Clinician's Commentary on McGowan et al.1

Leadership is a universal phenomenon; 2 however, how it is practised varies around the world. Leadership in health care is widely recognized as a requirement of professionals working in evolving and complex health care systems so that they can make sustainable changes and provide effective and efficient care. 3 We know that in physiotherapy (PT), leadership is necessary to respond to emerging health care trends and increase the profile of the profession, 1 but questions remain about how socio-cultural factors influence the enactment of leadership in PT around the world. Exploring cross-cultural perceptions of leadership is a necessary first step in facilitating global collaboration and educational initiatives that target the development of leadership skills in the profession. I commend McGowan and colleagues 1 for their study, which is the first to examine cultural comparisons of leadership in the field of PT. Gaining an international view of leadership has significant implications for physiotherapists across health care systems, both here in Canada and around the world. There is currently no consensus on the definition of leadership , and adding a cross-cultural component increases the complexity of the task. 4 Despite this challenge, McGowan and colleagues 1 defined key characteristics of leadership and, in an important step, recognized socio-cultural influences on the expression of key traits of successful leaders. Their findings revealed that both Irish and Canadian physiotherapists reported communication and professionalism as key attributes of leadership. However, factors associated with self-declaration as a leader differed significantly. Canadian physiotherapists were more likely to self-declare as leaders, and they associated the male gender, student supervision, and working in private practice as influential; Irish physiotherapists, however, reported the highest degree attained as the sole factor. These findings reinforce the idea that leadership manifests itself in various ways; what is effective in one context may not be so in another. 5 Despite the fact that Ireland and Canada belong to the same cultural cluster 5 and physiotherapists receive substantially equivalent training for autonomous practice, 6 similarities and differences in leadership perceptions remain. These similarities and differences underscore the need to investigate traits that are universally endorsed and fundamentally important to leadership and to identify those that are unique to individual cultures. 1 Further research must also explore the perceptions of leadership held by physiotherapists around the globe with varying training, professional scopes, and practice models in different geopolitical and socioeconomic contexts. 1 The impact of leadership …