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Article
Publication date: 25 April 2018

Graham Dickson and John Van Aerde

The purpose of this paper is to provide a case study demonstrating that LEADS in a Caring Environment Capabilities Framework in Canada can assist physicians to be partners in…

Abstract

Purpose

The purpose of this paper is to provide a case study demonstrating that LEADS in a Caring Environment Capabilities Framework in Canada can assist physicians to be partners in leading health reform.

Design/methodology/approach

A descriptive case-based approach was followed, relying on existing documents, research papers and peer-reviewed articles, to substantiate the effect of LEADS on physician leadership in Canada.

Findings

The Canadian LEADS framework enables physicians to lead by providing them with access to best practices of leadership, acting as an antidote to fragmented leadership practice, setting standards for development and accountability and providing opportunities for efficient and effective system-wide leadership development and change.

Research limitations/implications

A formal systematic review of the literature was not conducted. Findings can only be generalized to other cases if the reader sees contextual similarities between the present study context and the other case’s context.

Practical implications

This case demonstrates that national leadership frameworks have a role in facilitating physician leadership. Other national jurisdictions may wish to explore the Canadian case to determine how to use a common leadership language to engage physicians in health reform.

Social implications

Leadership is a key component of health reform. A common language and set of standards (LEADS) that can engage physicians will benefit patients and citizens in Canada.

Originality/value

This national case study shows how a nationally endorsed leadership framework such as LEADS can facilitate better physician leadership for health reform.

Details

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

Keywords

Article
Publication date: 6 December 2022

Mehri Karimi-Dehkordi, Graham Dickson, Kelly Grimes, Suzanne Schell and Ivy Bourgeault

This paper aims to explore users' perceptions of whether the Leadership Development Impact Assessment (LDI) Toolkit is valid, reliable, simple to use and cost-effective as a guide…

Abstract

Purpose

This paper aims to explore users' perceptions of whether the Leadership Development Impact Assessment (LDI) Toolkit is valid, reliable, simple to use and cost-effective as a guide to its quality improvement.

Design/methodology/approach

The Canadian Health Leadership Network codesigned and codeveloped the LDI Toolkit as a theory-driven and evidence-informed resource that aims to assist health-care organizational development practitioners to evaluate various programs at five levels of impact: reaction, learning, application, impact and return on investment (ROI) and intangible benefits. A comparative evaluative case study was conducted using online questionnaires and semistructured telephone interviews with three health organizations where robust leadership development programs were in place. A total of seven leadership consultants and specialists participated from three Canadian provinces. Data were analyzed sequentially in two stages involving descriptive statistical analysis augmented with a qualitative content analysis of key themes.

Findings

Users perceived the toolkit as cost-effective in terms of direct costs, indirect costs and intangibles; they found it easy-to-use in terms of clarity, logic and structure, ease of navigation with a coherent layout; and they assessed the sources of the evidence-informed tools and guides as appropriate. Users rated the toolkit highly on their perceptions of its validity and reliability. The analysis also informed the refinement of the toolkit.

Originality/value

The refined LDI Toolkit is a comprehensive online collection of various tools to support health organizations to evaluate the leadership development investments effectively and efficiently at five impact levels including ROI.

Details

Leadership in Health Services, vol. 36 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 9 November 2021

Ming-Ka Chan, Graham Dickson, David A. Keegan, Jamiu O. Busari, Anne Matlow and John Van Aerde

The purpose of this paper was to determine the complementarity between the Canadian Medical Education Directions for Specialists (CanMEDS) physician competency and LEADS…

Abstract

Purpose

The purpose of this paper was to determine the complementarity between the Canadian Medical Education Directions for Specialists (CanMEDS) physician competency and LEADS leadership capability frameworks from three perspectives: epistemological, philosophical and pragmatic. Based on those findings, the authors propose how the frameworks collectively layout pathways of lifelong learning for physician leadership.

Design/methodology/approach

Using a qualitative approach combining critical discourse analysis with a modified Delphi, the authors examined “How complementary the CanMEDS and LEADS frameworks are in guiding physician leadership development and practice” with the following sub-questions: What are the similarities and differences between CanMEDS and LEADS from: An epistemological and philosophical perspective? The perspective of guiding physician leadership training and practice? How can CanMEDS and LEADS guide physician leadership development from medical school to retirement?

