Michael D Fischer
Professor of Organisational Behaviour and Leadership. A business school social scientist and group analyst, my research has a strong empirical focus on the practice-level microsociology of organisational change in research-intensive settings, especially in healthcare. I specialise in ethnographic and comparative case studies, analysing intersubjective relations, emotions and politics, and their potential to influence and mobilise ideas, material practices, and organisational change.
Phone: +61 3 8844 4886
Address: Fischer Consults, Suite 245/139 Cardigan St,
Carlton, Melbourne, Victoria 3053
https://fischerconsults.com/
Phone: +61 3 8844 4886
Address: Fischer Consults, Suite 245/139 Cardigan St,
Carlton, Melbourne, Victoria 3053
https://fischerconsults.com/
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A number of programmes and practices have been suggested to provide psychological first aid to second victims after an error has occurred.3 Little attention, however, has focused on how medical training can prepare doctors for the inevitability of error, and thus help protect them from potentially severe emotional consequences in the future. The WHO has developed the Patient Safety Curriculum Guide for Medical Schools, which includes training on understanding and learning from mistakes.4 In addition, the case has been made for error management training in which students are encouraged to experience error in safe settings, such as simulation exercises.5 ,6 While these approaches are promising, a more broad-spectrum psychological intervention aimed at changing how students perceive mistakes and cope with setbacks could be advantageous. Research from social psychology suggests a promising intervention that could help assist students in being resilient when encountering difficulties and setbacks.
Our review is structured thematically and led by the five stated objectives of the commissioned work namely:
1. To identify promising leadership interventions applied in UK higher education that have a reliable evidence base and/or are theoretically informed.
2. To provide clarification on the conceptual and theoretical lenses applied to leadership and leadership development in the higher education sector and how these have developed over time, with reference to developments in related knowledge intensive sectors and settings.
3. To outline a conceptual framework for thinking about leadership development in higher education at different organisational levels and across institutional contexts.
4. To identify any metrics and/or tools currently used to evaluate the effectiveness and impact of leadership interventions, which could assist the Leadership Foundation in generating its own leadership development metrics in future.
5. To identify gaps in the literature on leadership and leadership development in higher education and make suggestions for future research.
The team leading this review have many years’ experience researching different aspects of leadership in public sector organisations, mainly but not exclusively in complex healthcare settings. Some of the team are also involved in designing and delivering leadership development activities more broadly.
We adopted a rigorous review methodology that drew on a diverse range of information sources - such as leadership texts – as well as previous literature reviews that had adopted looser approaches. Our approach was pragmatic and question driven, with due attention paid to the quality of the literature and appropriate inclusion and exclusion criteria.
In summary, the current literature on leadership development approaches in UK higher education appears small scale, fragmented and often theoretically weak, with many different models, approaches and methods co-existing with little clear pattern of consensus formation. The report highlights a paradox. The higher education sector is a “knowledge industry” but has a relatively poor record of investing in studying its own effectiveness.
One problem we identified was that leadership development was often seen as synonymous with leader development. We suggest the need to develop a broader conceptualisation of what leadership and leadership development is in higher education settings that moves beyond individual leaders and which considers leadership processes in higher education settings in more distributed, relational and contextual terms.
It is difficult to measure a leadership development programme impact if you are not clear about the definition of the nature of leadership development processes in higher education settings in the first place. In the studies we reviewed on leadership evaluation and metrics there appears to be no boundary that can be easily drawn around possible fields of measurement of higher education development programmes. Studies varied according to whether they are measuring the degree of changes in individuals, changes in the effectiveness of groups to which the leaders belong or wider forms of organisational change.
Published by the Leadership Foundation for Higher Education, London
http://www.lfhe.ac.uk/en/research-resources/publications/index.cfm/S5-03
Design/methodology/approach – The research included interviews with GPs, psychiatrists and others involved in medical regulation, representing patients and professionals. A qualitative narrative analysis of the interviews was then conducted.
Findings – Narratives suggest rising levels of complaints, legalisation and blame within the National Health Service (NHS). Three key themes emerge. First, doctors feel “guilty until proven innocent” within increasingly legalised regulatory systems and are consequently practising more defensively. Second, regulation is described as providing “spectacular transparency”, driven by political responses to high profile scandals rather than its effects in practice, which can be seen as a social defence. Finally, it is suggested that a “blame business” is driving this form of transparency, in which self-interested regulators, the media, lawyers, and even some patient organisations are fuelling transparency in a wider culture of blame.
Research limitations/implications – A relatively small number of people were interviewed, so further research testing the findings would be useful.
Practical implications – Transparency has some perverse effects on doctors' practice.
Social implications – Rising levels of blame has perverse consequences for patient care, as doctors are practicing more defensively as a result, as well as significant financial implications for NHS funding.
