Attaining clinical leadership skills
through continuing personal and
professional development (CPPD)

Dr Charu Chopra
Spec...
Objectives
What do we mean by clinical leadership?
Can leadership skills be learned (“innate vs
acquired”)?
Medical Leader...
What is Clinical Leadership?
Leadership is about setting direction,
influencing others, managing change
Northouse “A proce...
The roles of a clinical leader
Leading on call/ take
Leading ward rounds
Facilitating clinical decision making as part of ...
Setting the scene...
2007: Ara Darzi appointed health minister: A High Quality
Workforce:NHS next stage review published. ...
Personality traits, behaviour and leadership

Is “leadership” more about having certain “traits” (innate) or can
certain “...
Publication of UK-wide Medical Leadership
Competency Framework by the Academy of Medical
Royal Colleges and with the NHS I...
Medical Leadership Competency Framework
Enhancing engagement in medical leadership,
2010
Demonstrating personal qualities: developing self awareness,
managing yourself, CPD, acting with integrity
Working with ot...
Continuing
personal
and
professional
development
Medical Leadership Competency Framework
Enhancing engagement in medical l...
“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 impl...
Developing leadership skills through
reflective practice
reflective practice
Styles of leadership
Many models/ styles described in the literature
Flexibility in leadership styles required - mould to ...
What are the barriers to effective clinical leadership? - the effects
of “power”?

Recent media “doctors are
arrogant so a...
“Hubris” Syndrome... Do some clinical leaders risk exhibiting
these traits ?

Linked to power
described in politicians, di...
Summary
Clinical leadership is an important emerging theme
throughout clinical training for all doctors
The MLCF, adapted ...
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Cppd leadership

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  • Management is concerned with the marshalling and organisation of resources and maintaining stability. Distinct but complementary to leadership and the both go hand in hand.
  • Recent article Morrow et al., - (Clinical Teacher) : New Consultants felt relatively well prepared with respect to clinical skills from their SpR training but less well prepared for the management and leadership roles demanded by their roles. These should be explicit parts of the curriculum and assessed with same emphasis as there is on clinical skills.
    Non-clinical skills such as chairing meetings, persuading and negotiating, dealing with complaints are all parts of the consultant’s role. Skills based training should be introduced to address these aspects.
  • Quintax day - interesting as all the group except 2 were classified as “introverted”
    Correlation with Y chromosome
    behaviour style: concern for the task vs concern for people
    Kouzes and Posner: assert that leadership is an observable, learnable set of practices
  • 1. articulate own values, principles and understanding how these may differ from those of other individuals and groups
    own strengths and limitations, impact of own behaviour on others, effect of stress on behaviour
    identify own emotions and prejudices and how they affect judgement/ behaviour
    get feedback from others
    Range of CPPD activities - journal club, feedback, audits, peer learning
  • I actually think this framework encompasses many of the aspects we associate with C -P-P-D as a whole for health care professionals - and if one is a “good, effectual leader” is probably a hallmark of professionalism...
  • It is through reflection, and experiential learning (which is at the heart of CPPD), can we further explore our own ideas of what “good leadership” is and how we can become effective clinical leaders. Having a framework to focus on areas of professional development in a holistic way is a useful aid for CPPD.
  • Kurt Lewin: Autocratic, Democratic, Leissez-faire (decision-making)
    Transactional leadership - where leader makes explicit bargains with the team member about what they will receive in exchange for their work/ achievements. Clear goals are set and work delegated. vs Transformational leadership - where the leader inspires and motivates others to achieve a common goal/ purpose.
    Awareness of the various styles/ behaviours associated with leadership can allow us to reflect and probe into whether our adopted “style” of leading was the most appropriate in a given situation. And if so - why and how could the outcomes be further improved.
  • I am sure that programmes like Holby City portray Drs in an unfavourable light with respect to leadership.
    Toxic leaders: characterised by : making decisions alone, evasive, self-centred, excessive competitiveness, arrogance and pride vs “ethical leaders”.
  • Cppd leadership

    1. 1. Attaining clinical leadership skills through continuing personal and professional development (CPPD) Dr Charu Chopra Specialist Registrar Clinical Immunology
    2. 2. 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?
    3. 3. What is Clinical Leadership? Leadership is about setting direction, influencing others, managing change Northouse “A process whereby an individual influences a group of individuals to1. PROCESS achieve a common goal” 2. INFLUENCE 3. GROUP CONTEXT 4. GOAL ATTAINMENT
    4. 4. The roles of a clinical leader Leading on call/ take Leading ward rounds Facilitating clinical decision making as part of a team (multidisciplinary 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
    5. 5. 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.
    6. 6. Personality traits, behaviour and leadership 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.
    7. 7. 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
    8. 8. Medical Leadership Competency Framework Enhancing engagement in medical leadership, 2010
    9. 9. 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
    10. 10. Continuing personal and professional development Medical Leadership Competency Framework Enhancing engagement in medical leadership, 2010
    11. 11. “This way..... I’ll show you how to lead....” How can “leadership” be taught and learned?
    12. 12. 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
    13. 13. Developing leadership skills through reflective practice reflective practice
    14. 14. 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
    15. 15. 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)
    16. 16. “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?
    17. 17. 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?

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