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International Perspectives on Leadership in Higher Education

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Publication date: 21 November 2022

Leadership in higher education has become of increasing importance as the size of the enterprise has grown, and this has naturally led to a growing research interest in the topic. Using systematic review methods, this chapter interrogates and synthesises the research literature on leadership in higher education in terms of its meanings, application and practice, and the issues and critiques raised. It concludes that research into leadership in higher education has been both extensive and global in nature, identifying a variety of understandings, practices and approaches adopted, and the continuing dominance of white men in senior leadership positions. There is clearly scope for more research on this topic, which could both emphasise different issues and give greater recognition to the particular nature of higher education and higher education institutions.

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Tight, M. (2022), "Research Into Leadership in Higher Education: A Systematic Review", Blair, A. , Evans, D. , Hughes, C. and Tight, M. (Ed.) International Perspectives on Leadership in Higher Education ( International Perspectives on Higher Education Research, Vol. 15 ), Emerald Publishing Limited, Leeds, pp. 5-22. https://doi.org/10.1108/S1479-362820220000015001

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Effective Leadership in Higher Education - Final Report

A review of literature, and examination of interview data, examining leadership and leadership behaviours which are associated with effectiveness in HE. The list of effective behaviours found include: Providing direction; Fostering a supportive and collaborative environment; Establishing trustworthiness and having Credibility.

Effective Leadership in Higher Education - Final Report

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Three perspectives on leadership in higher education: traditionalist, reformist, pragmatist

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  • Published: 29 January 2024

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  • Bruce Macfarlane   ORCID: orcid.org/0000-0002-9399-6155 1 ,
  • Richard Bolden   ORCID: orcid.org/0000-0001-7158-6465 2 &
  • Richard Watermeyer   ORCID: orcid.org/0000-0002-2365-3771 3  

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There is a fragmented and complex literature about higher education leadership representing a diversity of ideological perspectives about its nature and purposes. Internationally, the literature has been strongly shaped by the importation of concepts and theories from management studies and a tradition of scholarship led by university leader-researchers. Drawing on an extensive literature review—drawing on over 250 books, book chapters, reports and journal articles—this paper identifies three key perspectives. The Traditionalist perspective is concerned with the cultural context, arguing that the import of neoliberal business practices into university leadership and management has undermined academic self-governance. The Reformist perspective focuses on values from a social justice perspective arguing for a more democratic and inclusive style of leadership including participation from historically under-represented groups. Finally, the Pragmatist perspective is more functionally focused in identifying the capabilities, skills and competences needed for effective leadership in universities at all levels. These three perspectives provide important insights into the culture, values and competences of university leadership reflecting the distinctive culture of higher education (traditionalist), its values as a reflection of wider society (reformist) and how best to practically manage and achieve positive change in such an environment (pragmatist). An appreciation of these perspectives and the skills, values and knowledge embedded in the literature will facilitate the evolution of leadership development and practice in alignment with contemporary organisational needs and societal expectations.

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Introduction

The literature on leadership in higher education (hereafter to be referred synonymously as ‘university’ or ‘academic’ leadership) is both complex and derivative, reflecting the fact that higher education studies is itself fragmented, drawing theoretically on a range of basic disciplines including sociology, psychology, history and philosophy. Researchers’ writing about university leadership are drawn from many disciplines and academic fields although management studies has been particularly influential in terms of both theory and practice. A range of terms have been imported into the modern university lexicon as a result of this influence such as quality management, performance indicators, workload allocation systems and transformational leadership. An added complexity is that those writing and researching about university leadership and management do not necessarily self-identify as authorities in this area but variously as social philosophers, policy sociologists, political sociologists, historians and gender and equity specialists. It is therefore hardly surprising that Bryman and Lilley ( 2009 , p.331) describe university leadership as ‘a strange field’ since, whilst leadership is a growing field of scholarship, relatively few academics focus their attention on the sector which employs them.

Perhaps, due in part to the neglect of academic leadership for so long by theoreticians, many influential contributors to the literature are former (or current) senior leaders in the sector, such as Eric Ashby, Robin Middlehurst, Peter Scott, Michael Shattock and David Watson. This is indicative of the way in which such writing and research have emerged out of experience and practice rather than empirical research. In recent years though, as the number of those possessing a PhD in higher education studies has grown, researchers studying university leadership are now more likely to be empirical investigators or theoreticians from a variety of academic fields rather than scholar-leaders. Consequently, literature about leadership in universities is spread across a wide range of journals since contributors are drawn from many different cognate fields. This bewildering variety of outlets inevitably means that many researchers in the leadership arena do not belong to the same disciplinary networks and societies and that research tends to be replicated or ignored as a result. This paper will seek to unpack this complexity by identifying three key perspectives, or ways of interpreting meaning and fostering understanding, and their underlying assumptions and agendas, based on a substantial literature review.