Originality/value – Transparent forms of regulation are assumed to be beneficial and yet little research has examined its effects in practice. In this paper we highlight a number of perverse effects of transparency in practice."
A number of programmes and practices have been suggested to provide psychological first aid to second victims after an error has occurred.3 Little attention, however, has focused on how medical training can prepare doctors for the inevitability of error, and thus help protect them from potentially severe emotional consequences in the future. The WHO has developed the Patient Safety Curriculum Guide for Medical Schools, which includes training on understanding and learning from mistakes.4 In addition, the case has been made for error management training in which students are encouraged to experience error in safe settings, such as simulation exercises.5 ,6 While these approaches are promising, a more broad-spectrum psychological intervention aimed at changing how students perceive mistakes and cope with setbacks could be advantageous. Research from social psychology suggests a promising intervention that could help assist students in being resilient when encountering difficulties and setbacks.
Our review is structured thematically and led by the five stated objectives of the commissioned work namely:
1. To identify promising leadership interventions applied in UK higher education that have a reliable evidence base and/or are theoretically informed.
2. To provide clarification on the conceptual and theoretical lenses applied to leadership and leadership development in the higher education sector and how these have developed over time, with reference to developments in related knowledge intensive sectors and settings.
3. To outline a conceptual framework for thinking about leadership development in higher education at different organisational levels and across institutional contexts.
4. To identify any metrics and/or tools currently used to evaluate the effectiveness and impact of leadership interventions, which could assist the Leadership Foundation in generating its own leadership development metrics in future.
5. To identify gaps in the literature on leadership and leadership development in higher education and make suggestions for future research.
The team leading this review have many years’ experience researching different aspects of leadership in public sector organisations, mainly but not exclusively in complex healthcare settings. Some of the team are also involved in designing and delivering leadership development activities more broadly.
We adopted a rigorous review methodology that drew on a diverse range of information sources - such as leadership texts – as well as previous literature reviews that had adopted looser approaches. Our approach was pragmatic and question driven, with due attention paid to the quality of the literature and appropriate inclusion and exclusion criteria.
In summary, the current literature on leadership development approaches in UK higher education appears small scale, fragmented and often theoretically weak, with many different models, approaches and methods co-existing with little clear pattern of consensus formation. The report highlights a paradox. The higher education sector is a “knowledge industry” but has a relatively poor record of investing in studying its own effectiveness.
One problem we identified was that leadership development was often seen as synonymous with leader development. We suggest the need to develop a broader conceptualisation of what leadership and leadership development is in higher education settings that moves beyond individual leaders and which considers leadership processes in higher education settings in more distributed, relational and contextual terms.
It is difficult to measure a leadership development programme impact if you are not clear about the definition of the nature of leadership development processes in higher education settings in the first place. In the studies we reviewed on leadership evaluation and metrics there appears to be no boundary that can be easily drawn around possible fields of measurement of higher education development programmes. Studies varied according to whether they are measuring the degree of changes in individuals, changes in the effectiveness of groups to which the leaders belong or wider forms of organisational change.
Published by the Leadership Foundation for Higher Education, London
http://www.lfhe.ac.uk/en/research-resources/publications/index.cfm/S5-03
Design/methodology/approach – The research included interviews with GPs, psychiatrists and others involved in medical regulation, representing patients and professionals. A qualitative narrative analysis of the interviews was then conducted.
Findings – Narratives suggest rising levels of complaints, legalisation and blame within the National Health Service (NHS). Three key themes emerge. First, doctors feel “guilty until proven innocent” within increasingly legalised regulatory systems and are consequently practising more defensively. Second, regulation is described as providing “spectacular transparency”, driven by political responses to high profile scandals rather than its effects in practice, which can be seen as a social defence. Finally, it is suggested that a “blame business” is driving this form of transparency, in which self-interested regulators, the media, lawyers, and even some patient organisations are fuelling transparency in a wider culture of blame.
Research limitations/implications – A relatively small number of people were interviewed, so further research testing the findings would be useful.
Practical implications – Transparency has some perverse effects on doctors' practice.
Social implications – Rising levels of blame has perverse consequences for patient care, as doctors are practicing more defensively as a result, as well as significant financial implications for NHS funding.
Originality/value – Transparent forms of regulation are assumed to be beneficial and yet little research has examined its effects in practice. In this paper we highlight a number of perverse effects of transparency in practice."
The research outlined in this volume shows that very few evidence-based management texts are apparent within health care organizations, despite the influence of certain knowledge producers, such as national agencies, think tanks, management consultancies, and business schools in the industry. Bringing together the often disconnected academic literature on management knowledge and public policy, the volume addresses the ways in which preferred management knowledges and texts in these publicly funded settings are sensitive to the macro level political economy of public services reform, offering an empirically grounded critique of the evidence-based management movement.