Impressions of action and critical action learning: exploring the leadership development of senior doctors in an English healthcare organization

The Global Leadership Mentoring Community: An evaluation of its impact on nursing leadership

AIM

To evaluate a year-long mentorship program, pairing nurses from different regions across the world to support their global leadership capability, and identifying additional consequences of their participation.

BACKGROUND

Investment in developing nurse leaders continues as a strategic global imperative. Building on the first cohort's recommendations, this second program illustrates continued progress.

PROGRAM EVALUATION

Using the logic model of program evaluation, this non-empirical paper uses data collected from anonymized questionnaires and participants' stories to help improve the program, illustrating innovative practices to develop the confidence and competence of emerging and established nurse leaders globally.

DISCUSSION

The value of mentorship was recognized, and there were gains for both mentors and mentees in the development of leadership confidence and competence. Through engagement and collaboration with the whole community, participants were encouraged to understand their own and others' cultures avoiding assumptions and stereotypes.

CONCLUSION

This evaluation illustrates that in addition to helping improve future programs, mentorship has enabled the growth of individuals' skill sets and the confidence to reach out to peers across the world to understand the meaning of global health and to make a meaningful contribution to the challenges they face.

IMPLICATIONS FOR NURSING PRACTICE

Nurse managers should be encouraged to develop and formalize a mentoring culture to benefit the leadership competence and well-being of their workforce.

IMPLICATIONS FOR NURSING POLICY

Every nurse has a responsibility to invest in nursing leadership for themselves and others. Mentorship can assist nurse leaders to build workforce capability to lead and contribute to the policy agenda locally, nationally, and internationally. Starting early and at the individual level, global mentorship programs can develop leadership expertise to help nurses find their voice and strengthen their confidence and competence to lead and therefore build the strategic leaders of the future.

Linking leadership development programs for physicians with organization-level outcomes: a realist review

BACKGROUND

Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization's performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing.

OBJECTIVE

To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes.

METHODS

We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O).

RESULTS

In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories 'culture', 'quality improvement', and 'the leadership pipeline': 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes.

CONCLUSIONS

LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes.

Using an implementation science approach to build leader facilitation capability in healthcare: a novel approach for enhancing action learning set facilitation

PURPOSE

The study describes the implementation of a novel strategy, entitled the Action Learning Set Facilitation Model, to develop internal facilitation capability to lead change. The Model incorporated the Novice-Experienced-Expert pathway, a facilitation development approach underpinning the integrated-Promoting Action on Research Implementation in Health Services Implementation Framework, with action learning methodology.

DESIGN/METHODOLOGY/APPROACH

A mixed-methods descriptive approach reports the results of 22 interviews, 182 Action Learning Sets and 159 post program survey data sets to explore facilitator experiences, strengths and potential application of the Model.

FINDINGS

At program completion, five novice (of 174) and one experienced (of 27) facilitator transitioned to the next facilitation level. The three groups of facilitators described positive change in confidence and facilitation skill, and experience of action learning sets. Inconsistencies between self-report competence and observed practice amongst novices was reported. Novices had decreasing exposure to the Model due to factors related to ongoing organisational change. Internal facilitators were considered trusted and credible facilitators.

RESEARCH LIMITATIONS/IMPLICATIONS

There are practical and resource implications in investing in internal facilitation capability, noting proposed and real benefits of similar development programs may be compromised during, or as a consequence of organisational change. Further research describing application of the facilitation model, strategies to enhance multisystemic support for programs and evaluation support are suggested.

PRACTICAL IMPLICATIONS

The Action Learning Set Facilitation Model offers promise in developing internal facilitation capability supporting change in organisations. Critical success factors include building broad scale internal capability, stable leadership and longitudinal support to embed practice.

ORIGINALITY/VALUE

This is the first application of the facilitation component of the integrated-Promoting Action on Research Implementation in Health Services implementation framework embedded to action learning sets as an implementation science strategy for leader development supporting organisational change.

When global meets local: Action learning, positionality and postcolonialism

This article explores changes in the positionality of Pakistani MBA students as they undergo an action learning (AL) intervention designed to encourage group reflection for the purpose of stimulating self-directed learning. Findings from this article suggest that reflecting openly and challenging deep-seated beliefs in AL groups disrupts learner positionality, creating temporary misalignment with embodied cultural dispositions which shape social interactions and relationships. When applied in the context of Pakistani business schools, public reflection in action learning groups creates dynamics resulting in three broad participant responses that trigger realignment with cultural norms: dissonance, aversion and ambivalence. As facilitators and educators, overlooking such responses to attempt empowering learners and encouraging self-direction can result in the unconscious reinforcement of power relationships that the reflective practice of action learning seeks to challenge.