🎙️In this episode, Bruce discusses ‘collective competency’ and leadership with Dr Nicky Kalafatis and Professor Rupert Pearse. The discussion takes these concepts outside of the surgical space and into environmental health and sports and leadership. Part 2 of the book proposes a surgical quality of care model which Bruce has called the ‘inside-out’ model. This model is based on a sequential approach to improving surgical care from within a hospital. To improve surgical care and outcomes in Africa, Bruce argues that we first need to address the personal needs of the surgical staff, such as personal health, nutrition, education and security, before they will have the emotional space to provide better care for surgical patients while at work. Once the personal needs of the staff are addressed, then education is necessary to develop a programme theory of how surgical teams can improve patient outcomes through planned interventions. As the whole surgical team is needed, from nurses to head surgeons and anaesthetists, to effectively deliver these interventions, it is important that the traditional steep hierarchy of the medical field is removed, to promote a ‘collective competency’ where everyone can contribute to providing this care. ‘Collective competency’ means we are encouraging the autonomy and agency for every team member to deliver the components of care that are needed. Dr Nicky Kalafatis is an anaesthetist and intensivist currently working in the UK. She spent 25 years in the public health sector in South Africa and was an examiner for the Colleges of Medicine of South Africa (CMSA) for both Anaesthesia and Critical Care. She is passionate about teaching and training and researched ‘fitness for purpose’ of South African anaesthetists as part of her PhD. She remains involved in South African anaesthesiology and is currently reviewing the national anaesthesiology curriculum as part of the College of Anaesthetists’ review committee. Her understanding of ‘collective competence’ is one of the key principles discussed in the podcast. Professor Rupert Pearse graduated in 1996 from St George’s Hospital Medical School, London, UK. After time working in general medicine and anaesthesia, he returned to St George’s Hospital where he developed many of his current research interests and completed his training in Intensive Care Medicine. In 2006, he was appointed Senior Lecturer in Intensive Care Medicine at Queen Mary University of London and was promoted to Professor in 2014. He gave up anaesthesia practice to concentrate on his clinical duties on the Adult Critical Care Unit at the Royal London Hospital and his research into improving patient outcomes following major surgery. Rupert has played a leading role in a number of large multi-centre trials, and a large part of his research takes place in the global health context. Together with Prof Bruce Biccard, he is joint lead of the NIHR Global Health Research Group on Perioperative & Critical Care. He is also Director of Clinical Research for his NHS trust and university, and chairs the NIHR-HTA Commissioning Committee.   🎙️To comment on the book please visit https://asos.org.za/index.php/book.