scholarly journals Darzi Clinical Leadership Fellows: an activity theory perspective

2018 ◽  
Vol 32 (6) ◽  
pp. 793-808 ◽  
Author(s):  
Rebecca Malby ◽  
Kieran Mervyn ◽  
Terry J. Boyle

Purpose The purpose of this paper is to review the impact of the clinical leadership programme, in enabling the Darzi fellows to lead change projects in health and care services, and to secure quality healthcare in the NHS beyond the lifetime of the programme. Design/methodology/approach A longitudinal empirical investigation of clinical leaders (n=80) over an eight-year period was framed through an activity theory (AT)-driven research methodology using a mixed-methods approach. Findings AT illuminated how change was sustained in the NHS in London through the Darzi Clinical Leadership Fellowship. By any reasonable measurement, this programme excels, with learning and positive behavioural change sustained after the Fellowship across the NHS. Further recognition is needed of the continuing development needs of fellows as they take on more responsible leadership roles in their careers. Research limitations/implications Darzi fellows are a hard-to-reach group. The sample represents a response rate of 34 per cent. In total, 77 per cent of respondents emanated from cohorts 5 to 8 programmes. Practical implications The investment in a clinical leadership programme focused on systems leadership for quality generates value for the NHS. Social implications Countless interventions flowed through London’s healthcare community and beyond as a result of the Fellowship. This research exposed how Darzi fellows continue to lead innovation for alternative healthcare outcomes. Many proactive fellows employ a suite of learned skills and capabilities to lead systemic change. Originality/value This research is the first known longitudinal clinical leadership development study undertaken. The Darzi programme has created a unique clinical network of mutually supportive, team-centric systems thinkers and doers, with an evidence-based approach to systems change. Many fellows are catalysing sustainable change in the healthcare environment.

2021 ◽  
pp. 095148482110102
Author(s):  
Florian Liberatore ◽  
Julia Schätzle ◽  
Henrik Räwer ◽  
Kia Homayounfar ◽  
Jörg Lindenmeier

Background The hybrid role (clinical and managerial leadership tasks) of physicians in medical leadership positions (MLPs) is a driver of the attractiveness of these positions. The increasing feminization of the medical profession makes gender-related preferences for hybrid roles relevant. Purpose The current study uses the (EPL) career aspirations framework to analyze the (gender-related) effects that efficacy beliefs, motivations, and preferences for clinical leadership and managerial leadership have on the willingness of chief physicians to apply for an MLP. Methodology: A survey of senior physicians in German university hospitals yielded a sample size of N = 496. The resulting data were analyzed using a structural equation modeling approach. Findings The results confirm the low preference for MLPs among senior physicians, which is mainly affected by preferences for managerial leadership tasks. Female senior physicians perceive the position of an MLP to be less attractive than their male counterparts do, and female physicians’ willingness to apply for an MLP is concurrently driven by their preferences for clinical leadership and managerial leadership tasks. Practical implications: Mentoring programs could boost female senior physicians’ preparedness for MLPs. Further, flexibility in fulfilling managerial leadership tasks could be promoted to make MLPs more attractive to women.


2017 ◽  
Vol 13 (4) ◽  
pp. 403-418
Author(s):  
Kate Thompson ◽  
Pippa Brown ◽  
Stephanie Vieira

Purpose The purpose of this paper is to describe an intervention with a group of homeless men from the Horn of Africa, service users of the Horn of Africa Health and Wellbeing Project in London. The group was conceived by the second author who noted the presence of significant psychosocial issues for her clients, but equally their reluctance to access mainstream mental health or social care services. Design/methodology/approach Designing the group and introducing it to the men involved threw up some challenges which are explored, and the impact of the group on participants is evaluated. Findings Overall both the participants and the facilitators evaluated the group positively and it appeared to have led to lasting change for some of the group members, and this is described. The authors argue that this sort of group may be a more acceptable way to work on psychosocial issues than something more directly focused on mental health intervention. The group protocol is outlined along with suggestions for future work in this area. Originality/value This intervention represents a creative alternative to more mainstream psychological interventions for homeless or exiled men.


