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PubMed2004

Competency identification and modeling in healthcare leadership.

In line with the current interest in leadership development across many industries today, a number of competency-based educational programming initiatives have been launched in professional education. As well, the National Summit on the Future of Education and Practice in Health Management and Policy in 2001 called for the documentation of learning outcomes for continual educational improvement in health management and policy. The National Center for Healthcare Leadership (NCHL) subsequently launched a comprehensive, multi-stage process for identifying the competencies salient to distinguishing outstanding leadership performance in health management. This article describes the plan and the processes associated with NCHL's specification of a preliminary model of core competencies for leadership in health management, as well as the continued methods for refinement and validation of the model with both educators and practitioners in the field. The initial version of the NCHL Competency Model has facilitated field-wide dialogue regarding outcomes-based learning and assessment for both educational and professional development program planning. Subsequent development of the model will continue to stimulate open exchanges regarding pedagogical practice, as well as facilitate the design of leadership assessments for individuals, programs, organizations, and the field at large.

Competency-Based Education↗
PubMedDate not supplied

Program director satisfaction with leadership skills.

CONTEXT: Educators in radiologic technology help students mature into health care professionals; however, not all educators receive formal training in education. The majority of radiologic technology educators train first as practitioners and later become educators. OBJECTIVE: Identify areas for professional development and effective methods to learn leadership skills. METHODS: Radiologic technology program directors from Joint Review Committee on Education in Radiologic Technology (JRCERT) accredited programs were surveyed and interviewed to determine their level of satisfaction with their leadership skills. RESULTS: Results indicate program directors are satisfied with most of their leadership skills. Budget and resources, conflict resolution and communication were identified as areas for improvement. Program directors identified workshops and lectures as their preferred method of learning leadership skills. SUMMARY: Program directors need to use a variety of skills for the successful operation of their programs. Even though results from this study indicate that radiologic technology program directors were satisfied overall with their leadership skills, there were areas that could use improvement.

Administrative Personnel↗
PubMed1988

[Is it necessary to promote leadership in nursing for the advancement of teaching-inservice programs?].

The author provides some material for reflection on the issue of developing leadership in the health sector; in this case, in the specific area of nursing. Within this context, her proposition is that leadership is a process which comprises different levels of development, having an individual and collective dimension as well as conceptual, methodological and operational aspects. She proposes the adoption of policies which would point to the need of encouraging nurses to play an effective role in the processes that lead to the making of important decisions in the sector; she advocates that nurses participate in drawing up national health plans and in the management of community health services. It is pointed out that "the power of nursing as a profession lies in its practice"; this entails the need for basic changes, both in services and in the area of education, if the leadership position that has emerged in several countries during the last decade is to be strengthened. Lastly, the article suggests that in order to strengthen nurses' potential leadership and managerial skills, they should begin to receive leadership training at the undergraduate level, thus awakening in the students the greatest possible interest in the scientific method and in the epidemiological method for the analysis of health and related problems.

Decision Making↗
PubMed1994

Leadership: a nursing perspective.

The Task Force for Collaborative Nursing Education Models was a successful collaboration involving female nurse administrators. The nature of leadership in the Task Force was studied as part of a larger research project examining the process of collaboration that evolved over the 40 months of its existence (October 1987-February 1991). A retrospective qualitative case study approach was used. Data were collected from an analysis of documents that had been generated by the group, and from 36 semi-structured interviews with the 28 Task Force members. Findings and conclusions about leadership were validated during a final group interview with eight selected members. Findings of this study support the following contentions: women lead differently than men, and leadership is a collective process rather than a specialized role assumed by a single person who influences the work of other group members. Leadership was also found to rotate among group members according to the issue being considered and the expertise of those present. These findings did not support the positivist theories of leadership prevalent in current nursing management text books.

Female↗
PubMed1994

The effect of self-esteem, family structure, locus of control, and career goals on adolescent leadership behavior.

Since leadership in formal and informal high school activities is one possible indicator of positive social adjustment among adolescents, it is worthwhile to better understand why certain adolescents become leaders and others do not. This study was designed to investigate the relationship between leadership behavior (dependent variable) and self-esteem, locus of control, family structure, and career goals. The participants were divided into a leadership group (n = 79) and a nonleadership (comparison) group (n = 124). Adolescents in the leadership group tended to be higher in internal locus of control, to live in a two-parent family structure, and to have more prestigious career goals. There was no significant difference between the two groups in level of self-esteem, although those in the leadership group with higher self-esteem also tended to have higher career goals.

Adolescent↗
PubMed1994

Organizational leadership: meeting the challenge.

Leadership can be learned. Knowledge of leadership theories can serve as basis for developing skills and techniques. Style, trait, and transformational leadership can be applied in both health care institutions and professional associations. Organizational leadership is challenging, but those challenges can help individual nurses grow in the leadership skills that will continue to be demanded in the ever changing healthcare arena.

Humans↗
PubMedDate not supplied

How a better understanding of transformational leadership can help improve your practice as a nurse administrator.

