Table 4

Effective learning approaches used by senior and emerging leaders

Themes and categoriesSenior leaderEmerging leader
I. Cross-pollination from a diversity of work experiences.
 Learning by doing.
  When you actually get to try something and it works it’s fantastic. When you try something and it doesn’t work it’s not fantastic, but you learn more (laughs) probably, from your mistakes than you learn from your successes. (PS11)*Learn from experiences.Take responsibility for increasingly larger projects.
 Learn from medical practice.
  You work in teams, you work in different situations where you have to learn how to see people and tell what they’re feeling. And you are used to taking in a lot of information in a short time and you need to make a decision in a short time. (PE08)*Communication skills, experience from different levels of the organisation allowed them to adapt argumentation approach and manage expectations.Fast decision-making, emotional intelligence, open-mindedness developed through the experience of clinical rotations.
 Leave your medical comfort zone.
  If you are a young doctor and you want to go into [leadership], you need to leave your comfort zone. (PS15)Formulate questions, client focus, adaptability, relationship building, adapt management ideas into medicine.Challenge one’s professional status, apply similar strategies across projects, problem solving, structure, work with data, presentation skills.
 Be a teacher and/or mentor.
  I see a lot of overlap between facilitation and improvement and pedagogical activities where you also facilitate learning. In one sense, it’s learning what you need to do to teach the subject and in another way it’s learning about the situation or about a shared problem. (PE04)Teaching and mentoring was an integral part of senior roles and seen as acts of leadership to help others develop new behaviours.Facilitating learning for others was experienced as a trigger to learn, particularly about group dynamics.
II. Reflection.
 Feedback and evaluation.
  […] during projects and between projects, on a yearly basis, structured evaluations and feedback, which are very good because we go over my good and bad traits and efforts and how to improve. (PE13)Coaching and mentoring by more senior people.Make systematic approaches to feedback and evaluation as well as senior colleagues a part of daily work.
 Observation.
  […] being able to learn from negative mentoring has been very useful [laughs] […] You see the consequences of different kinds of behaviours—the disruption and discomfort. (PS10)Negative examples of leadership.Collected observations of people and groups.
 Use theory to reflect on practice.
  [An MBA] made me understand the systematics of what I intuitively felt before and I understood the frameworks and theories. (PS18)Theory helps make sense of and frame one’s experiences.Situations where theory was experienced as applicable to practice contributed to enthusiasm about work.
III. Education integrated with practice.
  I really learn much more when I can work as a manager and then go to courses at the same time and I can think about what I do in my role as a manager from different perspectives. (PE19)MBA programmes that gave space to work on one’s own cases. A systems science course improved understanding of quality improvement and ability to see interdependencies.Formal education was a tool to establish credibility, become professional and develop networks, communication skills and personal leadership. It triggered further interest in management.
IV. Organisational environment that nurtures ambition and learning.
   I’m quite a confident person, both as a person and in my professional role [but] it’s still really important to have people around you who believe in you. It’s not enough to believe in yourself and I think that makes the difference. (PE21)Both groups attributed learning to their organisational contexts, particularly being surrounded by people who had faith in their capabilities, were interested in their input, supportive and encouraged openness, courage, ambition, commitment, creativity and honesty.
V. Luck of the draw.
 Nature.
  You can’t educate these things. You can modify a good person to be better. It is basically in the personality and then, of course, your social background. (PS18)Born this way/genetics: openness, honesty, commitment, competence, clarity, passion, persistenceBorn this way/genetics:
humility, openness, ambition, curious, enthusiastic, positive, ability to learn
 Nurture.
  It’s definitely lots of genetics, but it’s also my upbringing that’s shaped me more than anything. (PE21)Upbringing encouraged openness, honesty, commitment, competence, clarity, passion, persistence.During upbringing learnt to take responsibility, observe, prioritise academic achievement, connect with people.
  • *PS: senior leaders. PE: emerging leaders.