Objectives: Previous studies have demonstrated that physiotherapy managers and physiotherapy clinical specialists perceive themselves to be most effective at demonstrating leadership capabilities associated with human resource and structural frames. To date there have been no studies which have investigated clinical physiotherapists perceptions of the leadership capabilities of management in their workplaces. The four frame leadership model of Bolman and Deal (2013) can be used to evaluate leadership behaviours. This framework details four leadership frames: structural, human resource, political and symbolic. The aim of this study was to investigate clinical physiotherapists’ perceptions of the leadership capabilities of physiotherapy management in their workplace. Ethical approval was granted by the Faculty of Health Sciences Research Ethics Committee Trinity College Dublin.
Methods: A quantitative, cross-sectional study was performed using a paper-based survey with a purposive sample of physiotherapists from a range of workplaces (including public hospitals, private hospitals, primary care, voluntary organisations and private practices). Clinical physiotherapists from 34 physiotherapy teams were invited to participate in the study. The survey asked participants to rate 24 leadership capabilities using likert-type scales on two questions: “How important are these capabilities for physiotherapy management to demonstrate?”, and “How effective is physiotherapy management in your workplace at demonstrating these capabilities?” The 24 leadership capabilities included in the survey were derived from interviews conducted with physiotherapy managers and physiotherapy clinical specialists in earlier studies and were based on the leadership framework of Bolman and Deal (six capabilities for each frame). To compare ratings of the leadership capabilities in each frame the Friedman test was used. When a significant result was found, post-hoc analyses were performed using Wilcoxon signed ranks test with the Bonferroni correction applied. To compare ratings of importance of leadership capabilities with ratings of effectiveness on leadership capabilities in each frame Wilcoxon signed ranks tests were performed.
Results: The response rate was 55% (n=303). The Friedman test indicated that there was a significant difference in the ratings of importance of the leadership capabilities across the frames (X2(3) = 9.362, p=0.025). Post-hoc analysis demonstrated that the symbolic leadership capabilities were rated more highly for importance than the structural leadership capabilities (z=-2.640, p=0.008). The most highly rated leadership capability for physiotherapy management to demonstrate was ´Foster a positive workplace culture´. The Friedman test also indicated that there was a significant difference in the ratings of effectiveness on the leadership capabilities across the frames (X2(3) = 78.022, p<0.001). Post-hoc analysis demonstrated that the participants rated physiotherapy management to be most effective at demonstrating leadership capabilities associated with the structural and political frames and least effective on the symbolic frame. The leadership capability that participants rated physiotherapy management to be most effective at demonstrating was ´Ensure adherence to policy and procedure and clinical guidelines´. Participants rated the importance of the leadership capabilities more highly than they rated managerial effectiveness at demonstrating them on all four frames (p<0.001 for all frames).
Conclusions: The physiotherapists in this study perceived physiotherapy management in their workplace to be most effective at demonstrating leadership capabilities associated with the structural and political frames. However, they rated leadership capabilities associated with the symbolic frame to be the most important for physiotherapy management to demonstrate.
Implications: Physiotherapy managers and clinical specialists may benefit from specific leadership development programmes to develop their symbolic frame leadership capabilities.
References: Bolman, L.G. and Deal, T.E., 2013. Reframing Organizations: Artistry, Choice, and Leadership. John Wiley & Sons.
