Developing healthcare leaders for the 21st century: understanding and maximising leadership in pre-registration healthcare curricula in the West Midlands, UK

Background: Effective and influential leadership within healthcare organisations is essential to ensure high standards and quality of care. To deliver this, healthcare providers and educators need to encourage leadership in professionals from the outset of their careers. Additionally, significant monies are spent on leadership development after initial qualification. Enhancement of leadership teaching and experience within the pre-registration curriculum could, therefore, lead to future cost savings as well as improved patient care. Collaboration between three UK Universities allowed an opportunity for perspectives to be gathered from six stakeholder groups relating to the curriculum, academic environment and clinical environment. Purpose: The project sought to enhance understanding of what a range of different stakeholders believed “excellent leadership” looked like, and explore how leadership was taught in pre-registration healthcare education, so enabling the development of best practice for preparing future healthcare leaders. Methods: Separate focus groups were held locally in the three University areas for each of the stakeholder groups: students; university lecturers; clinical and commissioning staff across nursing, midwifery, physiotherapy, occupational therapy, paramedic science and dietetic professions as well as service users and carers. Each focus group was facilitated by the same researcher and lasted approximately one hour. A semi-structured approach incorporating six questions was used. Audio-taped discussions were transcribed verbatim and a thematic analysis was undertaken using content coding. This was validated by an approach of co-reading and agreement of themes within the research team. Results: Findings highlighted varying definitions of leadership and what participants perceived to be excellent or effective leadership. Participants commented on current methods of teaching leadership in undergraduate healthcare education, and how these methods could be enhanced. The value of multi-disciplinary learning, and good role-modelling in practice was identified as key to providing students with the essential leadership skills relevant to all healthcare professionals. Additionally, it was noted that leadership in healthcare education, although present, was not always recognised by as such by students, who did not necessarily appreciate leadership as a professional skill required by graduates. This was echoed by various participant groups including service users and carers, university educators and senior practice staff. Conclusion(s): The teaching of leadership should be “re-badged” and incorporated more overtly within all pre-registration health professional programmes. In addition, the relevance of leadership needs to be clarified and re-enforced within the academic as well as clinical setting. Good role modelling in practice is key to facilitating the development of early leadership skills. Implications: The results will inform the three participating universities and local healthcare providers on enhancing effective methods of incorporating leadership skills and qualities development in undergraduate curricula, and allow for sharing and communication of good practice, across the wider health economy.