A brief review of leadership theory.
Sign posts to guide your exploration of leadership theory.
Florence Nightingale School of Nursing & Midwifery.
What is leadership?
• The question continues to allude answers over time.

• Definitions often reflect the ethos of the time.

• What is clear however is that leadership occurs contextually within particular situations and within specific organizations.

• Leadership and it’s impact in the health service continues to attract particular attention in order to determine high quality and successful performance.
Defining Leadership theory
• A multi dimensional concept including interpersonal, interpersonal, inter-group and situational variables • Social nature of leadership considers the interpersonal skills necessary to be effective in a range of contexts • The ethical component refers to the issue of power and influence over others.
Leadership research
• Efforts to be able to determine which traits and skills can be attributed to a “good or not so good” leader or “effective or ineffective” leader remain a preoccupation in the academic and research literature
Current thinking in healthcare now • The focus of leadership in healthcare organizations is based upon the premise of collective team work being a priority for patient care • Shared or distributed leadership is propositioned as the way forward • Identifies principal values.
A review:
• Perhaps a helpful way to provide a review is to take a historical perspective through the leadership writing.

• But do attend to the conflicting results where one author values a particular trait or activity and another does not.

• One skill for reviewing the literature is to attend to date of publication and then consider where we are now 2019!
Historical steps.
• There is a value in reviewing where current understanding of leadership has emerged from. • It is interesting to note the influences of social history, social values, environmental context and organizational development in the development of leadership theories.
1930’s to 1950’s
• The predominant view is that leaders are born, not made. These theories refer to “Great man theories” and are characteristic of classical leadership

• Ascendancy to particular positions through lineage were considered to demonstrate that leaders are born and not made.

• This theory is identified as Classical leadership theory
Behavioural school of leadership

• 1930’s brought a focus upon the behaviours of leaders, in particular their decision making style: • Autocratic (leader centred or dictatorial), democratic (participative) and laissez-faire (group centred or autonomous decision making) This original work was explored by Lewin, Lippitt and White (1939)
1950’s to 1960’s
• The primary focus of interest was upon the behavioural elements of leadership practice. The view being that if the traits of effective leadership could be identified then leadership could be utilized to influence others.

• There continues to be interest in this the view, and more recent research continues to demonstrate particular characteristics corresponding to effective leadership and impact on “followers”
1960’s to 1970’s
Situational leadership came to the foreground as there was a growing awareness of the importance of the: 1. Relationship between the leader and those that were being led (followers) 2. Task structures 3. The power held by the leader in terms of their position in the system.
Situational Leadership.
The following variables were identified by Fiedler (1967)

• The extent to which the task was structured

• The way the leader interacted with others

• The position and power conferred upon the leader

• The preferred style that the leader adopted.
Situational leadership behaviours

• Telling

• Selling

• Participating

• Delegating Determining features are the necessary support (relationship behaviours) and guidance to the task (readiness to complete the tasks.
Transactional leadership
• Focus on the tasks to be achieved.

• Leader is clear in identifying the rewards/outcomes expected and the followers view the rewards as of benefit to them.

• The leader shapes the follower behaviour in order to achieve excellent outcomes.
Transformational Leadership.
• Transformational leaders focus upon each individual and seek to inspire motivation and provide the necessary intellectual stimulation that influences the follower behaviour.

• This style of leadership often enables achievements beyond expectations
5 actions for transformational leaders • Model the way • Inspire the shared vision • Challenge the process • Enable others to act • Encourage the heart.
Bass (1985) and Kouzes and Posner (1987)
Contemporary ideas
A number of approaches to a leaders practice are emerging which reflect social values and developments within the healthcare teams professional values.
2000 onwards
• Visionary leadership is considered to be present with the current fast paced, turbulence of organizational development or demise. Followers must be active and participative in order for the vision to be achieved.

• Authentic leadership considers the value base of the individual • Ethical Leadership recognition of the implications of influence over others.
Authentic Leadership (2015)
• Developing interest in authentic practice.

• Considers the importance of self awareness of the leader particularly in terms of engagement with others.

• Interplay between the leader and follower particularly in relation to follower satisfaction needs being met.
Shared, Distributed or Collective Leadership.

• Appreciation that many individuals ave leadership capability and capacity and the collective agenda may contribute to successful actions when brought together.
• The multi professional team being an example of the shared and mutual accountability for outcomes of care
Clinical Leadership.
Clear focus on direct client care To impact upon quality of care Clinical competence and visibility to the team Leadership roles for strategic work and direction Not linked to positions of authority.
What leaders in healthcare need to be able to do:

• Have personal mastery, self confidence and a positive self esteem

• Evidence of an “in depth” understanding of the whole organization and the context within which it operates

• Create a healthy and safe clinical work environment for the team members

• Understand the dynamics of leadership and the followers group.
Review your experiences
Critically review your personal thoughts and experiences of leadership in terms of:
1. Your style of leadership
2. Your experience of working with leaders
3. Your experience of leadership in the context of the organization you work within
Key resources for your exploration of leadership • Avery G.C. (2004) Understanding Leadership London Sage Publications • Gill R (2006) Theory and practice of Leadership London Sage Publications • Northouse PG (2010) 5th Ed Leadership: Theory and Practice London. Sage Publications • www.leadershipacademy.nhs.uk

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