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Abstract

Leadership has a rich historical tradition and has fascinated people for centuries. Key concepts and ideas drawn from that tradition and from research, and explored in the modern context of health care, such as leadership and power; leadership and organizational culture; leadership and courage; and the forms of leadership that adapt to context-self, interpersonal, and strategic-shape our definition of modern health leadership. That definition is the foundation upon which LEADS is built.

Many people spend time studying the properties of animals, or herbs; how more important it would be to study those of people, with whom we must live or die.

Baltasar Gracian

Stewart Dickson, MA, is a Regional Treaty Negotiator (Skeena) for the Ministry of Indigenous Relations and Reconciliation, in the British Columbia Public Service. Stewart contributed to the writing, design, editing and voice of the chapter, and conducted research and interviews with key informants to support its ethnographic elements.

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Notes

  1. 1.

    In an interview with the New York Times , Pulitzer Prize–winning author Jared Diamond was asked which book he would require President Obama to read if he could. His answer? Niccoló Machiavelli’s The Prince, written 500 years ago. He argued that while Machiavelli “is frequently dismissed today as an amoral cynic who supposedly considered the end to justify the means,” he is, in fact, “a crystal-clear realist who understands the limits and uses of power.”

  2. 2.

    Consider the number of compliance requirements in health care such as accreditation; clinical protocols; legal issues from patient/resident/client care, privacy, conflict of interest and possible/actual litigation, to labour and employment issues, workplace safety and the regulation of health care providers.

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Appendix: Leadership Theories

Appendix: Leadership Theories

This appendix contains short one or two sentence descriptions of the leadership theories most mentioned in recent literature and referenced in Chap. 2. Theories are categorized by theme and by the frequency they were referenced in the literature (adapted from Dinh et al., 2014 [33]). The theories are presented in two categories: Established Theories; and Emerging Theories. Only the theories with greater than 4% of the total frequency of mention are described in this Appendix.

Category: Established Leadership Theories

Sub-category

Theory

% Frequency

Description

Neo-charismatic theories

 

39

Neo-charismatic theories are those that pertain to attributes of leadership that engage followers in a variety of ways that include emotional bonding, agreement on task, and visioning a future. These sets of theories are based on the emotional appeal of the leaders and the extraordinary commitment of the followers. It encourages leaders and followers to become aware of their own personality types and of the people around them in order to be more effective in their workplace. The weakness of this approach is that there are few skills to learn

 

Transformational leadership

20

Transformational leadership theory is about how leaders inspire followers by transcending their own self-interests for the good of the organization. Transformational leadership is defined as a process in which a leader increases followers’ awareness of what is right and important to motivate followers to exceed performance expectations. Four important characteristics of transformational leadership include: effective communication, inspirational traits, trustworthiness, and teamwork

 

Charismatic leadership

10

Charismatic leadership theory says that followers make attributions of heroic or extraordinary leadership abilities when they observe certain behaviors from the leader

 

Transactional leadership

5

Transactional leadership theory posits that leaders involve, motivate and direct followers primarily through appealing to their own self-interest. The power of transactional leaders comes from their formal authority and responsibility in the organization. The main goal of the follower is to obey the instructions of the leader

Leadership and Information Processing

 

26

Leadership and information processing theories pertain to cognitive approaches to information processing and decision making processes in leadership including attribution theories, leader and follower cognitions (e.g., perceptions), the connectionist approach, and implicit leadership theories. This thematic category also answers questions like “what do I think leadership means?” and “what do I think is important” in being an effective leader?

 

Leader and follower cognition

13

Leader and follower cognition theory posits that leadership is determined by the mental models of both leaders and followers. It suggests that these mental structures are built up in part from experience; and by exploring these cognitive models we can understand how leaders and followers can work together better

 

Implicit leadership

7

Implicit leadership theory is a cognitive theory based on the idea that individuals create cognitive representations of the world and use these preconceived notions to interpret their surroundings and control their behaviours. These assumptions guide an individual's perceptions and responses to leaders. The term implicit is used because they are not outwardly stated and the term theory is used because it involves the generalization of past experiences to new experiences

 

