Clinical leadership: evaluating the benefits of action learning using co-operative inquiry.

Abstract

Background: Developing clinical leadership, to ensure the culture of care is strengthened, is the thrust of the ‘leading with compassion’ campaign by the English National Health Service (NHS) (NHS England, 2014). Senior clinicians are charged with invigorating compassionate leadership yet the roles of nurse and therapist consultants the most senior clinical role in the UK healthcare system, are often solitary ones, in which they are expected to embrace a myriad of responsibilities and where there continues to be ambiguity about their role and scope of practice. In such exposed positions in any healthcare system from a global perspective, consultant nurses and therapists are vulnerable to the vagaries of the demands made upon them and the need to strive ever harder to improve the quality of services and patient care (McIntosh & Tolson 2008). Mentorship can be seen as a way of supporting clinicians, even on a global exchange system but a system (Buckner et al 2015) where the consultants can support themselves through action learning (McGill & Beaty 2001) reinforces their commitment to each other and to the potential benefit of their organisation. The aim is to evaluate the effectiveness of an action learning set (ALS) to enhance clinical leadership and extend their scope and confidence more strategically Methodology: Using an approach advocated by Heron & Reason (2001), co-operative inquiry is a way of researching with rather than on people, of working with those who have similar interests and who wish to collectively understand their world and create new ways of exploring it. This approach helps also to learn how to change and enhance our working practices. With all active subjects fully involved as co-researchers in all research decisions, three cycles have been completed of four phases of discussion of reflection, analysis and action. The process is planned to last for 18 months. Data were analysed thematically. Findings: Four themes began to emerge from the data: development of scholarship, responding to changing need, extending networks and empowerment in role. Whilst the consultants had grown considerably in confidence in their leadership role, they did not feel that collectively they fully embraced the four dimensions prescribed by the Department of Health for the role. Nevertheless, the co-operative inquiry helped them realise how much they had gained from their collective learning in the group (ALS) and how, from the group they feel empowered to lead. The ALS has enabled them to remain focused and reflect critically both personally and within the group. Their reflections helped them value the importance of the role for the organisation, their credibility within the organisation and they have been keen to retain their peer support to ensure its sustainability. Conclusion: Whilst their motivation to ‘make a difference’ remains palpable, the outcomes of the co-operative inquiry included an enhanced understanding of the importance of openness and trust of each other and a willingness to share and learn from each other in a respectful and confidential environment with a receptiveness to change. They believe that they are more aware of their influence on others and feel more able to challenge their medical colleagues with greater conviction and now have a recognised voice within the organisation. Clinical relevance: Time away from their clinical responsibilities to consider improvement of issues challenging these autonomous practitioners has proved invaluable to the improvement of their specialist services and enhanced the confidence of those new to role. Additionally, this collaboration has improved communication across the organisation, enhanced their strategic leadership capability and given confidence to disseminate externally. Key words: leadership, action learning, co-operative inquiry, Words: 569 3 Bullet points as to how your work contributes to knowledge development in the selected theme: • The value of action learning sets for consultant therapists using a co-operative inquiry approach can lead to further empower individuals to address the complex problems in practice and lead to change. • Co-operative inquiry has been a powerful tool to engage these senior consultants in a number of cycles of reflection and evaluation, researching with each other and experiencing first hand the value of the ALS to each of them individually. • Action learning sets can help senior clinicians, early on in their leadership role, take ownership of their complex problems and commit to each other by supporting their development of creative thinking and problem solving. References: Bell M., Coen E., Coyne-Nevin A., Egenton R., Ellis A. and Moran L. (2007) Experience of an action learning set. 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