2014 ◽  
Vol 52 (2) ◽  
pp. 173-192 ◽  
Author(s):  
Lisa Petrides ◽  
Cynthia Jimes ◽  
Anastasia Karaglani

Purpose – The purpose of this paper is to contribute to the knowledge base on the ways in which assistant principals view their roles, and on the potential challenges involved in a distributed leadership model. Design/methodology/approach – The study employed a narrative capture method, in which assistant principals from two large urban school districts were asked to relate and self-interpret two leadership stories through a web-based narrative capture form. A total of 90 stories were collected from 45 assistant principals. Participants rated their stories based on a set of leadership indicators (including method of decision making and type of teacher interaction present in the story, among others); the results were analyzed statistically. Findings – Overall, participants tended to view their roles in terms of instructionally focussed leadership. However, leadership challenges emerged in several areas of leadership practice, including operational management and teacher professional development (PD). Demographic factors were found to influence leadership perceptions and practices. Research limitations/implications – This study begins to fill the empirical gap on assistant principal leadership roles, practices, and perceptions. Further research, using other methods (e.g. observation), is needed to collect evidence of in situ leadership practices of assistant principals, and how those practices impact and relate to school objectives for teaching and learning. Practical implications – The study sheds light on the leadership development needs of assistant principals and on the importance of ongoing, tailored PD, based on factors including where leaders are in their careers and how they envision their roles. Originality/value – This paper contributes to nascent scholarship regarding assistant principal school leadership.


2015 ◽  
Vol 28 (2) ◽  
pp. 100-118 ◽  
Author(s):  
Aleece MacPhail ◽  
Carmel Young ◽  
Joseph Elias Ibrahim

Purpose – The purpose of this paper is to reflect upon a workplace-based, interdisciplinary clinical leadership training programme (CLP) to increase willingness to take on leadership roles in a large regional health-care centre in Victoria, Australia. Strengthening the leadership capacity of clinical staff is an advocated strategy for improving patient safety and quality of care. An interdisciplinary approach to leadership is increasingly emphasised in the literature; however, externally sourced training programmes are expensive and tend to target a single discipline. Design/methodology/approach – Appraisal of the first two years of CLP using multiple sourced feedback. A structured survey questionnaire with closed-ended questions graded using a five-point Likert scale was completed by participants of the 2012 programme. Participants from the 2011 programme were followed up for 18 months after completion of the programme to identify the uptake of new leadership roles. A reflective session was also completed by a senior executive staff that supported the implementation of the programme. Findings – Workplace-based CLP is a low-cost and multidisciplinary alternative to externally sourced leadership courses. The CLP significantly increased willingness to take on leadership roles. Most participants (93 per cent) reported that they were more willing to take on a leadership role within their team. Fewer were willing to lead at the level of department (79 per cent) or organisation (64 per cent). Five of the 11 participants from the 2011 programme had taken on a new leadership role 18 months later. Senior executive feedback was positive especially around the engagement and building of staff confidence. They considered that the CLP had sufficient merit to support continuation for at least another two years. Originality/value – Integrating health-care professionals into formal and informal leadership roles is essential to implement organisational change as part of the drive to improve the safety and quality of care for patients and service users. This is the first interdisciplinary, workplace-based leadership programme to be described in the literature, and demonstrates that it is possible to deliver low-cost, sustainable and productive training that increases the willingness to take on leadership roles.


2017 ◽  
Vol 20 (2) ◽  
pp. 60-70 ◽  
Author(s):  
Randall Smith ◽  
Robin Darton ◽  
Ailsa Cameron ◽  
Eleanor K. Johnson ◽  
Liz Lloyd ◽  
...  

Purpose The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing. Design/methodology/approach The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings. Findings The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings. Originality/value Addressing the implementation of OBC in adult social care in England in the context of extra care housing.


2015 ◽  
Vol 29 (3) ◽  
pp. 355-367 ◽  
Author(s):  
Gladys Asuga ◽  
Scott Eacott ◽  
Jill Scevak

Purpose – The purpose of this paper is to evaluate the quality of the current provision for school leadership in Kenya, the extent to which they have an impact on student outcomes and the return on school leadership preparation and development investment. Design/methodology/approach – The paper draws from educational leadership, management and administration courses delivered by universities and other institutions to aspiring and practising educational leaders in Kenya. It employs a method for evaluating return on leadership development investment first articulated by Eacott (2013). Findings – While there is growth in provision, consistent with international trends, this provision is more recognised for its standardisation than points of distinction; there is minimal attention to identified dimensions of leadership leading to higher student outcomes which raises questions regarding the universality of school leadership preparation and development curriculum; and the high course costs of current provision is an inhibiting factor in assessing the return on investment in school leadership preparation and development. Research limitations/implications – The study was limited to publicly available documents from a limited sample of institutions. There is a need for more studies in the area. Practical implications – Institutions seeking to offer school leadership development have grounds on which to make decision about what programs their school leaders should undertake in terms of cost and quality. The study provides institution offering school leadership development courses evidence on which to base future policy direction. Social implications – The findings provide a case for investing in school leadership development given the impact courses may have on student outcomes. Originality/value – The paper provides a comprehensive overview of the current provision on school leadership preparation and development in Kenya. It contributes to its understanding in Africa in terms of quality, performance impact and return on investment.