Findings

Similarities and differences exist between the two frameworks from philosophical and epistemological perspectives with significant complementarity. Both frameworks are founded on a caring ethos and value physician leadership – CanMEDS (for physicians) and LEADS (physicians as one of many professions) define leadership similarly. The frameworks share beliefs in the function of leadership, embrace a belief in distributed leadership, and although having some philosophical differences, have a shared purpose (preparing for changing health systems). Practically, the frameworks are mutually supportive, addressing leadership action in different contexts and where there is overlap, complement one another in intent and purpose.

Originality/value

To the best of the authors’ knowledge, this is the first paper to map the CanMEDS (physician competency) and LEADS (leadership capabilities) frameworks. By determining the complementarity between the two, synergies can be used to influence physician leadership capacity needed for today and the future.

Details

Leadership in Health Services, vol. 35 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Content available
Article
Publication date: 17 May 2018

Graham Dickson and Karen Owen

369

Abstract

Details

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

Article
Publication date: 15 November 2017

Maya M. Jeyaraman, Sheikh Muhammad Zeeshan Qadar, Aleksandra Wierzbowski, Farnaz Farshidfar, Justin Lys, Graham Dickson, Kelly Grimes, Leah A. Phillips, Jonathan I. Mitchell, John Van Aerde, Dave Johnson, Frank Krupka, Ryan Zarychanski and Ahmed M. Abou-Setta

Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of…

2670

Abstract

Purpose

Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments.

Design/methodology/approach

The authors performed a scoping review using the Arksey and O’Malley framework, searching eight databases from 2006 through June 2016.

Findings

Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail.

Originality/value

This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations.

Details

Leadership in Health Services, vol. 31 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 15 December 2021

Elizabeth Hartney, Ellen Melis, Deanne Taylor, Graham Dickson, Bill Tholl, Kelly Grimes, Ming-Ka Chan, John Van Aerde and Tanya Horsley

This first phase of a three-phase action research project aims to define leadership practices that should be used during and after the pandemic to re-imagine and rebuild the…

Abstract

Purpose

This first phase of a three-phase action research project aims to define leadership practices that should be used during and after the pandemic to re-imagine and rebuild the health and social care system. Specifically, the objectives were to determine what effective leadership practices Canadian health leaders have used through the first wave of the COVID-19 pandemic, to explore how these differ from pre-crisis practices; and to identify what leadership practices might be leveraged to create the desired health and care systems of the future.

Design/methodology/approach

The authors used an action research methodology. In the first phase, reported here, the authors conducted one-on-one, virtual interviews with 18 health leaders from across Canada and across leadership roles. Data were analyzed using grounded theory methodology.

Findings

Five key practices emerged from the data, within the core dimension of disrupting entrenched structures and leadership practices. These were, namely, responding to more complex emotions in self and others. Future practice identified to create more psychologically supportive workplaces. Agile and adaptive leadership. Future practice should allow leaders to move systemic change forward more quickly. Integrating diverse perspectives, within and across organizations, leveling hierarchies through bringing together a variety of perspectives in the decision-making process and engaging people more broadly in the co-creation of strategies. Applying existing leadership capabilities and experience. Future practice should develop and expand mentorship to support early career leadership. Communication was increased to build credibility and trust in response to changing and often contradictory emerging evidence and messaging. Future practice should increase communication.

Research limitations/implications

The project was limited to health leaders in Canada and did not represent all provinces/territories. Participants were recruited through the leadership networks, while diverse, were not demographically representative. All interviews were conducted in English; in the second phase of the study, the authors will recruit a larger and more diverse sample and conduct interviews in both English and French. As the interviews took place during the early stages of the pandemic, it may be that health leaders’ views of what may be required to re-define future health systems may change as the crisis shifts over time.

Practical implications

The sponsoring organization of this research – the Canadian Health Leadership Network and each of its individual member partners – will mobilize knowledge from this research, and subsequent phases, to inform processes for leadership development and, succession planning across, the Canadian health system, particularly those attributes unique to a context of crisis management but also necessary in post-crisis recovery.