Attribution theories

4

The attribution theory of leadership suggests that a leader's judgment about his employees (or the follower’s judgment of the leader) is influenced by their attribution of the causes of the other individual’s performance. Attribution theory attempts to explain behaviours by indicating a cause. More specifically the theory looks at how the leader or follower assesses the meaning of a particular event based on the motives for finding the cause as well as his or her understanding of the environment

 

Information processing and decision making

3

The information processing and decision making theory suggests that how leaders process information and their personality are both related to leadership effectiveness, and the relationship is moderated by leader behavior. In this theory, leaders, process information by two interacting, bi-directional systems; that is, the rational (analytical) and experiential (intuitive) systems, and the outcome influences how followers interpret events, make decisions, behave, and feel

Social Exchange/Relational Leadership Theories

  

Social exchange theories of leadership say that human relationships and social behavior are rooted in an exchange process. In any leader-follower relationship, people weigh the risks and rewards. When those relationships become too risky for either leader or follower, the ability of the leader to influence the follower diminishes accordingly

 

Leader-member exchange (LMX)

21

The leader–member exchange (LMX) theory is a relationship-based approach to leadership that focuses on the two-way relationship between leaders and followers. It suggests that leaders develop an exchange with each of their subordinates, and that the quality of these leader–member exchange relationships influences subordinates' responsibility, decisions, and access to resources and performance

 

Relational leadership

4

Relational leadership theory focuses on the idea that leadership effectiveness has to do with the ability of the leader to create positive relationships within the organization. This theory suggests that the leader acknowledges the diverse talents of group members and trust the process to bring good thinking to the socially responsible changes group members agree they want to work toward

Dispositional/Trait Theories

 

20

The Dispositional/Trait Theories category includes theories that looked at individual differences in leaders and investigated specific traits, abilities or clusters of abilities that contribute to leadership effectiveness. It includes the traditional trait approach, as well as other newer approaches, i.e., nature of managerial traits, managerial attributes, skills and competence, situational relevance of skills, and leader motive

 

Trait theories

16

Trait leadership theories aim to outline integrated patterns of personal characteristics that reflect a range of individual differences inn leaders; and yet foster consistent leader effectiveness across a variety of group and organizational situations

Leadership and Diversity

 

11

The focus of the Leadership and Diversity category is on domestic and cross-cultural issues of leadership

 

Leadership and diversity

7

Leadership and Diversity theories investigate the experiences of women and minorities in leadership positions, and of diverse followers within domestic borders, e.g., the benefits of more women leaders, the challenges facing women in leadership roles

 

Cross-cultural leadership

4

The cross-cultural leadership thematic category includes articles comparing the leadership processes of one culture to another; or looking at leadership in non-US populations to discern if European/US leadership theories applied in such settings/culture, country & attributes of leadership, universality, cultural & institutional changes, differences in Leadership across cultures, leadership in the multinational firm, and the GLOBE Project

Follower-Centric Leadership Theories

 

9

Follower-centric leadership theories prioritize the follower in the leader–follower pairing

 

Followership theories

7

Followership theories : Specifically, this sub-category includes research that investigate follower attributes related to the leadership process (e.g., identity, motivation, and values), the active roles follower play in leader–follower dynamics, romance of leadership, and follower outcomes

Behavioural Theories

 

8

The behavioural leadership theories sub-category focuses on research into the nature and consequences of participative, shared leadership, delegation, empowerment of leadership, studies on task-oriented behavior and initiating structure, and people or relations-oriented and individualized consideration behavior, critical incidents, the high-high leader, leadership behavior taxonomies, and specific task behaviors

 

Participative, shared leadership: delegation and empowerment

5

Participative , shared leadership theories include distributed leadership and collective leadership . Shared leadership practice is not related to the knowledge and skills of only one leader, but a participative perspective in which individuals and situations interact with each other. The important part in shared leadership is not the formal position or role of individuals, but their knowledge and competencies regarding the topic. In distributed leadership , individual expertise is the central concept: collective work as well as collective learning by working on goals through communication and interaction is prominent, rather than individual work

 

Leadership skills/competence

4

The leadership skills/competence approach takes into account the knowledge, skills and abilities that the leader has. A leader can learn certain skills and/or competencies and become more effective. The focus is on the leader him or herself, rather than the situation or context; although this theory may encompass situational variety in determining what skills are needed. More recent literature emphasizes the concept of capabilities: bundles of competencies that must adapt to situation and circumstance

Contingency Theories

 

7

The contingency theory sub-category encompasses research into how the here the leader adjusts to the situation or adjusts the situation to fit him- or herself. This included the Lease Preferred Co-worker (LPC) contingency model, path-goal theory of leadership, leadership substitution theory, situational leadership theory, multiple linkage model, cognitive resources theory, applications for adaptive leadership, life cycle theory of leadership, and normative decision model, and flexible leadership theory

,

No one theory received more than 1% mention

 

Other theories include: path and goal theory, situational leadership theory; contingency leadership theory, leader-substitute leadership theory, etc.

