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Article
Publication date: 22 September 2021

Charlotte L. Hassett, David M. Gresswell and Sarah V. Wilde

This paper aims to explore whether a United Kingdom (UK) clinical psychology training programme (the programme) was effective in producing graduates who are confident in…

Abstract

Purpose

This paper aims to explore whether a United Kingdom (UK) clinical psychology training programme (the programme) was effective in producing graduates who are confident in leadership, within the context of the National Health Service and reflecting the British Psychological Society’s views of leadership.

Design/methodology/approach

Mixed methods design surveys were administered to prospective-, current- and alumni trainee clinical psychologists on the programme, enquiring about their view of leadership, motivation to lead (MtL) and aspects of the course that are helpful and which need further development. Data collected from 92 individuals were analysed using content and thematic analysis (TA).

Findings

From the TA, three themes were identified concerning the meaning of leadership as follows: professional identity, Improving the quality of services (team; organisations and wider context), professional skills. Overall, participants thought leadership was important to the role of a clinical psychologist, with prospective trainees reporting that the desire to develop as leaders influenced their decision to apply to the programme. Moreover, participants felt confident in leadership skills and that the training programme helped develop their leadership skills, with the alumni participants demonstrating a greater MtL. Placements, group study and specific modules were identified as contributing to the development of their leadership skills, but participants felt more teaching on leadership is needed. Recommendations have been suggested to improve the development of leadership skills on the programme.

Research limitations/implications

The research was undertaken on a small cohort of trainees based in the UK.

Practical implications

Participants were motivated to become clinical leaders but this motivation needed to be nurtured and developed particularly through structured placement and teaching experience.

Originality/value

This service evaluation is the only audit of the leadership of the programme and the findings will contribute to the existing body of reviews in this area.

Details

The Journal of Mental Health Training, Education and Practice, vol. 16 no. 6
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 14 June 2013

Sandra G. Leggat and Cathy Balding

While there has been substantial discussion about the potential for clinical leadership in improving quality and safety in healthcare, there has been little robust study…

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Abstract

Purpose

While there has been substantial discussion about the potential for clinical leadership in improving quality and safety in healthcare, there has been little robust study. The purpose of this paper is to present the results of a qualitative study with clinicians and clinician managers to gather opinions on the appropriate content of an educational initiative being planned to improve clinical leadership in quality and safety among medical, nursing and allied health professionals working in primary, community and secondary care.

Design/methodology/approach

In total, 28 clinicians and clinician managers throughout the state of Victoria, Australia, participated in focus groups to provide advice on the development of a clinical leadership program in quality and safety. An inductive, thematic analysis was completed to enable the themes to emerge from the data.

Findings

Overwhelmingly the participants conceptualised clinical leadership in relation to organisational factors. Only four individual factors, comprising emotional intelligence, resilience, self‐awareness and understanding of other clinical disciplines, were identified as being important for clinical leaders. Conversely seven organisational factors, comprising role clarity and accountability, security and sustainability for clinical leaders, selective recruitment into clinical leadership positions, teamwork and decentralised decision making, training, information sharing, and transformational leadership, were seen as essential, but the participants indicated they were rarely addressed. The human resource management literature includes these seven components, with contingent reward, reduced status distinctions and measurement of management practices, as the essential organisational underpinnings of high performance work systems.

Practical implications

The results of this study propose that clinical leadership is an organisational property, suggesting that capability frameworks and educational programs for clinical leadership need a broader organisation focus.

Originality/value

The paper makes clear that clinical leadership was not perceived to be about vesting leadership skills in individuals, but about ensuring health care organisations were equipped to conceptualise and support a model of distributive leadership.

Details

Journal of Health Organization and Management, vol. 27 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 12 March 2018

Selma Ebrahim

The purpose of this paper is to explore how multi-professional approved clinicians (MPACs), responsible for the care of patients detained under the Mental Health Act…

Abstract

Purpose

The purpose of this paper is to explore how multi-professional approved clinicians (MPACs), responsible for the care of patients detained under the Mental Health Act (2007), can enable clinical leadership in mental health settings.