The ‘leaderist turn’ in higher education

It has been observed that over the last twenty to twenty-five years, there has been a notable growth in the use of the term ‘leadership’ in public services (e.g. Newman, 2005 ). It follows that the use of this term to describe those holding senior, formal roles within universities has become the dominant noun. Whilst the term ‘leader’ is now in common parlance, its previous iterations, ‘administrator’ and ‘manager’, respectively, are indicative of changing demands and expectations based on an action and change-oriented approach (e.g. Kennie & Middlehurst, 2021 ). This is a matter of self-description since historically academic ‘leaders’, as they have become known today, were formerly more likely to describe themselves as ‘administrators’ and to define their role as an act of service to the university (e.g. Ashby, 1970 ). However, since the mid 1990s (e.g. Neumann, 1993 ), it has become less common to see the word ‘administrator’ used to describe academic leaders except in some international contexts beyond the UK, such as the USA and Turkey (e.g. Balyer & Özcan, 2017 ). In common with other public services, academic leadership culture has shifted from a focus on governance and administrative processes to leadership or executive management (Middlehurst et al., 2009 ).

This has led to the rise of the so-called ‘career track’ route into university leadership and the relative decline of what Deem referred to as the ‘good citizen’ and the ‘reluctant manager’ (Deem, 2003 , np). Whilst all three routes remain in evidence (Bolden et al., 2008 ), growing expectations and responsibilities mean that senior university leadership roles are now almost exclusively conceived in terms of a career choice. The term ‘manager’, as in ‘academic manager’ (see Winter, 2009 ), became more widely used in the 1990s but has since been largely displaced by that of ‘leader’ (Arntzen, 2016 ) interpreted as a deliberate attempt to shift the function of those charged with administrative responsibility in the public sector to bring about change and reform as part of a new policy discourse (O’Reilly & Reed, 2010 ). This ‘leaderist turn’ (Morley, 2013a , p.116) conveys the sense of a powerful and dynamic individual capable of bringing about change rather than the more passive sounding language of ‘administrators’ or even ‘managers’ suggesting a transformational rather than transactional style. Semantically, the terms ‘management’ and ‘managers’ have pejorative implications especially in contexts strongly influenced by new managerialism, such as Britain, Australia and New Zealand (see Deem & Brehony, 2005 ).

Methodology

This paper provides a substantial review of the literature drawing on 266 sources (books, book chapters, reports, doctoral theses and journal papers) drawn from 99 different academic journals. These sources variously offer empirical, conceptual, theoretical and practice-based reflections on leadership and derive from searches across a range of online databases including the Educational Resources Information Centre (ERIC), Scopus databases, Google Scholar, Semantic Scholar and the discovery engine ResearchRabbit . The key search terms used were ‘leadership’, ‘higher education’ and ‘universities’. Literature searches were mainly confined to the thirty-year period between 1991 and 2021 although the review contains reference to some historical literature which is important in explaining the evolution of university leadership as a sub-field of research. The literature was sorted using thematic analysis that identified 28 different topics such as neo-liberalism, new public management, digital leadership, women and leadership, effective leadership and the role of the dean as leader. These topics were then sorted into three contrasting perspectives associated with academic leadership. Further details on this process are available from the authors on request.

It needs to be stressed that this literature review is not intended as comprehensive or systematic but as a snapshot view in respect to its principal strands of research, thought and argument with a specific focus on the literature about leadership in and of universities. In this regard, academic leadership is defined as a function accomplished by academics and professional support staff, in collaboration with others, rather than something done by the institution as an entity itself. Whilst consideration is given to wider processes and outcomes of academic leadership, the role and impact of universities in ‘leading’ social change more generally (e.g. in respect to climate change) will be excluded, as will the role of students as leaders of which there is now a substantial literature. Whilst the bulk of the literature stems from the Anglosphere, especially the UK, the USA and Australia, there are an increasing number of papers and doctoral theses now appearing from authors based in East Asia, Africa, South America and the Middle East on topics such as women’s lived experiences in attaining leadership positions in a Saudi Arabian context (e.g. Alhoian, 2020 ) and management competencies in Turkish universities (Balyer & Özcan, 2017 ). The underrepresentation of the global south is broadly similar to the wider field of higher education studies although the situation is gradually improving in terms of relevant literature published in English.

