Evidence Of Leadership Research Articles

A qualitative study of perceptions of senior health service staff as to factors influencing the development of Advanced Clinical Practice roles in mental health services.

WHAT IS KNOWN ON THE SUBJECT?: Advanced clinical practitioners (ACPs) are, typically, non-medical healthcare professionals, who possess advanced clinical skills, a master's level qualification and evidence of leadership, management and research abilities. Most ACPs are nurses and new ACP roles are increasingly being established around the world. The views of senior staff towards new mental health nursing roles in organizations are likely to influence their introduction and sustainability Research on mental health nursing ACP roles is sparse. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The paper uniquely provides specific information as to factors perceived by senior staff as affecting the implementation of ACP roles in mental health services. A wide range of mental health services were perceived as potentially benefiting from ACPs. Establishing role clarity for MHN ACPs is perceived as being as essential to successful introduction of the role, as has been found for other specialities. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Participants identified a need for early engagement with service users and professions about new ACP roles and for processes that can evaluate ACP roles once they established. Some mental health nurses may require long-term developmental pathways to help prepare them to take on a master's level course and then the ACP role. ABSTRACT: Introduction Advanced clinical practice (ACP) roles are increasingly being developed internationally. Identifying factors perceived as affecting the development of ACP can support effective implementation. Aim To understand the views of senior health service staff as to factors influencing the development of ACP roles in mental health services. Method Focus group and semi-structured interviews. Participants were directors of nursing (n=10) and other senior staff from roles important to workforce development (n=10). Results Content analysis suggested seven categories: understanding the role and national guidelines, attitudes to the role, learning from implementing other roles, understanding prerequisites for development, challenges, opportunities and future support/actions. Prerequisites for success would include early engagement with stakeholders. Medical attitudes towards ACP roles were perceived as generally more positive than previously. Discussion The study provides unique information regarding perspectives of senior staff regarding the implementation of ACP roles in mental health services. A wide range of mental health services were perceived as potentially benefiting from ACPs, with the importance of role clarity being highlighted and long-term developmental pathways for staff. Implications for practice Successful Implementation of ACP roles may require clear role definition, early engagement with stakeholders and processes to evaluate role outcomes.

Quantitative Evidence of Leadership in Collaborative Governance: The South Florida EMAs’ Experience with HIV/AIDS

The enactment of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act in 1990 enabled establishment of Health Services Planning Councils across the U.S. in areas disproportionately impacted to help provide care and treatment to infected and affected populations. These Councils impacted areas called Eligible Metropolitan Areas (EMAs) that used collaborative governance model to complement implementation efforts. To promote cross sector stakeholders’ representation and participation in collaborative governance, these Councils relied on collaborative leaders to ensure effectiveness, collaborative success, and sustainability of outcomes. Using quantitative evidence from surveys on dimensions of collaborative governance, this research analyzes the efforts of leaders in collaborative governance in the Councils of Broward and Palm Beach Counties of South Florida. The results highlight similarities between the two Councils in terms of the leadership’s contributions to deliberativeness, consensus, and collaboration. The results also accentuate the iterative and multi-dimensional nature of collaborative governance as a viable postmodern alternative to traditional bureaucratic governance in collective problem solving with integrated collaborative leadership to foster multi stakeholder engagements, and exemplify local governments’ constructive efforts as part of the overall national response to issues surrounding HIV/AIDS. Keywords: Leadership, HIV/AIDS, Collaborative Governance, Health Services, Collaborative Process, Outputs/Outcomes DOI: 10.7176/JESD/11-8-01 Publication date: April 30 th 2020

A Tale of Two Neighbourhoods: Some Evidence of Leadership, Learning, and Liveability

