Fig. 2.1
Structure of team action projects in surgery
Fig. 2.2
Example of team composition
Formal preparation should be followed by leadership auditions. Every participant in the Leadership Development Program was provided opportunity for a larger leadership role within the Department of Surgery. In any department of surgery there are many opportunities: clerkship director, associate chair for research, division head, residency program director. The auditions were structured to give graded responsibilities and the possibility of larger leadership roles. These tests of leadership are designed to answer two fundamental questions. From the perspectives of the other members of the department: Is the developing leader good at leading? From the perspective of the new leader: Do I like being out front? And, is this something I want to be a permanent part of my life?
Leadership development is stimulated by feedback. A powerful tool for intermittent feedback is the 360° evaluation method. In this process, differing perspectives of the leader – from supervisors, peers, direct reports, nurses, and house staff – provide appraisal of strengths, weaknesses and areas for improvement. The responses are rendered anonymous to encourage candor. Usually, both a structured evaluation instrument and written comments are provided. All leaders need periodic feedback on their performances as leaders. The structure of the 360 method with its holistic view and anonymous evaluations helps leaders see themselves as others see them. Leadership improves with practice. What changes is the leader’s capacity to use interpersonal relationships to move and shape people and events. All participants in the Leadership Development Program were required to participate in a 360° evaluation. A series of professional coaching sessions then followed to first interpret the results and then to suggest methods for leadership improvement.
2.8 The Leadership Dilemma
As Chatman and Kennedy note, “The obvious traits such as confidence, dominance, assertiveness or intelligence, have not, it turns out, shown the level of predictive validity that one would hope for. Rather, we suggest three subtle but likely more powerful qualities that transcend particular individual differences and behaviors. They are a leader’s diagnostic capabilities, the breadth and flexibility of his behavioral repertoire, and his understanding of the leadership paradox” [7]. Here diagnostic acumen is meant as the ability to determine for every situation the unique contribution that the leader could make to crafting a solution to that particular circumstance. The obvious value is that every challenge is considered on its own merits and that proposed solutions are tailored. It also follows that leaders need a broad and flexible array of behaviors to respond to an equally wide array of complex situations.
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