Design/methodology/approach

A questionnaire was completed by clinical psychology and mental health nursing practitioners in a mental health trust in the UK working towards or having gained approved clinician (AC) status, identifying barriers to implementation of the roles and enablers. Qualitative interview data were also gathered with psychiatrists, clinical psychologist and Mental Health Nurse ACs (three in each group).

Findings

There are a number of barriers and enablers of distributed leadership promoted by the MPAC role. Themes identified focused on enabling person-centred care, clinical leadership and culture change more broadly within mental health care. The AC role is supporting clinical leadership by a range of professionals, promoting patient choice by enabling access to clinicians with the appropriate skills to meet needs. Clinical leadership roles are promoting links between organisational priorities, teams and patient care, fostering distributed leadership in practice.

Research limitations/implications

This project reflects the views of a limited number of practitioners within one organisation which limits generalisabilty.

Practical implications

Organisations need clear strategies linked to workforce development and implementation of the roles to capitalise on their potential to support clinical leadership and person-centred care.

Originality/value

This study provides initial qualitative data on potential benefits and challenges of implementing the role.

Details

The Journal of Mental Health Training, Education and Practice, vol. 13 no. 2
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 4 July 2016

Erwin Loh, Jennifer Morris, Laura Thomas, Marie Magdaleen Bismark, Grant Phelps and Helen Dickinson

The paper aims to explore the beliefs of doctors in leadership roles of the concept of “the dark side”, using data collected from interviews carried out with 45 doctors in…

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Abstract

Purpose

The paper aims to explore the beliefs of doctors in leadership roles of the concept of “the dark side”, using data collected from interviews carried out with 45 doctors in medical leadership roles across Australia. The paper looks at the beliefs from the perspectives of doctors who are already in leadership roles themselves; to identify potential barriers they might have encountered and to arrive at better-informed strategies to engage more doctors in the leadership of the Australian health system. The research question is: “What are the beliefs of medical leaders that form the key themes or dimensions of the negative perception of the ‘dark side’?”.

Design/methodology/approach

The paper analysed data from two similar qualitative studies examining medical leadership and engagement in Australia by the same author, in collaboration with other researchers, which used in-depth semi-structured interviews with 45 purposively sampled senior medical leaders in leadership roles across Australia in health services, private and public hospitals, professional associations and health departments. The data were analysed using deductive and inductive approaches through a coding framework based on the interview data and literature review, with all sections of coded data grouped into themes.

Findings

Medical leaders had four key beliefs about the “dark side” as perceived through the eyes of their own past clinical experience and/or their clinical colleagues. These four beliefs or dimensions of the negative perception colloquially known as “the dark side” are the belief that they lack both managerial and clinical credibility, they have confused identities, they may be in conflict with clinicians, their clinical colleagues lack insight into the complexities of medical leadership and, as a result, doctors are actively discouraged from making the transition from clinical practice to medical leadership roles in the first place.

Research limitations/implications

This research was conducted within the Western developed-nation setting of Australia and only involved interviews with doctors in medical leadership roles. The findings are therefore limited to the doctors’ own perceptions of themselves based on their past experiences and beliefs. Future research involving doctors who have not chosen to transition to leadership roles, or other health practitioners in other settings, may provide a broader perspective. Also, this research was exploratory and descriptive in nature using qualitative methods, and quantitative research can be carried out in the future to extend this research for statistical generalisation.

Practical implications

The paper includes implications for health organisations, training providers, medical employers and health departments and describes a multi-prong strategy to address this important issue.

Originality/value

This paper fulfils an identified need to study the concept of “moving to the dark side” as a negative perception of medical leadership and contributes to the evidence in this under-researched area. This paper has used data from two similar studies, combined together for the first time, with new analysis and coding, looking at the concept of the “dark side” to discover new emergent findings.

Details

Leadership in Health Services, vol. 29 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 16 November 2015

Ninna Meier

– The purpose of this paper is to explore how leadership is practiced across four different hospital units.

Abstract

Purpose

The purpose of this paper is to explore how leadership is practiced across four different hospital units.

Design/methodology/approach

The study is a comparative case study of four hospital units, based on detailed observations of the everyday work practices, interactions and interviews with ten interdisciplinary clinical managers.

