Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contact us Login 
  • Users Online:349
  • Home
  • Print this page
  • Email this page


 
 Table of Contents  
MEDICAL EDUCATION
Year : 2022  |  Volume : 10  |  Issue : 2  |  Page : 300-306

Academic leadership in the era of curricular and quality transition toward excellence: Frameworks that guide actions needed for facilitating and sustaining change


Department of Community Medicine and Medical Education, Believers Church Medical College, Thiruvalla, Kerala, India

Date of Submission20-Nov-2022
Date of Acceptance23-Nov-2022
Date of Web Publication23-Dec-2022

Correspondence Address:
Dr. Thomas Vengail Chacko
Believers Church Medical College, Thiruvalla - 689 103, Kerala
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/amhs.amhs_272_22

Rights and Permissions
  Abstract 


Leadership literature indicates that focus has shifted from “top-down hierarchical” to “leadership everywhere” approach within organizations and this also applies to academic leadership. The context in which the new eco-leadership discourse has emerged, is presented as it is important for academic leaders to be aware that they need to tailor their leadership style and approach to be ready for the 21st century challenges arising from “triple disruptions due to digital and technology revolution, environmental emergency, and rising societal iniquity.” The framework of “leading from within” that has emerged from research on leadership in higher education has been found to be relevant and resonates well with academic leaders in India and so is presented in greater detail. Understanding of different academic leadership frameworks has been used to generate guidelines for academic leaders to use for implementing the changes that they would be expected to make to improve quality and make faculty future-ready.

Keywords: Academic leadership, appreciative inquiry, change management, dean leadership, eco-leadership, institutional excellence, leadership frameworks


How to cite this article:
Chacko TV. Academic leadership in the era of curricular and quality transition toward excellence: Frameworks that guide actions needed for facilitating and sustaining change. Arch Med Health Sci 2022;10:300-6

How to cite this URL:
Chacko TV. Academic leadership in the era of curricular and quality transition toward excellence: Frameworks that guide actions needed for facilitating and sustaining change. Arch Med Health Sci [serial online] 2022 [cited 2023 Jan 31];10:300-6. Available from: https://www.amhsjournal.org/text.asp?2022/10/2/300/364976




  Introduction Top


In its quest for ensuring patient safety in an interconnected world, curricular paradigm shifts are being undertaken across the world from traditional, compartmentalized, discipline-based curricula that are mostly teacher-driven to a more student-centered, outcomes-based curriculum that focuses on meeting health-care needs with competent graduates who are job ready for working as a member of the health team in health systems.[1] This curricular transition also lays the foundation for institutions to adopt national standards for medical education for inputs, processes, and outcomes for quality assurance and quality improvement. Apart from this concern for ensuring patient safety within the country as well as in the interconnected world where workforce migration is happening to meet the global needs for the health workforce, the managements of educational institutions in a competitive demand–supply environment are themselves under pressure to be recognized as “centers of excellence” so that they can attract students with higher academic capability potential and thereby produce a competent graduate who can then compete better for higher qualification opportunities at the national and international levels. This also leads to such institutions getting better recognition and higher ranking at the national and international levels.

In order that institutions are able to adapt and thrive in the new competitive norm described above, there is a need for those who administer or run medical schools to look beyond the traditional medical school Principal/Dean type of thinking and doing. This is because they are essentially working as managers who run the institution efficiently maintaining the status quo but are often spending a lot of time “firefighting as crisis managers” as tasks pile up in quadrant I i.e., urgent and important described by Stephen Covey.[2] This is what differentiates a manager from a leader who anticipates through envisioning the changes in the future and the challenges that the 21st century's “triple disruptions due to digital and technology revolution, environmental emergency, and rising societal iniquity” described by Western.[3] Academic leaders are expected to foresee the change before it happens and empower faculty and the system to be ready before the change happens.


  Leadership Models/Frameworks and Changing Trends Top


Many leadership models are described in the literature. Each of them has a focus that fits the purpose for leading an organization or a system. They have also been changing over the years keeping up with the times and the new challenges that get thrown in with the changing times.

