Current theoretical thinking asserts that leadership should be distributed across many levels of healthcare organisations to improve the patient experience and staff morale. However, much healthcare leadership education focusses on the training and competence of individuals and little attention is paid to the interprofessional workplace and how its inherent complexities might contribute to the emergence of leadership. Underpinned by complexity theory, this research aimed to explore how interprofessional healthcare teams enact leadership at a micro-level through influential acts of organising. A whole (interprofessional) team workplace-based study utilising video-reflexive ethnography occurred in two UK clinical sites. Thematic framework analyses of the video data (video-observation and video-reflexivity sessions) were undertaken, followed by in-depth analyses of human-human and human-material interactions. Data analysis revealed a complex interprofessional environment where leadership is a dynamic process, negotiated and renegotiated in various ways throughout interactions (both formal and informal). Being able to "see" themselves at work gave participants the opportunity to discuss and analyse their everyday leadership practices and challenge some of their sometimes deeply entrenched values, beliefs, practices and assumptions about healthcare leadership. These study findings therefore indicate a need to redefine the way that medical and healthcare educators facilitate leadership development and argue for new approaches to research which shifts the focus from leaders to leadership.
Bibliographical noteThe authors wish to thank all participants in this study, the Scottish Medical Education Research Consortium (SMERC), NHS Education for Scotland (Scottish Deanery) and Professor Tim Dornan, Queens University Belfast, who contributed to the initial stages of data analysis in his role as Visiting Professor for SMERC. All authors contributed to the study conception and design. LG contributed to data collection and analysis and wrote the first draft of the paper and edited various iterations. All VRE data collection stages were undertaken by LG. CER also contributed analysis and edited each iteration of the paper. JK and JC contributed to data analysis and also commented on various iterations of the paper. This research was part of LG’s Ph.D. research which was generously funded by NHS Education for Scotland through SMERC.
- Leadership education
- Video-reflexive ethnography
- complexity theory