Findings

Comparing leadership as configurations of practices across four different clinical settings, the author shows how flexible and often shared leadership practices were embedded in and central to the core clinical work in all units studied here, especially in more unpredictable work settings. Practices of symbolic work and emotional support to staff were particularly important when patients were severely ill.

Research limitations/implications

Based on a study conducted with qualitative methods, these results cannot be expected to apply in all clinical settings. Future research is invited to extend the findings presented here by exploring leadership practices from a micro-level perspective in additional health care contexts: particularly the embedded and emergent nature of such practices.

Practical implications

This paper shows leadership practices to be primarily embedded in the clinical work and often shared across organizational or professional boundaries.

Originality/value

This paper demonstrated how leadership practices are embedded in the everyday work in hospital units. Moreover, the analysis shows how configurations of leadership practices varied in four different clinical settings, thus contributing with contextual accounts of leadership as practice, and suggested “configurations of practice” as a way to carve out similarities and differences in leadership practices across settings.

Details

Journal of Health Organization and Management, vol. 29 no. 7
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 5 August 2014

Abeda Mulla, Alistair Hewison and Jonathan Shapiro

The way change occurred at a strategic level and in four clinical services in three hospitals was examined. The purpose of this paper is to report how the hospitals…

Abstract

Purpose

The way change occurred at a strategic level and in four clinical services in three hospitals was examined. The purpose of this paper is to report how the hospitals designed and delivered change at organisational and clinical service level to improve services for patients, and the role of clinical leadership in this process.

Design/methodology/approach

A comparative case study involving semi-structured interviews was undertaken. These involved a range of senior managers in 2009 (n=77), 2011 (n=21) and 2012 (n=29). Interviews with staff involved directly in service delivery were also carried out in 2011 (n=92). The interviews were recorded digitally, transcribed verbatim, and analysed thematically using the Framework Method.

Findings

The value of, and approach taken to clinical leadership varied across the hospitals and over time. This was affected by the culture and priorities of the organisation. Some strategies for developing clinical leadership were developed, however they were limited. It was expected that capable clinical leaders would emerge, and be supported. Effective clinical leadership during organisational and service change required direct executive or managerial support and relied on clinical “champions”.

Originality/value

The paper demonstrates that despite the importance of clinical leadership being widely recognized in policy and research, there were no established programmes in place at the hospitals that were studied to support it. Rather there was a reliance on clinical staff coming forward to take on leadership roles as part of organizational efforts to bring about change.

Details

International Journal of Leadership in Public Services, vol. 10 no. 3
Type: Research Article
ISSN: 1747-9886

Keywords

Article
Publication date: 27 January 2012

Stephen George Willcocks

The purpose of this paper is to explore leadership effectiveness, with reference to nurses in the UK National Health Service (NHS).

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Abstract

Purpose

The purpose of this paper is to explore leadership effectiveness, with reference to nurses in the UK National Health Service (NHS).

Design/methodology/approach

The paper is literature based. It explores the history and policy background to nurse leadership. It reviews a range of approaches to leadership and applies the theoretical findings to the case study of nurse leaders

Findings

The paper suggests there are several inter‐related aspects to consider in relation to developing the effectiveness of nurse leaders – these may be grouped around: developing core competencies; developing emotional intelligence; developing readiness and motivation; developing contextual sensitivity; and developing clinical innovation and change.

Practical implications

The paper discusses the implications of the findings for the leadership development of nurses and makes recommendations.

Originality/value

The paper attempts to incorporate the insights from a variety of different approaches to leadership and apply them to nurse leaders in the UK NHS.

Details

Leadership in Health Services, vol. 25 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 4 October 2011

John Edmonstone

The paper seeks to describe a national strategic and multi‐professional clinical leadership programme designed and developed for the National Health Service in Scotland…

1516

Abstract

Purpose

The paper seeks to describe a national strategic and multi‐professional clinical leadership programme designed and developed for the National Health Service in Scotland. It addresses the policy imperatives behind the programme, the local and national processes for identifying future clinical leaders and their preparation through the programme.

Design/methodology/approach

The background context and case for the programme are considered against international and local contexts. The programme's roots are explored, drawing upon the extensive consultation process used. The programme design is explained and the evaluation methodology and results are described.