Three perspectives on leadership

In reviewing a broad range of literature, it is possible to differentiate three main approaches to understanding and exploring academic leadership. The ‘traditionalist’ perspective is concerned primarily with the cultural context and the extent to which this influences the perceived desirability or effectiveness of approaches imported from other sectors. The ‘reformist’ perspective focuses on how values and purposes shape and inform leadership within the sector, with the aim of promoting more ethical and inclusive approaches. The ‘pragmatist’ perspective is predominantly concerned with identifying the skills, competences and behaviours associated with ‘effective’ leadership in universities. We consider these as complementary, and occasionally competing, perspectives that are associated with different assumptions and agendas around the nature and purpose(s) of university leadership (e.g. Western, 2019 ) (see Table  1 ).

Traditionalist perspective

Any review of the literature cannot ignore that a significant and growing strand of work about university leadership focuses on a critique of its contemporary practices in the sector, a perspective we shall label ‘traditionalist’. Authors from this perspective argue that the adoption of management practices from other sectors is problematic given the distinctive cultural context of higher education. This, according to a very wide range of academic critics, has eroded ‘collegiality’ (e.g. Kligyte & Barrie, 2014 ) and ‘traditional’ forms of academic self-governance (see Palfreyman & Tapper, 2013 ). So-called ‘new managerialism’ (Deem & Brehony, 2005 ), marketisation and the student-as-consumer (Furedi, 2011 ), neo-liberalism (Giroux, 2002 ), new public management (Askling & Stensaker, 2002 ), performance management (Waring, 2017 ) and audit culture (Power, 1994 ), especially in relation to the quality assurance function, are all regarded as unwelcome influences in this respect. The erosion of academic autonomy resulting from these changes is described by Burnes and colleagues (Burnes et al., 2014 , p.905) as amounting to a ‘dysfunctional centralism’ where academics are told ‘what to teach, how to teach, what research to conduct and where to publish’.

There is a long history of the idea that universities are in a state of ‘crisis’ (Tight, 1994 ) from The Crisis in the University (Moberly, 1949 ) to more recent titles such as English Universities in Crisis (Frank et al., 2019 ). This ‘crisis’ literature continues with renewed vigour evidenced by the publication of recent books and papers using dystopian terms in relation to the contemporary university such as ‘hopeless’, ‘die’ and ‘death’ (Fleming, 2021 ; Hall, 2020 ; Wright & Shore, 2017 ). It is not the purpose of this review to evaluate the accuracy of this or any of the other perspectives, but to highlight the somewhat siloed nature of discussions and the differing assumptions and agendas on which they are based. It is important though in analysing this strand of literature to clearly identify what is being lamented as ‘lost’ or ‘under threat’, and why. At the heart of traditionalist assertions is the perception that academic self-governance has been supplanted by corporate power. A generation ago, McNay ( 1995 ) argued that collegial culture had been largely replaced by a managerial or corporate culture. More recently, it has been argued that these processes have been exacerbated by the COVID-19 pandemic (e.g. Watermeyer et al, 2021a , b ) with university leaders also demonstrating a lack of compassion (Denney, 2020 ). Regardless of the historical accuracy of perceptions and claims in respect to the loss of academic self-governance and collegiality (see Tight, 2014 ), this is, nonetheless, a persistent critique of university leadership.

Ashby’s description of academic governance as ‘a sort of inverted hierarchy’ conforms with the golden age beliefs of traditionalists (Ashby, 1958 , p.71) in which policymaking is initiated at departmental level and then rises via the Faculty and the Senate. He saw the role of the vice chancellor as one of chairing discussions about policy rather than personally initiating change. The Jarratt Report ( 1985 ) symbolised one of the first major challenges to this type of culture recommending the adoption of management practices from the business sector, labelling students as ‘customers’ and the vice chancellor as a university’s chief executive. The perception that a change in the style of academic leadership has taken place has largely taken root since the late 1980s and continues to this day conveyed by a substantial literature (e.g. Burnes et al, 2014 ). Academic leadership is now seen as squarely aligned with the ideology of management threatening academic autonomy both at the most senior level and in relation to other roles such as the deanship (e.g. Johnson & Cross, 2004 ). Smyth ( 2017 ) describes ‘zombie leadership’ in the ‘toxic university’ whilst Jameson ( 2019 , p.279) advocates ‘dialogic resistance’ to performance management and ‘managerial instrumentalism’. In a British context, it is argued that pre-1992 universities have followed post-1992 institutions in adopting a more corporate and executive style of leadership and management (Shepherd, 2018 ). The effect of what is perceived as more corporate forms of leadership is seen to have altered the nature of key university functions, such as academic development, shifting the approach to one focused on a managerial agenda rather than being practitioner-led (Land, 2001 ).