Social implications

This research has shown that there is an immediate need to develop innovative and influential leadership action – commensurate with its findings – to supporting the evolution of the Canadian health system, the emotional well-being of the health-care workforce, the mental health of the population and challenges inherent in structural inequities across health and health care that discriminate against certain populations.

Originality/value

An interdisciplinary group of health researchers and decision-makers from across Canada who came together rapidly to examine leadership practices during COVID-19’s first wave using action research study design.

Details

Leadership in Health Services, vol. 35 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 11 April 2018

Sandra Turner, Ming-Ka Chan, Judy McKimm, Graham Dickson and Timothy Shaw

Doctors play a central role in leading improvements to healthcare systems. Leadership knowledge and skills are not inherent, however, and need to be learned. General frameworks…

Abstract

Purpose

Doctors play a central role in leading improvements to healthcare systems. Leadership knowledge and skills are not inherent, however, and need to be learned. General frameworks for medical leadership guide curriculum development in this area. Explicit discipline-linked competency sets and programmes provide context for learning and likely enhance specialty trainees’ capability for leadership at all levels. The aim of this review was to summarise the scholarly literature available around medical specialty-specific competency-based curricula for leadership in the post-graduate training space.

Design/methodology/approach

A systematic literature search method was applied using the Medline, EMBASE and ERIC (education) online databases. Documents were reviewed for a complete match to the research question. Partial matches to the study topic were noted for comparison.

Findings

In this study, 39 articles were retrieved in full text for detailed examination, of which 32 did not comply with the full inclusion criteria. Seven articles defining discipline-linked competencies/curricula specific to medical leadership training were identified. These related to the areas of emergency medicine, general practice, maternal and child health, obstetrics and gynaecology, pathology, radiology and radiation oncology. Leadership interventions were critiqued in relation to key features of their design, development and content, with reference to modern leadership concepts.

Practical implications

There is limited discipline-specific guidance for the learning and teaching of leadership within medical specialty training programmes. The competency sets identified through this review may aid the development of learning interventions and tools for other medical disciplines.

Originality/value

The findings of this study provide a baseline for the further development, implementation and evaluation work required to embed leadership learning across all medical specialty training programmes.

Details

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

Keywords

Content available
Article
Publication date: 4 July 2016

Graham Dickson and Karen Owen

400

Abstract

Details

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

Article
Publication date: 4 July 2016

Anita J. Snell, Graham Dickson, Debrah Wirtzfeld and John Van Aerde

This is the first study to compile statistical data to describe the functions and responsibilities of physicians in formal and informal leadership roles in the Canadian health…

Abstract

Purpose

This is the first study to compile statistical data to describe the functions and responsibilities of physicians in formal and informal leadership roles in the Canadian health system. This mixed-methods research study offers baseline data relative to this purpose, and also describes physician leaders’ views on fundamental aspects of their leadership responsibility.

Design/methodology/approach

A survey with both quantitative and qualitative fields yielded 689 valid responses from physician leaders. Data from the survey were utilized in the development of a semi-structured interview guide; 15 physician leaders were interviewed.

Findings

A profile of Canadian physician leadership has been compiled, including demographics; an outline of roles, responsibilities, time commitments and related compensation; and personal factors that support, engage and deter physicians when considering taking on leadership roles. The role of health-care organizations in encouraging and supporting physician leadership is explicated.

Practical implications

The baseline data on Canadian physician leaders create the opportunity to determine potential steps for improving the state of physician leadership in Canada; and health-care organizations are provided with a wealth of information on how to encourage and support physician leaders. Using the data as a benchmark, comparisons can also be made with physician leadership as practiced in other nations.

Originality/value

There are no other research studies available that provide the depth and breadth of detail on Canadian physician leadership, and the embedded recommendations to health-care organizations are informed by this in-depth knowledge.

Details

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

Keywords

Content available
Article
Publication date: 4 October 2011

Graham Dickson and Donald J. Philippon

1052

Abstract

Details

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

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