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Transcript of Cppd leadership
Attaining clinical leadership skills through continuing personal and
professional development (CPPD)
Dr Charu ChopraSpecialist Registrar Clinical Immunology
Objectives
What do we mean by clinical leadership?
Can leadership skills be learned (“innate vs acquired”)?
Medical Leadership Competency Framework (July 2010)
What are the barriers to good clinical leadership?
How can CPPD help overcome these?
What is Clinical Leadership?What is Clinical Leadership?What is Clinical Leadership?What is Clinical Leadership?
Leadership is about setting direction, Leadership is about setting direction,
influencing others, managing changeinfluencing others, managing change
Northouse “A process whereby an Northouse “A process whereby an
individual influences a group of individuals individual influences a group of individuals
to achieve a common goal”to achieve a common goal”1. PROCESS 2. 1. PROCESS 2.
INFLUENCE INFLUENCE
3. GROUP CONTEXT 3. GROUP CONTEXT
4. GOAL 4. GOAL
ATTAINMENTATTAINMENT
The roles of a clinical leader
Leading on call/ take
Leading ward rounds
Facilitating clinical decision making as part of a team (multi-disciplinary teams, staff meetings)
Negotiating and persuading
Dealing with complaints
Training/ supervising
Leadership skills not just important medical/ clinical directors but are relevant for many health care professionals
Setting the scene...
2007: Ara Darzi appointed health minister: A High Quality Workforce:NHS next stage review published. Darzi’s vision - quality at the heart of health care provision. “Engaging clinicians to implement change”
Clinician as practitioner, partner and leader
New emphasis on clinical leadership
Good clinical leaders and managers are central in instrumenting effective changes/ developments in NHS organisation.
Similar leadership emphasis seen with other health care providers eg Kaiser Permanante in USA.
Is “leadership” more about having certain “traits” (innate) or can certain “acquired” competencies constitute good clinical leadership?
Innate - you’ve either got it or you haven’t! Early 20th Century emphasis on charisma, intelligence, energy and dominance
Literature reviews in 1970’s - no correlation between personality traits and leaders vs non-leaders
2002: weak positive correlation between successful leaders and extraversion, conscientiousness and openness to experience
weak negative correlation with neuroticism
Kouzes and Posner: assert that leadership is an observable, learnable set of practices.
Personality traits, behaviour and leadership
Publication of UK-wide Medical Leadership Competency Framework by the Academy of Medical Royal Colleges and with the NHS Institute for Innovation and Improvement.
Shared leadership: “A dynamic, interactive influencing process among individuals in groups in which the objective is to lead one another to the achievement of group goals.”
Applicable to all medical undergraduates, post-graduates and Consultants
Medical Leadership Competency FrameworkEnhancing engagement in medical leadership,
2010
Demonstrating personal qualities: developing self awareness, managing yourself, CPD, acting with integrity
Working with others: developing networks, building and maintaining relationships, encouraging contribution, working within teams
Managing services: planning, managing resources, managing people, managing performance
Improving services: ensuring patient safety, critically evaluating, encouraging improvement and innovation, facilitating transformation
Setting direction: Identifying the contexts for change, applying knowledge and evidence, making decisions, evaluating impact
Medical Leadership Competency FrameworkEnhancing engagement in medical leadership,
2010
Continuing personal
and professional development
“This way..... I’ll show you how to lead....” How can “leadership” be taught and learned?
CPPD and leadership
MCLF is a useful “framework” to encourage debate about learning and what leadership is.
How do we implement this form of learning from undergraduate to postgraduate years and beyond? How do we assess it?
E-learning: www.e-lfh.org.uk
Reading/tutorials about leadership, insight into own practice, reflection, scenarios, videos
360 degree feedback, peer learning, case conferences, presentations, engage in reflective practice, psychometric testing, patient surveys, mentoring, leading MDTs, involve patients/carers/others in decision making, inter-professional learning etc
Developing leadership skills throughreflective practice
Styles of leadership
Many models/ styles described in the literature
Flexibility in leadership styles required - mould to the situation
Balance needs of patients, the organisation, team, resources
“shared leadership”
How to cope in times of continuous change
Transactional (more managerial / planning) approaches not sufficient in times of change
What are the barriers to effective clinical leadership? - the effects of “power”?
Recent media “doctors are arrogant so and so’s.......”
“Toxic” leaders (Jean Lipman Blumen)
Commissioning to be in control of doctors (= more power?)
Hubris Syndrome (Lord Owen)
“Hubris” Syndrome... Do some clinical leaders risk exhibiting these traits ?
Linked to power
described in politicians, dictators (in the absence of mental illness)
narcissistic propensity to see the world... arena to exercise power and seek glory
take actions to cast themselves in good light
excessive confidence in themselves/ own judgement
loss of contact with reality
restless, reckless, impulsive
HOW CAN WE AVOID THIS: EFFECTIVE CPPD?
Summary
Clinical leadership is an important emerging theme throughout clinical training for all doctors
The MLCF, adapted to the wider context, is a useful foundation to guide training and CPPD
Flexibility in leadership styles ---> more effective
The dangers of bad/ toxic leadership ?hubristic leadership - is this a real problem in the clinical world?