Findings

Key learning related to programme design and delivery issues is highlighted, as is that relating to leadership itself.

Research limitations/implications

This is a one‐country case study but draws upon recent international good practice.

Originality/value

The case study identifies how a small (five million population) country can devise a strategic clinical leadership programme which reflects the distinctive direction adopted at policy level of working closely with clinical leaders.

Details

Leadership in Health Services, vol. 24 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 27 July 2012

Luu Trong Tuan

This research aims to look through the data of Nhan Dan Gia Dinh Hospital, a state‐owned hospital in Vietnam, for evidence on whether a clinical governance initiative…

1983

Abstract

Purpose

This research aims to look through the data of Nhan Dan Gia Dinh Hospital, a state‐owned hospital in Vietnam, for evidence on whether a clinical governance initiative cultivates ethical leadership, market‐ or innovation‐oriented culture, knowledge sharing, and knowledge‐ or identity‐based trust.

Design/methodology/approach

Data were collected through a case study approach with hospital document collection, field observations, and in‐depth interviews conducted between April 2009 and April 2011.

Findings

The findings demonstrated that a clinical governance initiative, when effectively implemented, can function as a lever for behavioural transformations in the hospital towards ethical leadership, market‐ or innovation‐oriented culture, knowledge sharing, and knowledge‐ or identity‐based trust.

Originality/value

The current research provides a portrayal of an effective clinical governance initiative with its proactive hospital outcomes such as ethical leadership, market‐ or innovation‐oriented culture, knowledge sharing, and knowledge‐ or identity‐based trust on the hospital journey of sustainable health creation. This paper also highlights the necessity for research that examines other organizational outcomes of clinical governance in Vietnamese hospitals of other ownerships.

Details

Clinical Governance: An International Journal, vol. 17 no. 3
Type: Research Article
ISSN: 1477-7274

Keywords

Open Access
Article
Publication date: 23 April 2018

Lyn Kathryn Sonnenberg, Lesley Pritchard-Wiart and Jamiu Busari

The purpose of this study was to explore inter-professional clinicians’ perspectives on resident leadership in the context of inter-professional teams and to identify a…

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Abstract

Purpose

The purpose of this study was to explore inter-professional clinicians’ perspectives on resident leadership in the context of inter-professional teams and to identify a definition for leadership in the clinical context. In 2015, CanMEDS changed the title of one of the core competencies from manager to leader. The shift in language was perceived by some as returning to traditional hierarchical and physician-dominant structures. The resulting uncertainty has resulted in a call to action to not only determine what physician leadership is but to also determine how to teach and assess it.

Design/methodology/approach

Focus groups and follow-up individual interviews were conducted with 23 inter-professional clinicians from three pediatric clinical service teams at a large, Canadian tertiary-level rehabilitation hospital. Qualitative thematic analysis was used to inductively analyze the data.

Findings

Data analysis resulted in one overarching theme: leadership is collaborative – and three related subthemes: leadership is shared; leadership is summative; and conceptualizations of leadership are shifting.

Research limitations/implications

Not all members of the three inter-professional teams were able to attend the focus group sessions because of scheduling conflicts. Participation of additional clinicians could have, therefore, affected the results of this study. The study was conducted locally at a single rehabilitation hospital, among Canadian pediatric clinicians, which highlights the need to explore conceptualization of leadership across different contexts.

Practical implications

There is an evident need to prepare physicians to be leaders in both their daily clinical and academic practices. Therefore, more concerted efforts are required to develop leadership skills among residents. The authors postulate that continued integration of various inter-professional disciplines during the early phases of training is essential to foster collaborative leadership and trust.

Originality/value

The results of this study suggest that inter-professional clinicians view clinical leadership as collaborative and fluid and determined by the fit between tasks and team member expertise. Mentorship is important for increasing the ability of resident physicians to develop collaborative leadership roles within teams. The authors propose a collaborative definition of clinical leadership based on the results of this study: a shared responsibility that involves facilitation of dialog; the integration of perspectives and expertise; and collaborative planning for the purpose of exceptional patient care.

Details

Leadership in Health Services, vol. 31 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

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