Power and Influence of leadership

 

7

The focus of the power and influence thematic category is on the concepts of power and influence, power types and sources, consequences of position and personal power, impression management and influence, coding scheme tactics, and political skills. The focal level of analysis for these influence and political tactics is dyadic, group and organizational as opposed to institutional, regional, and societal

 

Power and influence of leadership

4

The power and influence of leadership approach explores the practice of power and influence, considers different leader frames of reference that affect how leaders think about and use power, looks at some sources and types of power, and outlines ways leaders exercise power and influence

 

Political theory and influence tactics of leadership

3

The political theory and influence tactics of leadership research explores how leaders in a formal political context exercise power and influence through political activity

Category: Emerging Leadership Theories

Sub-category

Theory

% Frequency

Description

Strategic Leadership

 

24

The strategic leadership sub-category addresses leadership phenomena at the highest levels of organizations and how executive leaders influence organizational performance. The focal level of analysis involves CEO or other top leader and/or top-management teams (TMT) at the upper echelon levels of the organization

 

Strategic/top executive

12

Strategic/top executive topics include constraints on executives, top management teams and leadership succession, conditions affecting the need for strategic leadership, and effects of CEO leadership

 

Upper echelons theory

9

Upper Echelons theory explores how top executives’ thoughts, intellectual constructs and values influence how they come to understand their environments; and how this understanding then influences strategic decisions and organizational performance

 

Public leadership

3

The public leadership focus includes research on public leadership, e.g., president, professional politicians, as they direct large bureaucracies, determine strategy, and are commonly viewed as reasons for success or failure of public initiatives in parallel with their corporate counterparts

Team Leadership

 

15

The team leadership sub-category includes research where teams were the primary focus, or the articles attempted to apply one or more leadership theories to team settings in a novel fashion. The focal level of analysis involves teams and groups at the mid- and lower-level echelons of the organization

 

Leadership in team and decision groups

15

Topics encompassed by leadership in team and decision groups theory include the nature of leadership in different types of teams, determinants of team performance, procedures for facilitating team learning, guidelines for team building, and leadership function in decision making in groups

Contextual theories of leadership

 

15

The contextual leadership theories sub-category addresses leadership in specific context arenas. Social network and integrative perspectives of leadership were also included

 

Contextual theories of leadership

6

Contextual leadership theories explore the mediating effect of context such as the national context; function context—e.g., military, health or education setting; and discrete organizational context, and how leadership practices often are constrained by contextual variables (i.e., period of time in organizational processes) and singular events or circumstances

 

Social network theories of leadership

4

The social network theories of leadership explore the contribution of multiple actors and bidirectional influence (top-down and bottom-up) that unfolds along different time scales (from minutes to years). Social network theory emphasizes inter-personal networks as both cognitive structures in the minds of organizational members and opportunity structures that facilitate and constrain leadership understanding and successful action

Complexity and systems leadership theories

  

The complexity and systems sub-category encompass catastrophe or complexity theory, with the concept of complex adaptive systems (CAS) and encompassed how complexity theory was useful in describing how leaders can be successful in turbulent environments

 

Complexity theories of leadership

3

Complexity theories of leadership are based upon the application of complexity theory to the study of organizational behavior and the practice of leadership. In essence, complexity theory is about (1) the interaction dynamics amongst multiple, networked agents, and (2) how emergent events—such as creativity, learning, or adaptability—arise from these interactions. Leadership as mediated and practised by the influence of these factors is the substance of complexity leadership

Leader Emergence and Development

 

