Leadership Matters: Tensions in Evaluating Leadership Development

The Problem. This article explores some of the tensions that required careful management in the design and delivery of a leadership development program. This discussion draws particularly upon a formal evaluation of two cohorts, each comprising approximately 20 senior managers working in adult social care. Complexity theory, notably Complex Responsive Processes of Relating, is used to make visible, explore and articulate the need to hold in tension apparently contradictory forces and requirements. The program was established at a critical time in the U.K. government's public services reform agenda, which was unfolding during a period of increasing resource constraint. This included a requirement upon commissioners to demonstrate impact and return on investment (ROI) in development programs. However, complexity theory explains why a direct causal relationship between inputs and outcomes is not amenable to demonstration by evaluation. The Solution. Consequently, the approach to demonstrating ROI explored the microprocesses underpinning the development of the participants' thinking and practice through formative real time and post hoc evaluation. This comprised a range of qualitative techniques: extended observations provided an "ethnographic" overview of the program; participant and stakeholder interviews gave insight into critical incidents and key learning points; and guided conversations placed greater emphasis on the everyday experience of participants in applying their learning. It is argued that such an approach to evaluation is both a research intervention and a contribution to the development process. The Stakeholders. Our article will be of particular relevance to human resource professionals, leadership development practitioners, commissioners, business schools and evaluators facing the challenge of finding meaningful measures of "ROI" for individual and organizational development. © 2013 SAGE Publications

Fatigue as a symptom or comorbidity of neurological diseases

Fatigue, best described as an overwhelming feeling of tiredness and exhaustion, occurs in the context of various neurological diseases. The high prevalence of fatigue as either a symptom or a comorbidity of neurological disease must be taken seriously, as fatigue interferes with patients' activities of daily living, has a remarkable negative impact on quality of life, and is a major reason for early retirement. The tremendous consequences of fatigue are consistent across neurological diseases, as is the uncertainty concerning its underlying pathophysiological mechanisms. Inconsistencies in defining fatigue contribute to the present situation, in which fatigue represents one of the least-studied and least- understood conditions. Tools for assessing fatigue abound, but few can be recommended for clinical or research use. To make matters worse, evidence-based pharmacological treatment options are scarce. However, non-pharmacological approaches are currently promising and likely to become of increasing importance. In sum, fatigue is challenging for both health-care professionals and patients. The present article aims to provide a comprehensive review of the literature on fatigue in neurological disease, and to reveal its complexity, as well as weaknesses in the concept of fatigue itself