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Barriers and enablers to academic health leadership

Aleem Bharwani (Cumming School of Medicine, University of Calgary, Calgary, Canada)
Theresa Kline (Department of Psychology, University of Calgary, Calgary, Canada)
Margaret Patterson (Werklund School of Education, University of Calgary, Calgary, Canada)
Peter Craighead (Cumming School of Medicine, University of Calgary, Calgary, Canada)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 6 February 2017




This study sought to identify the barriers and enablers to leadership enactment in academic health-care settings.


Semi-structured interviews (n = 77) with programme stakeholders (medical school trainees, university leaders, clinical leaders, medical scientists and directors external to the medical school) were conducted, and the responses content-analysed.


Both contextual and individual factors were identified as playing a role in affecting academic health leadership enactment that has an impact on programme development, success and maintenance. Contextual factors included sufficient resources allocated to the programme, opportunities for learners to practise leadership skills, a competent team around the leader once that person is in place, clear expectations for the leader and a culture that fosters open communication. Contextual barriers included highly bureaucratic structures, fear-of-failure and non-trusting cultures and inappropriate performance systems. Programmes were advised to select participants based on self-awareness, strong communication skills and an innovative thinking style. Filling specific knowledge and skill gaps, particularly for those not trained in medical school, was viewed as essential. Ineffective decision-making styles and tendencies to get involved in day-to-day activities were barriers to the development of academic health leaders.


Programmes designed to develop academic health-care leaders will be most effective if they develop leadership at all levels; ensure that the organisation’s culture, structure and processes reinforce positive leadership practices; and recognise the critical role of teams in supporting its leaders.



The authors would like to acknowledge the assistance of Corinne Clark for data entry, the Ward of the 21st Century for use of their equipment and research space and members in the Office of the Dean, Cumming School of Medicine for their mentoring role in this process. The authors declare that they have no financial support or relationship-based conflicts of interest.


Bharwani, A., Kline, T., Patterson, M. and Craighead, P. (2017), "Barriers and enablers to academic health leadership", Leadership in Health Services, Vol. 30 No. 1, pp. 16-28.



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Copyright © 2017, Emerald Publishing Limited

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