Burns, Aine; (2022) Exploring collaboration and leadership in postgraduate medical education (PME) in a London teaching hospital: A Self-Study approach. Doctoral thesis (Ed.D), UCL (University College London).

Preview

Text Burns_10152951_thesis_id_removed.pdf Download (3MB) | Preview

Abstract

There is a dearth of research on leadership experiences in postgraduate medical education (PME). This work examined the lived experience and performance of a leader (director) in PME in a large London teaching hospital. The objective was to improve training and gain generalizable insights to assist others in PME leadership roles. Uniquely, the study followed a self-study (SS) paradigm, not used previously in healthcare education. There were three distinct research components. The first a continuous autoethnographic appraisal of the researcher’s leadership performance in PME. The second a collaborative action research (CAR) project with two Trust education leads (TELs) and the third a further CAR project that emerged during the first COVID-19 pandemic surge in 2020 and involved a sizeable and diverse group of hospital colleagues and trainees. In line with SS and CAR methodology, a variety of mainly qualitative tools were employed to generate data for iterative analysis and cyclical action. These included diaries, recorded and transcribed research meetings, action logs, recalled meetings and encounters, e-mails, some artefacts and frequent timed stream of consciousness writings (termed ‘free writing’ FW) that served to tap into subconscious thoughts related to the DME role. The findings revealed previously hidden gaps between the author’s aspirations and practice and evidenced the effect of changes enacted. Considerable tensions around operational pragmatism, control, relationships, acting as the conduit between education policy makers and those at the coalface, were evidenced and considered. Further, the emotional capital of PME leadership was exposed and critiqued. When faced with the COVID-19 crisis, lessons from the first CAR study enabled the enactment of a flat, collaborative, compassionate and effective leadership style purposefully harnessing trainee intellectual potential and ‘local’ knowledge to solve new and complex problems. This leadership strategy proved successful and impacted positively on many areas of hospital function during the crisis. Crucially, placing trust in younger colleagues was highly effective and valued by the trainees. The model has potential to transfer to other circumstances. The study identified four key interconnected themes: context, tensions and emotions, complex relationships, and self-actualization as a leader, as important in the evolution of the authors DME journey from dissatisfied struggling leader through to mobilizing collaborative actions to enacting a new leadership style during the COVID pandemic. After-action reflections make the case for reimagining the DME role and how the key themes could be used as a starting framework. The unique contribution of this study is the use and value of SS in medical education, the novel exploration of the lived experience of a DME and the demonstration that ‘collaborative’ leadership in PME was effective during crisis and non-crisis times. It exposes the invidious position DMEs, and trainees are placed in and concludes that increased trust and autonomy with decreased bureaucracy will enable better trainee experience and so could impact on retention.

Download activity - last month

Export as JSONXMLCSV

Download activity - last 12 months

Export as JSONXMLCSV

Downloads by country - last 12 months

Export as JSONCSVXML

Archive Staff Only

View Item