1. CPD day for NACT UK members
BLIME
Basics for Leadership In Medical Education
CPD day for NACT UK members
May 2017
“ I think a major challenge for education is holding on to and articulating …
…..so it does not become disrupted by political expediency or financial cutbacks”
Leadership - a shared process of enhancing the collective and individual
capacity of people to accomplish their work roles effectively

2. Your role(s) in Medical Education
In pairs:
Are your roles well defined?
Do you know your responsibilities?
For your Trust?
For your School / Deanery / HEE / University / other organisation?
Do others understand what you do?
In pairs- 6 minutes (3+3)
Suggest people mix if they wish – maybe identify someone with similar roles to discuss.

3. YOUR ROLE
Leadership
Management
Education

4. Expanded Role of College Tutor
Chair of Surgical Faculty Group
Responsible for quality control of surgical education environment in Trust, including skills centre
Responsibility for ensuring relevant standards regarding training are met, e.g NatSIPSS
Support for ALL surgeons in Trust including SAS doctors (and others doing surgery, e.g. nurses?)
Co-ordination of mentoring programmes and advice to surgeons in difficulty in conjunction with DPA
Educational development and appraisal of Specialty Leads (Tutors) – who in turn are responsible for their respective ES/CS
Handout the JD for College Tutor
Discuss what roles a College Tutor could undertake
The expanded role of a tutor is equivalent to a deputy DME and some Trusts have adopted this model for the large specialties of surgery and medicine
The revised job description makes it clear that the College Tutor can take on these roles, but needs discussion with the DME
How many sessions would this role require to do it properly?

5. Management of Doctors in Training
This diagram demonstrates the various roles of the trainee and it has been reproduced as a handout for distribution to the delegates.
They have a responsibility to learn and the GMC have defined the roles of the supervisors who support them.
Trainees also have a responsibility to work and support the service, getting clinical day-to-day supervision by all members of the MDT. And they are performance managed through the Clinical Lead / Director – like all doctors.
The responsibility of the DME and the Tutors in all specialties is to ensure a suitable learning environment – we will discuss that further in Day 2
Specialty Tutors also have a responsibility to ensure F1 & F2s get supervision and support
Produced by Liz Spencer and endorsed by the NACT Council, 2013.

6. Styles
Complete the handout
Discuss in 2s or 3s

7. Goleman’s 6 leadership styles
In groups:
In your educational leadership role discuss:
Which style(s) do you feel
that you adopt most frequently?
Have you been in a situation where you recognise that you have used
one of these styles to good effect?
Or used a style that was less than
optimal??
10 minutes in groups and 5 minutes plenary
Leadership styles
Coaching “you can do it..”
“Do what I say”
Commanding
Visionary “Come with me”
Affiliative “People first”
“What do you think?”
Democratic”
“Do as I do now”
Pacesetting
Golemans’ article – Leadership that gets results – was provided as part of the pre-course work for Day 1
One of the best-known models is Daniel Goleman’s six leadership styles. Goleman is probably best known for his work on emotional intelligence (as opposed to cognitive intelligence) and he also carried out a ground-breaking study on leadership published in the Harvard Business Review in 2000 as ‘Leadership That Gets Results’.
To recap these 6 styles are:
Coercive – do what I say,
Pace-setting – do as I do,
Authoritative – come with me,
Affiliative – people come first,
Democratic – what do you think, and
Coaching – try this
In small groups and considering your educational leadership role ……………… 10 mins for this then 5 mins plenary discussion.
Make the point that there is no ‘right’ style and that the most effective leaders are able to move between styles choosing the one that best suits the situation.
Also emphasise that surgeons tend to adopt different leadership styles in clinical situations
Goleman’s 6 leadership styles

8. Leadership
P – perception – to horizon scan, detect opportunity, create vision for development
A – articulation – of the vision with clarity, paint image of success, break down into bite-size pieces
C – conviction – be positive, believe in the vision, passion,
E – empathy – demonstrate understanding of others, appreciate difficulties, remain positive,
R – resolve – remain unswerving, repeat vision frequently, if know it is right thing then must be achieved even if takes a while

9. FMLM Behaviours Self: Team Player / Team Leader:
Self awareness & self-development
Personal resilience, drive & energy
Team Player / Team Leader:
Effective teamwork
Cross-team collaboration
Corporate responsibility:
Corporate team player
Corporate culture and innovation
System Leadership
The advantage of the FMLM framework is that the described behaviors are observable, measurable and assessable
They can therefore be used to assess any doctor’s leadership role – either self-assessment or to aid development and inform appraisal / revalidation
Delegates should have done this as part of their pre course work so can refer to that here.

10. Self assessment

11. Chairing Meetings
As part of leading a team or project and encouraging individuals to contribute ideas In small groups: What skills are important for a good Chair? 5 minutes
Leading a team or project (task) and encouraging contributions from the team, often requires you to chair meetings
The resources made available to you before the course included a guide to chairing a meeting..
What skills are important for a good Chair? Discuss in small groups (5 minutes). Facilitator to summarise on a flip chart
2nd click: will bring in the illustration of the qualities of good Chairs

12. Stakeholders
Who do we work with
Internal & external

13. The Education Environment
Changing Behaviours in the Workplace

14. What are we cultivating?
Group 1
What is a good learning environment
Group 2
Essential ingredients for positive learning culture in the workplace
3 minutes

