Category: TWU Online

As already expressed by many of my fellow students this was an exercise that proved to be more difficult than I had anticipated.  There is a lot of great information to deliberate on in the Unit 3 unit notes, and ranking these concepts in order of importance was quite the mental exercise.

In the end how I chose to complete this assignment was to embrace the realization that I am, indeed, a Masters student and that this new identity requires me to apply what I learned from reading the notes.  The blog that follows is my evaluation, synthesis, and organization of the material with an attempt at a reasoned explanation of how and why these concepts apply to my practice and context.

Summary Sentence #1  – There is much that I need to practice.

The number one idea that strikes me is that there much I still need to practice.  In order to be a critical thinker there is an intelligence to practice. (Source:  Unit 3 notes).  Excellence also requires practice – repeatedly doing what is good, repeatedly doing what is right, arguably, repeatedly doing what is difficult or challenging until excellence becomes a habit (Source:  Unit 3 notes, Durant (1926, p. 87)).  Becoming a critical thinker also requires the practice of thinking critically (Source:  Unit 3 notes).  There are many traits, skills and behaviours that I already possess or have developed, but I also need to be engaged and intentional in practicing intelligence, excellence and thinking critically.  In my context the practice of critical thinking is absolutely essential if I am going to make the best decisions for patients, staff, taxpayers and multiple other stakeholders in both the present and in the future.

Summary Sentence #2 – There are many virtues that I still need to cultivate.

True leadership is not just the acquisition of knowledge or skills, or even relying on my own innate abilities or traits.  There must be a cultivation of virtues that work in symphony with technical competence and professionalism.  The power and impact of knowledge is diminished without the wisdom to know when you have enough knowledge, the right knowledge, and when it is appropriate to share that knowledge.  Self-confidence and determination can be perceived as arrogance and stubbornness, or even as forcing of my will upon another if not married to the virtue of temperance.  It is suggested that intelligence and energy can actually be destructive and dangerous within an organization or team without the virtue of integrity (Source:  Unit 3 notes, Hoerr, 2017, p. 73)).  Exemplary conduct requires the development of skills, traits and virtues to be used in harmony with one another.  In my practice the virtues of wisdom, integrity, courage, justice and temperance (Source:  Unit 3 notes, Bondi et al, 2016, p.108)) are invaluable in the multiple human interactions I experience each and every day.

Summary Sentence #3 –  There is a responsibility to learn and gain knowledge for the benefit of those I lead (Source:  Unit 3 notes, adapted from Chong, 2015)) and this will require effort. 

Continuing education and informed study is absolutely necessary in order to remain knowledgeable and intelligent in an area of practice.  In the majority of professions this requires remaining up to date with regards to the expanding knowledge related to the practice.  Followers may be taken in initially by a leader with charisma, but will lose respect for a leader that is not, or does not remain knowledgeable.  In order to lead others well I need to gain knowledge in order to teach and to advocate, be able to articulate and communicate that knowledge in way that are understood, and listen as others share their knowledge.  In order to gain knowledge in the varied fields of medicine I am responsible for I must learn how to be intentional in my study of valid and reliable sources.  However, determining what are valid and reliable sources in the field of medicine requires, in and of itself, critical thinking.  Wading through all of the research available and determining what information is relevant and reliable is time consuming and intellectually exhausting.  But the outcome of the work is worth it.  Knowing what is best practice and evidence based is a requirement for me to lead effectively and provide the best possible service to patients and families.

Summary Sentence #4 – Faith and reason can, and should, co-exist. 

As a Christian with Bachelor of Science Degrees in both Biology and in Physical Therapy this has been a defense that began in earnest in my university years and has continued into my professional career.  In a science-based profession it is assumed that faith and logic are contradictory and therefore, are incompatible. However, not only is it possible to have a personal faith and be a critical thinker, I would submit that I do myself a disservice by not critically evaluating what I believe and why I believe it.  As a science major and a Christian one of my favourite quotes is found in Isaiah 1:18, in which God Himself challenges us to the ultimate reasoning exercise:

“Come now, and let us reason together, saith the LORD” (KJV).

In my context I have the opportunity to demonstrate that reason and faith can co-exist (Source:  Unit 3 notes), and I also have the responsibility to engage in dialogue and respectful debate when my beliefs or mindsets are challenged.

In reviewing the Unit 3 notes I can self-reflect and recognize where day to day demands and pressing time commitments have dulled my critical thinking skills in areas of my life and practice where I have not been challenged.  For example, since I provide very little clinical care I have not been a preceptor for a Physical Therapy student for years, and much of my practice with patients has gone unchallenged.  I do not routinely question why I prescribe a certain exercise or treatment, and nor do I question if my entire practice is still current best practice.  Has this been your experience?  If so, what are some areas where you no longer think as critically as you once did?  If this is not your experience, how have you managed to maintain these critical thinking skills?

I am thankful that I have the opportunity now to intentionally renew these skills through this Masters journey.

Completing this assignment today was quite the learning experience.

I discovered quite quickly that I find it difficult to assess myself beyond the experiences of the day.  I had an awful day, and one specific moment in which I did not respond well.  I know that moment doesn’t define me, and is not typical of my behaviour, but I struggled to rate myself above that regrettable action.

I learned that those closest to me know me best, and I cannot wear masks with them.  Co-workers rated me high on self-confidence and self-assurance; relatives and friends rated me lower.  Which tells me that I am a good actress.  I am not sure yet if this is a good quality, or not so good.

