Followership: much more than simply following the leader

Patient engagement with psychological safety

Psychological safety is a multidimensional, dynamic phenomenon that concerns team members' perception of whether it is safe to take interpersonal risks at work. It is particularly important within health care teams who need to work interdependently to coordinate safe patient care within a highly complex, variable and high-stakes work environment. High levels of psychological safety have clear benefits for patient safety by improving the delivery of clinical care and promoting health care providers' job satisfaction and well-being. Feeling psychologically safe can enable team members to engage in speaking up behavior, such as asking questions, pointing out mistakes, or reporting errors. Several studies have explored psychological safety in health care teams and its impact on patient safety. These studies have highlighted the importance of psychological safety in health care organizations and provided strategies for promoting psychological safety. Psychological safety in health care involvement with patients can improve patient engagement.

Twelve tips for using tactical decision games to teach non-technical skills

Tactical decision games (TDGs) have been used in healthcare and other safety-critical industries to develop non-technical skills training (NTS). TDGs have been shown to be a realistic, feasible, and useful way of teaching NTS such as decision making, task prioritisation, situational awareness, and team working. Our 12-tips for using TDG to teach NTS are based on our experience of integrating them into an undergraduate medical and nursing programme. We cover how to design successful TDGs, how to facilitate and debrief them and how to integrate TDGs into curricula. We have found TDGs to be a cost-effective, low fidelity, and useful method of delivering NTS teaching, ideally as an adjunct to immersive simulation. Learners find them a useful way to be introduced to NTS in a safe and relaxed environment, with particular emphasis on critical decision making and prioritisation.

Determining a common understanding of interprofessional competencies for pre-registration health professionals in Aotearoa New Zealand: A Delphi study

There is growing awareness that factors such as the growing incidence of co-morbidity and increasing complexity of patient health needs cannot be addressed by health professionals practicing in isolation. Given this, there is an increasing emphasis on preparing students in health-related programs for effective interprofessional practice. Less clear, however, are the specific skills and clinical or learning opportunities necessary for students to develop effectiveness in interprofessional practice. These factors drove a team associated with a tertiary health education provider in Hamilton, New Zealand to transform traditional clinical student experiences in the form of an interprofessional student-assisted clinic. The clinic was intended, in part, to provide students with opportunities to learn and experience interprofessionalism in practice but was hampered by limited information available regarding the specific skill requirements necessary for students in New Zealand to learn in this context. In this Delphi study, we synthesize national expert opinion on student competency indicators necessary for effective interprofessional practice. The resultant set of indicators is presented and opportunities for application and further research discussed. The paper offers guidance to others seeking to innovate health curricula, develop novel service-oriented learning experiences for students, and foster interprofessional practice competence in the future health workforce.

Psychiatric leadership development in postgraduate medical education and training

The value of strong, compassionate medical leadership in the delivery of high-quality care to patients within mental health services is clear. Leadership development, however, is far less well explored. This article is for psychiatric trainees, trainers and mental health organisations. It provides an introduction to the importance of leadership development within postgraduate medical training, the theory that should underpin its delivery, and the opportunities for both informal and formal leadership development within psychiatric training.

Followership: a review of current and emerging research

Purpose

Over time, the role of followers within leadership discourse has gained greater status, leading to followers being acknowledged as significant actors in the leadership process. This has led to the development of follower-centric leadership studies, as well as the more emergent research area of followership, with followership research having the specific intention to find out about followers from the perspective of followers. In this paper, the authors provide a review of role-based followership approaches, and implicit leadership and followership theories as a basis to build a case for follower implicit followership theories (FIFTs) as a focus area for future research.

Design/methodology/approach

The authors conducted a review of seminal and current role-based followership literature, with a specific focus on FIFTs and followership studies conducted within the African context.

Findings

Implicit theories have been an area of leadership research that has added much value, and as such could do the same for development of followership research. FIFTs as a research area are nascent and, as such, should continue to be explored in order to expand our understanding of followership.

Originality/value

To the best of the authors' knowledge, this is one of the first literature reviews to have a specific focus on FIFTs, as well as on followership research conducted within the African context.

Healthcare leadership development during a pandemic: do not stop, adapt

Research carried out in 2016 by two of the authors of this article investigated the role that leadership ‘theory’ plays within an individual's leadership development and identified other components of clinical leadership programmes that are key to enabling the development of future leaders. While early career doctors identified leadership theories and concepts as important within their development as clinical leaders, these must be closely tied to real-life practices and coupled with activities that aim to develop an increased self-awareness, understanding of others, clinical exposure and leadership tools that they can use in practice. During a healthcare crisis, such as a global pandemic, maintaining a focus on leadership development (particularly for more junior clinicians) might not be seen as important, but leadership is needed to help people and organisations ‘get through’ a crisis as well as help develop leadership capacity for the longer term. This article, drawing from contemporary literature, the authors' own research and reflections, discusses how leadership development needs to continually adapt to meet new demands and sets out tips for those involved with clinical leadership development.