Nursing administrators of today find themselves practising in an environment of permanent whitewater--an environment of chaotic change. Not only is the environment changing, so too are our employees: their needs, motives and priorities are vastly different than those we knew 20 years ago. The challenges of permanent whitewater cannot be overcome without effective leadership. Theorists agree that most North American organizations are currently overmanaged and underled. Certainly the leadership record of Canadian health care institutions has not been impressive. This paper will examine a selected set of concepts which the author believes are essential for nursing administrators who wish to provide real leadership to their departments and organizations: transformational (as compared to transactional) leadership; feminine (as compared to masculine) leadership; and empowerment. The literature review draws out both theory and practical applications.

Female↗
PubMed1997

Leadership and organizational skills in academic medicine.

BACKGROUND AND OBJECTIVES: The complex and unique challenge of academic medicine requires that faculty possess both organizational and leadership skills. This article presents a framework of leadership and organizational skills in family medicine. METHODS: We conducted a focused review of the literature, of presentations at national primary care meetings, and of the curricula of several national faculty development fellowship programs to identify the current emphases, strategies, and outcomes regarding organizational and leadership development activities for academic physicians. RESULTS: We identified three types of organizational and leadership development strategies and programs, including isolated faculty development workshops at national meetings, longitudinal faculty development fellowship programs, and organizational change efforts within an academic department or residency training program. Indicators that these efforts are successful have primarily been reported in the context of career satisfaction, retention in academic medicine, and attainment of administrative roles or higher academic rank among faculty who have participated. CONCLUSIONS: Organizational and leadership development is occurring in the context of both individual and organizational initiatives. We propose a cycle-of-learning framework that provides one model for development of these essential skills.

Curriculum↗
PubMedDate not supplied

Impact of leadership development on competencies.

Managed care has changed role expectations for front-line nurses. Roles now include outcome management, team coordination, and guardianship of patient's continuity along the continuum. Organizations are investing in leadership development training for non-management nurses in hopes that such competencies will enhance their value-added competitive edge, but data are needed to validate the value of such training to the organization. Authors report the self-perceived competencies in leadership understanding and ability (in a study of 87 participants) before and after leadership development training that focused on: planned change, communication, conflict, group dynamics, systems theory, and oppressed group behavior. Significant increases were reported in both understanding and ability to perform stated competencies both immediately after and 3 months after 3 days of training. Self-perceptions of both leadership understanding and ability before leadership training were higher for those with advanced degrees and/or those in management positions. However, some of these differences became insignificant after training.

Clinical Competence↗
PubMed1997

[Study of the relation between transformational leadership of the head nurse and supplementary efforts of nursing personnel].

The present study proposes to show that the ethos of the Head Nursing staff is related to the practice of transformational leadership, and to additional efforts displayed by the treatment staff. Using a sampling of 57 nurses, it was established that transformational leadership presented a positive influence on additional efforts which were superior to that produced by transactional leadership. Contrary to transactional leadership, transformational leadership was shown to exert a positive effect on the ethos of the leader who in turn, had a positive influence on the extra care supplied by the nursing staff.

Humans↗
PubMed1997

[The surgical nurse: his/her leadership of auxiliary nursing personnel].

This investigation as carried out in order to promote follow-up in the studies concerning nurse's leadership in the hospital context. Emphasys is given to the nurses that works in surgical ward unities. As a theoretical framework, authors utilized the model of leadership proposed by Hersey and Blanchard, named Situational Leadership. The objective was to analyze the correspondence of opinion between nurses and nursing auxiliary personnel about the leadership style of nurse should adopt in accordance with the maturity level of an element of the auxiliary personnel based on six categories of activities that were studied. Authors found out that nurses should adopt the styles of participant leadership, such as E3 (participating) and/or E4 (delegating).

Adult↗
PubMed1998

[Characteristics of the leadership of health center coordinators in the autonomous community of Murcia].

OBJECTIVE: To describe the style and effectiveness (adaptability) of the leadership of coordinators of an autonomous community according to the model of leadership on the ground, analysing its relationship with the work environment. DESIGN: Observational crossover study. SETTING: All the functioning teams in this community. PARTICIPANTS: Medical and nursing coordinators. MEASUREMENTS AND MAIN RESULTS: Hersey and Blanchard's questionnaire on leadership on the ground was employed. This identifies 1) the predominant style (scoring for style 0-12). On the approach of the coordinator to personal relationships and/or task development, it identifies 4 points: direction, persuasion, participation, delegation. 2) Adaptability of the manager (ranging from +24 to -24), based on that the best choice between different options depends on the maturity of the group. To contrast work environment and leadership, a validated questionnaire, adapted to our milieu, was used. Overall reply rate (51 coordinators) was 89.4%. Analysis of styles was: persuasive 5.05 points (SD = 1.25), participatory 4.74 (SD 1.76), directive 1.2 (SD 1.11) and delegating 0.34 (SD 0.68). Adaptability scored 8.38 points (SD = 4.67), and was greater for the nursing coordinators (p < 0.002) without differences for type, place or teaching qualifications. The work environment, both overall and by dimensions, correlated with adaptability, although no relationship was found with leaders' styles. CONCLUSIONS: Leadership adaptability was quite high and greater in nursing. The most prevalent styles were the persuasive and the participatory, more efficacious in teams of average maturity. Theoretical effectiveness was positively related to a better work environment.

