Going beyond the hero in leadership development: the place of healthcare context, complexity and relationships Comment on “Leadership and leadership development in healthcare settings – a simplistic solution to complex problems?”

There remains a conviction that the torrent of publications and the financial outlay on leadership development will create managers with the skills and characters of perfect leaders, capable of guiding healthcare organisations through the challenges and crises of the 21st century. The focus of much attention continues to be the search for the (illusory) core set of heroic qualities, abilities or competencies that will enable the development of leaders to achieve levels of supreme leadership and organisational performance. This brief commentary adds support to McDonald’s (1) call for recognition of the complexity of the undertaking.


Introduction
The growing fascination or perhaps emerging cult of leadership has been one of the most enduring aspects of work over the last two decades, a phenomenon that is reportedly as pervasive now as it was in the time of the ancients (2). Much has been made in recent times of the perceived failure of charisma and narcissistic organisational leaders (3) and yet both media coverage and mainstream writings continue to seek a torch-holder for corporate leadership and larger than life leader figures. Such a focus remains of central importance in healthcare contexts too. In support of this quest for leadership, countless managers across the globe are embarking on leadership development activities to support their current roles or future aspirations as organisational leaders (4). There is a belief that the deluge of publications and considerable investment in leadership development activities will create managers with the skills and characters of leaders, capable of guiding our healthcare organisations through the crises of the 21st century workplace. Indeed, the sheer volume increase in leadership development initiatives has created expectations of better leaders in our workplaces. Typically informed by mainstream leadership approaches that privilege functionalist perspectives and positivist epistemologies, such development programmes often espouse the value of intuitively appealing, dominant approaches such as charismatic or transformational leadership models, with their 'heroic' assumptions that romanticise the influence of individual leaders and underestimate the significance of local and organisational context and relationships (5). Such approaches ignore any critical engagement with the complex conditions, processes and consequences of leadership-followership dynamics in the contexts of contemporary organisations (6,7). Indeed critical approaches to researching and conceptualising leadership and leadership development are still greatly outnumbered by mainstream accounts (8). Even within more critical writings, relatively little attention is paid to the relational dimensions of leadership and to followers and other participants in the leadership relationship. These 'others' are rarely asked to participate in research or development activities on leaders and leadership. In the few (albeit developing number of) studies that have sought to include relational perspectives, such colleagues have been included in development interventions only to assess the qualities of their leaders and to comment on what it is that defines good and poor leadership (9). Such studies, largely quantitative surveys, not only presume that participants can identify themselves as followers of leaders, but also tell us little about the follower or other parties in the leadership relationship. Virtually all leadership development interventions seek to target those individuals who are perceived as current or future occupants of leadership roles. If we accept that leadership is co-produced by at least leaders, peers and followers (as well as the organisational context in which it occurs), it follows that these parties should be active in participating in leadership learning -going beyond completion as anonymised 'raters' of their managers within the 360 survey instruments and other questionnaires that seek psychometric predictions of leader behaviours. There is considerable risk that the preoccupation with leaders reinforces an exclusive focus on self-awareness, self-development and self-improvement at the expense either of gaining insight into relational dynamics or of an appreciation of the context and environment within with leadership occurs (6,10). This raises a significant question as to how can something that is purportedly relational, and founded on the impact that one person has on many others, merely and purely focus on the one person, the leader? The continuing preoccupation of many leadership development interventions with the skills, abilities and competences of the leader as an individual serves to reinforce this transcendental quality, and runs the risk of aggrandising the value of the leader's accomplishments -to the potential detriment not only of followers and others in the leadership relationship, but also to the goals of contributing towards the enhancement of leadership learning and development within the organisation. The exclusive focus on leaders can thus eclipse considerations of other parties to leadership encounters and ignore broader contextual factors that need to be recognised as part of more critical deliberations of leadership development activities.

