outcomes and impact of training and development in health management and leadership in relation to competence in role: a mixed-methods systematic review protocol

background the need for competence training and development in health management and leadership workforces has been emphasised. however, evidence of the outcomes and impact of such training and development has not been systematically assessed. the aim of this review is to synthesise the available evidence of the outcomes and impact of training and development in relation to the competence of health management and leadership workforces. this is with a view to enhancing the development of evidence-informed programmes to improve competence.   methods and analysis a systematic review will be undertaken using a mixed-methods research synthesis to identify, assess and synthesise relevant empirical studies. we will search relevant electronic databases and other sources for eligible studies. the eligibility of studies for inclusion will be assessed independently by two review authors. similarly, the methodological quality of the included studies will be assessed independently by two review authors using appropriate validated instruments. data from qualitative studies will be synthesised using thematic analysis. for quantitative studies, appropriate effect size estimate will be calculated for each of the interventions. where studies are sufficiently similar, their findings will be combined in meta-analyses or meta-syntheses. findings from quantitative syntheses will be converted into textual descriptions (qualitative themes) using bayesian method. textual descriptions and results of the initial qualitative syntheses that are mutually compatible will be combined in mixed-methods syntheses.   discussion the outcome of data collection and analysis will lead, first, to a descriptive account of training and development programmes used to improve the competence of health management and leadership workforces and the acceptability of such programmes to participants. secondly, the outcomes and impact of such programmes in relation to participants’ competence as well as individual and organisational performance will be identified. if possible, the relationship between health contexts and the interventions required to improve management and leadership competence will be examined.