Year: 2017
Type: dissertation
Study design: Observational Study
Abstract: The physiotherapy profession in Ireland is experiencing a period of transition and change\nand is facing many challenges. The importance of leadership in healthcare has been\nrecognised, however, to date there has been little research examining leadership in the\nprofession of physiotherapy. The aim of this PhD thesis was to explore perceptions of\nleadership capabilities among physiotherapists in Ireland and to identify the leadership\nchallenges facing the physiotherapy profession. A scoping review was conducted to\nexplore the literature on leadership in physiotherapy. This review concluded that\nleadership in physiotherapy is an under-researched phenomenon but interest and\nresearch in the field are growing.\nIn the first study of this thesis, members of the Irish Society of Chartered Physiotherapists\n(ISCP) were surveyed about leadership and leadership development. The results\ndemonstrated that physiotherapists in Ireland perceive communication and\nprofessionalism to be the most important leadership capabilities. A high percentage of\nthe respondents perceived themselves to be a leader (74%) and the majority (53%) rated\nattaining a leadership position as very important or extremely important. Formal\nleadership training had been completed by 24.7% of respondents and informal\nleadership training had been completed by 32.8% of respondents. Participation in\nleadership development training was found to be associated with self-declaration as a\nleader and with placing importance on attaining a leadership position.\nThe first study demonstrated the leadership capabilities that the general physiotherapy\npopulation perceive to be important. The leadership capabilities of a specific cohort of\npotential physiotherapy leaders, physiotherapy managers, were investigated in the\nsecond study. This study was based on the leadership framework of Bolman and Deal\n(1991, 2008). In phase 1 of the study, physiotherapy managers were surveyed using the\nLeadership Orientations Survey. Results of the survey demonstrated that the\nphysiotherapy managers used the human resource frame most often followed by the\nstructural frame. Most respondents used only one frame or no frames at all and only a\nsmall number were found to use three or four frames. In keeping with the theory of\nBolman and Deal, a statistically significant trend was found between the number of\nframes that a manager uses and their perceived effectiveness as a manager and as a\nleader. To explore the leadership capabilities of physiotherapy managers in more detail,\nin phase 2 of the second study semi-structured interviews were conducted with a\npurposive sample of physiotherapy managers. Analysis of these interviews demonstrated that the managers predominantly used leadership capabilities associated\nwith the human resource and structural frames. The managers’ use of the political frame\nwas more varied, some leadership strategies and behaviours associated with the political\nframe were reported, however there were also difficulties reported with capabilities in this\nframe. The symbolic frame was underused by the managers and there was less\nrecognition of its importance. The managers in this study also identified challenges facing\nphysiotherapy leaders and the physiotherapy profession. These challenges were: time\nconstraints, lack of resources, other professions and changing structure.\nIn study III, the leadership capabilities of another cohort of physiotherapy leaders,\nphysiotherapy clinical specialists and APPs, were explored. Analysis of these interviews\ndemonstrated that the clinical specialists/APPs also predominantly worked through the\nhuman resource frame. The clinical specialists reported consistent use of capabilities\nassociated with the structural frame whereas there was less prevalent use of political\nand symbolic frame leadership capabilities. A common theme in these interviews,\nhowever, was the concept of leading by example which falls within the symbolic frame.\nThe clinical specialists/APPs reported the same challenges as those identified by the\nphysiotherapy managers but also identified two additional challenges: ordering images\nand career structure.\nIn the final study, clinical physiotherapists’ perceptions of the leadership capabilities of\nphysiotherapy management in their workplace were investigated. Clinical\nphysiotherapists were sent a paper-based survey which asked them to rate both the\nimportance of 24 leadership capabilities and the effectiveness of physiotherapy\nmanagement in their workplace at demonstrating them. Results of the survey\ndemonstrated that ratings of importance of the leadership capabilities were significantly\nhigher than ratings of effectiveness. The greatest difference between ratings of\nimportance and ratings of effectiveness were found on the symbolic frame capabilities.\nPhysiotherapy management were rated as most effective on leadership capabilities\nassociated with the structural and political frames.\nThe results of this thesis suggest that physiotherapy managers and clinical\nspecialists/APPs may benefit from training to further develop their leadership\ncapabilities. This training should focus particularly on leadership capabilities associated\nwith the symbolic frame. Further research is needed to guide the design and evaluation\nof these leadership development interventions.
Author: Emer McGowan
Language: English
Subfield: Strategy and Management
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2729619993