Objectives: Investigation of the leadership capabilities of physiotherapists is needed to allow better understanding of current leadership practice and to enable appropriate training programmes to be developed. To date there have been no studies of the challenges facing physiotherapy leaders. The type of leadership required may vary according to the challenge to be addressed. A key role of leaders is to identify and analyse the challenges that need to be addressed. The four frame leadership model of Bolman and Deal can be used to evaluate leadership behaviours. Bolman and Deal (2013) contend that a leader who can use multiple frames when addressing problems will be more effective than leaders who rely solely on one frame in all situations. The aim of this study was to explore physiotherapy managers´ perceptions of their leadership capabilities and the challenges they face. Ethical approval was granted by the Faculty of Health Sciences Research Ethics Committee Trinity College Dublin.
Methods: In this qualitative, descriptive study semi-structured interviews were conducted with a purposive sample of physiotherapy managers in Ireland. Eighteen physiotherapy managers from a range of clinical and workplace backgrounds participated in the study. Interviews were conducted in person, audiotaped and additional notes were made by the researcher. The interviews were analysed through a qualitative descriptive approach using template analysis. The coding template was based on the Bolman and Deal Leadership framework. This framework details four leadership frames: structural, human resource, political and symbolic. Additional codes in the data that did not fit into the initial deductive codebook were subsequently added to the codebook to allow further themes to be identified. To ensure the trustworthiness of the analysis, two additional researchers independently coded six transcripts and gave feedback on the coding and codebook. Other measures employed to ensure the quality of the analysis included member checking, maintaining an audit trail and recording personal bias statements before analysing the interviews.
Results: The physiotherapy managers described leadership capabilities associated with each of the four leadership frames. However, the language used by the physiotherapy managers suggested that they work predominantly through the structural and human resource frames. Leadership capabilities associated with the structural frame were co-ordinating their service, holding people accountable for results, goal setting, planning, and ensuring alignment with rules and guidelines. Leadership capabilities associated with the human resource theme were supporting and assisting people, encouraging and motivating team-members, facilitating the development of others and communication strategies. The employment of capabilities associated with the political frame varied between participants; some participants were comfortable working through this frame while others found it more difficult. Leadership capabilities associated with the political frame included networking, negotiating, promoting the profession and conflict management. The symbolic frame was underused by the participants; there were fewer examples given of capabilities such as communicating their vision, demonstrating passion, facilitating a positive workplace culture and mentoring. Within the theme ´leadership challenges´ four subthemes were found; ´changing structure´, ´lack of resources´, ´other professions´, and ´time constraints´.
Conclusions: Physiotherapy managers work predominantly through the structural and human resource frames. Physiotherapy managers perceive the physiotherapy profession to be facing several leadership challenges. To successfully meet these challenges physiotherapy managers will need to demonstrate balanced and effective leadership skill sets.
Implications: The physiotherapy profession is facing many challenges. Effective leadership is needed to successfully address these challenges. Physiotherapy managers may need specific leadership development training to develop leadership capabilities in the political and symbolic leadership frames.
References: Bolman, L.G. and Deal, T.E., 2013. Reframing Organizations: Artistry, Choice, and Leadership. John Wiley & Sons.