A traditionalist perspective is evident in a range of writing by social philosophers (e.g. Ronald Barnett and Stefan Collini), cultural critics (e.g. Henry Giroux), sociologists (e.g. John Holmwood) and media scholars (e.g. Des Freedman). Whilst this perspective can be dismissed as ‘golden ageism’ evidence suggests that a sense of ‘them’ (i.e. academic leaders) and ‘us’ (i.e. academic faculty) is firmly entrenched across the sector. A large-scale survey of 5888 British academic staff by Erickson et al., ( 2021 , p.7), for example, found that ‘the led’ have a negative opinion of their leaders, with major themes including ‘the dominance and brutality of metrics; excessive workload; governance and accountability; perpetual change; vanity projects; the silenced academic; work and mental health’. The rise of corporate objectives in university management has, according to some researchers, caused an identity schism for academics (Winter, 2009 ). Recent literature indicates a hardening sense of a ‘them’ and ‘us’ attitude. The university workplace is characterised as ‘toxic’ and academics work in what Fleming ( 2021 ) describes as ‘darkocracies’. Here, bullying is one of the notable, emerging themes within the traditionalist literature (e.g. Hollis, 2019 ). Milley and Dulude ( 2021 , p.1) accuse leaders of committing ‘troubling acts’ whilst the qualitative work from the large-scale study of Erickson et al., ( 2021 , p.15) reveals ‘endemic bullying and harassment’. Here, there is a close connection with so-called ‘microaggressions’, involving daily indignities and slights which are often linked to the strong role of hierarchy in universities and broader intersectionalities that exist in all organisations including race, gender, disability and sexual orientation (Young et al, 2015 ).

From a different perspective, Heffernan and Bosetti ( 2020 ) explore bullying and acts of incivility experienced by those working at the level of a dean, from both below and above, with anger and frustration at re-structuring and performance management important factors in their analysis. Incivility provides a broader way of thinking about workplace behaviour involving acts of anger, abuse and intimidation beyond more narrowly constructed notions of bullying where the same person is the victim of repeated acts of intimidation (Hodgins & Mannix McNamara, 2017 ).

Vice-chancellor pay, especially in the UK and Australia, has come under increasing scrutiny too in recent years as a symbol of the discontent of those who regard their reward levels as out of kilter with university performance (Bachan & Reilly, 2015 ). Most analyses are predictably uncomplimentary and indicate that internal governance structures do not exercise sufficient control over the pay of senior management (Walker et al, 2019 , p. 450). Boden and Rowlands ( 2022 ) come to a relatively similar conclusion, urging the need for governance reform. Aside from academic interest, the topic has attracted considerable and unfavourable press attention, as catalogued by Heffernan ( 2021 ) who analyses 190 press and online articles published in a five-year period between 2013 and 2018.

Reformist perspective

Another significant strand of the literature pertains to what might be characterised as a ‘reformist’ perspective. Authors from this perspective are focused on what needs to change to make leadership more progressive and inclusive. The conceptualisation of leadership style here has tended to focus on people in senior management roles, notably senior university leaders (e.g. Bargh et al., 2000 ). Such work continues to be common (e.g. Drew, 2010 ) and includes scholarship concerning other managerial levels, such as the deanship of academic faculties (e.g. Seale & Cross, 2018 ) and departmental leadership (e.g. Knight & Trowler, 2001 ). Instead, as Davis and Jones ( 2014 , p.367) contend, ‘there is a need to move beyond focus just on “the leader” as control agent, to leading which opens up spaces to consider more shared, creative and collaborative approaches to the field’. This alternative conceptualisation involves de-emphasising the ‘hero’ leader (Eddy & Van Der Linden, 2006 ) and framing leadership in more inclusive terms as taking place at all levels within the university, approaches labelled as collective (e.g. Bolden et al., 2008 ), distributed (e.g. Van Ameijde et al., 2009 ), shared (Kezar & Holcombe, 2017 ) and based on systems leadership development (Bolden et al., 2019 ), respectively. Here, it has been suggested that shared leadership and distributed leadership are terms which are closely connected and are sometimes used inter-changeably and that ‘collective leadership’ is an umbrella term which can incorporate both sets of ideas and avoid unnecessary conceptual confusion (e.g. Goksoy, 2016 ).

