What does it take to be a leader in evidence-based healthcare?

Our new Evidence-Based Health Care Leadership Programme starts in March 2021, and is designed to help you develop, apply and enhance the leadership skills you are building and give you the knowledge and inspiration to discover and test your new found perspectives. Here, Director of the programme Kamal Mahtani reflects on what it takes to be a leader in evidence-based healthcare. 

Being an evidence-based healthcare (EBHC) practitioner has many privileges: opportunities to produce and apply research aimed at improving people’s current and future health, to work in multidisciplinary teams, and to develop new skills, like teaching. There are also economic benefits, not just individually, but for society too. And there is the opportunity for career development, which for some may mean leading and inspiring others.

But such a career also has numerous challenges for some. For example, the continuous drive to obtain funding, job security (for you or members of your team), and the need to balance research with other activities such as teaching, clinical practice or management.

So, despite all these pressures, how is it possible to be a leader in EBHC? And what does it entail? One way of demonstrating EBHC leadership is to generate high-quality evidence as a research Principal Investigator (PI). The UK Concordat to Support the Career Development of Researchers states that:

“The Principal Investigator takes responsibility for the intellectual leadership of the research project, for the overall management of the research and for the management and development of researchers.”

A wonderful ambition, but one that comes with heroic responsibilities, which some may feel unachievable. This is understandable. Although being a PI offers the tantalizing opportunity to sample high-level academic success, it is weighted with considerable responsibility and the need to manage success with potential failure. Few, if any of us, are born with all of the 68 skills and characteristics suggested as core components of a successful Principal Investigator.

So perhaps there are other ways of demonstrating academic leadership? Binney and colleagues discuss the concept of “Living Leadership”, which recognises our messy, nonlinear, complex environment and the leadership skills needed to both acknowledge and navigate it. They propose three themes, which I have extrapolated to the academic environment:

1. Leading happens between people – leadership is a social process, not an entity owned by any one individual. Good leadership is about connecting with people, in a moment, a situation, or a task. It is often most successful when there is a feeling of reciprocity. This is particularly relevant to research environments which can thrive on strong connections and collaboration: between colleagues, with funders, and between those who identify research needs and those who use research to meet those needs. Think about a successful research collaboration you have worked in: how did you connect with each other and what was it about the connection that made the collaboration a success? How did the leader of the collaboration achieve good collaboration?
2. Leaders are shaped by context – the process of leadership is shaped by context, the environment, the individual situation you find yourself in. Think of the leadership needed when a deadline is due, say for a large grant submission. It may sometimes be completely justifiable to give those around you specific instructions (or directions) ensuring that all team members know what they should be doing, and when it needs to be done by. Compare this with the leadership needed when helping a new student to settle into a team, when a coaching or advisory approach may be far more appropriate and far more effective. In academia, an effective leader is someone who is capable of adapting themselves to maximize the full potential of the leadership process.
3. People are most effective when they bring themselves to leading – to connect with people while being sensitive to the context in which they are connecting, leaders should bring a bit of themselves to the process of leadership. People respond to people, not a brand or a logo. Unlike the business world, true academic currency is not money, it is shared intellect. It is turning thoughts, ideas, and visions into realities, rarely on one’s own. Making the most of this currency means drawing on the humanity of leading, guided by ones own values, senses, and experience.

These three themes represent a different model to consider, amongst the various leadership styles that have been described. But whatever your thoughts and experiences of leadership, a consistent finding is that there is no “magic bullet” for being a successful leader, in any healthcare setting. A critical component, however, is to recognise the need to develop the skills and understanding of what leadership means to you, and how you want to enact it. This might be through greater self-reflection and analysis. But equally, it can be realised through formal leadership training, something that is being increasingly recognised by higher institutions, funders, and healthcare organisations. As a result, there is a growing number of resources to support healthcare researchers, at all stages of their career. Such opportunities can facilitate navigating the challenges of an academic career and unleash potential leaders in their own right and in their own way.

Kamal R Mahtani is a GP, Associate Professor and Deputy Director at the Centre for Evidence-Based Medicine. He is Director of the Evidence-Based Health Care Leadership Programme and the Oxford International Primary Care Leadership Programme.

Disclaimer: The views expressed in this commentary represent the views of the author and not necessarily anyone else mentioned in this article, the host institution, the NHS, the NIHR, or the Department of Health.

Acknowledgements: A previous version of this blog has been posted here. Helpful comments on an earlier draft were provided by Jeffrey Aronson, George Binney and Veronika Williams.

Competing interests: I receive funding from the NIHR to conduct independent research relevant to the NHS and to Chair the NIHR HTA Primary Care committee. I am a member of the NIHR Leadership Support and Development programme, which is facilitated by some of the authors of the “Living Leadership” book.