A framework for leadership and management of a medical school in South Africa

[摘要] English: In future, more emphasis will be placed on the outcomes of education and onits impacts on health care and health status. In this, leadership andmanagement play a decisive role. It will be required of the leadership andmanagement of a medical school to adapt to the changing needs anddemands of medical education.Managers need to reassess their role and create an environment within whicheducation and training can be conducted successfully. The complexity ofmedical and education institutions; the changes that have occurred and arestill occurring; as well as the expectations of higher education and healthinstitutions and bodies, demand that urgent and informed action be taken inleadership and on the management front.The question that has arisen was, 'How can a medical school meet thedemands for effective and efficient leadership and management in a changingenvironment, taking into consideration the unique features of academicinstitutions?Against this background, the problem that was addressed, was that of a lackof a framework within which to fit the concept of leadership and managementin a medical school. Therefore the aim of this study was to address theproblem by designing such a framework for leadership and management inmedical schools on which the leadership and management of a school couldbe modelled if a school should wish to do so.The objectives were to gain a deeper insight into approaches to leadershipand management per se, particularly in institutions for higher education,including medical education and training; to gain an understanding of thechanges impacting on higher education and the role that it plays in leadershipand management; to determine criteria for a framework for academicleadership and management in a medical school; to test the criteria (bymeans of formulated statements) for leadership and management in amedical school; and to design a framework for leadership and managementthat can be implemented in any medical school in South Africa.Quantitative and qualitative approaches were used to complement eachother; to provide a better understanding of the research problem; as well asto enhance the interpretability of the research findings. The methods whichwere used and which formed the basis of the study, comprised a literaturereview, and - as the empirical study - structured interviews and Delphiquestionnaires.The focus of the literature study was on the higher education system andinstitutional management trends and challenges, as well as on certainperspectives of leadership and management, describing the meaning ofleadership and management in an academic context; the characteristics andqualities of leaders and managers; as well as the challenges that theleadership and management group face. The literature review was used as asupport for the design of the interview guide that was used during thestructured interviews.Questions pertaining to aspects such as challenges which have to be faced;strategies that have to be followed in addition to the needs in order tosuccessfully master the challenges; difficulties concerning leadership andmanagement; the role that has to be played; as well as leadership qualitiesand managerial knowledge, skills and competencies needed for effectiveleadership and management; were included. Six participants were selectedfor the structured interviews by means of judgement sampling and formulatedcriteria. The analysis of the interview findings was done by the researcheraccording to scientific methods. The results were displayed in tables andwere used, together with the criteria identified from the literature study, tocompile the statements that were used in the Delphi questionnaire.The Delphi technique not only provides quantitative information about thesubject of the study, but also qualitative information. The Delphiquestionnaire which had been structured, included nine sections, namelychallenges; strategies; roles; leadership qualities; managerial knowledge,skills and competencies; performance areas; management structures;infrastructure and facilities; as well as the aspects that have to be addressedin a framework for leadership and management. Six experts were selectedfrom higher education institutions who occupied positions where they playeda leadership role and/or were involved in academic management. Theanalysis of the various rounds of the Delphi process was done manually bythe researcher. The results of the Delphi process are included in theAppendices.All the respondents in the empirical study consented to take part. Pre-testingof the interview guide and the Delphi questionnaire were done through pilotstudies. These actions were undertaken to ensure the reliability, validity andtrustworthiness of the study.The findings of the empirical study were reported on by means of adescription and discussion of the structured interviews, followed by those ofthe Delphi study. These findings were used to compile a framework forleadership and management in a medical school.The premises for the academic leadership and management framework; thedeparture points for successful implementation; the different role-players whoinfluence leadership and management in medical schools; as well as detailedformulations of the recommendations on each aspect included in theframework, were given. The researcher proposed two ways of how therecommendations made in the framework could be used, namely a sliding anda layering approach and/or by using them together with a planning indicator.Final conclusions were drawn, and the limitations of the study andrecommendations were highlighted.With this study an attempt was made to contribute to effective and efficientacademic leadership and management in Medical Schools in South Africa.

[发布机构] University of the Free State