The notion of ‘servant leadership’ based on the work of Greenleaf ( 1970 ) has attracted the interest and attention of researchers (e.g. Wheeler, 2012 ). Here, leadership is about service and not about the leader pursuing their own self-interest. Given the pressures on contemporary academics to research and publish in order to advance their careers, leadership responsibilities may sometimes be perceived as unwelcome reinforcing a separation between academic and administrative work (Rich, 2006 ). The idea of servant leadership is about fulfilling a service duty to others and is closely related to the concept of academic citizenship (Macfarlane, 2007 ) and approaches to teaching which promote student autonomy and self-direction rather than dependence and compliance (Hays, 2008 ). Servant leaders think of themselves as fellow professionals who attain a position with authority and responsibilities but are willing to accept that they have limited power in the context of a university culture that respects academic autonomy. In many respects, servant leadership is linked with the tradition of rotating the head of department role amongst full professors, a practice that still exists in some institutions. Another closely connected and strongly values-driven position is that of ‘authentic leadership’ (e.g. Buller, 2018 ) where the ethical values and beliefs of leaders are congruent with those of their followers. They are self-aware and do not separate their home or life values from those that guide them in the workplace (George, 2003 ). In a higher education context, there is room for this concept to be explored in more depth, although it should be noted that there is growing critique of this approach and the extent to which true authenticity is either desirable or possible (e.g. Iszatt-White et al., 2021 ).

These various nomenclatures (distributed, collective, servant, authentic, etc.) have a common goal of moving away from the idea of leadership by the few and towards the idea that leadership is performed by people at all levels—trends reflected in leadership theory and practice beyond higher education. They seek to empower a wider range of people within the organisation to think of themselves and act as leaders. The notion of leadership is conventionally associated with those who hold formal roles, such as vice chancellors, deans, heads of department and programme directors. However, leadership may be exercised in practice by many academics and professional support staff who do not necessarily hold a formal leadership role. This is sometimes termed non-positional leadership (Juntrasook et al., 2013 ). Further, for example, a professor, or other influential academic, may offer intellectual leadership without necessarily being appointed to any formal management role (e.g. Macfarlane, 2012 ). Part of this democratisation of the notion of leadership (Woods, 2004 ) is linked to the methodology of leadership researchers. Analysing the perspectives of the ‘led’ (Evans et al, 2013 ) provides an alternative to relying on interviewing senior leaders (e.g. Martin & Marion, 2005 ) which is a more commonplace method.

The reformist agenda interrelates closely with equality themes and the tensions between excellence and diversity (Deem, 2009 ). There is now a substantial body of work critiquing the ‘absence’ of women from leadership roles both at middle and senior academic levels (e.g. Aiston & Yang, 2017 ; Morley, 2013b ). This literature is often written from a gendered and feminist perspective by researchers who are committed to the advocacy of change. The so-called ‘pipeline theory’—that increasing numbers of women in male-dominated occupations will lead to more equality as women get promoted to the top jobs—is regularly critiqued. Instead, the phrase ‘leaky pipeline’ (e.g. Berryman, 1983 ) is a metaphor that has become something of a cliché over the last thirty to forty years and a focus of research attributed to both direct and indirect forms of discrimination including the disproportionate commitment of women to service and the way the lower status of ‘academic housework’ compared with research can hold back the progression of women into senior leadership roles and even as full professors (e.g. Misra et al., 2011 ). The concept of the ‘glass ceiling’, where women do not make their way into leadership positions as fast as their male counterparts, originates from analysis in the business sector (Hymowitz & Schellhardt, 1986 ) and is now a phrase regularly invoked in the literature about women and leadership (e.g. Davis & Maldonado, 2015 ). Another related term, which provides a more concrete explanation of direct discrimination, is the so-called ‘glass cliff’ phenomenon (Ryan & Haslam, 2005 ). This identifies the way that women are more likely to be appointed as leaders of companies that are failing financially or during institutional crises compared to their male counterparts, thereby making it more difficult for them to succeed in post and more likely to be dismissed—a phenomenon also observed in universities (e.g. Peterson, 2016 ).

Diversity leadership, as it is termed, is frequently invoked in the North American leadership literature (e.g. Gasman et al., 2015 ) and is now penetrating the UK literature too (e.g. Singh & Kwhali, 2015 ). This term represents structured attempts to make universities more diverse and overcome barriers that have conventionally limited the participation of black and minority ethnic staff and students. Here, there are conceptual links with the notion of transformational or ‘turnaround’ leadership (see Fullan & Scott, 2009 ) as opposed to transactional leadership further reinforcing the language of leaderism as a change agent, noted earlier (e.g. Aguirre & Martinez, 2002 ). Further, there has been a growing consciousness about the lesbian, gay, bisexual, transgender and queer communities on campus (Bullard, 2013 ). Much of the emerging literature in this area is from North America with Pryor ( 2017 ) coining the expression ‘queer leadership’ whilst Sumara ( 2021 , p.7) has used the term ‘queer outsiders’ in explaining how individual identity can adversely impact academic career prospects.