Research on community-based organisations’ potentials and capacities to mobilise community at grassroots levels are emerging rapidly. Yet, inadequacy in terms of understanding how these grassroots institutions participate within Local Agenda 21 processes persists. Despite the establishment of Local Agenda 21 for sixteen years in Malaysia, research on the development of community leadership and learning in mobilising community remains scarce. This paper thus attempts to assess community leadership and learning through participation in Local Agenda 21 programs. Triangulated data collection methods comprising document analysis, experts’ interviews, and case study approach were undertaken to evaluate the development of local sustainable initiatives implemented by two community-based organisations within the platform of community participation facilitated by the City Council of Petaling Jaya. Building on Purdue’s leadership and trust framework as well as instrumental and communicative learning concepts, this qualitative study finds that continuous participation resulting from a continuous charismatic leadership has caused the local neighbourhoods to keep learning. This finding suggests that neighbourhoods participating actively in sustainability platform may substantially contribute to social dimensions of neighbourhood liveability, depending on the extent of community leadership and learning.

Leadership In Learning And Teaching In Higher Education: Perspectives Of Academics In Non-Formal Leadership Roles

Developing leaders and leadership are key factors to improve learning and teaching in higher education. Despite the abundance of literature concerning developing formal leadership, fewer studies have been conducted with academics in non-formal leadership roles that focus on how they develop their leadership in learning and teaching. Publication and funding metrics are evidence of leadership and success in research. Metrics in learning and teaching exist, but are less well accepted and valued. We undertook a qualitative descriptive study to examine how academics in non-formal leadership roles at an Australian university understood leadership and described their leadership in teaching. Following ethical approval, eight participants were interviewed using a semi-structured format. Thematic analysis revealed four themes: leadership is the ability to influence direction; all about the culture; becoming visible and speaking up; and learning leadership together. Participants said leading teaching teams effectively and influencing quality learning experiences for students and colleagues is ‘evidence’ of leadership in learning and teaching. Some said a few research colleagues and formal leaders did not accept such ‘evidence’ and continued to favour leadership of research teams. This paper contributes new strategies as possible ways forward to facilitate cultural change in higher education institutions that include: a need for formal leaders and academics to reach agreement about evidence of effective leadership in learning and teaching; academics sharing innovations to effectively lead teaching teams and to promote quality teaching experiences for students; and mentoring colleagues in learning and teaching.

Editor’s Choice: Investing wisely in our leaders

Strong leadership is crucial to ensuring that patients receive the best clinical care and that the health service functions as well as possible. Doctors are therefore encouraged to seek out opportunities to develop leadership skills wherever they can, and presenting evidence of leadership is seen as an important facet of interviews for consultant roles …

Examining the validity of AHRQ's patient safety indicators (PSIs): is variation in PSI composite score related to hospital organizational factors?

Increasing use of Agency for Healthcare Research and Quality's Patient Safety Indicators (PSIs) for hospital performance measurement intensifies the need to critically assess their validity. Our study examined the extent to which variation in PSI composite score is related to differences in hospital organizational structures or processes (i.e., criterion validity). In site visits to three Veterans Health Administration hospitals with high and three with low PSI composite scores ("low performers" and "high performers," respectively), we interviewed a cross-section of hospital staff. We then coded interview transcripts for evidence in 13 safety-related domains and assessed variation across high and low performers. Evidence of leadership and coordination of work/communication (organizational process domains) was predominantly favorable for high performers only. Evidence in the other domains was either mixed, or there were insufficient data to rate the domains. While we found some evidence of criterion validity, the extent to which variation in PSI rates is related to differences in hospitals' organizational structures/processes needs further study.

Why do interventions work in some places and not others: A breastfeeding support group trial

In a cluster randomised controlled trial of a policy to provide community breastfeeding support groups in Scotland, breastfeeding rates declined in 3 of 7 intervention localities. From a preliminary study, we expected breastfeeding outcomes to vary and we prospectively used qualitative and quantitative methods to ask why. Ethnographic in-depth interviews, focus groups, observations and survey data were analysed to build seven embedded case studies. A pyramidal model of how primary health service organisations implemented the policy was constructed prior to knowing trial outcomes to minimise bias. Informed by a realist approach, the model explained variation in (a) policy implementation (b) the breastfeeding outcomes, whereas the quantity of intervention delivered did not. In the three localities where breastfeeding rates declined, negative aspects of place including deprivation, unsuitable premises and geographical barriers to inter-professional communication; personnel resources including staff shortages, high workload and low morale; and organisational change predominated (the base model tiers). Managers focused on solving these problems rather than delivering the policy and evidence of progress to the higher model tiers was weak. In contrast, where breastfeeding rates increased the base tiers of the model were less problematic, there was more evidence of leadership, focus on the policy, multi-disciplinary partnership working and reflective action cycles (the higher model tiers). We advocate an ethnographic approach to the design and evaluation of complex intervention trials and illustrate how this can assist in developing an explanatory model. More attention should be given to the complex systems within which policies and interventions occur, to identify and understand the favourable conditions necessary for a successful intervention.

