<![CDATA[Clinician involvement in management is crucial to align managerial decision-making with patient-centered care; however, unresolved challenges in hybrid roles often lead to role conflict and ethical dilemmas. Despite governance reforms that support clinical leadership, evidence integrating physicians and nurses in hybrid clinician-manager roles remains limited. This study addressed this gap by applying a three-domain framework to systematically explain the factors shaping the effectiveness of hybrid clinician-manager roles. This scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR). Two databases (SCOPUS and PubMed) were systematically searched from 01.01.2015 to 26.02.2025. A total of 21 papers were included. We found that hybrid clinicians perform key strategic roles in improving patient safety, care quality, interprofessional collaboration, and organizational efficiency. Their effectiveness was shaped by three interrelated factors: background and professional identity, influencing legitimacy and authority; motivation, encompassing both aspirational and reluctant engagement; and role enactment, including position and hierarchy. Hybrid managers possess clinical legitimacy and cultural capital that enhance frontline engagement while enabling them to bridge clinical realities and organizational strategy, thereby effectively linking policy with practice and increasing their value to healthcare institutions. Furthermore, lack of formal training and persistent role conflict emerged as common barriers. In conclusion, hybrid roles enhanced hospital performance when clinical expertise, intrinsic motivation, and organizational support were aligned. Strengthening leadership development, clarifying role expectations, and addressing structural hierarchies could improve the sustainability and strategic impact of hybrid clinician leadership.]]>