[Table 1] below captures in a nutshell what was classified as broad leadership discourses during the past century by Western through his research work.[3] Although these observations were made for organizations and leadership styles in general, they are also seen in academic institutions even today in varying degrees. It is consolidated in a tabular form to help us better understand the purpose for which a particular discourse of leadership evolved in the given context/circumstance, its effect on the workforce, and benefits for the organization so that academic leaders with position power can choose which elements of leadership strategies and activities they can choose from to achieve the vision and mission of the organization they have been entrusted to lead. Academic leaders who do not enjoy position power but are entrusted to play formal or informal leadership roles within the subecosystems (departments, empowered groups, etc.) can also use this knowledge to better understand the style and strategies used higher up the leadership ladder within the organization, and exercise an approach that best suits their purpose of existence within the subecosystem that they are leading. Literature on leadership indicates that the leadership approach has moved from top-heavy leadership roles in organizations to “leadership everywhere” within the organization. Hence, there is a need for those in formal leadership positions to recognize this and create an enabling and supportive institutional environment with policies in place that empower faculty through capacity building of all faculty for leadership roles irrespective of whether they hold formal academic leadership positions or not.
Table 1: The four broad leadership discourses during the past century (Western 2019)

Click here to view


In these modern times, faced with triple disruptions due to the digital and technology revolution, environmental emergency, and rising societal iniquity, it is good to know more about the eco-leadership discourse. It makes us aware that educational institutions are also part of larger ecosystems external to it and so are influenced by the changes that are happening around us, especially in the 21st century, where even human survival is at stake. It also makes the academic leader aware of systems within systems and the need to promote networking and connectivity and interdependence achieved through distributing Leadership internally and thereby transforming the organization through empowered specialized teams that are more autonomous, creative, participatory, and self-managing. In this type of setup, among the faculty and staff, there is a sense of organizational belonging i.e., being a “part of the whole” community. Within such institutions, there exists an “eco mindset” wherein there is a shift from top-down leadership toward influencing ecosystems and sharing collaborative structures which through collaborative networking mobilizes and energizes the whole organization.


  Academic Leadership for Managing Curricular Change and Institutional Excellence Top


In the context of the contemporary leadership literature and the author's own investigation through the use of appreciative inquiry (on leadership attributes and activities from workshop participants attending the academic leadership workshops that have impressed them the most), conducted over a decade at National and International Conferences in Health Professions Education found the following responses shown in [Table 2] below.
Table 2: Appreciative inquiry to discover qualities and action taken by their academic leaders

Click here to view


The output from the appreciative inquiry shown in [Table 2] is in line with the research output that led to the strategy of “leading from within” by Wolverton and Gmelch. They studied successful academic leaders in higher education in the United States and came up with the definition of academic leadership as “the act of building a community of scholars to set direction and achieve common purposes through the empowerment of faculty and staff.”[4]

There are three essential elements in the above definition, namely (1) building a community of scholars, (2) set direction and achieve common purposes, and (3) empowering faculty and staff. A similar sentiment is echoed in Kotter's very popular eight-step model of “leadership for change” which includes what corresponds to creating a community of practice (stated as creating a sense of urgency and forming a powerful guiding coalition), setting direction (reflected in steps of creating a vision and communicating the vision), and finally empowering others to act on the vision.[5] Literature in the field of health professions education under the recommended practical tips to develop a community of scholars also includes three major steps: establish the community – the vision identifying the need or purpose, then grow the community, and sustain the community.[6]

Hence, guided by the leadership literature, I am building on the Wolverton and Gmelch framework as stated in their definition of academic leadership in the light of the various discourses on leadership to fit the contemporary Indian academic context in general and applying it for providing academic leadership for change management to implement the newly introduced curricular reform in India – the transition to competency-based medical education (CBME) as well as leadership for change to take the institution to make it recognized as an “Institution of Excellence” as follows:

Building a community of scholars

For the academic leader of an institution or even the subecosystems within it, it is important to build a “community of practice.” Wenger (2000) defined it as “Communities of practice are groups of people who share a concern, a set of problems or a passion about a topic and who deepen their knowledge and expertise in this area by interacting on an ongoing basis…”.[7] It developed as a learning theory that promoted self-development and professional development but later evolved as a management tool for improving an organization's competitiveness.[8] For the members within this community of practice, there are benefits such as it helps them overcome challenges, gain access to expertise, and resources in the short term to make the work that they are doing more meaningful and optimized. In the long term, it helps them through collaborative advantage with personal and professional development to build their own professional identity and recognition. For the organization, it helps them in the short term with problem-solving, optimal use, and reuse of resources, keeping all updated in knowledge about the latest “state-of-the-art” and synergizes across units complementing each other's strengths to meet the needs of the organization. In the long term, the organization gains through the synergic capabilities of members, in the development of new strategies, promoting innovation, and enabling talent retention.

