Educational leadership in health professions education

Abstract

The aim of this thesis was to explore perceptions and experiences of educational leaders leading educational change and development in health professions and interprofessional education. The sensitising concepts of the thesis were power and resistance and the thesis hence adopted theoretical power perspectives on educational leadership and employed qualitative approaches within the methodological framework of phenomenology.

Study I explored the experiences of educational leaders leading change and development within an undergraduate medical programme. The educational leaders perceived a lack of authority and status towards their colleagues as a result of an unclear mission, the fact that education had a low level of status at the university as well as a lack of traditional means of power. They also experience meeting resistance towards change and development in the shape of change fatigue, organisational obstacles and conservatism. Their opportunity to use influence towards change and development emerged from a high degree of freedom as well as the creation of vicarious legitimacies connected to research or clinical work, instead of education.

Study II further explored the experiences of educational leaders in undergraduate medical education and their identity formation. The educational leaders expressed an ambiguity towards their identity as educational leaders as a result of both an unclear educational role as well as the perceived difficulties in leading colleagues towards educational change and development. The educational leaders seldom experienced receiving feedback on their work from higher levels of the institution, which in turn lead them to feel that their role was mostly of a symbolic character. However, the status of being an educational leader was confirmed from time to time by other educational leaders as well as colleagues with a special interest in education.

Study III explored the experiences of educational leaders leading change and development within a nursing programme. The educational leaders expressed the means of achieving educational change and development as building relationships with colleagues as well as using the elaborate decision-making structures of the programme. Experiences of resistance towards change were perceived as originating from lack of authority, organisational structures and memories and intrinsic avoidance of leadership.

Study IV explored interprofessional education (IPE) as an example of educational change and development. A comparison of the definition, rationale and presentation of IPE between educational leaders and official policy documents revealed how underlying differences of meaning attached to IPE can create potential difficulties regarding implementation. Successful implementation postulates transparent and clear senior leadership support within an institution.

The thesis shows how the findings of study I-IV are important to highlight in connection to research-based faculty development programmes for educational leaders in health professions education; a prerequisite for leading educational change and development successfully.