Developing a leadership competency model for Chinese oncologists using the Delphi method

BACKGROUND: Leadership has become an essential component of medical professionalism; yet, China lacks leadership competency models grounded in physicians' clinical realities. This study aimed to develop a context-specific leadership competency model for Chinese oncologists, aligning international frameworks with local healthcare priorities. METHODS: A three-round modified Delphi study was conducted between June and October 2024. The process began with a preliminary model comprising 6 domains and 30 competency items, derived from a scoping review and the National Health Service Medical Leadership Competency Framework. 40 oncology-related experts evaluated both the six proposed domains and the 30 competency items in round 1 using 9-point Likert scales and open-ended feedback. In round 2, experts screened the suggestions from round 1 through binary (yes/no) evaluations. The resulting refined list was subjected to a final rating in round 3, again using 9-point Likert scales to establish consensus. Quantitative data (mean scores, SD, percentage agreement) and thematic analysis of qualitative feedback were used to iteratively refine the model across rounds. RESULTS: Experts reached consensus on a final leadership competency model comprising 6 domains and 40 specific competencies. The highest-rated competencies included integrity, continuous personal development, healthcare quality management, learn and apply new technologies and ensur patient safety. New competencies, not present in the initial model, also emerged-such as clear expression, empathy, influence on the public, familiarity with end-of-life care, health economics evaluation and vision building-capturing the evolving expectations of oncologists as communicators, collaborators and system improvers in a rapidly changing healthcare environment. CONCLUSIONS: The resulting competency model reflects the multidimensional nature of oncologist leadership, encompassing professionalism, teamwork, service improvement and social responsibility. It offers a practical framework for leadership development and assessment in oncology and provides methodological guidance for building physician leadership competency models in other medical fields.