To build this community of practice, the academic leader must demonstrate behaviors or actions that show you care about others, involve others in new ideas and projects, support effective coordination by working cooperatively with others, provide opportunities for people to share ideas and information, treat others with respect, and make them feel they are an important part of the organization contributing to the reason for the existence of the organization.[4]

In the realm of the new competency-based curriculum shift paradigm, the academic leader needs to actively and deliberately build this community of practice for the implementation of the new CBME curriculum. This is because the faculty themselves are pioneers journeying in unchartered curriculum implementation which they themselves have neither observed nor experienced. Existing faculty development workshops mostly only create awareness about what needs to be done. The Curriculum Implementation Support Program workshop and document does provide pointers but when the faculty embark on the implementation journey, they find the going tough and are clueless, and so need handholding from the community of practice of faculty implementing CBME who share this concern. By doing this, they get an opportunity to seek and give help to overcome the challenges faced in implementing CBME.

While attempting to build communities of practice, we should recognize that there is always a tension between satisfying an individual's needs for personal and professional growth and empowerment versus the organization leveraging it for remaining competitive and financially sustainable. To cultivate a community of practice, it is recommended to focus on ensuring support for members to interact with each other, share knowledge, and build a sense of belonging within the institution, within teams, and subecosystems to ensure optimizing the functioning of these groups.[8] Forming such groups is easier than actually making it work and come alive. Research shows that this can happen when CoP members are made to engage in the collaborative learning process of being made to “think together” and through the understanding that emerges from the collective wisdom and its application to finding solutions and thereby guide each other to address the issue of common concern.[9]

Some of the tools that we have tried for building this CoP include among others:

  • Forming faculty e-mail groups, WhatsApp (or other) social media groups within the organization
  • Giving (and seeking) feedback in a safe nonthreatening environment (where feedback is expected as a norm)
  • Leaders could within this community of practice use appreciative inquiry to discover what is working in various departments (or even individual success stories) and then disseminate this among the rest of the faculty to help overcome the challenges faced[10]
  • Within the institution (or beyond) we can also form learning circles in the physical or virtual realm and formed by a group of peers, sometimes with a senior colleague (s) who act as an adviser.[11] Faculty can also be engaged in a feed-forward “game” described by Marshall to find solutions to problems.[12] I have found it useful to “buy-in” faculty into the advantages of being in a CoP
  • Formation of larger CoP of educators/discipline-wise faculty within the state/national level to address issues of concern that are common to all in the wider group.[13]


Practical tips to ensure the formation, growth, and sustaining the community are well described in the article by Ramani et al. and are well worth the time to visit them before you embark on the task of establishing one in your own institution.[6]

Set direction and achieve common purposes

What sets apart a leader from a manger is that the leader has a long-range perspective with an eye on the horizon (future) asking “what” and “why” versus the manager's short-range view (in the present/today) asking “how” and “when” with an eye on the “bottom line;” the leader challenges the status quo, innovates and does the right things compared to the manager's acceptance of the status quo and doing the things the right way.

We in leadership positions often find faculty and staff within organizations are often “too busy” with “routine work” or supervisor-assigned tasks that are often not in alignment with the institution's vision, mission, and reason for existence or establishment. They, therefore, have “no time” for activities that are in fact needed to fulfill the institution's vision, mission, and activities essential for the institution to move toward excellence. Hence, for the academic leader, it is important to engage and involve the faculty in the visioning exercise to refine it further and get them on your side to “own up” the institution's vision so that it becomes a “shared vision” and not a “Vision statement hung in the head of the institution's chamber” alone.[14] This act of engagement of all within the organization makes all of them aware of the common purpose for which they are working in the organization (feel they are a part of the whole). This also helps identify some 'redundant activities” that can then receive less priority compared to those that are in alignment with the goals, objectives, and vision/mission of the organization.

In the current competitive world, it is with an eye on the future and its own survival, organizations need to strive for excellence and make the institution recognized as an “institution of excellence”. For this to be achieved, an effective leader catalyzes commitment to a vigorous pursuit of a clear and compelling vision so as to stimulate higher performance standards to be achieved by everyone within the organization.