A literature that considers disabled leadership is far less developed and difficult to identify. In fact, some suggest that ‘disability has been almost totally ignored in the leadership literature’ (Boucher, 2017 , p.1005). Disability as it pertains specifically to a university context is even less apparent with only a few examples (e.g. Martin, 2017 , 2020 ) that discuss experiences of being disabled and the challenges associated with a culture of ableism endemic to universities. A nascent strand of a reformist literature considers leadership in the milieu of technological and specifically digital disruption resulting from greater use of education technology (EdTech) associated with the pandemic experience and transitioning work practices. This strand focuses predominantly on the acquisition of digital capabilities (Beetham, 2015a , b ) and digital literacies in higher education (e.g. Newland & Handley, 2016 ), leadership perspectives on the use of EdTech (e.g. Laufer et al., 2021 ), e-leadership (e.g. Arnold & Sangrà 2018 ), leadership for technology enhanced learning (e.g. Evans & Morris, 2016 ) and the role of digital leadership (e.g. Sharpe et al., 2022 ).

Pragmatist perspective

The final major strand of the leadership literature relates to what might be termed a ‘pragmatist’ perspective. Here, the focus is on the practicalities of leading in academe, and the skills and competences needed to be an effective leader (e.g. Lumby, 2012 ). Bryman ( 2007 ) produced a review of the literature on effective leadership that is closely connected to this strand that still provides a helpful basis for understanding the range of perspectives albeit limited to the UK, the USA and Australia. While this study is now dated much of relevance has been published since and from authors working in an international context beyond the Anglosphere. Major themes within the effectiveness literature include the identification of attributes, capabilities, competences, skills and behaviours necessary to be an effective leader. An Australian national study drawing on substantial primary data identified personal capabilities (e.g. decisiveness), interpersonal capabilities (e.g. influencing), cognitive capabilities (e.g. diagnosis) and leadership competence (e.g. self-organisation) (Scott et al., 2008 ). Other recurring and familiar themes in the literature include credibility and acting as a role model (e.g. Mahdinezhad et al., 2018 ). Leadership ‘agility’, or being flexible when facing complex dilemmas, is recommended by Thompson and Miller ( 2018 ) writing in the context of nurse leaders along with fostering civility and inclusiveness in a high-pressure environment.

There is a literature around contextual challenges which seeks to identify those pertinent to the academic leader. Raelin ( 1995 ) recommends striking a balance between administrative control and academic freedom in the management of academics whilst Braun and colleagues (Braun et al., 2016 ) express a similar challenge in terms of tension between the desire for individual creativity and innovation as opposed to the need for control of activities via appropriate structures, procedures and (legal) regulations. Within the pragmatist strand, there is a further well-established literature about the leadership challenges that face heads of department (or departmental chairs), deans and presidents working at different ‘levels’ within the university. Much of this position-specific literature stems from a North American perspective and includes themes which are well-established, especially in a US context, such as the role of the president in fund raising (Satterwhite & Cedja, 2005 ) as well as other perennial concerns such as networking (Rabovsky & Rutherford, 2016 ).

Goodall’s ( 2009 ) study of what makes for a successful president in a research-intensive university provides findings that resonate with the traditionalist argument, whereby leading researchers rather than professional, career-track administrators make the best institutional leaders. This may, however, be because research active staff are more willing to follow them, or simply that such institutions are more likely to attract such candidates, rather than because their research skills equip them for the top jobs. Some of the literature focused on top leaders illustrates the disconnect between the pragmatists and the reformists especially the unreconstructed male chauvinist title of Stephen Trachtenberg’s ( 2009 ) book, Big Man on Campus , about his time as a university president. Aside from literature about the various formal levels of leadership in the university, there is further coverage in relation to the main conventional functions of the university in respect to how to lead teaching (e.g. Marshall et al., 2011 ) and research (Evans, 2014 ) and how best to achieve an integration of them both from a management perspective (Locke, 2005 ).

The literature about the leadership of professional services is an important element of the pragmatist perspective providing insights into the challenges of being a head of marketing (Trocchia & Andrus, 2003 ), administrating online learning (Burnette, 2015 ), linking HR practices to job satisfaction (Khan et al., 2019 ) and faculty or educational development (e.g. Blackmore & Blackwell, 2006 ). Whitchurch ( 2008 ) uses the term ‘third space’ professional to refer to those roles that span both academic and professional services domains. Despite the growing significance of such roles, there remains little explicit research in this area and what there is highlights the paradoxes and shifting terrains (White et al., 2021 ) they need to navigate.