Leading and learning as a transcultural experience: a visual account

Leaving one's own territory in research by taking part in an international project is like learning a new language: it's not just learning a new vocabulary and grammar, but is a total human experience which is best learnt in everyday activity. Social scientists like Jean Lave argued that ‘knowledge‐in‐practice, constituted in the settings of practice, is the locus of the most powerful knowledgeability of people in the lived‐in world’. Different scientific communities have culture‐bound discourse norms, therefore, differences in discourse patterns sometimes operate as a barrier to the exchange of scholarship between two related cultures. ‘In view of the importance of international communication between scholars, it is vital for scholars to understand the cultural basis of many discourse patterns.’ This article gives an insight into how individuals and schools involved in an international project struggle to find new understandings of their own attempts at leadership and learning. Throughout the project the interconnectedness between places, rooms, areas and feelings during the journey of the ‘Carpe Vitam: Leadership for Learning’ project was a cooperative endeavour to extend and deepen the understanding of one's own theories and practices in relation to that of others, on both the individual and organizational levels. A collaboration of this kind can help in understanding the cultural bias of one's own research approach and that of the other cultures involved. The visual account is a narration of collegial development between educators from universitites and schools struggling for clarification, experience and evidence of leadership for learning.

Climbing the Academic Ladder

Climbing the Academic Ladder

Europe as a Great Power

Where is Europe?' Senator John McCain asked the United States Congress on 11 August 1992 with reference to the widening conflict in the former Yugoslavia. 'We have seen Germany recognize the sovereignty of some Yugoslav nations, but what evidence of leadership have they demonstrated beyond that action?'(f.1) The senator expressed not an isolated sentiment but rather the incomprehension of a good many of his colleagues at the unwillingness of America's strongest allies to cope with a crisis on their doorstep, and he touched on the reason why in the Balkans above all the New Europe of 1992 looked depressingly like older incarnations. Collective European will had been scarce in the face of unilateral German initiatives to force recognition of the breakaway republics of Croatia and Slovenia, and there was, as McCain spoke, little evidence of an emerging European formula for Balkan peace.The Balkan episode speaks volumes about contemporary Europe's preparedness to assume the responsibilities of a great power in the governance of post-cold war international relations. At no point during the political disintegration of Yugoslavia and the serial wars of succession that followed was a European-brokered peace and the enforcement thereof remotely convincing. Instead, Europe welcomed 20,000 United States troops to enforce an accord engineered by a Clinton administration reluctant to take up a task many Americans considered an inherently European calling. At that point, Michael Sturmer, a German historian, suggested that the only reasonable verdict available was that 'the Europeans, so powerful and active on the economic scene, will need Uncle Sam to protect them against their weakness, opportunism, and disunion.'(f.2) The contending forces in the Balkans had never recognized Europe as a force to be reckoned with. It projected neither moral authority nor the diplomatic stamina of a regional peacemaker.We are traditionally accustomed to thinking of great powers in terms of their ability to bring a degree of order and stability to relations among states in their region, an additional capacity to influence the norms governing relations between states globally, and their assumption of both special rights and responsibilities for the maintenance of those norms. We are also comfortable with the notion that the European states system constitutes a civilization and that Western Europe has since 1945 been involved in an effort to rehabilitate that civilization after its civil war of the first half of this century. Native to European standards of civilized behaviour, both within and between states, is the identification of the freedom of commerce, mobility, and personal conviction as fundamental human rights sanctified for some 350 million people in the European Convention on Human Rights. Measured by its post-cold war diplomacy, the New Europe remains a restorative project and features neither the attributes of a great power nor those of a particularly self-confident civilization.(f.3) Its states are often collectively incapable of exerting political will even within regions that may be considered part of the European periphery.The Nature Of The European ProjectIndeed, political will is a concept with which few European leaders are altogether comfortable after more than forty years of painstaking consensus-building and process-driven integration. The European Union (EU) has devoted only residual energies to the wreckage of its recognition diplomacy in Yugoslavia, largely because of what now appears to be an inability to look outward and beyond the administrative tasks of 'building Europe' that have consumed its attention for four decades. Before the fighting broke out, the discussion of the broader goals of a prospective European foreign policy proceeded in the somniferous vocabulary of integration, and it continued in much the same vein even as the Balkan war came to dominate the world press. At times, it was almost as if some invisible cone of silence over Brussels served to muffle the distant chatter of small arms in Sarajevo, Gorazde, and Srebrenica. …

