO CRD42014013572; Current Controlled Trials ISRCTN35327119; and National Institute for Health Research (NIHR) Portfolio registration 162114.FundingThe NIHR Health Technology Assessment programme.

BACKGROUND: Nurse-led pelvic floor muscle exercise and lifestyle education programs are effective first-line interventions for women with stress incontinence (SI). PURPOSE: To develop an evidence-based stress incontinence care protocol (SICP) using the Stevens Star Model of Knowledge Transformation and evaluate its effect on the frequency and quantity of urinary incontinence, quality of life, pelvic muscle self-efficacy levels, and lifestyle variables of women with SI. METHODS: An SICP was developed on the basis of the Star model. The views of an expert were consulted for testing the content validity of the protocol. Using a pretest-posttest experimental design, 68 women with SI who visited an outpatient clinical at a hospital in Turkey were prospectively enrolled in the intervention (n = 34) and control (n = 34) groups. After obtaining baseline demographic and health history information, participants completed the King’s Health Questionnaire, the Broome Pelvic Muscle Exercise Self-Efficacy Scale, a 3-day voiding diary, and a 1-hour pad test. The intervention group received an 8-week program of care according to the Star model-derived SICP, and follow-up assessments were completed by both groups after 8 and 12 weeks. RESULTS: The content validity index for the SICP was 91.9%. The intervention group had a reduced quantity and frequency of urinary leakage, reduced King’s Health Questionnaire scores, and increased Broome Pelvic Muscle Exercise Self-Efficacy Scale scores (P < .05). CONCLUSION: Care provided according to the Star model-derived SICP reduced the quantity and frequency of SI and improved the perceived pelvic muscle exercise self-efficacy and quality of life of the participants.

ObjectivesThe Educational Needs Assessment Tool (ENAT) is a self-completed questionnaire, which allows patients with arthritis to prioritise their educational needs. The aim of this study was to evaluate the effects of needs-based patient education on self-efficacy, health outcomes and patient knowledge in people with rheumatoid arthritis (RA).MethodsPatients with RA were enrolled into this multicentre, single-blind, parallel-group, pragmatic randomised controlled trial. Patients were randomised to either the intervention group (IG) where patients completed ENAT, responses of which were used by the clinical nurse specialist to guide patient education; or control group (CG) in which they received patient education without the use of ENAT. Patients were seen at weeks 0, 16 and 32. The primary outcome was self-efficacy (Arthritis Self Efficacy Scale (ASES)-Pain and ASES-Other symptoms). Secondary outcomes were health status (short form of Arthritis Impact Measurement Scale 2, AIMS2-SF) and patient knowledge questionnaire-RA. We investigated between-group differences using analysis of covariance, adjusting for baseline variables.ResultsA total of 132 patients were recruited (IG=70 and CG=62). Their mean (SD) age was 54 (12.3) years, 56 (13.3) years and disease duration 5.2 (4.9) years, 6.7 (8.9) years for IG and CG, respectively. There were significant between-group differences, in favour of IG at week 32 in the primary outcomes, ASES-Pain, mean difference (95% CI) −4.36 (1.17 to 7.55), t=−2.72, p=0.008 and ASES-Other symptoms, mean difference (95% CI) −5.84 (2.07 to 9.62), t=−3.07, p=0.003. In secondary outcomes, the between-group differences favoured IG in AIMS2-SF Symptoms and AIMS2-SF Affect. There were no between-group differences in other secondary outcomes.ConclusionsThe results suggest that needs-based education helps improve patients’ self-efficacy and some aspects of health status.Trial registration numberISRCTN51523281.