In terms of what is new or recent, the advent of COVID-19 has brought crisis leadership very much to the fore (e.g. Samoilovich, 2020 ), with other foci for crisis leadership including racial incidents on campus (Fortunato et al., 2018 ). The role of digital leadership has come into prominence lately and has been accelerated by the pandemic (e.g. Watermeyer et al., 2021a ).

The three perspectives identified in this review—traditionalist, reformist and pragmatist—represent important alternative points of departure and foci of analysis. Existing or budding academic leaders would benefit from an understanding of each of these perspectives in order to fully appreciate the challenges they face and the environment in which they are leading. A triangulation of these three perspectives is especially recommended in terms of compensating for the potential myopia and inherent bias that comes from privileging any of them (see Fig. 1 ). Each of these perspectives manifests limitations in terms both of their range of vision and capacity to accommodate and/or respond to other outlooks and orientations shaped for instance by disciplinary orientation that might offer a wider lens to the various contextualisations of leadership.

figure 1

Scoping the leadership literature

Criticism of literature about university teaching often centres on its collective lack of relevance and sensitivity to different disciplinary traditions. Much the same criticism has been applied to university leadership that makes little reference to disciplinarity (Blackmore, 2007 ) although there is some work indicating styles and types of challenges for leadership both within and between disciplines (Lawson, 2016 ; Martin et al., 2003 ). The absence of a disciplinary context is most evident in relation to the pragmatist literature although some relevant pragmatist work can be found in subject-specific journals. This does not guarantee however that disciplinary context will be sufficiently addressed. A stronger emphasis in the literature concerning leadership in different disciplinary settings would be helpful, especially for practitioners but the specialist nature of such work makes it unlikely to emerge.

The ability to understand culture and context—disciplinary, departmental, institutional, national and global—is central to any successful leader too. The university leadership literature has drawn extensively on work in other sectors, both public and private, and there are especially strong parallels with the entry of new public management into education settings as a result of public sector reform in the UK and elsewhere (e.g. Hall, 2020 ). Furthermore, the generic leadership literature is substantially focused on the corporate or private sector, and here, influential work on motivation (e.g. Maslow, 1954 ), change management (e.g. Kotter, 1996 ) and servant leadership (e.g. Greenleaf, 1970 ) has had a powerful effect on thinking. Moreover, contingency theory, with its emphasis on cultural and situational attenuation, is at the heart of any real understanding of leadership, especially on an international and cross-cultural basis influenced by Geert Hofstede ( 2001 ) amongst others.

In terms of context, the traditionalist perspective also offers some important insights as it focuses on what is perceived to have been lost or is considered currently imperilled. Kligyte and Barrie ( 2014 ) comment that collegiality represents an interface between leaders and the led. This tells us that an attenuation to the themes and concerns expressed in the traditionalist literature is important to understand even if the dystopian premise of these perspectives is open to question. There is a wider issue in respect to the extent to which the pragmatist literature is sufficiently tailored to an institutional context. Here, it is common to see lists of attributes, qualities, competencies and behaviours in relation to leadership identified by writers and researchers, but these can sometimes appear to be largely undifferentiated from generic leadership dispositions. Spendlove ( 2007 ), for example, identifies 23 competencies for effective leadership just four of which appear to be specific to universities. Similar criticisms might be levelled at other influential work connected with effective leadership in the sector (e.g. Bryman, 2007 ) although some authors from a pragmatist perspective offer a more nuanced approach emphasising university contexts and cultures (e.g. McDaniel, 2002 ). There are clearly tensions between traditionalist and reformist standpoints particularly in respect to claims about values and purpose(s). The traditionalist perspective largely highlights values associated with academic freedom and autonomy whilst the reformist perspective is primarily concerned about issues of social justice and equality. Yet there are areas in which a traditionalist perspective, with respect to the effects of neo-liberalism, can align with a reformist agenda focused on justice and equity issues on campus (e.g. Museus & LePeau, 2019 ). The pragmatist literature provides an important counter-balance to the arguments and concerns of the traditionalist and the reformist perspectives, respectively. Combining the two perspectives, Wald and Golding ( 2020 ) acknowledge the negative perceptions of academic leadership but also emphasise its positive benefits, such as the opportunity to improve and develop the department.