Besides the above reason, there is a need in the current environment of the 21st century where change is happening at a rapid pace and organizations need to respond to changes in the ecosystem outside the institution. A leader, therefore, needs to engage in a visioning exercise to foresee the change that will happen before it happens so that efforts for capacity building of faculty and staff can be initiated to make them “future ready.”[15] Only such organizations will be in a better position to overcome the challenges presented by the change when it does happen. Some of the tools [Figure 1] that the author has found useful are – “Crystal ball gazing: Time travel into the future” where using appreciative inquiry, the faculty discover what worked in the past that might work for the challenging tasks and ways things are happening in the future.[15],[16] Backcasting is a strategic planning method that asks a team to imagine and create an ideal future and then work backward to identify what steps need to be taken (backward planning) to get to the ideal state from the current state. This ensures that what is visualized in the future, is achieved.[17] As you get closer to the present time, it becomes more clear what types of strategies and responses will be necessary to enable progress toward the preferred future. Backcasting can be especially useful if there is high complexity, a pressing need for fundamental change, or if the present dominant trends in existence are part of the problem.[18]
Figure 1: Visioning Tools Time-Travel visualizing future state and Backcasting for its strategic planning

Click here to view


To set direction, the academic leader must demonstrate behaviors or actions that show you effectively communicate priorities and that you have plans that extend beyond the immediate future, engage others to collaborate in defining the institution/department's vision, and encourage others to share their ideas of the future; you are more action oriented to actions guided by the agreed vision rather than maintaining status quo and open to consider how a specific plan of action might be extended to benefit others and this action will have an impact in line with institution's and individual's goals. These behaviors are listed as a checklist that can be used for self-assessment of what you are already doing (and continue to) and what you need to start doing to develop as a leader leading others from within.[4]

Empowering faculty and staff

To make the vision a reality, staff need to be empowered by making them grow professionally in their capabilities through in-service capacity-building opportunities such as workshops that create awareness and then longitudinal learning experiences such as workshop series and fellowship programs to build up skills on the job; encouraging a few to also take up higher qualifications in their own disciple or if they choose – in Health Professions Education so that they can, in turn, provide leadership roles to guide others.

Empowering staff is also needed for the faculty and staff to be “future ready” as change is inevitable and happens for a variety of reasons including changes in technology, business processes, organizational structure, and government policies. Leaders help facilitate change by supporting people during the transition from the current state to the future state.

To discharge this important function of empowering staff, the academic leader must demonstrate behaviors or actions that show that you provide them with needed resources, information, and skills development opportunities, communicate what to expect in return for accomplishing goals, recognize, appreciate, and reward good performance besides sharing power and influence with others.[4]

Academic leaders need to be good mentors to empower faculty to grow and excel in what they are doing. Institutional growth and march toward excellence happen when faculty and staff therein grow and excel.

The qualities of a good academic mentor are that she/he is always learning and striving to become better in pursuit of excellence, is always available and approachable, provides feedback on performance for its improvement, demands perfection, and who helps all to achieve this.

There are several models of mentoring to empower people to grow professionally and one of them, appropriately known by its acronym-the GROW model, is simple and easy to remember (G: Goal – helps elicit from the mentee what they aim to achieve; R: Reality – helps the mentee to self-assess where they are now so that they can also receive feedback based on mentor's observations/appraisal; O: Options – helps mentee identify the options to bridge the gap and possible sources/people who can be of help; W: Way Forward – elicit the actions that need to be taken, get a commitment for it and a broad work plan with timeline).[19]


  Actions Needed for Facilitating and Sustaining Change Top


Guiding action as informed by leadership models is summarized and presented in [Table 3]:
Table 3: Approaches for academic leaders to implement competency-based medical education and institutional excellence

Click here to view


From [Table 3], it becomes clearer to academic leaders about how they can use the various leadership frameworks for providing academic leadership at the institutional level to implement curricular changes such as the new CBME curriculum that we have been entrusted with. Some of us have been entrusted with leadership roles to take our institutions toward excellence so that it becomes the institution of first choice for admission by aspiring students.