The ubiquity and cost of leadership development
Leadership development has become a multi-billion dollar global experience, with an estimated annual spend of 14 billion US dollars on leadership development world-wide (11). Spend in the UK is estimated at something in the order of 20 million days a year on programmed management development activity which doubles if more informal activity is included. With regard to leadership development programmes, in a study in the UK (12), the 30 organisations (from a total of 44) which replied to postal questionnaires reported a shortage of leadership skills, with just one of the 30 organisations reporting itself as having the leadership skills thought necessary for success. Leadership development was a top or important priority in 78% of UK-based organisations, and leadership development initiatives were common, with 23 (82%) of organisations stating that they have them. The preferred form of training was through short courses, with only one-fifth of organisations sending staff on courses which ran for more than two weeks. The impact of these courses was not known, with 60% of respondents reporting that no formal evaluation had been undertaken. Little support was provided to participants either while they were on programmes or upon their return to the organisation. In a study of 2,600 organisations in 74 countries with 1,900 Human resources (HR) professionals and 12,500 leaders a number of key factors were identified associated with worrying trends in leadership development activity (11). Such findings indicated low satisfaction with the effectiveness of leadership development, despite the rising investment in planned events, with only 1 in 3 leaders believing that they are getting value for money from the development they are receiving. Furthermore, the study identifies that only 18% of HR respondents feel that their companies have the quality and quantity of leaders they will need to run their companies in 3-5 years from now. These results are supported in the limited literature that explores such development programmes, a literature that is primarily evaluative research which attempts to assess the success of the programmes in terms of whether or not they achieve their stated objectives -very much at the reactions level of Kirkpatrick's (1975) taxonomy of evaluation (cited in Day). Of even greater concern, writers do not question the assumptions upon which the courses are built. The more informed evaluations in the UK healthcare context (13) show that participants report themselves better able to handle the demands of their jobs, but these studies are small-scale -often reporting evaluations of just one programme. More recent critical writings reinforce the importance of engaging research on leadership and management development (6,10,14). Mabey and Finch-Lees (15) identify 5 sets of arguments in relation to the imperative of seeking to identify the value and significance of management and leadership development activities. These range from the seemingly measurable and more frequently studied economic and financial arguments through to the recognition of multiple perspectives of differing stakeholders; the moral or ethical reasons and the identity creation issues. This is important as so many approaches to leadership learning seek to define so narrowly what it means to be a leader.

Encouraging new approaches
There remains the tendency of leadership development programmes to offer normalised solutions to leadership development in their endeavours to develop standard models and robust competency frameworks that foster compliance rather than widen the scope of possible and heterogeneous approaches in leaders. Within an emerging field of more critical approaches to exploring leadership (18)(19)(20), there is a growing recognition of the value of balancing the desire for some prescribed outputs from learning interventions with a need to nurture leaders (and future leaders) and to encourage reflexive space in which they can explore, challenge and develop their learning both as individuals and more collectively as peers, followers and leaders (7,16). Such critical approaches to studying, conceptualising and practising leadership (and leadership development more specifically) are both encouraging and opportune, as they provide much greater potential to challenge the taken for granted assumptions of much mainstream writing and to address questions relating to power dynamics; contextual and other factors. They offer opportunity to rethink ways in which to breath new life into traditional approaches to leadership learning (19,20). There is a need to move away from prescriptive and leadercentric approaches and towards viewing leadership as a social process, which encourages individuals and organisational members to inter-relate in ways that encompass new forms of intellectual and emotional meaning. More contextual, relational and interconnected approaches should occur in leadership development activities. These should acknowledge the impact of dominant ideas about leadership on the self, but also the ways in which participants interact with others, and the ways in which those interactions are constitutive of the self. However, this is advocated cautiously, as its purpose is not a psychoanalytic, therapeutic or counselling encounter, but rather to use the development of self-knowledge and relational understandings in ways that are challenging and also productive. A similar approach is advocated by Sinclair (17) who has written influentially on the limitations of leadership development and leadership education and the ongoing preoccupation with heroic and leader-centric notions. She promotes an approach that combines 3 principles in her leadership teaching. First, reflection has become the basis of being a better leader, and participants are encouraged to delve into their history and journey as leader and follower; second, learning comes from direct experience and the resource of the whole group can be used to this effect. Finally, leadership theory is used as a body of ideas and concepts to be examined critically both in the light of participants' experiences, but also on ethical and moral grounds. Such engagement with critical perspectives is also apparent in Carroll and Levy's (10) innovative approaches to leadership learning and development. Their research and development through the New Zealand Leadership Institute is informed by social constructionist theory and practice. They seek to pioneer work that is 'informed and shaped by understandings of identity, discourse and social context' (10). They also recognise the need for dynamic, relational, contextual and multiple approaches to leaders' identities and the leadership context. Similarly, Petriglieri (7) argues that to improve leadership learning, leaders need to consider how images, assumptions and stories they carry in their minds necessarily impacts on how they approach, understand and learn from experiences. He conceptualises leadership learning as identity workspaces in which it is important to work within three streams of research: the participants' experiences of leading and following; making sense of their life stories as part of their identities; and their emotions and the unconscious. Attention to emotional and unconscious research thus recognises that managers experience complexities, contradictions and tensions which need to be reflected in learning and development approaches (18).

Concluding thoughts
Leadership development activities need to become more inclusive, eclectic, integrated and contextually aware (6,8,14). Rather than leadership being a straitjacket, it should seek to improve interactions between managers, clinicians, knowledge workers and all employees. It should enhance the quality of working life in general. Leadership learning should therefore be designed in more inclusive and relational ways so that key parties to the leadership relationship are actively engaged. Such learning should encourage participants to challenge the taken for granted, normative and hegemonic assumptions of leadership and introduce other ways of seeing, interpreting and understanding themselves, their colleagues and their work contexts. Embracing more critical approaches to leadership learning should encourage scholars, students and practitioners alike to be more eclectic, creative and heterogeneous in their approaches to thinking about, researching and practising leadership.

Ethical issues
Not applicable.