McCray, Janet

Palmer, Adam

Warwick, Robert

A United Kingdom (UK) study of the impact of a critical action learning (CAL) module on the leadership development of Doctors examined the immediate effect of this learning strategy at an individual level (McCray. Palmer &amp; Warwick, 2016). Findings indicated that participants had gained a form of leader enablement in their NHS (National Health Service) setting, underpinned by leader resilience and reflexivity. Aligning with other studies set in the NHS (Blackler &amp; Kennedy, 2004. Pedler &amp; Abbott, 2008. Hicks &amp; Winterburn, 2012), this confirmed a role for CAL (Ram &amp; Trehan, 2010) in Doctor Leader development. What remains of interest is has this learning been sustained? Here in this paper we return to the same NHS research cohort two years on to question: “What learning from the CAL experience has been applied in practice and to what effect?

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      BAM2016 This paper is from the BAM2016 Conference Proceedings                 About BAM The British Academy of Management (BAM) is the leading authority on the academic field of management in the UK, supporting and representing the community of scholars and engaging with international peers.  http://www.bam.ac.uk/  Sustaining action learning skills in Doctors’ Leadership practice   Abstract A United Kingdom (UK) study of the impact of a critical action learning (CAL) module on the leadership development of Doctors examined the immediate effect of this learning strategy at an individual level (McCray. Palmer & Warwick, 2016). Findings indicated that participants had gained a form of leader enablement in their NHS (National Health Service) setting, underpinned by leader resilience and reflexivity. Aligning with other studies set in the NHS (Blackler & Kennedy, 2004. Pedler & Abbott, 2008. Hicks &Winterburn, 2012), this confirmed a role for CAL (Ram & Trehan, 2010) in Doctor Leader development. What remains of interest is has this learning been sustained?   Here in this paper we return to the same NHS research cohort two years on to question: “What learning from the CAL experience has been applied in practice and to what effect?”                      Leaders in The National Health Service The NHS  is a complex organisation, wherein  complexity can be defined as   “consisting of adding different kinds of parts to  a system and then adding constraints to those parts”(Tainter and Taylor, 2014, p168 ) .Using complexity as an analogy to explore ordinary human interaction as an ongoing temporal process,  Stacey and others coined the term complex responsive processes of relating (Shaw, 2002; Stacey, 2007, 2012; Stacey et al., 2000).  Drawing on Hegel (and those influenced by him such as GH Mead, (1934 )Elias  (1978) and Weick (1995), Stacey and others pay attention to the complexity of power relations between people as they anticipate, make sense and take action from which others do likewise. These are socially reflexive processes, by this we mean that our own reflexive development is affected and effects the social melee of which we are a part to such a degree a distinction between the self and the social becomes unhelpful.  As people make gestures (e.g. to do or say something) these are responded to within the existing power figurations in which they are ‘bound’ (Elias, 1978).   Complexity offers ways to consider everyday interactions between people as they engage in the anticipatory endeavour of organisational life; particularly those ongoing and conflicting activities, paradoxes that seem to be essential in the way people ‘rub along’. These issues of power dynamics, particularly around the edges disciplines and understandings, are often over looked (Contu, 2013). Design and Evaluation of Leader Programmes In the NHS setting, leaders  are challenged to tackle “wicked” problems (Grint, 2005, p9); the wicked problem being that of providing unlimited health services to all who need them. Within in this complex environment the  design and evaluation of leadership programmes and effectiveness measures of leaders/leadership in action  has become harder (Watkins et al., 2011). Moving away from the traditional leadership courses of business schools and proposing a more nuanced approach to leader and follower power, influence, and agency (Collinson and Tourish, 2015) can be hard when that position remains privileged.  Further  Mabey, (2008) makes the point that within this complex and shifting context  a solely functionalist mind-set towards evaluation is problematic and that we should complement our insights from critical, dialogic and interpretive perspectives.  Jarvis et al (2013, p 29 ) write that viewing evaluation as both research and development  can enable a process of collaboration and knowledge sharing and harvesting of wisdom, which can in turn inform thoughtful leadership development  investment.  With these considerations in mind, as developers, facilitators and researchers of CAL in an organisational development context we were aware of the need to address the developments and critical debates that surround it.   