Cross-Over Studies↗
PubMed2001

Student leadership and activism for social change in the US.

As the US health-care system continues on a path toward greater patient and provider dissatisfaction and decreasing access to primary health services, there is a growing need for leadership among tomorrow's health professionals. Students of today must acquire the skills to lead the United States toward solutions that will offer universal access and eliminate disparities. As examined in the US, there are two main modes for students to learn these meaningful skills; curriculum- and institution-based leadership development and organization-based leadership development. In this paper we review these two methods from an American perspective and discuss ways that educational institutions can support student leadership development. In addition, we address ways in which non-governmental organizations can provide opportunities to foster student leadership. Lastly, we offer recommendations for US policy change at institutional, local, state, and national levels to help achieve the goals stated above.

Journal Article↗
PubMed2005

Leadership trends in academic pediatric departments.

OBJECTIVE: To examine recent turnover trends among chairs of academic pediatric departments. METHODS: Membership data for the 150 institutions represented by the Association of Medical School Pediatric Department Chairs in the United States, Canada, and Puerto Rico were reviewed for the time period of 1993-2003. RESULTS: From 1993 to 2003, 278 individuals (250 men and 28 women) held the position of chair. The mean time of service was 5.58 +/- 3.2 years (median: 5 years). Twenty-nine individuals served continuously as chairs during the 11-year period. Seventy-two individuals served as interim chairs. Twenty-eight women were appointed either chairs or interim chairs during the 11 years. The number of female chairs decreased from 13 in 1993 to 11 in 2003. Female chairs were in office 3.42 +/- 2.72 years. A total of 123 departments had a change in leadership, with a mean annual turnover rate of 17% (range: 4.6-24%). Three departments had 5 different leaders as either interim chair or chair and 6 departments had 4 different leaders during this time period. Neonatology was the most common subspecialty represented by recent pediatric chairs, although nephrology was the subspecialty with the greatest proportional representation. CONCLUSIONS: Departments of pediatrics have high turnover of leadership. Women, in particular, serve for relatively short periods and appear to be under-represented within the leadership of pediatrics. Efforts should be made to ascertain personal qualities that allow sustained leadership and to attract more women into leadership positions.

Academic Medical Centers↗
PubMed2002

The power of servant leadership to transform health care organizations for the 21st-century economy.

Physician leadership is emerging as a vital component in transforming the nation's health care industry. Because few physicians have been introduced to the large body of literature on leadership and organizations, we herein provide a concise review, as this literature relates to competitive health care organizations and the leaders who serve them. Although the US health care industry has transitioned to a dynamic market economy governed by a wide range of internal and external forces, health care organizations continue to be dominated by leaders who practice an outmoded transactional style of leadership and by organizational hierarchies that are inherently stagnant. In contrast, outside the health care sector, service industries have repeatedly demonstrated that transformational, situational, and servant leadership styles are most successful in energizing human resources within organizations. This optimization of intellectual capital is further enhanced by transforming organizations into adaptable learning organizations where traditional institutional hierarchies are flattened and efforts to evoke change are typically team driven and mission oriented.

Delivery of Health Care↗
PubMed1995

The sexual division of leadership in volunteer emergency medical service squads.

This article reports on theoretical and empirical research that explored the hypothesis that there is a sexual division of leadership in volunteer emergency medical service (EMS) squads. This hypothesis was tested against survey data obtained from 216 current members of nine upstate New York volunteer EMS squads. Despite several mitigating characteristics of these organizations, and despite the lack of supporting statistical evidence at the aggregate level of officership, the research found statistically significant confirmation of sex bias in officer selection when leadership was disaggregated into line and staff officer positions. Medical qualifications and length of EMS squad membership were also included in the model as determinants of leadership experience. These results are discussed relative to the question of the sexual division of leadership in the overarching nonprofit and voluntary sector of the U.S. economy.

Data Collection↗
PubMed2006

[Leadership strategies--the Bible as a guide to management in the health care system].

Management and leadership are an integral part of any organisation, to optimise procedures and increase efficiency. Aims, ideals and structures first need to be defined for tasks to be carried out successfully, particularly in difficult times. A good example for the way communities can effectively and with conviction pass on their values and standpoints from generation to generation, grow in strength and also influence their surroundings is provided by religion. This paper focuses leadership provided by charismatic personalities within the Jewish and Christian religions. Monasteries have run hospitals without governmental support ever since the Middle Ages. Leadership within today's health care system calls for a variety of strategies in the different phases of development. In times of limited resources and multifarious societies, leadership implies both a scientific as well as an ethical challenge.

Austria↗
PubMed1986

Critical leadership.

Leadership is the process of motivating others to think or act in a specific manner. In critical clinical situations leadership is often lacking. This results from a failure both to understand the leadership role and the elements necessary to carry out this role. The basic elements and models of leadership are described. Eleven basic principles needed to understand and teach medical crisis management are developed.

Education, Medical↗