Predicting the admission into medical school of African American college students who have participated in summer academic enrichment programs

To identify cognitive and noncognitive variables as predictors of the admission into medical school of African American college students who have participated in summer academic enrichment programs (SAEPs). The study sample comprised 309 African American college students who participated in SAEPs at the Medical College of Georgia School of Medicine from 1980 to 1989 and whose educational and occupational statuses were determined by follow-up tracking. A three-step logistic regression was used to analyze the data (with alpha = .05); the criterion variable was admission to medical school. The 17 predictor variables studied were one of two types, cognitive and noncognitive. The cognitive variables were (1) Scholastic Aptitude Test mathematics (SAT-M) score, (2) SAT verbal score, (3) college grade-point average (GPA), (4) college science GPA, (5) SAEP GPA, and (6) SAEP basic science GPA (BSGPA). The noncognitive variables were (1) gender, (2) highest college level at the time of the last SAEP application, (3) type of college attended (historically African American or predominately white), (4) number of SAEPs attended, (5) career aspiration (physician or another health science option) (6) parents who were professionals, (7) parents who were health care role models, (8) evidence of leadership, (9) evidence of community service, (10) evidence of special motivation, and (11) strength of letter of recommendation in the SAEP application. For each student the rating scores for the last four noncognitive variables were determined by averaging the ratings of two judges who reviewed relevant information in each student's file. In step 1, which explained 20% of the admission decision variance, SAT-M score, SAEP BSGPA, and college GPA were the three significant cognitive predictors identified. In step 2, which explained 31% of the variance, the three cognitive predictors identified in step 1 were joined by three noncognitive predictors: career aspiration, type of college, and number of SAEPs attended. In step 3, which explained 29% of the variance, two cognitive variables (SAT-M score and SAEP BSGPA) and two noncognitive variables (career aspiration and strength of recommendation letter) were identified. The results support the concept of using both cognitive and noncognitive variables when selecting African American students for pre-medical school SAEPs.

Evidence of Leadership

Evidence of Leadership

Perceptions of Search Consultants of Qualities School Boards Seek in Superintendents

This study sought to determine those qualities that school boards seek when they employ superintendents as perceived by superintendent search consultants. The author found the following qualities to be extremely important when school boards are seeking superintendents: performance in previous positions, performance during the interview, evidence of leadership and managerial skills, communication skills, and experience and success with school constituent groups.

Manual Training Teachers and other Teachers—A Comparison of Their Perceptions and Satisfactions and a Commentary

This paper reports on an investigation into fourteen Queensland high schools with instruments measuring perceptions of school climate, bureaucratization, satisfaction and professionalism. The factor scores of manual training teachers and those of teachers of general subjects are compared and five significant differences found. Manual training teachers believe less in the importance of autonomy and more in the importance of service. They perceive in their schools more evidence of leadership and more opportunities for participation in decision-making and they are more satisfied with their colleagues than are other teachers in the schools. The relative lack of supervision they experience appears to be “a healthy neglect”.