The Setting and the Programme  The NHS trust in this study  commissioned a  bespoke leadership programme with a critical  action learning module (CAL) as one  part of a Post-Graduate Certificate in Strategic   Management and Leadership for Doctor Leaders. It was hoped this would change the organisational culture, impact on performance, establish new networks for collaboration and  improve quality and resilience of care delivery . An earlier research  study  ( McCray, Warwick and Palmer, 2015 ) was  carried out with the programme  delegates immediately after the  CAL module  to evaluate its immediate  effect. This sought to explore  any reported  change  in  the self  and leader behaviour. Two years on the same cohort of Doctor Leaders have been re-interviewed  to ask “What learning from the experience  has been sustained post CAL ? ”.  This paper This paper will present findings from  two  data sets - the self reported immediate impact (Data set 1)  and the sustainability (Data set 2)  of a CAL module   on the  practice of Doctor Leaders. The paper will : 1.Report findings from data set 1  which explored the self reported immediate impact of a CAL  programme on the practice of nine Doctor Leaders. 2. Present  data set 2  of the  study which asked what leader practice has been  sustained in practice post leader development intervention. 3. Critically review whether  a CAL programme can contribute to the sustainability of capabilities and  resilience of Doctor Leaders.  Methodology A critical theorist  position  has been adapted by the three authors.  We are academics and collaborative partners of the NHS trust in the study. In this context  we recognise  the complexity , policy history, economic  reality and culture (Baynes,1995)  of the  NHS setting  and the dominance of conventional theories of leadership which can  unproblematically change others and their practice  without noting the contradictions that power dynamics can engender (Collinson and Tourish, 2015).  Method  We have drawn on a narrative inquiry method  to develop our research.  Narrative can be defined as focusing on the meanings that people ascribe to their experiences, seeking to provide "insight that (befits) the complexity of human lives" (Josselson, 2006, p.4).We found the general guidance and  thematic framework  of Ritchie and Lewis (2003) helpful throughout  the data analysis process. In phase one the first data sets were read  separately by all three authors to note striking moments (Katz and Shotter, 2004) where  attention to  the  use of  words and phrases  (Shotter , 2007) helped  orientate and focus on the flow of conversation prioritised by the participants . This process supported the  identification of  preliminary themes, which were then checked for similarity and any differences. This resulted in a very high level of correlation.  Following this first analysis , the  themes were then re visited   and refined  by the lead author.  Lastly these were agreed by all three authors.  The final themes were reflexivity, resilience  with an overarching theme of leader enablement .Figure 1presents  the theme development for reflexivity.  Participants Voices Initial Themes Refined Themes Themes Final Theme ALS gets under the veneer to the meaningful  Richness of interaction and sharing experience  Changed as a leader acting less didactically and taking time to think as a leader    Relating to the self unexplored in normal context of practice       Shift in thinking and prioritising             Thinking processes         Self disclosure Dealing with emotional and personal subjects  Affecting listening and communications skills  Self-identity and confidence explored positively   Found ALS liberating, reassuring and supportive  Cathartic experience Security and trust confidentiality  is high value  ALS offers a safe place to discuss difficult  issues  Supportive environment Critical challenge of leadership Personal change has happened  Leadership responses behaviour and rationale  have changed  Transfer of listening, building relationships and  critical questioning skills in leadership roles.  Sharing self with others beyond daily professional interaction  Skills to build trust were demonstrated        Positive environment in which to undertake this different sort of learning   Safety – it was safe to do this in the setting created     Impact of the set experiences   Having done this it was empowering Listening and Attention in the “now”      How talk and listening in set affects other people       Sense making not action outside set but analysis and understanding of the  “Now”             Attending         Impact                             Reflexivity  1. Reflexivity It was Bourdieu that noted that the more expert we are in a particular game, the less it becomes available to us to notice and therefore reflexively engage with it (Bourdieu, 1990, 81). In the findings,  the rules  of the ALS procedure were again seen as being an important enabling constraint, but so too was the nature of social learning  (Realin,2013). One participant states : “And I have thought, blimey did you...did I hear that right...did you really say that...did it mean to come out quite like that?’  