15. Successful Learning Environments
Inspirational Leadership
Efective Management
Positive Partnership
Open, trusting, OK to ask & reflect
Appropriate rota
Time for discussion
Between healthcare providers & tertiary institutions
Task focused to Behaviour focused
induction
Clear definition of roles & expectations
Role-model
Professional Knowledge
Evidence of proficiency
Consistent behaviour
Released for training
Multiprofessional team know what is needed & their role to engage with novices
Assist staff to integrate
Feedback, discussion & support (supervisor)
Role model - professional Knowledge, evidence of proficiency, behaviour
Lear by observation as well as participation – time required to discuss, reflect and distil learning from this
HENDERSON A., BRIGGS J., SCHOONBEEK S., & PATERSON K. (2011) A framework to develop a clinical
learning culture in health facilities: ideas from the literature. International Nursing Review 58, 196–202

16. Developing a learning culture: twelve tips for individuals, teams and organizations
Value and recognize the need for lifelong learning
Energize active learning amongst students
Develop self-awareness
Be open to new ideas
Make time for learning
Teams should provide protected time for learning
Develop a shared team, departmental or organizational vision
Take time out to build the team
Develop leadership skills
Learn from mistakes
Think about the wider environment
‘Take time to smell the roses’
Stinsin L, Pearson D, Lucas B. Medical Teacher, Vol. 28, No. 4, 2006, pp. 309–312

17. Published Feb 2015

18. Building a Supportive Environment GMC 2015
Valuing doctors in training
Departmental cohesion & leadership
Workload & stress for trainees & consultants
Communication with trainees and recognising undermining & bullying
Effective senior leadership

20. GMP March 2013
you must work collaboratively with colleagues, respecting their skills and contributions
you must treat colleagues fairly and with respect
you must be aware of how your behaviour may influence others within and outside the team.

21. GMP March 2013
you must work collaboratively with colleagues, respecting their skills and contributions
you must treat colleagues fairly and with respect
you must be aware of how your behaviour may influence others within and outside the team.

22. The JoHari Window ASK TELL Shared discovery Known by self
Unknown by self
Known by others
Open/Free
Area
Blind Area
TELL
Shared discovery
Progressive reveal slide: Article in Post Day 1 Resources
This is quite a simple tool which can be used for illustrating and improving self-awareness and mutual understanding between individuals within a group. It was devised in the mid 1950s by two American psychologists - Joseph Luft and Harry Ingham – hence the name of the model is based on their 2 first names.
The Johari Window actually represents information - feelings, experience, views, attitudes, skills, intentions, motivation, etc - within or about a person - in relation to their group. It is like window with 4 ‘panes’ or regions, each of which is normally shown to be the same size
The Johari Window 'panes' can be changed in size to reflect the relevant proportions of each type of 'knowledge' of/about a particular person in a given group or team situation.
Click 1: By asking for and receiving feedback from others, the individual’s open area can be extended across into their “blind area” as information that was unknown to the individual about him/herself is shared.
Click 2: If the individual so chooses, s/he can extend their open area down into their hidden area by disclosing information about themselves to others in the group
Click 3: Through the continued exchange of information between the individual and others in the group, the open area can be pushed further and into the area that was previously unknown to both the individual and to others.
The final Take Home Message from this is the need to ensure that there is an OPEN area with all their colleagues & team members – this requires you to tell your colleagues (and trainees) things about yourself AND to seek feedback about the impact of your behaviours on them.
Unknown by others
Hidden Area
Unknown Area

23. Purpose of feedback Recognise and build on strengths
Identify limitations & structure development needs
Encourage self awareness & insight
Set clear goals to improve performance and assist in career development
BECAUSE YOU CARE

24. What are we going to do when we experience / witness undesired behaviours?
Discuss with the person in private
calm, thoughtful, prepared
Send person to office to calm down
Regular feedback – individual / group
Define what are acceptable & non-acceptable behaviours
Develop a process of how to handle undesirable behaviours & include in induction
Involve a neutral person – named individual who anyone can go to ? Specialty tutor
Clarify role of the ES/CS in this for trainees

25. 2 Groups How should we give feedback How should we receive feedback
What makes it difficult?
How should we receive feedback
What makes it go wrong?

26. Principles of Giving Feedback
Describes behaviour and its impact – non-judgmental
Specific, Sensitive & Timely
Confidential FREQUENT – all the time!
Involves the receiver – conversation – manage the airtime >50% theirs
Relevant to the curriculum / stage of training - prioritised
Against known expectations – don’t move goal post
Confronts important or difficult issues
Balanced – positive & negative
Is understood and accepted by the receiver
Method of delivery flexed according to receiver
Is given by someone who genuinely wants to help
Suitable venue – away from patients – clarify timeframe & agenda

27. Receiving Feedback
In private? Agenda stated so am prepared. Confidential.
I will listen & be open to comments / suggestions
Am respected as a person & doctor, treated as an adult
From someone who cares & who I trust / respect
Direct, honest, frequent
Empowered to discuss / Time for discussion
I make action plan with guidance, may need time to reflect
Understand formative nature
My opinion invited & I am listened to
Taylored to seniority & builds on existing knowledge
Treat it as a gift 

28. And ….
We agree that when we are the receiver of feedback we will listen, reflect and learn

29. “Leaders …..have a crucial role to play in shaping a positive culture…”
Berwick August 2013

30. Problem Solving

31. Stages of Problem solving
Define and analyse (5 mins)
Define exactly the issue
Fact finding - goal / barrier(s)
Looking for possible solutions (7 mins)
Generate possible actions – use whole group
Analyse options
Summarise and devise action plan (3 mins)
Make decision on action / timeline / review

32. Action Learning Sets
4 groups
1 hour

33. Individual Reflection
Leadership
Management
Education
What have you gained from today?
What are you going to
DO as a consequence?
Remember you can shape the future!
Activity to take 10 minutes
Handout the reflection form– ask delegates to reflect – what has today meant to you, what have you learned – want are you going to do? Discourage any talking to neighbours, etc – these are to be their own thoughts