Conference keynote speech on culture change in healthcare: why everyday conversations matter

Last week I delivered a conference keynote speech on culture change in healthcare, focused on how doctors can make appraisal conversations more human-centred. 

I’ve often been invited as a conference speaker to talk about organisational culture, leadership behaviour and psychological safety, particularly in healthcare settings. This event brought together doctors from across specialties, all working within the same constraints: time pressure, regulation, performance scrutiny and rising burnout. 

The keynote focused on a simple question: 
How do we improve culture when formal processes feel increasingly transactional? 

For context, medical appraisals are structured professional development conversations that support reflection, learning and revalidation. They are a requirement for doctors and play a formal role in assessing development, performance and professional standards. 

In theory, appraisals support personal and professional growth. 

In practice, many clinicians experience them as compliance exercises. 

This is where culture forms. Not through strategy documents, but through routine conversations that demonstrate what really matters. 

A question during the keynote was whether development initiatives actually improve culture. Many of us have experienced team-building activities that felt disconnected and ineffective. 

The psychology evidence supports that scepticism. 

Research consistently shows that one-off team-building events rarely lead to sustained culture change. They may boost morale temporarily, but they don’t reliably change behaviour, relationships or norms. 

Culture changes when: 

• Behaviour changes repeatedly 

• Expectations are reinforced over time 

• Conversations become more reflective, respectful and development-focused 

This is why appraisal conversations are so powerful. They happen regularly. They shape identity, belonging and standards. Small changes here can have disproportionate cultural impact. 

As a keynote speaker on coaching and culture, I’m often asked whether there is an evidence base for this work. 

There is. 

Systematic reviews and meta-analyses in organisational psychology show that coaching and leadership development interventions are associated with: 

• Improved leadership behaviour and interpersonal effectiveness 

• Higher psychological safety and learning within teams 

• Better quality conversations about performance, feedback and development 

These outcomes are strongly linked to healthier team climates and cultures. Culture change does not happen because an organisation “does coaching”. It happens because coaching changes how people think, relate and act at work. 

I don’t usually share feedback publicly, but this anonymised comment captures the intent of the work clearly: 

That last sentence matters. 

Culture improves when people leave feeling able to do something differently on Monday, not just when they feel motivated on the day. 

I'm invited to be a conference keynote speaker when an organisation wants: 

• Evidence-based insight grounded in psychology 

• Practical application, not abstract theory 

• Honest discussion about why culture initiatives fail 

• Clear links between leadership behaviour, coaching and culture 

• Content that resonates with clinicians, leaders and HR alike 

I specialise in healthcare, but the principles apply across sectors where pressure, hierarchy and accountability shape behaviour. 

If you’re planning a conference and looking for a keynote speaker on organisational culture, coaching or leadership in healthcare, I’d be happy to talk. 

You don’t need another initiative. 

You need better conversations. 

References 

• Grover, S., & Furnham, A. (2016). Coaching as a developmental intervention in organisations: A systematic review. PLOS ONE, 11(7), e0159137. 

• Jones, R. J., Woods, S. A., & Guillaume, Y. R. F. (2016). The effectiveness of workplace coaching: A meta-analysis. Journal of Occupational and Organizational Psychology, 89(2), 249–277. 

• Athanasopoulou, A., & Dopson, S. (2018). A systematic review of executive coaching outcomes. Academy of Management Learning & Education, 17(4), 555–585. 

• Bozer, G., & Jones, R. J. (2023). Understanding coaching culture: A review and research agenda. Coaching: An International Journal of Theory, Research and Practice.