Activating knowledge-based practice through healthcare leadership development: insights from the second study of a broader action research project

This study demonstrates that activating knowledge-based leadership development in rural municipalities can be strengthened through the conscious choice of relational and participatory pedagogies. Our main contribution is a model of how pedagogical and relational principles-such as appreciation, involvement, and psychological safety-can be operationalized to build leadership capacity in municipal healthcare services. Leadership development appears most effective when embedded in shared experiences, supported by competent facilitators, and anchored in safe and appreciative environments. Within this context, psychological safety emerged as both a condition for, and a driver of, learning, interpersonal connection, and cultural change. The findings further highlighted the importance of continuity, organizational anchoring, and inclusive practices to sustain leadership development over time.