Practical ways to develop leadership and management skills, experience and capabilities
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Leadership development is highly personal and can be challenging. Trainers, supervisors and educators need to be able to support their trainees at each stage of development, including their readiness to learn from exposure to and engagement in different situations.
Trainees require support and encouragement from their trainers, supervisors and educators to navigate a range of leadership tasks and situations that aim to stretch and challenge them, coupled with meaningful, tailored feedback on their performance.
While those responsible for education, training and supervision may have gained leadership experience in different situations and contexts, if not in formal roles, they may have received little formal leadership development themselves. Therefore they may find it challenging to identify opportunities for leadership development and provide feedback to trainees. This guide aims to address this gap and provide ideas and examples for both trainers, supervisors, educators and trainees to engage routinely in leadership development in the workplace.
Workplace-based learning
Leadership opportunities and activities can be found everywhere in clinical and non-clinical situations for all healthcare professionals. Our survey of trainers and trainees found that the workplace is where doctors should primarily learn to develop their leadership capabilities in both clinical and non-clinical situations. This reflects the Center for Creative Leadership 70:20:10 model for learning and development:
- 70% of learning is gained from hands on experience in the workplace
- 20% from interaction with others (social learning)
- 10% from formal courses or training.
Recent thinking is more fluid and contextualised than a strict percentage, but ‘learning leadership’ involves a combination of on-the-job, social and formal learning. The task for trainers, educators, supervisors and trainees is to optimise learning and highlight connections through these three approaches.
In everyday practice, leadership involves a combination of what you do and how you do it.
In this section, **video examples** and case studies of useful developmental activities in which doctors in training have engaged and some ideas around how trainers and supervisors can hold meaningful professional conversations geared around leadership and management are presented.
Examples of workplace-based learning
Leadership activities can be fully integrated into everyday practice (such as leading a ward round, clinic, or team meeting) as well as being ‘over and above’ routine work (e.g. improvement projects or other leadership initiatives). The leadership activities in which doctors in training can (and should) engage will probably become increasingly complex and impactful as they progress through training. However, at any level, it is vital that doctors are exposed to activities which help develop:
- Understanding of how practices, departments, services, organisations, and systems work: structures, functions and cultures
- Awareness of how communications function and how decisions are made (formally and informally)
- Understanding of themselves, strengths, preferences and areas for development
- Skills in handling a range of clinical and managerial situations; being able to judge when to take leadership, when management is required, and when and how to follow
- Being able to work with people with different ideas, perspectives, and backgrounds to optimise engagement and inclusion and manage conflict appropriately.
How leadership and management skills are developed
Learning should be scaffolded according to stage of training and individual development, supported by relevant coaching and mentoring. Whilst leadership activities, learning and feedback should be embedded into all aspects of clinical work, it is often hard to understand how to use experiential learning in practice and when and how to engage in more formal learning opportunities. Petrie’s (2014, 2015) concepts of horizontal and vertical development provide a useful framework.
Horizontal development
Horizontal development (Petrie 2014, 2015) is all about adding new skills, capabilities and knowledge to a leader’s repertoire. It is an essential part of leadership development as it provides the underpinning concepts, models and tools. For example:
- if you are thinking about planning a change, knowing about some change models and being able to use management tools would be helpful
- if you are writing a reflection on an event or situation, a reflective model will help you to structure your thinking and writing
- if you are undertaking a quality improvement project, then learning about improvement methodologies will be essential.
Short courses or programmes (online or face to face) can be useful for providing an introduction to concepts and current thinking, knowledge transfer and for upskilling or learning about specific topics.
Longer programmes give more opportunities for networking and self and skill development and extended programmes help develop new mindsets, engage in in-depth discussions and deeper learning as well as recognise learning through a formal award.
Many programmes are blended or hybrid, with centralised e-learning to cover the theoretical basics and philosophy supplemented by local workshops. This approach can improve accessibility and enable more people to ‘learn leadership’.
Vertical development
Key to being and becoming an effective leader is the development of a mindset that is open to experiences, opportunities, ideas, perspectives, and growth. Such a mindset involves taking responsibility for one’s own learning, being curious and reflective about what is happening and why and being willing to identify and seek out opportunities for learning and personal growth.
Petrie (2014) suggests that vertical development for leadership requires exposure to ‘heat experiences’ (challenging or stimulating experiences), willingness to hear ‘colliding perspectives’ from colleagues from different professions, career stages and settings and supported, guided reflection to aid ‘sensemaking’.
Both the trainer and trainee need to work together to identify and seek out opportunities for development and to make time for reflection, feedback, and subsequent action.
The learning or developmental conversation is central to vertical leadership development because it involves helping the learner to process and make sense of their experiences and apply these insights to practice.
Heat experiences are situations where you might feel challenged, uncomfortable or uncertain. Doctors are trained to recognise and learn from clinical experiences throughout their training, learning from observation, reflection and conversation so that they are better equipped to manage an intense situation the next time. The same process can be applied to leadership development. Heat experiences (if used as part of a learning process) can provide you with an opportunity for the greatest growth.
Colliding perspectives involve actively and proactively exposing oneself to and interacting with people with different perspectives and ideas. It is the essence of inclusive leadership, where diversity of experiences and ideas are welcomed and nurtured. Role models and examples of good (and bad!) practice can come from many sources, in multi professional settings as well as outside the workplace. Supporting trainees to collaborate, work and learn together, for example through action learning sets or team projects can help provide extra support and feedback on leadership and management skills. Examples of learning approaches include shadowing junior/senior leaders; purposeful observation; small group discussions; case work/studies; mixing specialities, professions and occupations; embedding opportunities for reflective practice.
Sensemaking is the final part of vertical leadership development and is all about having conversations and reflecting about situations, how you operated, what impact you had on the situation, how other people might have felt or working out why they reacted or behaved in the way they did. As with other aspects of professional development, these reflections should lead you to a better understanding of the situations and help you decide to make changes in your behaviour or thinking and identify actions you can take, including horizontal development. Mentoring, coaching and action learning can all help support vertical development for leadership.
Horizontal and vertical leadership development work together and it will vary between individuals and their own experiences and needs. For example, you might go on a course and take learning from that to help you explore practical applications of the learning in the workplace. Alternatively, a heat experience might lead you to recognise that more knowledge or insight into what happened and how to manage it is required.
The associated resources provide different examples of how trainers and trainees have used this approach in practice to enhance their leadership development.
Section resources
Videos
Click here to see video examples from healthcare leaders – workplace based leadership development.
Podcasts
Online talks
Brown, B. (2010) ‘The power of vulnerability’. Ted.com.
Edmonston, A. (2017). ‘How to turn a group of strangers into a team’. Ted.com.
Goleman, D. (2012) ‘Introduces Emotional Intelligence’. YouTube.
Reitz, M. (2017) ‘How your power silences truth’. YouTube.
Robertson, I. (2012) ‘Resilience: Factors that increase resilience’. YouTube.
Sinek, S. (2009). ‘How great leaders inspire action’. Ted.com.
Snowden, D. (2010) ‘The Cynefin Framework’. YouTube.
Websites
FMLM training and development hub
FMLM Leadership commitment for junior doctors
A doctor’s guide to everyday leadership
Networks
Record keeping
FMLM Leadership development passport
Annual review of competency progression (ARCP)
e-Learning
elearning for healthcare (2020) Management and Leadership Skills - elearning for healthcare.
Articles, books, reports
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