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Leadership and Clinical Education Workshop 1 What is leadership? Whats it got to do with clinical education? Adding a leadership dimension to clinical.

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Presentation on theme: "Leadership and Clinical Education Workshop 1 What is leadership? Whats it got to do with clinical education? Adding a leadership dimension to clinical."— Presentation transcript:

1 Leadership and Clinical Education Workshop 1 What is leadership? Whats it got to do with clinical education? Adding a leadership dimension to clinical facilitation

2 Leading clinical learning Workshop 1: Learning outcomes Reflect on the concept of leadership within the context of clinical education Understand the general principles of the Leadership and Clinical Education (LaCE) framework Discuss the application of the LaCE framework to everyday clinical education practice Identify opportunities for your personal/professional development as a leader of clinical education

3 Leading clinical learning What is leadership? 60 second question How do you define leadership and what are the attributes of good leadership?

4 Leading clinical learning What is leadership? A leader is best when people barely know he exists; not so good when people obey and acclaim him; worst when they despise him. Fail to honour people they fail to honour you, but of a good leader who talks little when his work is done, his aim fulfilled - they will say We did this ourselves Lao-Tzu (6 BC)

5 Leading clinical learning What is leadership? A leader is a dealer in hope Napoleon Bonaparte

6 Leading clinical learning What is leadership? Setting an example is not the main means of influencing others; it is the only way. Albert Einstein

7 Leading clinical learning What is leadership? …. any behaviour that influence the actions and attitudes of others to achieve certain results Australian Leadership Development Centre, 2007

8 Leading clinical learning What is clinical education? 60 second question How do you describe clinical facilitation/education and what are the attributes of good facilitation?

9 What is clinical education? Clinical education (my definitional attempt).. a process which facilitates … the translation of theory into clinical knowledge and professional skills through the provision of positive learning experiences within quality learning environments.. McAllister et al. (1997, p.3) and...Nash (2010) Leading clinical learning

10 Clinical learning environment – an interactive network of forces Students Clinical staff Care recipients Clinical facilitators Learning environment Quality of the learning experience Quality of learning outcomes

11 Leading clinical learning Clinical education: What does the evidence tell us? Quality clinical facilitation: Nursing students perceptions of effective Vs ineffective clinical teachers (n=214) Interpersonal relationships eg. good relationships with nursing team Personality characteristics eg. enthusiastic approach Teaching ability eg. encourages thinking and learning Professional competence eg. good professional knowledge Tang et al. (2005)

12 Leading clinical learning Clinical education: What does the evidence tell us? Students (n=134) Interpersonal relationships Evaluation Nursing competence Teaching ability Personality traits Clinical educators (n=17) Interpersonal relationships Nursing competence Evaluation Teaching ability Personality traits Ratings of 5 subsets of effective clinical educator characteristics Lee at al. (2002)

13 Clinical education: What does the evidence tell us? Clinical learning environments: Positive factors recognition of students presence, appreciation and support a collegial environment where students are perceived as members of the team good communication team spirit a positive atmosphere democratic leadership styles positive interactions with staff Papp et al. (2003), Clare et al. (2002, 2003) Leading clinical learning

14 Clinical education: What does the evidence tell us? Clinical learning environments: Less positive factors lack of direction poor communication unrealistic expectations lack of collaboration between students and staff unreceptive or ambivalent staff students perceived to be a burden Grindel et al. (2001); Clare et al. (2003); DHS, VicHealth (2009) Leading clinical learning

15 Clinical education: What does the evidence tell us? Positive ward atmosphere and effective clinical supervisory relationships with staff - the most important factors contributing to the quality of clinical learning (Saarikoski et al. 2002) Optimal clinical learning requires an adequate practice environment, a good relationship with a team or individual with sound theoretical knowledge and stimulating dialogue (Field, 2004) Leading clinical learning

16 Leadership: toward the how.. Thinking about how leaders lead, ie. influence others to achieve desired results: Several approaches/perspectives: Leadership as power Personal characteristics of leaders Leadership behaviors Leadership styles Situational leadership models Transformational leadership models Killian (2007) Australian Leadership Development Centre

17 Leading clinical learning Leadership as power positional authority, reward power, coercive power, expertise, interpersonal power effective leaders expand their power base beyond limits of positional authority use of rewards is one of the simplest yet most powerful forms of power a leader can exert coercive power should be used with care & judgement expertise is useful but not sufficient on its own importance of relational power is likely to increase Killian (2007)

18 Leading clinical learning Personal characteristics early trait / great man theories no single list found to hold true contemporary thinking includes: dominance, extraversion, sociability, self-confidence, high levels of energy, resilience and intelligence (reasoning + social intelligence, a sub-component of emotional intelligence) social intelligence – single largest factor impacting on leadership effectiveness (Killian, 2007) Aristotle once said that we are the sum of our behaviours; excellence therefore is not an act but a habit.

