This paper argues that studies of middle leaders have focused too much on their functions and characteristics, taking insufficient account of the influence of social and political contexts on leaders' choices of actions. Use of the analytical framework of Communities of Practice (Wenger, 1998) can address this oversight, but it pays insufficient attention to the dynamic processes by which people interact and make meaning of their interactions. The paper concludes that combining existing theories of power with the framework of Communities of practice gives a more complete view of middle leaders at work than current approaches.
ABST RAC TThis paper reviews the research recently undertaken on the Head of Department role in secondary schools in England and W ales and aims to link current knowledge to their in¯uence on classroom teaching and learning processes. A rather fragmentary literature exists which tends to deal with the role from a holistic point of view. N o research could be found which speci® cally relates these tw o aspects directly, but some suggestions are made which might help in providing the direction of future research.
Background
Medical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, as an ‘executive virtue’, offers a way to navigate the practice virtues for any given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis-based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.
Methods
The primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n = 131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian, MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.
Results
We found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ ‘collective practical wisdom’, including the phronesis virtue. This study advances the existing theory and practice on phronesis as a decision-making approach due to the availability of these continua.
Conclusion
Given the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, the continua in the form of a video series and app based moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well.
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