Leadership in Health System Shahid Beheshti University of Medical Sciences School of Medical Education Strategic Policy Sessions: 24 Dr. Shahram Yazdani

Defining leadership  Leadership is the process through which an individual attempts to intentionally influence another individual or group in order to accomplish a predetermined set of goals

Characteristics of leadership  Leadership is a process. It is a verb, an action word, not a noun.  Leadership manifests itself in doing; it is a performing art.

Characteristics of leadership  Only individuals lead.  The locus of leadership is in a person. Inanimate objects do not lead, groups do not lead, only people do.

Characteristics of leadership  The focus of leadership is other individuals and groups.  A leader cannot exist without followers.

Dr. Shahram Yazdani6 Characteristics of leadership  Leadership entails influencing followers, their thoughts (the cognitive target of influence), feelings (the affective target), and their actions (the behavioral target).  Influence is leadership’s center of gravity and most critical element.

Characteristics of leadership  The objective of leadership is goal accomplishment.  Leadership is instrumental; it is done for a purpose.

Characteristics of leadership  Leadership is intentional, not accidental.  All of us unknowingly influence others hundreds of times each day, but those are not acts of leadership.

What is leaders main tasks?  Leaders have two main tasks:  To set a path, goal, or vision for the people who are being led.  To motivate people to pursue and eventually achieve the goal.

Leadership Versus Management  A manager have different roles such as formulating goals, developing strategies, communicating, making decisions, collecting information, planning, organizing, monitoring, and resolving conflicts;  But without leadership or with poor leadership the organization is impaired.

Multidirectionality  Leadership is multidirectional.  A person can lead not only subordinates in his organization but also peers, superiors, and individuals and groups outside the organization.

Leadership and Power  The more power a person possess, the greater the potential that he or she will be able to influence other individuals and groups.  The key concept here is potential; one can have power and not use it.

Sources of power  Office power: power associated with a particular managerial office  Expert power: information, knowledge, skill, abilities, and experience  Referent power: connection with other individuals and groups who possess influence  Reward / Coercive power: control of incentives  Charismatic power: one’s own persona

Characteristics of Good Leadership

What influences leadership effectiveness?  Nature  Nurture  Situational factor

The nature argument Trait Leadership Effectiveness And Success

The Nurture Argument Trait Leadership Effectiveness And Success Abilities & Behaviors

The Situational Argument Trait Leadership Effectiveness And Success Abilities & Behaviors Situation

Stogdill Research Factors Affecting Leadership  Capacity  Intelligence  Alertness  Verbal facility  Originality  Judgement  Achievement  Scholarship  Knowledge  Athletic accomplishments

Stogdill - continued  Responsibility  Dependability  Initiative  Persistance  Aggressiveness  Self-confidence  Desire to excell  Participation  Activity  Sociability  Cooperation  Adaptability  Humor

Stogdill - continued  Status  Socioeconomic position  Popularity  Situation  Task to be accomplished  Followers to be led

Dr. Shahram Yazdani22 Kurt Lewin oKurt Lewin(1930): three type of leadership 1.Autocratic Leadership (direction) 2.Democratic Leadership (facilitation) 3.Laissez-faire Leadership

Dr. Shahram Yazdani23 Leadership Behavior Continuum Manager centered Follower centered Use of authority by Manager Freedom for subordinates TellSellParticipateDelegateTell & AskAsk & Tell

Dr. Shahram Yazdani24 Path-Goal Model Evans & House & Dressler EffortPerformanceRewardMotivation InstrumentalityExpectancyValence Subordinate Perceptions Work Environment Characteristics Subordinate Characteristics Leader Behavior (style)

Path Goal Model  Expectancy is the relation between effort and performance  Instrumentality is the degree to which a person perceives that performance will lead to reward  Valence is the strength of a person’s preference for different types of reward

Path Goal Model  According to expectancy theory a person will be highly motivated when effort results in performance (high expectancy) and when performance leads to rewards (high instrumentality) that are valued (high valence)

Implications of Path Goal Model  The path between effort, performance, and reward is difficult. The leader must do everything possible to turn what is often a cow path into a well designed, high-speed freeway  Individuals’ valences are heterogenous

Implications of Path Goal Model  The contingency most under a manager’s control is his own leadership style:  Instrumental behavior (defining objectives and specifying the task to be performed)  Participatory behavior (seeking follower input on decisions that affect them  Achievement-oriented behavior (establishing goals and setting expectations that challenge followers)

Factors affecting effectiveness of leadership  Characteristics of the manager: Traits / dispositions Skills Values  Characteristics of followers: Skills Knowledge Experience Responsibility Understanding of goals and tasks  Characteristics of situation: Time availability Nature of problem

Educating for Leadership (FP Program in Iran)  Individual Coaching  Team Building and Teamwork  Meeting Management  Empowering and Delegation  Conflict Negotiation  Positional Bargaining  Interest Based Bargaining  Third Party Alternative Dispute Resolution  Consensus Building  Stakeholder Analysis  Advocacy  Collaboration and Partnership Building

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