The policy and the practice: early-career doctors and nurses as leaders and followers in the delivery of health care

Abstract

There are increasing calls, from a range of stakeholders in the health sector, for healthcare professionals to work more collaboratively to provide health care. In response, education institutions are adopting an interprofessional education agenda in an attempt to provide health professionals ready to meet such calls. This article considers the nature of and interaction between professional and personal identity, power relations and leadership and followership in relation to the work practices of junior doctors and novice nurses and suggests ways in which understandings from these considerations might influence the educational preparation of students for these professions.

Dimensions, discourses and differences: trainees conceptualising health care leadership and followership

“…33,34 However, empirical studies in health care have focused on establishing leader traits, behaviours and styles, aligned with an individualist discourse (e.g. 35,36 [37][38][39] ). However, Fairhurst and Uhl-Bein argue for leadership research approaches that 'go beyond individual based theorising and survey approaches to the interactional processes at the heart of leadership'.…”

“…). Other research perpetuates this individualism by focusing on defining what makes a good leader or what attributes belong to whom (e.g …”

“…This is true although the importance of leadership development at all stages of medical careers has been endorsed by medical regulators worldwide . One of the few published studies exploring early‐career doctors’ and nurses’ understandings of leadership found that each group conceptualised leadership differently . These conceptualisations were influenced by a range of sources, including educational background, professional roles, professional bodies and organisational expectations (see also).…”

Implicit leadership theories and followership informs understanding of doctors’ professional identity formation: A new model

“…Problems may also arise in multi-disciplinary team settings where doctors, nurses and allied health professionals are required to work closely together. Doctors in this context may struggle to take leadership initiatives from those who are not doctors, however appropriate it is for that person to lead and how ever well qualified they are to do so (Barrow, McKimm & Gasquoine, 2011). Doctors who lead with the full support of their followership may not, therefore, be the most appropriate or able to lead, as their leadership expertise and ability is rarely that which is under scrutiny, rather it is their prototypicality that ensures loyalty.…”

Doctors on Status and Respect: A Qualitative Study

“…These changes are seen to be particularly threatening to the tacit (or experiential) dimensions of clinical knowledge and to the practice of the "art" of medicine (see Nettleton, Burrows, and Watt 2008;Watt, Nettleton, and Burrows 2008). With respect to their position in relation to other health professionals, doctors seem to be largely supportive of other professional groups extending their roles, but express concerns about role confusion and lack of adequate skill on the part of these other practitioners (see Barrow, McKimm, and Gasquoine 2011;Voogdt-Pruis et al 2011).…”