And sometimes you want to applaud them for doing so.  I guess those comments are all part of the learning process, if you consider that the Learning Set is there to facilitate you learning more about yourself and more about the environment in which you work and about how you support and interact with others.”(AL1).  Findings from data set 1 have shown that AL can enable reflexivity, the key features of which include a public dimension and a change of pace in conversation.  The reflexivity gained during  the experience of  the AL set has had an impact on the individual resilience of leaders in the study. A building of emotional resources was evidenced (McCray et al, 2015). Figure 2 shows  the theme development for resilience.    2. Resilience Participants Voices Initial Themes Refined Themes Final Theme  Link with performance and place to discuss organisational factors impacting on performance    Action points / feedback very motivating showed what had been achieved Receiving comments on use of tools and improvements  Getting feedback was important Appreciate being given information by the set Post set reflections been powerful Sharing of solutions /coping  alternatives for difficult leadership situations was of value      ALS place to discuss performance and actively note performance in an equitable way      Value of use of feedback from the group and then the set adviser in relation to written and verbal commentary of the leadership events      Gave an indicator of personal progress  and change        Perception of problems is different        Link  between intention and possible action was explored critically but shared collegiately (Enablement)         Personal Progress recorded and critiqued           Helps  resilience (Enablement)                     Resilience   Ramsay’s (2005) work around multiple narratives is of interest here. The idea that hearing alternative voices and gaining a more communal reflection of events may enable participants to notice assumptions  they may make about complex situations. This can shift thinking  from a description of events to an experience in the context of the future.    Here this was illustrated when participants described a shift in their response to problems and problem solving  : “I think just be being open and discussing things, and in the workplace I am more willing to face situations which I would have shied away from in the past so I am arranging various meetings and discussing issues that are arising and facing them up front.  That’s the change in the workplace.” (AL9). As the perception of the “problem “ changed  from a  logical technical position towards that of the complex, inter-related  and uncertain, results highlight  a difference in the psychological response claimed. The AL process  with a an absence of “answers” in the traditional educational sense  has offered participants the opportunity to become “bricoleurs” (Weik, 1993)  whereby  instead of waiting for an ideal set of conditions, they have learnt to address problems with what resources they have to access, and adapt (de Walle, 2014).The idea of gaining greater  leadership capacity and stamina was critical in terms of motivating and inspiring others. The AL process seems to have been important in building these aspects of resilience for leaders on the programme.  3. Leadership Enablement  The overarching theme of leadership enablement  illustrates the recognition by participants of the way they were developing in order  to recognise the dynamics of the context (the NHS Trust), personal attributes and relationship building in enabling them to tackle complex problems utilised in the building of reflexivity and resilience.  A move from their reliance upon  traditional technical educational behaviour previously played out in the form of  hierarchical  leadership to examining that of a more adaptive, shared  and innovative (Heifetz, 1994) change response (Haeusler, 2010).  Phase Two  The importance of the AL principles in supporting learning are clearly recognised and articulated by the participants in their accounts of experiences in the sets. Whilst this stage of the research does address the impact on participants’ confidence in their abilities as leaders it still needs to investigate what happened to the actions they took through their change projects and the impact on the Trust as a whole. Keen to explore this further we  will revisit and re-interview  participants  (Data set 2)   to question if  an AL programme can contribute to the sustainability of  leadership capabilities and  resilience.  Our  exploration and preliminary findings will be reported in the session. We will  seek to answer how the ALS activity of  the quizzing and exploring of others enabled a movement of thought of the participant, and the group;  and by what mechanisms  this has been continued and whether post development programme any  new understandings of self and leadership have emerged.   