Competencies for Successful Middle Managers
in Healthcare and Medical Education

Kingdom of Saudi Arabia (KSA) and Kingdom of Bahrain (KB) are currently in the process of rapid transformation of health care to self-sustained autonomous system. Middle managers (MM) play a pivotal role in achieving this goal.

Aim: To develop a feasible, reliable and valid scale for measuring leadership and managerial competencies of MM in KSA and KB.

Methodology: The conceptual framework by Zhou (2019) using mixed method approach was followed. After procuring ethical clearance from concerned authorities and informed consent from all the participants (n = 27), semi structured interviews were conducted across three groups Top Management (TM), MM, and Lower Management (LM) for creation of items for the scale, which were later approved by five experts. 202 participants from medical education (ME) and health care (HC) responded to the new scale. Cronbach's alpha, Exploratory and Confirmatory factor analysis were performed to confirm internal consistency and validity.

Results: The model fit was adequate with a good GFI (0.90), TLI (0.96) and RMSEA (0.06). Seven major themes emerged from thematic analysis, while a structural model with three inter-related constructs – ‘professionalism and problem solving’, ‘team management and adaptation’, and ‘time management and expertise’ were recognized based on factor analysis.  Both TM and LM identified the ability to motivate (70.8%), as comprising one of the most significant characteristics for MM. TM also indicated that concern and consideration of subordinates (68.8%) was important. LM considered being active (71.6%) as important for MM. Interestingly, MM had scored these attributes lower, illustrating the different ways in which MM is perceived across the three levels of management. Importantly, MM acknowledge concern for employee well-being, relationship, communication, and being active as crucial competences, representing a mix of all competences identified by the three levels of management.

Conclusion: The “Leadership and Managerial Competency Scale for Middle Managers in Gulf Region (LMCS-MM Gulf Region)” developed under this study reflect what people in the three levels of management (lower, middle, and top) across ME and HC value in a (hypothetical) middle manager. This scale has several implications in selection, training and appraisal of MM in ME and HC.

Committee
Elizabeth Holloway, PhD, ABPP, Chair
J. Beth Mabry, PhD
Reginald Sequeira, PhD

​​​​​​​Held in Defense Room #1 https://antioch.zoom.us/j/640371973