Mastery of Leadership Competencies: Leader Led Learning or Mentorship?

Purpose:

The objectives of this study were to identify leadership competencies required by health services leaders and determine the role of mentorship in leadership development.

Methods:

  A quantitative approach using an exploratory and descriptive design was used in this study.  

The concepts leadership, management, leadership development, mentorship and mentorship models were explored through the literature review.  A number of studies, internationally and locally, reinforced the significance of mentorship in the preparation of health care professionals for leadership positions. Models of mentorship were analysed and the common threads, that ran through all models, that were identified were guidance of mentees and demonstration of caring.  This enabled  the mentee reached his/her full potential and was able to utilise communication skills  optimise outputs. Caring, teaching and supporting appeared to be the key concepts in all models.

 A census survey was conducted to obtain the relevant data. Some researchers consider surveys to be shallow in that they do not add to the depth of scientific knowledge (Burns & Grove 2009:245).  However, Polit and Beck (2006:241), rate surveys as highly flexible and applicable to many populations, and emphasise the fact that surveys can focus on a wide range of topics.

The reason that a survey was selected in this study, was to reach a population that was widely distributed geographically.

The instrument that was developed, was a modified questionnaire based on the American College of Health Care Executives’ questionnaire for assessment of leadership competencies. Consent was obtained from Dr Reed L Morton of the association.The following competencies were included in the questionnaire:

• Communication and relationship management: As leaders in health services in the public sector constantly deal with internal and external stakeholders, communication is an inherent competence in the role of a leader. Success of leaders in lobbying for resources and in motivating teams to function effectively is highly dependent on competence in communication and relationship management. This was the personal observation and experience of the researcher.
  • Leadership skills and behaviour: while leadership skills are varied, Goleman (1998:94) speaks to a leader needing strategic vision.
  • Human Resources Planning: Leaders in health services are highly dependent on human resources to ensure optimal service delivery.
  • Financial Planning: As much as the public sector institutions are not profit driven, health services leaders are accountable for the finances allocated from government funding.
  • Strategic Planning: this competence is key to efficient use of resources and projections for improvement of  outputs

Leaders were asked to assess themselves on the five competencies over two periods, i.e. on assumption of their positions and at the time of completing the questionnaire. Each of the competencies comprised a specific set of skills.

In addition they were asked to complete anecdotal notes on mentorship and its significance in the preparation of health professionals for leadership.

The questionnaire tested for validity and reliability and dispatched to the sample population via email. Respondents were managers in positions of Deputy Director (level 11) and upward that were working in the Departments of Health in two provinces in South Africa

Results:

Analysis  of data demonstrated that experience or leader led learning assisted managers in improving technical competencies of human resources, financial and strategic planning.  The number of respondents comprised a fairly small sample of managers that were exposed to mentorship and others that were not. Therefore, an independent two sample t-test was performed to identify which leadership competencies were lacking in the two groups of respondents. The results indicated that at a <5% level of significance, communication and relationship management, human resource planning and leadership skills and behaviour were lacking in the first year in office if the respondents had not participated in mentorship programmes prior to taking office. After two years or more in office, there was still a lack of competency in communication and relationship management and leadership skills and behaviour at a 5% level of significance.

This result reinforced the fact that experience or leader led learning resulted in acquiring expertise in technical leadership competencies. However, development of expertise in the competencies that are often regarded as “soft skills” required something more than experience.        

Ten (21.73%) out of 46 of the respondents were exposed to different forms of mentorship programmes, before being appointed to their current positions. The majority (8; 80%) of these ten respondents stated that the programmes were useful and contributed to confidence in their current positions. In addition to this the majority,  (28; 80%) of those that did not participate in mentorship programmes felt that they would have been better prepared for leadership positions if they had undergone leadership development through mentorship.

Conclusion:

The need for capacity building of personnel in leadership positions is reiterated by various authors and researchers on the issue of leadership competencies in the health sector in Africa and South Africa in particular.

Ngatia and Kimotho (2009) quote Thabo Mbeki (2006) as saying that Africa needs to invest resources into “reconstruction of credible and competent leadership capacity”.

The authors also state that numerous government leaders consistently cite the fact that, personnel managing health systems are not adequately prepared to succeed in leadership positions. They stress the need to “re-tool and re-skill health sector leaders in order to assist them to “plan, organise and maximise the use of available resources to reach their goals and mission”,   reinforcing the need for mentorship.  The authors also stress the need to narrow the gap in skills and competencies in health leadership by ensuring that leadership and management training is part of the curriculum of health professionals.

 It is recommended that leadership development for future leaders be embedded in succession planning, based on policy guidelines. The initiation of leadership development should begin with the curricula of health sciences courses. This supported by research that shows that health care professionals that are excellent in their field were not necessarily well prepared for leadership

Limitations of this study were that a response rate of 30% (46 out of 153) was achieved and due to the narrow geographical coverage, the findings could not be generalised. In retrospect setting up personal or face to face interviews or the uitilisation of field workers to administer and collect completed questionnaires may have yielded a better response rate.