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Chapter 12 Contemporary Leadership Theories - Quick Reference

Transformational vs Transactional Leadership

  • Transactional leadership: task-focused; maintains relationships through performance-based rewards; effective for maintaining status quo.

  • Transformational leadership: change-focused; builds vision, inspiration, and growth beyond self-interest; motivates followers to exceed expectations.

  • Both styles can co-exist in leaders; emphasis and effectiveness depend on context.

Key Concepts and Characteristics

  • Transformational Leadership Characteristics (Bass):

    • Charisma: vision, mission, trust

    • Inspiration: high expectations, symbols, clear purposes

    • Intellectual Stimulation: challenge thinking, encourage problem solving

    • Individualized Consideration: coaching, personalized attention

  • Transactional Leadership Characteristics (Bass):

    • Contingent Reward: rewards for performance

    • Management by Exception (Active): monitor for deviations and correct

    • Management by Exception (Passive): intervene only when standards are not met

    • Laissez-Faire: avoidance of responsibility

Transformational Leadership in Practice

  • Transformational leadership emphasizes emotion, values, and vision to drive change and innovation.

  • Not mutually exclusive with transactional leadership; effective leaders exhibit a mix depending on the situation.

  • Transformational leadership tends to elevate follower performance beyond what transactional leadership alone achieves.

Kotter’s Eight Phases of Transformational Change

  • 8 Phases:

    1. Create a true sense of urgency

    2. Build a powerful guiding coalition

    3. Form a strategic vision

    4. Communicate the vision clearly

    5. Remove obstacles and empower action

    6. Plan for and create short-term wins

    7. Consolidate gains and produce more change

    8. Anchor new approaches in the culture

  • Common transformational errors (per Kotter, 1995):

    • Failure to create urgency

    • Failure to form a guiding coalition

    • Failure to create a clearly understood vision

    • Failure to effectively communicate the vision

    • Failure to remove obstacles

    • Failure to plan for short-term wins

    • Proclaiming success prematurely

    • Failure to anchor change

  • Enablers for success: establish urgency (SWOT/market analysis), form coalitions, articulate a clear vision, use multiple communication channels, empower experimentation, reward visible short-term wins, institutionalize changes in culture

Implications for Health Care

  • Health care faces regulatory, financial, and delivery-model changes requiring transformational capability.

  • Balance needed: transactional for efficiency/rules, transformational for change/innovation.

  • Outcomes: transformational leadership linked to higher job satisfaction and lower turnover; transactional dominance historically in health care.

Other Contemporary Leadership Approaches

  • Symbolic Leader (Bolman & Deal): interpret experiences, frame events, use stories and rituals to impart meaning; consistent rules.

  • Superleadership: leaders share power and promote self-leading teams; leaders still guide but empower followers to lead themselves.

  • The Charismatic Leader: high self-confidence, trust in followers, vision; ethical vs unethical examples; development plan (six steps):

    • Step 1: Be the first to initiate

    • Step 2: Expect and grant esteem

    • Step 3: Ask questions and favors

    • Step 4: Stand tall, smile

    • Step 5: Be human, humorous, hands-on

    • Step 6: Slow down, listen

  • Servant Leadership: focus on serving followers; development of people; performance coaching; positive health care outcomes linked to servant leadership; distinction from transformational: servant centers on followers with organizational outcomes as a consequence.

  • Collaborative Leadership: engage across boundaries and outside formal control; align multiple stakeholders toward shared goals; critical in integrated systems (e.g., ACOs); requires trust, shared knowledge, and collective problem solving.

Traits, Behavior, and Competencies

  • Big Five Personality Factors (Judge et al., 2002; DeHoogh et al., 2005):

    • Extroversion

    • Agreeableness

    • Conscientiousness

    • Emotional Stability

    • Openness to Experience

    • Context matters: relationships between personality and leadership style vary with dynamic vs. stable work environments

  • Emotional Intelligence (EI): five components (Goleman):

    • Self-awareness

    • Self-management

    • Self-motivation

    • Empathy

    • Social skills

    • EI predicts leadership effectiveness and can be developed; group-level EI supports smarter teams (Druskat & Wolff)

  • Behavioral Competencies: what outstanding performers do across situations; competency models are used in health care education and leadership development (NCHL framework; ACHE domains)

    • NCHL framework: levels by career stage; five domains: leadership, communications/relationship management, professionalism, business knowledge/skills, health care environment knowledge

    • ACHE/Health Leadership Alliance: 300+ competencies across five domains

    • Competencies require motivation and opportunity to translate into performance

  • Appendix 12-A: Traits and Skills of Collaborative Leaders

    • Traits: Self-confidence, Decisiveness, Resilience, Energy, Need for achievement

    • Skills: Communication, Social Influence, Analytic, Technical, Continual learning, Self-management, Willingness to assume responsibility, Flexibility, Service mentality, Strategic thinking, Facilitation, Personal integrity

  • Appendix 12-B: Six Key Practices for Leading Collaborations

    • Practice 1: Assess common interests; set goals; identify barriers

    • Practice 2: Clarify purpose and vision; mobilize action

    • Practice 3: Build trust; effective communication; active listening

    • Practice 4: Share knowledge/authority; empower collaborators

    • Practice 5: Develop people; foster shared leadership

    • Practice 6: Self-reflection; continuous learning

Summary Takeaways

  • Contemporary leadership combines traits, behaviors, follower dynamics, environment, and organizational goals.

  • Organizations need a balance of transactional and transformational leadership to perform today and adapt to change.

  • Beyond traditional styles, charismatic, servant, collaborative, symbolic, and superleadership offer additional pathways to influence and drive change in health care settings.

  • Development of behavioral competencies, emotional intelligence, and collaborative capabilities are essential for effective health care leadership in a complex, evolving environment.

Quick Reflection prompts

  • Compare and contrast transactional vs transformational leadership and when each is most appropriate.

  • Assess which leadership style dominates in a given health care setting and why.

  • Consider Benton’s six steps for executive charisma; discuss applicability to your work context.

  • Identify which collaborative practices you could apply to improve a cross-department project in your organization.