14

The leader emergence and development sub-category is focused on research that prescribed or described pathways or processes by which leaders came to possess leadership capacity, follower recognition of leadership status, and a systems perspective of leadership. Specific topics include leadership training programs, designing effective training, specific techniques of leadership training, learning from experience, developmental activities, self-help activities, facilitating conditions for leadership development, development and identification of leaders, and leadership assessment, appraisal and selection

 

Leadership development

9

Leadership development theories explore the processes that lead to the expansion of a person's capacity to be effective in leadership roles and processes. It takes two forms: individual leader development; and leadership development, which is the expansion of a one's ability to be effective in leadership roles and processes

 

Leadership emergence

5

Leader emergence theory concerns itself with how a group member emerges and maintains a leadership position within a group or organization; not necessarily as a function of formal position. The individual acquires emergent leadership through the support and acceptance of other people in the organization and it is the “emergent leader” who is most respected and most followed in any leadership setting

Ethical/Moral Leadership Theories

 

11

This ethical/moral sub-category encompasses leadership theories that have in common a core focus on altruistic behaviour as a foundation for effective leadership

 

Authentic leadership theory

4

Authentic leadership theory describes leaders who are self-aware, process positive and negative ego-relevant information in a balanced fashion, achieve relational transparency with close others, and are guided in their actions by an internalized moral perspective. The theory emphasizes building the leader’s legitimacy through honest relationships with followers which value their input and are built on an ethical foundation

 

Ethical leadership theory

3

Theories of ethical leadership investigate leader moral priorities, including how an ethical orientation toward leadership is developed; how an ethical approach to leadership is important; the consequences of ethical leadership and how it can be sustained.

Leading for Creativity, Innovation and Change

 

9

The leading for creativity, innovation and change sub-category investigated creative leadership processes from a variety of perspectives, covering topics like innovation and organizational learning. Research in this thematic sub-category also dealt with leader's roles in organizational change, or larger social changes in society or government, e.g., developing a vision, implementing changes, and influencing organizational culture. These changes were spurred by direct or indirect actions of leaders

 

Leading for creativity and innovation

5

Leading for creativity and innovation theories emphasize the use of innovation theory and creativity processes in the practice of leadership. Tangential theories are authentic, complexity, abusive, transformational, organizational change, shared and team leadership

 

Leading organizational change

3

Leading for organizational change theories focus on how leaders can unleash the potential of systems and people to adjust and adapt in ways that successfully address the needs of a shifting environment. Topic areas include leadership and ambidexterity, dynamic capabilities, innovation, and paradox and tension. They are also tangential to theories on complexity, leadership and networks, and collective leadership

Identity-Based Leadership Theories

 

8

The identity-based sub-category of theories includes self-concept and social identity approaches to leadership, i.e., studies adopting the work on leader categorization theory and studies adopting other social identity and self-concept frameworks

 

Social identity theory of leadership

4

Social identity theory describes the emergence of a leader as being based on a group member's resemblance to a prototypical leader as determined by other group members. Leadership is perceived as a group process generated by social categorization and prototype-based depersonalization processes associated with social identity

 

Identity and identification process theories of leadership

4

Identity and identification process theories of leadership posit that leaders are perceived in an organizational setting as leaders through a process of mutual influence in which social interaction among individuals as well as contextual factors cause leader and follower identities to shift over time and across situations. Leader identities are constructed through individuals projecting an image as a leader and others mirroring back and reinforcing that image as legitimate

Other

 

13

A potpourri of other individual theories is found in the research literature. Two that are profiled here are emotions and leadership; and destructive/abusive/toxic leadership

 

Emotions and leadership

8

The emotions and leadership construct encompass leaders' and followers' affect, and a variety of influences that emotions, positive and negative, have at all levels of leadership both on the leader and follower

 

Destructive/abusive/toxic leadership

3

Destructive/abusive/toxic theories encompass cases where leaders misbehaved, acted in ways contrary to the well-being of followers and/or the organization, and the setting where they were leaders, including abusive leadership, toxic leadership, and followers’ susceptibility and destructive followership as well

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Dickson, G., Dickson, S., Tholl, B. (2020). Illuminating Leadership and LEADS. In: Dickson, G., Tholl, B. (eds) Bringing Leadership to Life in Health: LEADS in a Caring Environment. Springer, Cham. https://doi.org/10.1007/978-3-030-38536-1_2

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