Learning leadership through
practice – healthcare managers’
experience
Kerstin Nilsson and Carina Fura
˚
ker
Institute of Health and Care Sciences, The Sahlgrenska Academy,
University of Gothenburg, Go
¨
teborg, Sweden
Abstract
Purpose – The aim of this study is to describe the experience of Swedish healthcare managers
(HCMs) of learning leadership through practice.
Design/methodology/approach – The study is based on a qualitative approach, and critical
incident technique guided the data collection. Interviews with 22 hospital HCMs provided a total of 50
narratives. These narratives were categorised by classifying them according to their manifest content,
and a latent content analysis resulted in categories with additional sub-categories.
Findings – Leadership learning occurred in relation to reorganisation, developmental work and
conflicts. About 50 per cent of the narratives were classified as “managing conflicts”. The learning
outcome in the classes was related to the categories “personal development”, “interpersonal leadership
qualities” and “developing leadership strategies”. About 50 per cent of all learning outcome was a
result of managing conflicts.
Research limitations/implications – To be able to transfer the findings to a wider context in
healthcare, further research into experience-based leadership learning in healthcare is needed.
Practical implications – A majority of the narratives as well as the learning outcomes are related to
managing conflicts. This indicates that in management development programmes, as well as
leadership courses, the focus on conflict management should be extended, and also that HCMs need
support from their employer in their conflict management duties.
Originality/value – With its use of critical incident technique, this study contributes to an
understanding of HCMs’ experience-based leadership learning – a field in which limited research has
been conducted.
Keywords Leadership, Learning, Management, Hospitals, Health leadership competencies,
Health services, Experience, Sweden
Paper type Research paper
Introduction
In Sweden, about 4,000 head nurses and 1,300 head physicians are employed by the
county councils, and manage approximately 120,000 nurses and 40,000 physicians
(Sveriges kommuner och landsting, 2008). They are expected to handle structural
changes and technical developments (Nilsson et al., 2005, Hertting, 2003); they are also
required to be accessible, providing holistic patient-centred and patient-managed care
(Douglas and Douglas, 2005, Nilsson, 2003) and developing their staff’s evidence-based
competence, as well as being in charge of their daily work (Nilsson et al., 2005, Hertting,
2003, Nilsson, 2003). Healthcare managers (HCM) therefore need to take into account
many different, often conflicting, interests (Bourdeaux, 2007; Reenock and Gerber,
2007). The importance of HCM’s leadership is unquestionable (Silbaugh and Leider,
2009; Caldwell et al., 2008; Cummings et al., 2010; Xirasagar et al., 2006; Xirasagar,
The current issue and full text archive of this journal is available at
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LHS
25,2
106
Leadership in Health Services
Vol. 25 No. 2, 2012
pp. 106-122
q Emerald Group Publishing Limited
1751-1879
DOI 10.1108/17511871211221037