2015 ◽  
Vol 34 (9) ◽  
pp. 1161-1180 ◽  
Author(s):  
Teerapun Chaimongkonrojna ◽  
Peter Steane

Purpose – The purpose of this paper is to examine the impact of the Full Range Leadership Development Program (FR-LDP) of middle managers of a furniture company in Thailand and explore how they experience the leadership development phenomenon. It addresses the fundamental question of how effective leadership behaviors occur and are sustained. Design/methodology/approach – In total, 31 middle managers completed a six-month multi-methods development program of three alternating training sessions and on-the-job practice. A 360-degree feedback survey of the Multifactor Leadership Questionnaire 5X Short, comprising 284 questionnaires of “leaders” and “raters,” was used to measure the change in effective leadership behaviors and the overall leadership outcome. A sub-sample of 20 participants from these managers was selected for in-depth interviews at the end of the intervention. Semi-structured interviews and critical incident analysis was applied to understand the leadership experience of these managers. Findings – The study revealed that leadership behavior and overall outcome performance had improved over the course of the FR-LDP. The program did contribute positively to individual learning. Sustained effectiveness was not due solely to the development or intervention process, but also on individual objectives and action, together with supervisor interest and support. Research limitations/implications – The study provides a valid, in-depth insight into leadership in Thailand, which has practical application. However, the size of the sample may not be sufficient for broad generalizations in other cultural contexts or environments. Originality/value – The study extends the understanding of how middle managers develop transformational leadership in Thailand. The study contributes to how middle managers learn what they need to know, how they get to know it and factors that influence their practice of transformational leadership in their workplace. The findings provide to organizations options on resources, talent retention and sustaining organizational performance.


2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Amy M. Seegmiller Renner ◽  
Heidi L. Borgwardt ◽  
Monica Coyle ◽  
Susan Moeschler ◽  
Anjali Bhagra

Purpose This case study aims to demonstrate how the Greater Leadership Opportunities for Women (GLOW) Mayo Clinic Employee Resource Groups (MERG) has positively impacted leadership development focusing on growth, resilience, inspiration and tenacity (GRIT) and increased advancement for female leaders at Mayo Clinic. It will also establish how the innovative utilization of employee resource groups can positively impact the development of leaders within an institution in general and specially can enhance behaviors related to GRIT. Design/methodology/approach This case study design was used to measure the impact of the GLOW MERG’s interventions through qualitative and quantitative approaches that highlight both process and outcome to increase study validity through complementarity, which “seeks elaboration, enhancement, illustration, clarification of the results from one method with the results from another” (Greene, et al., 1989, p. 259) as well as completeness and context (Onghena et al., 2019; Schoonenboom and Johnson, 2017; Bryman, 2006). Learning outcomes (knowledge), skill accomplishments and attitude development were evaluated within two weeks after each session and annually through standardized surveys sent to participants via email. The surveys were designed to capture key information about the sessions, including the impact of the session content, the willingness and ability of attendees to apply the learning and identification of opportunities for improvement in session design and delivery, as well as measure satisfaction with the activities offered, the frequency and method(s) of communication, barriers to session attendance and particular topics or speakers of interest to members (Appendix 1). Response options included dichotomous scales, Likert-type scales, multi-select and free text. This provided a voluntary response sampling, as post-session surveys were sent to all session attendees and annual surveys were sent to all GLOW MERG members, which allowed individuals to choose if they would respond to the surveys (Creswell and Creswell, 2018). To foster an environment of continuous improvement, plan-do-study-act (PDSA) cycles (Langley et al., 2009) were conducted after every survey by the event planning team and the GLOW MERG Board. Interventions were tested, reviewed and discussed during monthly board meetings and event planning. Improvements were made and results were shared with key stakeholders through regular communication channels. Additionally, 30 past and present GLOW MERG leaders were surveyed to measure their perceived impact of participation in the GLOW MERG interventions using dichotomous scales, multi-select and free text responses (Appendix 2). This targeted purposive sample was selected because of their high level of engagement with the MERG to provide a retrospective evaluation of the success of the GLOW MERG, and its interventions for career advancement related to the development of GRIT attributes, knowledge and skills resulting in career advancement for those who are/have been highly engaged with the MERG. Findings The results spanning the past few years of GLOW MERG interventions has shown that the GLOW MERG has been successful in providing targeted educational events that address the GRIT knowledge, skills and attributes, needed for female health-care leaders to be successful in developing GRIT capabilities. By staying true to its mission and vision, the GLOW MERG has been able to promote, educate and empower female leaders at Mayo Clinic while actively breaking down the barriers that can prevent women from obtaining leadership positions. Research limitations/implications There are several limitations with this case study’s data collection and sampling methods. First, the post-session and annual survey sampling was based mainly on ease of access, with responses obtained from respondents who are more likely to volunteer or those with the strongest opinions. This allowed for potential bias as responses may not be representative of all GLOW MERG member opinions. Furthermore, the purposive sample of present and past GLOW MERG leaders was also subject to volunteer bias and may not have be representative of the GLOW MERG population. Additionally, the case study examined the practices of only one site and MERG group and may not be representative of all sites or employee resources groups. Practical implications The interventions implemented by the GLOW MERG to assist women with developing GRIT knowledge, skills and attributes – barriers women often face in leadership roles – were tested, reviewed and discussed during monthly board meetings and event planning. PDSA cycles were conducted, improvements were made and results were shared with key stakeholders through regular communication channels (Langley et al., 2009). Key lessons learned from these assessments include: One size does not fit all for leadership development. GLOW members have a wide variety of backgrounds, skills and experiences. Repetition is important in the development of GRIT knowledge, skills and attributes associated with GRIT. A one-time event provides attendees with an information overview and the steps to start developing a new skill but no dedicated time to practice and implement that skill. Originality/value The innovative utilization of employee resource groups can positively impact the development of leaders within an institution in general and specially can enhance behaviors related to GRIT.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Arthur F. Turner ◽  
Gareth Edwards ◽  
Catherine Latham ◽  
Harriet Shortt