19 Leading clinical learning Leadership behaviours Competency-type models strategic thinking, change management, relationship builder, staff developer etc. Models based on roles/skills decision making, technical, interpersonal etc.

20 Leading clinical learning Leadership styles concern for people / concern for results eg. Blake-Mouton grid 1,1 delegate and disappear 9,1 produce or perish 5,5 middle of the road 1,9 friendly but not productive 9,9 team environment high satisfaction & high production

21 Leading clinical learning Situational approaches importance of context in deciding the right leadership approach in a given situation eg. Hersey & Blanchards model S1 – telling/directing S2 – selling/coaching S3 – participating/supporting S4 - delegating

22 Leading clinical learning Transactional / transformational approaches transactional leaders - focussed on day-to-day operations transformational leaders - motivate followers to perform to their full potential ….. translate intention into reality and sustain it … use power wisely (Burns 1978; Bass 1985)

23 Leadership and Clinical Education (LaCE) framework Leading clinical learning So, to the LaCE framework....

24 Leadership and Clinical Education (LaCE) framework Leading clinical learning This is a leadership framework that is designed to build your professional capabilities now and in the future. The LaCE framework conceptualises clinical education leadership as involving: cognitive and behavioural complexity personal valuing of best practice critical observation and reflection commitment to ongoing learning and development

25 Leadership and Clinical Education (LaCE) framework The Framework is designed around 4 key areas, all of which relate to the role of a clinical facilitator/supervisor. The precise emphasis on individual areas will vary depending on the individual context / situation. Each section of the Framework contains key attributes of clinical education leadership practice that are supported with self- assessment tools for personal reflection. The Framework is underpinned by core professional values in relation to ongoing learning for quality practice and professional development. Leading clinical learning

26 Establishing direction Enacting self development Executing the role Enacting to achieve Dimensions of practice Attributes Sharing vision and values Setting clear goals Promoting a culture of learning Communicating effectively Interacting in a range of contexts Empowering others to achieve Clinical teaching & learning Assessing students performance Managing day-to-day business Knowing self Obtaining feedback on performance Engaging in personal and/or professional development Professional learning Personal development Enhanced student outcomesAchievement of personal / professional goals Leadership and Clinical Education Framework REFLECTION ON PRACTICE ACTION LEARNING

27 Using the framework to enhance clinical education practice Personal reflection on your own practice Reflecting on feedback obtained from others Identifying areas for personal improvement Putting an action plan in place Evaluating the outcomes achieved Leading clinical learning LaCE dimensions and attributes

28 Leading clinical learning Some closing thoughts… Leaders are responsible for getting results through others. Leaders should be judged not by what they do, but rather by what those around them are doing and achieving. In this light it is very clear that leadership is people work, with a focus on achieving results. Australian Leadership Development Centre

29 Leading clinical learning The task of leadership is not to put greatness into humanity but to elicit it - for the greatness is already there John Adair, 1990, Not bosses but leaders

30 Leading clinical learning References Bass, B. (1985). Leadership and performance beyond expectations. New York: The Free Press. Bennis, W. & Nanus, B. (1985). Leaders : the strategies for taking charge. New York: Harper & Row. Blake, R. & Mouton, J. (1994). The managerial grid. Houston: Gulf Publications. Burns, J. (1978). Leadership. New York: Harper & Row. Clark, D. (1997). In Zilembo, M. & L. Monterosso. (2008)., Nursing students perceptions of desirable leadership qualities in nurse preceptors: a descriptive study, Contemporary Nurse, 27(2), Harvey, G., Loftus-Hills A., Rycroft-Malone J., et al. (2002). Getting evidence into practice: the role and function of facilitation. Journal of Advanced Nursing, 37, 577–588. Hersey, P., Blanchard, K. & Johnson, D. (2001), Management of organizational behavior: leading human resources. Upper Saddle River, N.J. : Prentice Hall. Kouzes, J. & Posner, B. (2003). The five practices of exemplary leadership. In Kouzes, J. Business Leadership. San Francisco: Jossey-Bass. Lambert, V. & Glacken, M. (2006). Clinical education facilitators and post-registration paediatric student nurses perceptions of the role of the clinical education facilitator, Nurse Education Today, 26(5), Lee, C., Cholowski, K. & Williams, A. (2002). Nursing students and clinical educators perceptions of characteristics of effective clinical educators in an Australian university school of nursing, Journal of Advanced Nursing, 39(5), McAllister, L., Lincoln, M., McLeod, S. & Maloney, D. (1997). Facilitating learning in clinical settings. Cheltenham, UK : Stanley Thornes. Pratt, D., Arseneau, R., & Collins, J. (2001). Reconsidering good teaching across the continuum of medical education, The Journal of Continuing Education in the Health Professions, 21, 70–81. Robinson, C. (2009). Teaching and clinical education competency: Bringing two worlds together, International Journal of Nursing Education Scholarship, 6(1), Tang, F., Chou, S., Chiang, H. (2007). Students perceptions of effective and ineffective clinical instructors, Journal of Nursing Education, 44(4),


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