I also learned that my self-assessment is congruent with others on the traits that relate to my internal drivers, but there were discrepancies on the more relational traits (empathic, friendly, etc).  Though I am not happy that others rated me lower on these, I am happy that I am now aware:  the truth about me will set me free. This journey of change will likely be difficult, but I am excited to set my foot out the door.

I have often heard of the terms “servant leadership” but had never before taken the opportunity to find material as detailed in scope as the reading for this post.  I found the ideas and concepts from the Nordhouse text that details the Model of Servant Leadership (p. 232) thought provoking, encouraging, and challenging.  For the purposes of this discussion I have chosen to select a principle from each of the three main components of the model, and for the purposes of my own development all three that I have selected will be, to varying degrees, difficult for me to realize in my practice.

Context and culture is listed as one of the antecedent conditions that will impact servant leaders.  Nordhouse makes the statement:  “… in health care… settings, the norm of caring is more prevalent…”  (p. 231).  I would agree that each and every person that enters a health care job or profession does so because they care about people.  However, my experience in health care for the last 10 years is that it can difficult to be a servant leader in this setting, and one of the factors that contributes to the challenge is the unionized environment.  Whether historical, or whether by design, or by intent I do not wish to debate here, but the context in health care in my province is that the relationship between out of scope managers/leaders and unionized employees is supposed to be adversarial.  It is difficult to be a servant leader in a culture where serving others is constantly viewed through a lens of mistrust.  Having been in a manager/director role now for over 10 years there is hope – I can see where consistent servant leader behaviours can break down these barriers.  However, staff turnover in health care is also a constant issue so it is difficult for servant leaders to develop the long term relationships required to create trust and mutual purpose between employees and managers.

Conceptualizing is listed at the top of the Servant Leader Behaviours and of the three principles that I discuss this is, and will continue to be, the most difficult for me in my chosen career.  From a personal perspective I continue to wrestle with bringing the vision and strategic plans from the senior leaders at 30,000 feet down to the front line staff at ground level in a way that is understood.  From a system level, it is difficult to conceptualize the overall goals of health care when they consistently change.  Governments are voted in and voted out – the overall goals change.  Governments change direction – the overall goals change.  Public interest groups lobby government – specific goals change.  Communication up and down the lines of authority can be like the game “telephone” at times.  Later on in the chapter Nordhouse discusses that one of the criticisms of the servant leader model is the inclusion of conceptualizing:  “Being able to conceptualize is undoubtedly an important cognitive capacity in all kinds of leadership…” (p. 241). I am truly humbled by this statement and know that this needs to be an area of focus if I wish to improve as a leader.

The third principle that I will find challenging to consistently realize in my practice is organizational performance under the Outcomes heading of the model.  First, organizational performance in health care is a difficult metric to measure.  Second, as stated earlier, the culture does not encourage, and in some instances, does not even permit followers to function in a capacity that goes beyond their basic job requirements.  Third, my areas of responsibility are very small in the context of the full scope of my organization.  However, I have experienced and been inspired by organizations where servant leadership has changed the behaviours of individual employees and how teams function, so I remain committed to the challenge of improving the organizational performance to the extent that I am able for the sake of my patients and their families.

As I reach the end of my blog I realize that I inadvertently did not select any intrinsic challenges where I discuss how I need to incorporate or improve on my personal servant leader behaviours.  Of course I know that this is far from the truth – there is much that I still need to work on in me.  But change in me is a daily, sometimes moment by moment experience; influencing widespread change in a culture and change in others is not my daily experience.  So I have preconditioned myself to believe that influencing individuals, groups and situations is more difficult, challenging, and, well… unlikely.  So my closing question to invite further comment and discussion is this:  are there others who have wrestled with this mindset?  And does this mindset put limits on one’s ability to lead?

“Leadership is a process whereby an individual influences a group of individuals to achieve a common goal.” (Northouse, 2016, p. 6)

As I reflect on all of the leadership roles that I have held, and all of the follower roles that I have held, the word that strikes me in this definition is “process”.  When I think of the word “process”, I always assign “time” to this word.  Every process takes time.  Does true leadership take time?

We have all experienced situations where an individual can lead or influence a group of people in a moment in time.  Assigned leaders are expected to be able to make decisions, cast vision, develop and implement strategy from the moment that there position is announced, and successful leaders appear to accomplish all of these things.  Emergent leaders can influence others and create a following from the time that they enter a room, and we have all seen this play out in positive and negative ways.

The best way that I can pull together my thoughts and my learning from the reading is to apply it to examples from my healthcare world.  I have two professional licenses:  Physical Therapist and Emergency Medical Responder (EMR).  Responding to an emergency scene requires an entirely different set of leadership skills than treating a rehabilitation patient.  On an emergency scene the group context and goals are known, and power is absolutely necessary.  The incident commander has legitimate power that is assigned to him/her, as well as expert and informational power.  There may be a relationship with the commander, in which case there may be referent power, but even in the absence of relationship everyone must follow that person’s lead.  The influence on the team is through assigned power – the group context dictates this in order to attain the goal of saving lives.  This is positive leadership that is established in seconds.

In the physical therapy world, the process is quite different.  The team is often two people:  the physical therapist and the patient.  The physical therapist does have informational and expert power, but wielding this without referent power is often disastrous.  Coercing a patient in pain to do exercise is almost never successful.  The group context, and the goal attainment requires the use of referent power and the development of a trusting therapeutic relationship so that the patient understands that our purpose is mutual.  This is positive leadership that is established over days.

Obviously both scenarios are different, and the different leadership styles are absolutely.  Based on the reading, one could argue that the first leader is functioning more in a management role than in a leadership role.  So I pose the question again (more to myself than to my fellow students):  does true leadership take time?