Introdução: Estão definidos na literatura as competências do enfermeiro líder clínico como uma prática avançada, nomeadamente na área da melhoria da qualidade dos cuidados e na segurança do cliente. De modo a facilitar a tomada de decisão dos gestores torna-se pertinente o uso de um instrumento de medida. Para perceber qual a confiança destes enfermeiros na sua função em Portugal e de a medir decidimos validar para o contexto cultural português uma escala – CNLSES®. Neste trabalho serão explanados modelos de cuidados de enfermagem e o seu contributo para a qualidade e segurança nos cuidados (Modelo de Estrutura, Processo e Resultado; Modelo de Efetividade de Cuidados de Enfermagem; Modelo de Resultados de Qualidade em Saúde; Modelo de Organização de Cuidados de Saúde; Modelo Cuidado Centrado na Pessoa). Objetivos: Adaptar, para a cultura portuguesa o CNLSES®, dando origem à versão portuguesa do mesmo. Determinar as propriedades psicométricas do CNLSES - PT na população portuguesa. Método: Trata-se de um estudo quantitativo, observacional e descritivo-transversal. A versão portuguesa do CNLSES® foi obtida através do processo de adaptação transcultural. A amostra deste estudo é não-probabilística e intencional. O CNLSES-PT foi aplicado a 329 enfermeiros responsáveis de turno/equipa e/ou com especialidade. Apresentação dos resultados: Obteve-se um instrumento com 47 itens e 7 dimensões, com uma variância explicada de 61,139% para a totalidade do instrumento. Verificou-se uma matriz de correlação aceitável para cada uma das dimensões. Relativamente à qualidade de relação entre as variáveis de cada dimensão obteve-se KMO > 0,8 para todas as dimensões e o teste de esfericidade de Bartlett`s = 0,000 para todas as dimensões. A validade de conteúdo foi assegurada pela realização do teste reteste e pela comissão de peritos. A fiabilidade foi garantida através da determinação da consistência interna, tendo sido testada através do Alfa de Cronbach onde se obteve o total de 0,960 e da determinação da correlação de Pearson no teste reteste. A validade de construto foi efetuada através da Análise Fatorial em componentes principais com rotação ortogonal pelo método Varimax e pela análise Fatorial Confirmatória. Conclusão: Da análise efetuada obtivemos melhores resultados com uma matriz de sete dimensões tendo sido redefinidas as dimensões: Cuidado Centrado no Cliente, Gestão da Unidade, Liderança Clínica, Redução de Custos, Gestão da Equipa e Planeamento de Cuidados. O CNLSES® revelou ser um instrumento adequado para ser aplicado em Portugal, através das suas características psicométricas.

Oral anticoagulation is a time-tested and effective therapy for patients at risk for thromboembolism (Ansell, 1993). Because of the high risk–benefit ratio of oral vitamin K antagonists, physicians are sometimes reluctant to initiate therapy even for well-established indications (Kutner et al., 1991; McCrory et al., 1995). Furthermore, management is recognized as labor intensive. These factors can be minimized and the benefits of treatment maximized by implementation of an expert model of management that can be achieved with a coordinated and focused system of care known as a coordinated anticoagulation clinic (Ansell and Hughes, 1996). Patient self-testing (and management) may also foster more wide-scale and effective treatment of thromboembolic disorders. The concept of a coordinated anticoagulation clinic (ACC) is not new. Programs focusing on the management of oral anticoagulation have existed in the United States since the late 1950s, and several Scandinavian and other European countries are well known for their coordinated programs (Loeliger et al., 1984), some of which oversee the care of all anticoagulated patients in their respective countries. In the United States, ACCs are growing in number and diversity of services, spurred on by increasing evidence of improved clinical outcomes and cost-effectiveness. The basic elements of a coordinated ACC include (1) a manager or team leader (physician, pharmacist), (2) support staff (nurse practitioner, pharmacist, or physician assistant), (3) standardized record keeping and a computerized database, (4) a manual of operation and practice guidelines, and (5) a formal mechanism for communicating with referring physicians and patients. Currently, most oral anticoagulation therapy in the United States is managed by a patient’s personal physician. In essence, the monitoring and dose titration of patients with thromboembolic disease represents a relatively small proportion of the physician’s overall clinical practice. This approach can be characterized as “traditional” or routine medical care. There may be no specialized system or guidelines in place to track patients or ensure their regular follow-up. An ACC uses a focused and coordinated approach to managing anticoagulation (Ansell et al., 1997).

The Clinical Scholars (CS) National Leadership Institute (CSNLI) equips interprofessional teams of health care professionals through equity-centered leadership training, preparing them to be change leaders working to advance health equity in communities across the US and its territories. At the time of this writing, four cohorts consisting of 131 Fellows from 14 different disciplines, participating in 36 different teams of two to five members are working on “Wicked Problem Impact Projects”, an implementation science-based approach to action learning projects. This chapter reports on the design of the 3-year CS experience, the onsite and distance-based training support, and the subsequent learning responses of 98 participants, 30 of whom had completed the 3-year training (Cohort 1), 34 of whom had completed 2-years of the training (Cohort 2), and 34 who had completed 1-year of the training (Cohort 3). The training program is guided by 25 competencies that weave leadership and equity throughout, which are divided into four families: Personal, Interpersonal, Organizational, and Community & Systems. Learning outcomes indicated that Fellows are highly satisfied, with all participants rating their experience at 6.10-6.77 on a 7-point scale across all sessions, all years. Retrospective pre-and post-tests assessed learning gains on the competencies, indicating statistically significant changes from baseline to midpoint in participant knowledge, attitude, use, and self-efficacy in each of the 25 competencies and large and significant gains by competency family. The Clinical Scholars Program presents an in-depth, longitudinal, state-of-the-art approach to promoting the cultivation and development of a large and sophisticated set of skills that intentionally integrate leadership competencies with a focus on health equity. Taken together, these outcomes show how a logical and structured process, using widely available tools, can contribute to both learning and implementation of skills that lead to real world impacts in communities. Given the results reported at the close of their Clinical Scholars experience, the data suggest that investing in robust, intensive leadership development of interprofessional teams is a smart decision for impacting the culture of health in communities nationwide.