PurposeThe purpose of this paper, based on reflections from practice, is to shed light on the realities of using walking as a tool for learning and development. This is done through an initial analysis of longitudinal reflective data spanning seven years and connecting these reflections to the concepts: being-in-the-world, belonging and Ba.Design/methodology/approachThis research takes a practice based phenomenological and reflective approach. The value of this approach is to seek a new understanding, through three distinct conceptual frames, of the effective use of walking within management development.FindingsThe findings connect three conceptual approaches of being-in-the-world, belonging and “Ba” to the practicalities of delivery, thus encouraging practitioners and designers to deeply reflect on the role of walking in management development.Research limitations/implicationsA limitation is that this is largely a personal story exploring the impact of an intuitively developed set of interventions. Despite this, the paper represents a unique and deep interpretation of walking as a mechanism for management development.Practical implicationsThe paper concludes with three recommendations to practitioners wanting to use walking in management development programmes. These are: facilitators need to be familiar with their surroundings; they should look for spaces and places where participants can connect and build relationships; and organisers and sponsors need to recognise how walking not only consolidates knowledge but can help create knowledge too.Originality/valueThis is a unique, seven-year longitudinal study that broadens the theoretical focus of walking as a mechanism for management and leadership development that combines the theoretical lenses of being-in-the-world, belonging and “Ba”, the authors believe, for the first time in research on management development.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
John Basil Read III

Purpose The purpose of this paper is to explore the benefits of incorporating the tenants of followership into leadership curriculums as a means of increasing employee engagement in the organization’s mission. Design/methodology/approach Five years ago, the author reported on the impact instruction in followership had in helping a government agency achieve a significant change in workplace culture. This paper provides an update on the agency’s followership instruction, insights on how development of followership skills can enhance organizational agility, collaboration and engagement and strategies for incorporating followership into a leadership development curriculum. Findings The literature suggests that followers can partner with the leader to advance organizational objectives and enhance outcomes through proactive participation. Evidence from three followership programs suggests that indoctrination in followership principles leads to better understanding of the impact follower contributions play in achieving mission-related goals. Research limitations/implications Much of today’s leadership instruction leverages industrial-age concepts on treatment of followers in the workplace. This type of instruction limits leader/manager thinking on how to best leverage the knowledge-age talents resident in the workforce. This paper suggests that followership instruction increases the potential for followers to make meaningful contributions that enhance organizational agility and competitiveness while simultaneously improving leader strategies for engaging followers. Originality/value Instruction in the principles of followership is gaining momentum in academia and in the public and private sectors. Yet, the number of resources for teaching the subject is limited. This paper provides insights into the impact of teaching followership, suggestions on structuring a followership curriculum and recommends resources for creating meaningful instruction.


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