How clinical leaders learn

How clinical leaders learn

“Are we heading into a future where knowing is obsolete?”[1]

The changes and challenges facing healthcare, coupled with the overwhelming and growing supply of information, put in doubt traditional and static forms of education.  In these forms, the student is ‘filled’ with the theories and information needed to perform specific roles and functions.  The rate of knowledge production is so great, that much of what is learned in such programs is likely to be superseded before the student has completed their program.  Education programs that are static may have the paradoxical affect of making the student more resistant to the changing context as they cling to the theories they learned and become closed to new ideas.  This is amplified in leadership development programs, where the view that the leader is the font of all knowledge is no longer tenable.

Furthermore, the problems confronting clinicians do not lend themselves to traditional education and tried solutions.  It is not enough to simply develop clinical leaders’ individual management competencies.  The process of developing skills must also be transformative on a personal, organisational and professional level.  The problem is that the standard approach to training and development for leaders do not translate into individual, team and organisational improvements immediately (and sometimes they never do!)  The focus is on the skills, competencies and the trainer’s processes – and not on the real problems and challenges that the manager has to deal with in reality.

The reality is that every team member is unique – and every manager is unique – and in these times, there are more unique situations and problems than standard ones.  This can be terrifying and paralysing for emerging and even well established leaders and managers. When it all seems too ambiguous and unpredictable, there is a natural inclination to seek out or establish a predictable process.  This is particularly helpful for people who lack the skill and experience to draw on.  But what managers need is an understanding of their broader work context, an ability to see challenges and opportunities in it, the confidence to solve problems, and engage people around innovative solutions.  They need to learn by doing.

Jennings found that 80% of people will tell you that their greatest learning experiences occurred while they were trying to complete a task, 20% while they were in a formal learning environment[2]. Mitra found similar results in his studies and has since been disrupting traditional forms of education with his ‘Self Organised Learning Environments’, where people learn by solving problems together.[3]  Salman Khan[4] was probably the first to coin the term ‘flipped class room’, where the classroom is for applying the thinking – the thinking is done before they get to the classroom.  The theme is learning by doing and by solving problems together.

A survey of unit managers from across the Barwon South Region in Victoria in 2013 revealed that on-the-job training was preferred by 72% of the respondents, 67% formal and accredited courses, 64% networking (with other managers), 51% nominated peer support and 33% mentoring and coaching[5].

The Australian Academy of Clinical Leadership (AACL) encourages leaders to develop their capacity to find and research the information they need, and have the creative and critical thinking capacity to apply it in novel and innovative ways to the problems faced by the nurses, health care organisations, the system and the community at large.

The AACL professional development programs blends theoretical, experiential learning opportunities around a curriculum of big questions and wicked problems, using:

  • On-line learning and engagement
  • Face to face training and facilitation
  • Mentoring and coaching
  • Action based projects in the workplace and beyond
  • Problem based learning

The principles underpinning all of AACL’s professional development programs are that they should:

  • Be relevant to the leader’s work context
  • Be action based so the leader can learn while leading
  • Encourage people to learn by having a go without fearing failure
  • Encourage improvement beyond the individual
  • Encourage critical leadership thinking to assess, diagnose and come up with solutions regardless of the situations or people they face
  • Build confidence through practice and exposure to new places, experiences and challenges
  • Provide opportunities to connect with and learn with other leaders
  • Foster a learning and innovation culture in healthcare
  • Empower clinicians to continually look for opportunities to develop and demonstrate their leadership
[1] Sugata Mitra (2013) Build a School in the Cloud.  Accessed at:
[2] Charles Jennings, The 70:20:10 Framework for Building Capability. Accessed at:
[3] Mitra Op cit
[4] Salmon Khan (2011) “Let’s use video to reinvent education”. TED Talk accessed at:
[5] Sullivan, 2013 “Barwon South West Region NUM survey”, unpublished