AbstractCurrent theoretical thinking asserts that leadership should be distributed across many levels of healthcare organisations to improve the patient experience and staff morale. Much medical education literature on leadership focusses on the training and competence of individuals. 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 leadership emerges in the interprofessional healthcare workplace.
Epistemologically grounded in social constructionism, this research was undertaken in two phases, using narrative inquiry and video-reflexive ethnography (VRE) methodologies. Phase 1 involved nineteen individual and eleven group interviews with 67 UK medical trainees at all stages of training and from a range of specialties. Narrative interviewing techniques were employed to capture medical trainees’ conceptualisations and lived experiences of leadership and followership. In Phase 2, a work-based study was undertaken utilising VRE to explore how leadership is enacted in the interprofessional healthcare workplace. This occurred in two UK clinical sites: one GP practice and one hospital ward. Participants came from the entire interprofessional team. Multiple complementary forms of analysis were used across both phases including: thematic framework analysis; big ‘D’ Discourse analysis; structural narrative analysis; and interactional analysis (including little ‘d’ discourse analysis).
Findings identified that leadership is not a single thing ‘possessed’ by individuals but rather leadership involves many processes. This research showed that the ways in which leadership is conceptualised, narrated and enacted is affected by many aspects including individuals, context, relationships and the systems in which leadership exists. The findings of this thesis therefore indicate a need to redefine the way that medical and healthcare educators facilitate leadership development and argues for new approaches to research in this field which shift focus away from leaders to, focusing instead, on leadership.
|Date of Award||2014|
|Sponsors||NHS Education for Scotland|
|Supervisor||Charlotte Rees (Supervisor), Jean Ker (Supervisor) & Jennifer A. Cleland (Supervisor)|