Within Australia, as with many other countries, governments
have struggled in the past 10–15 years to reform
health services (Banks 2010). The reforms are
driven by a complex interplay of factors leading to: the
struggle to provide timely contemporary quality health
care in the context of increasing demand for services;
downsizing of health care infrastructure, due largely to
economic constraints; the growing burden of chronic
disease; increasing use of advanced technologies in care
delivery; ageing populations; workforce supply and
demand imbalances; increasing concerns about risk,
quality and safety; and the rise of the even more
bureaucratic approaches to management, which often
exclude clinicians and are driven by economic rationalism
(Leatt & Porter 2003, Daly et al. 2009). There is
ample evidence to suggest that because of the relentless
and often imposed changes, health professionals in
many practice settings have become disempowered,
beleaguered and disaffected (Leatt & Porter 2003).
Clinical leaders and managers have a crucial role to play
in enhancing work quality for staff (American Association
of Critical-Care Nurses 2005, Duffield et al.
2009, 2011). Scholars in nursing and health care are
challenged to respond and best meet the needs of clinical
leaders and managers, by ensuring appropriate
educational support is available. Furthermore, there is a
need to ensure that curricula are contemporary, relevant
and responsive to practice realities and will provide the