References Baynes, K., (1995) “Democracy and the Rechtsstaat,” in The Cambridge Companion to Habermas, S. White (Ed), Cambridge: Cambridge University Press. Blackler, F. & Kennedy, A. (2004) The Design and Evaluation of a Leadership Programme for Experienced Chief Executives from the Public Sector. Management Learning, 35, 181-203. Bourdieu, P. (1990) The Logic of Practice. Cambridge, UK: Polity Press. Collinson, D,  Tourish, D. (2015), 'Teaching Leadership Critically: New Directions for Leadership Pedagogy', Academy Of Management Learning & Education, 14, 4, pp. 576-594, Business Source Complete, EBSCOhost, viewed 27 June 2016. Contu  a. (2013) On boundaries and difference: Communities of practice and power relations in creative work. Management Learning,  Available from: http://mlq.sagepub.com/cgi/doi/10.1177/1350507612471926.  De Walle, S. V. (2014) Building Resilience in Public Organizations: The Role of Waste and Bricolage. Innovation Journal, 19(2), 2-18.  Elias N (1978) What is Sociology? New York: Columbia University Press. Grint, K (2005) Leadership: limits and possibilities. Basingstoke: Palgrave Macmillan. Haeusler, J. C. (2010) Medicine Needs Adaptive Leadership. Physician Executive, 36(2), 12-15.  Heifetz, R. A., Linsky, M., and Grashow, A. (2009) The practice of adaptive leadership.  Tools and Tactics for Changing   Your Organization and the World. MA: Harvard Business Press. Jarvis, C. Gulati, J. McCririck, V. and Simpson, P. (2013) Leadership Matters:  Tensions in Evaluating Leadership Development. Advances in Developing Human Resources 15(1) 27 –45 Josselson, R. (2006) Narrative   research and the challenge of accumulating knowledge. Narrative Inquiry, 16(1), 3-10. Katz, A. M., and Shotter, J.  (2004) On the way to "presence": Methods of a "social poetics". In: D. A. Pare and G. Larner (Eds), Collaborative Practice in Psychology. New York: Haworth Clinical Practice Press.  Mabey, C.  Finch Lees, T. (2008)  Management and Leadership Development  London : Sage. McCray, J. Palmer, A. Chmiel, N. (2015) "Building Resilience in Health and Social Care Teams" Personnel Review  accepted for publication 14/9/15. Manuscript ID PR-04-2014-0095. McCray, J.  Warwick, R. Palmer, A. (2015) A The impact of an action learning programme on senior medical professionals in clinical leadership roles within a United Kingdom NHS health trust. Exploratory paper presented at British Academy of Management Conference. University of Portsmouth. September 2015. Mead, G (1934) Mind, Self, & Society. Chicago: Chicago University  Pedler, M. & Abbott, C. (2008) Lean and learning: action learning for service improvement. Leadership in Health Services, 21, 87-98. Raelin, J. (2001) Public Reflection as the Basis of Learning. Management Learning, 32(1), 11–30.   Ramsey C (2005) Narrative: From Learning in Reflection to Learning in Performance. Management Learning, 36(2), 219–235,  Available from: https://www.lib.byu.edu/cgi-bin/remoteauth.pl?url=http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2005-05611-004&site=ehost-live&scope=site\ncaroline.ramsey@northampton.ac.uk. Ram M and Trehan K (2010) Critical action learning, policy learning and small firms: An inquiry. Management Learning, 41(4), 414–428,  Available from: <Go to ISI>://WOS:000281383000003. Riessman, C.  K. (2008) Narrative methods in the human sciences. Thousand Oaks, Ca: Sage.  Ritchie, J. Lewis, J. (2003) Qualitative Research Practice – A Guide for Social Science Students and Researchers.  London: Sage. Rogers, E.M. (2003) Diffusion of Innovations. London: Free Press. Rose, S. (2015) Better Leadership for tomorrow. NHS Leadership Review.  London: HMSO. Shaw P (2002) Changing Conversations in Organizations - A Complexity Approach to Change. Abingdon, UK: Routledge. Shotter, J. (2006) Understanding process from within: An argument for withness thinking. Organization Studies   27, 585-604.  Stacey R, Griffin D and Shaw P (2000) Complexity and Management - Fad or Radical Challenge to Systems Thinking? Abingdon, UK: Routledge. Stacey R (2007) Strategic Management and Organisational Dynamics - The Challenge of Complexity. Fifth. Harlow: Prentice Hall. Stacey R (2012) Tools and techniques of leadership and management: meeting the challenge of complexity. London and New York: Routledge. Tainter J and Taylor T (2014) Complexity, problem-solving, sustainability and resilience. Building Research & Information, 42(2), 168–181. Weick KE (1995) Sensemaking in Organizations. London: Sage. Weick, K.E., (2001) Making Sense of the Organization, Malden MA: Blackwell. Welbourn D, Warwick R, Carnall C, et al. (2012) Leadership of whole systems. London.             

Sustaining action learning skills for Doctors following a leadership development programme

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Sustaining action learning skills for Doctors following a leadership development programme

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