Managing asthma in primary healthcare

Asthma brings considerable challenges for family doctors because of its variety of shapes, different levels of severity, a wide age range, and the fact that in the last decades clinicians are able to offer much better treatment options with a better level of disease control and a higher quality of life. The objectives of the current review article are to provide an up-to-date review by primary care respiratory leaders from different countries of the most significant challenges regarding asthma diagnosis and management, the importance of team work and the problems in recognizing and dealing with difficult-to-manage and severe asthma in primary care. The article provides a short review of the main challenges faced by family physicians and other primary health care professionals in supporting their patients in the management of asthma, such as asthma diagnosis, promoting access to spirometry, the importance of a multiprofessional team for the management of asthma, how to organize an asthma review, the promotion of patient autonomy and shared decision-making, improving the use of inhalers, the importance of the personalized asthma action plan, dealing with difficult-to-manage and severe asthma in primary care and choosing when, where and how to refer patients with severe asthma. The article also discusses the development of an integrated approach to asthma care in the community and the promotion of Asthma Right Care.

Twelve tips for developing a global community of scholars in health professions education

Scholarship in Health Professions Education is not just original research, it also includes study of educational processes, and application of new knowledge to practice. The pathways to successful scholarship are not always clear to novice educators. In this article, we describe strategies to establish a Community of Scholars (CoS), where more experienced and senior members guide junior members in scholarship to advance the field. Drawing on Lave and Wenger's concepts of Communities of Practice (CoP), we describe twelve practical tips, which include generation of a shared vision, formation of a global community of scholars, engagement in scholarly initiatives, and development of a professional identity, categorised under three major steps: establish, grow, and sustain the community. The tips embrace inclusivity for diverse cultural contexts which further provide opportunities for Health Professions Educators, interested in forming communities of practice, to work on scholarly outputs and add value to the professional arena.

The leadership and followership challenges of doctors in training during the COVID-19 pandemic

Research carried out in 2016 by the authors investigated the challenges that doctors in training experience around leadership and followership in the NHS. The study explored contemporary healthcare leadership culture and the role of followership from the perspective of early career doctors. It found that the leadership and followership challenges for these doctors in training were associated with issues of social and professional identity, communication, the medical hierarchy, and relationships with senior colleagues (support and trust). These challenges were exacerbated by the busy and turbulent clinical environment in which they worked. To cope with various clinical situations and forms of leadership, doctors in training engage in a range of different followership behaviours and strategies. The study raised implications for medical education and training and suggested that followership should be included as part of formal training in communication and team working skills. The importance of both leadership and followership in the delivery of safe and effective patient care has been brought sharply into focus by the COVID-19 pandemic. This article revisits these challenges in light of the pandemic and its impact on the experiences of doctors in training.

Capturing the wisdom of the crowd: health professions' educators meet at a virtual world café

BACKGROUND

Conversations about educational challenges and potential solutions among a globally and culturally diverse group of health professions' educators can facilitate identity formation, mentoring relationships and professional network building. The COVID-19 pandemic has made it even more important to co-create and disseminate knowledge, specifically regarding online and flexible learning formats.

APPROACH

Based on the principles of social learning, we combined speed mentoring and world café formats to offer a virtual Zoom™ workshop, with large and small group discussions, to reach health professions' educators across the globe. The goal was to establish a psychologically safe space for dialogue regarding adaptation to online teaching-learning formats.

EVALUATION

We aimed to establish psychological safety to stimulate thought-provoking discussions within the various small groups and obtain valuable contributions from participants. From these conversations, we were able to formulate 'hot tips' on how to adapt to (sometimes new) online teaching-learning formats while nurturing teacher and student wellbeing.

REFLECTION

Through this virtual workshop we realized that despite contextual differences, many challenges are common worldwide. We experienced technological difficulties during the session, which needed rapid adaptation by the organising team. We encouraged, but did not pressure, participants to use video and audio during breakout discussions as we wanted them to feel safe and comfortable. The large audience size and different time zones were challenging; therefore, leadership had to be resilient and focussed. Although this virtual format was triggered by the pandemic, the format can be continued in the future to discuss other relevant global education topics.