Florence
Nightingale
Foundation

Student Leadership and Me, ‘How Can I Begin?’ 

Authored by Chris Gibson, August 2022 

The Messenger Report [1] which was published in June 2022 firmly pushes leadership in the National Health Service (NHS) as a mechanism for collaboration and inclusion. In the report it is argued that effective leadership is needed and that leaders should be nurtured and developed throughout their NHS careers. The report pushes the virtues of inclusive and compassionate leadership to help the NHS thrive in an environment where the pressures on it are ever increasing. Edmonstone [2] argues that healthcare leadership is dominated by a ‘managerialist ideology’ whereby those at the top are managers rather than leaders. In his paper he suggests that a way to circumvent this is for higher education institutions (HEIs) to integrate practice-based leadership development opportunities in their programmes. This thinking is already well established in medical programs with students even taking collaboration international within some institutions [3]. An article by Home, Jones and Horton for the Health Foundation [4] welcomed the focus on culture and behaviour in the Messenger report but worried about how the recommendations would be implemented and have long term transformative impact. Coming back to Edmonstone’s article and one way to ensure this cultures change is to influence students during their formative training in HEIs.  

There are already many undergraduate healthcare leadership programs available for students, from the Florence Nightingale Foundation [5], Council of Deans 150 Leaders Program [6] or even the Edward Jenner Programme [7] which is available to aspiring leaders in the workforce as well as apprentices. There are, surely, many more out there however, what links them all is that they are voluntary and require motivated students to apply.  

Would putting leadership as part of a university program have a negative effect on students’ perception and feelings of leadership in the way that some students are put off reflective practice by having to complete an essay on it as part of their studies? [8]. Is it possible to get students who are not ready to apply to external programmes to take their first steps as leaders? Can these students be encouraged rather than expected to display leadership qualities? Will this help to build a culture of positive and inclusive leadership in the next generation of NHS workforce? Thus, meeting the recommendations of the Messenger Report and ensuring that Nurses, Midwives and Allied Health Professions (NMAHPs) are represented in the top tier of future leadership and not just doctors, consultants and potentially nonhealthcare individuals.  

The BBC Health Check and the episode ‘Can you be a kind boss?’ [9] spoke of the work of Joseph Folkman. Specifically, the article ‘I’m the Boss! Why Should I Care If You Like Me?’ which he co-authored with Jack Zenger [10]. In this article they outline some positive behaviours that contribute to a likable leader. Things like ‘positive emotional connections’, or being kind, nice and polite, ‘cooperate with others’, ‘ask for feedback’, ‘be future focused’. All of these are traits inherent in healthcare students. Why are these things important? In the podcast Folkman goes on to explain that there is a strong correlation between being likable and being effective. Effectiveness and efficiency go hand in hand and papers have been written about using leadership development to improve both quality of healthcare and the efficiency within a healthcare setting [11]. So, it follows that if healthcare leaders are likable, they will also be effective not just in moving agendas and visions forwards but also in the standard of their patient care as these characteristics reflect the ‘patient at the centre of everything we do’ mantra of the NHS constitution [12]. 

What does this mean for healthcare students though? Probably that most of them are already displaying leadership traits and attributes. That rather than try to ‘train them to be leaders’ an initial step should be to identify what they are already doing and how they may already be on their leadership journey. This can be done readily without it forming part of an assignment or a grade, removing the fear of failure from leadership because at a formative level this is not going to be helpful. It means as well that many students are probably doing much more as leaders than they may realise, helping them to identify this and to praise them. This form of ‘process praise’ has been shown to have more positive impact than just ‘person praise’ [13] and while age and development can impact its effectiveness who doesn’t like to be praised for doing something right? Especially something that we potentially did not know we were already doing.  

In short, the NHS needs a culture of leaders at every level, students are most likely already displaying the traits and attributes of future leaders, by supporting, developing and praising their leadership journey this pool of future NHS leaders can be ready to drive change from before they graduate.  

References:

[1] Department of Health and Social Care (2022) ‘Leadership of a collaborative and inclusive future’. Available at: https://www.gov.uk/government/publications/health-and-social-care-review-leadership-for-a-collaborative-and-inclusive-future/leadership-for-a-collaborative-and-inclusive-future#recommendations (Accessed: 6 August 2022).  

[2] Edmonstone, J.E. (2017) ‘Escaping the healthcare leadership cul-de-sac’, Emerald Insight, 30(1), pp. 76-91, Available at: http://dx.doi.org/10.1108/LHS-02-2016-0012 (Accessed: 6 August 2022).  

[3] Wu, A., Kielstein, H., Sakurai, T., Noel, G., Viranta-Kovanen, S., Chien, C-L., and Bernd, P. (2019) ‘Internationalization of Medical Education – Building a Program to Prepare Future Leaders in Healthcare’, Medical Science Educator, 29, pp. 535-547. 

[4] Home, J., Jones, B., and Horton, T. (2022) ‘Reforming management and leadership in the NHS: Does the Messenger review go far enough?’, The Health Foundation, Available: https://www.health.org.uk/news-and-comment/blogs/reforming-management-and-leadership-in-the-nhs (Accessed: 6 August 2022).  

[5] Florence Nightingale Foundation, Available at: https://florence-nightingale-foundation.org.uk/academy/leadership-development/leadership-programmes/ (Accessed: 6 August 2022). 

[6] Council of Deans Student Leadership Programme, Available at: https://www.councilofdeans.org.uk/studentleadership/ (Accessed: 6 August 2022).  

[7] NHS Edward Jenner Programme, Available at: https://www.leadershipacademy.nhs.uk/programmes/the-edward-jenner-programme/#:~:text=The%20Edward%20Jenner%20programme%20is,suite%20of%20online%20short%20courses. (Accessed: 6 August 2022).  

[8] Timmins, F., Murphy, M., Howe, R., and Dennehy, C. (2013) ‘“I Hate Gibb’s Reflective Cycle 1998” (Facebook © 2009): Registered Nurses’ Experiences of Supporting Nursing Students’ Reflective Practice in the Context of Student’s Public Commentary’, Procedia – Social and Behavioural Sciences, 93, pp. 1371 – 1375, Available: https://doi.org/10.1016/j.sbspro.2013.10.046 (Accessed: 6 August 2022).  

[9] BBC Health Check (2022) ‘Can you be a kind boss?’, Available at: https://www.bbc.co.uk/programmes/w3ct32wq (Accessed: 6 August 2022).  

[10] Zenger, J., and Folkman, J. (2013) ‘I’m the Boss! Why Should I Care If You Like Me?’, Harvard Business Review, Available at: https://hbr.org/2013/05/im-the-boss-why-should-i-care (Accessed: 6 August 2022).  

[11] McAlearney, A.S., and Butler, P.W. (2008) ‘Using Leadership Development Programs to Improve Quality and Efficiency in Healthcare’, Journal of Healthcare Management, 53(5), pp. 319-331.  

[12] Department of Health and Social Care (2021) The NHS Constitution for England, Available at: https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england (Accessed: 6 August 2022). 

[13] Haimovitz, K., and Corpus, J.H. (2011) ‘Effects of person versus process praise on student motivation: stability and change in emerging adulthood’, Educational Psychology, 31(5), pp. 595 – 609, Available at: https://doi.org/10.1080/01443410.2011.585950 (Accessed: 6 August 2022).  

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