In the new contemporary eco-leadership discourse, where leadership roles are distributed everywhere within the organization and its subsystems, academic leaders must recognize the current leadership style and structure in the organization they find themselves in. Then, they should strive for promoting eco-leadership mindset and culture. When leaders start empowering those whom they lead, it leads to the whole organization marching toward excellence in a more efficient and synergistic way.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. Lancet 2010;376:1923-58.  Back to cited text no. 1
    
2.
Covey SR. The 7 Habits of Highly Effective People: Restoring the Character Ethic. New York: Free Press; 2004.  Back to cited text no. 2
    
3.
Western S. Leadership: A Critical Text. 3rd ed. London: Sage Publications; 2019.  Back to cited text no. 3
    
4.
Wolverton M, Gmelch WH. Developing academic leaders dean leadership. In: College Deans: Leading from Within. Ch. 3. Westport, CT, USA: American Council on Education, Oryx Press; 2002.  Back to cited text no. 4
    
5.
Kotter JP. Leading Change: Why Transformation Efforts Fail. Magazine Harvard Business Review, May-June, 1995. Available from https://hbr.org/1995/05/leading-change-why-transformation-efforts-fail-2. [Last accessed on 2022 Nov 22].  Back to cited text no. 5
    
6.
Ramani S, McKimm J, Findyartini A, Nadarajah VD, Hays R, Chisolm MS, et al. Twelve tips for developing a global community of scholars in health professions education. Med Teach 2021;43:966-71.  Back to cited text no. 6
    
7.
Wenger E. Communities of practice and social learning systems. Organization 2000;7:225-46. Available from: https://doi.org/10.1177/135050840072002. [Last accessed on 2022 Jan 13].  Back to cited text no. 7
    
8.
Li LC, Grimshaw JM, Nielsen C, Judd M, Coyte PC, Graham ID. Evolution of Wenger's concept of community of practice. Implement Sci 2009;4:11.  Back to cited text no. 8
    
9.
Pyrko I, Dörfler V, Eden C. Thinking together: What makes communities of practice work? Hum Relat 2017;70:389-409.  Back to cited text no. 9
    
10.
Kumar LR, Chacko TV. Using appreciative inquiry to help students identify strategies to overcome handicaps of their learning styles. Educ Health (Abingdon) 2012;25:160-4.  Back to cited text no. 10
    
11.
Ahmed S, Morahan P, Wells R, Magrane D, Carvalho P, Shah H. Creating a community of practice using learning circles: A unique design. MedEdPORTAL 2014;10. [doi: 10.15766/mep_2374-8265.9896].  Back to cited text no. 11
    
12.
Library of Professional Coaching. 10 Reasons to Use Feedforward by Marshall Goldsmith – Coaching for Behavioral Change. Posted on 06 June, 2016. Available from: https://libraryofprofessionalcoaching.com/applicationsuses/executive-coaching/10-reasons-to-use-feedforward-by-marshall-goldsmith-coaching-for-behavioral-change/. [Last accessed on 2022 Nov 22].  Back to cited text no. 12
    
13.
Sherbino J, Snell L, Dath D, Dojeiji S, Abbott C, Frank JR. A national clinician-educator program: A model of an effective community of practice. Med Educ Online 2010;15:5356. [DOI: 10.3402/meo.v15i0.5356].  Back to cited text no. 13
    
14.
World Federation for Medical Education. Basic Medical Education WFME Global Standards for Quality Improvement; 2015. Available from: https://wfme.org/publications/wfme-global-standards-for-quality-improvement-bme/?wpdmdl=831%27;return false;%22%3EDownload%3C/a%3E%3C/div%3E%3Cdivclass=%22media-body%22%3E%3Ch3 class=%22media-heading%22 style=%22padding-top: 0. [Last accessed on 2022 Nov 18].  Back to cited text no. 14
    
15.
Chacko TV. Time travel: Journey into the future. SEAJME 2008;2:91-2.  Back to cited text no. 15
    
16.
Gilmore TN, Shea GP. Organizational learning and the leadership skill of time travel. J Manage Dev 1997;16:302-11.  Back to cited text no. 16
    
17.
McTighe J, Thomas RS. Backward design for forward action. Educ Leadersh 2003;60:52-5.  Back to cited text no. 17
    
18.
Holmberg J, Robert KH. Backcasting – A framework for strategic planning. Int J Sustain Dev World Ecol 2000;7:291-308.  Back to cited text no. 18
    
19.
University of Glasgow. GROW Model of Mentoring. Available from https://www.gla.ac.uk/media/Media_414501_smxx.pdf. [Last accessed on 2022 Nov 18].  Back to cited text no. 19
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Leadership Model...
Academic Leaders...
Actions Needed f...
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed238    
    Printed12    
    Emailed0    
    PDF Downloaded44    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]