It is perhaps more accurate to speak of academic leadership literatures rather than a single and cohesive body of work since the disciplinary, methodological and ideological influences on this field of thought and empirical work are so disparate. In this respect, the literatures reflect the heterogenous identity narratives of various academic ‘tribes and territories’ (Becher & Trowler, 2001 ). Another way of understanding this disparate body of work is by reference to a distinction between a literature about leadership, drawing on critical sociological perspectives, and literature for leadership that is more empirically driven and derived from a mix of socio-psychological theory as well as an amateur tradition of reflection and anecdote from serving and former university leaders. The former perspective advocates the view that university leadership is characterised by a loss of trust between academics and managers and that this represents a crisis. The focus of the latter perspective is on the practical possibilities of improving leadership practice equipping leaders with the knowledge and tools they need to make a positive contribution. It is vital therefore that development programmes and interventions incorporate insights from all three perspectives outlined above to address the fragmentation and division that characterises this field.

The need for leaders to variously anticipate, recognise and respond to the disruptions of continuing organisational and ideological transformations affecting universities and how these are experienced by its various ‘tribes and territories’ (Becher & Trowler, 2001 ) makes the case for boundary-spanning across these discursive enclaves ever more important. This is not to suggest that it is possible, or even desirable, to develop an ‘integrated’ approach to academic leadership, but to develop greater sensitivity to the competing demands, expectations and sources of legitimacy and influence within the academic environment. Sewerin and Holmberg ( 2017 ) provide an analogy of four ‘rooms’ of university leadership—where people may fail to notice that they are speaking at cross purposes or that important spaces for debate and discussion about academic priorities are drowned out by dominant (usually managerialist) agendas. This analogy aligns with our hope that in outlining these three perspectives, academic leaders remember to allow opportunities for people to voice and consider alternative perspectives. Such an approach would suggest the need to firmly embed critical thinking, reflection and experience as the cornerstones of academic leadership learning and development as in other sectors where context is an important factor in determining what is regarded as ‘good’ leadership (e.g. Ciulla, 2011 ).

This analysis of the university leadership literature has sought to explore key perspectives on understanding the challenges facing leaders across the sector. Traditionalist, reformist and pragmatist perspectives are distinct but not hermetically sealed off from one another. Some researchers and writers have contributed to more than one of these strands since a traditionalist point of view does not preclude reformist beliefs or, indeed, an ability to identify pragmatic measures by which to implement change. An understanding of all three perspectives is vital for those charged with leadership responsibilities, especially at a senior level, as well as helping to make the perspectives of the led more informed. The traditionalist literature provides an insight into the cultural norms and traditions of higher education, highlighting the perceived mismatch between the principle of academic self-rule and the growing corporate authority of contemporary leadership practice. This is an important message for any leader working in a university to understand, whether they agree with its veracity or not. The reformist perspective identifies the degree to which the values of leadership are aligned with societal and political aspirations and expectations whilst writing from a pragmatist point of view explores the range of skills and competencies that leaders need in practice, and how this links to organisational performance.

The core messages of the three strands of the literature represent perspectives that cannot necessarily (and should not) be integrated or aligned but which leaders need to be cognisant of. Here, it is important to respect the special culture of higher education (traditionalist), its values as a reflection of wider society (reformist) and how best to practically manage and achieve positive change in such an environment (pragmatist). An understanding of the ways in which higher education is evolving—from the perspective of different stakeholders—should enable a more pluralistic appreciation of academic leadership and recognition of how different bodies of literature and evidence can constructively inform leadership development and practice to meet changing organisational needs and societal expectations.

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Macfarlane, B., Bolden, R. & Watermeyer, R. Three perspectives on leadership in higher education: traditionalist, reformist, pragmatist. High Educ (2024). https://doi.org/10.1007/s10734-023-01174-x

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  • Effective Leadership Development in Higher Education: Individual and Group Level Approaches

Susanne Braun, Tanja Nazlic, Silke Weisweiler, Beata Pawlowska, Claudia Peus, Dieter Frey 10.12806/V8/I1/IB6

Introduction

Effective leadership is central to an organization’s success. Several studies have shown the positive effects of leadership development on a variety of organizational variables such as followers’ satisfaction, commitment, and performance (Barling, Weber & Kelloway, 1996; Dvir, Eden, Avolio & Shamir, 2002; Popper, Landau & Gluskinos, 1992). As Arsenault (2007) suggests, “Universities are definitively not immune to this need for effective leadership as they face similar challenges as any other organization” (p. 14). However, leadership development in higher education is still an under-investigated field of research and application (Bryman, 2007; Castle & Schutz, 2002). To date, faculty are appointed to a senior rank based upon their deep subject knowledge, experience, and scientific accomplishment (e.g., number of publications in international journals), not based on leadership skills. Subsequently, senior faculty members hold leadership positions without adequate preparation. Moreover, to strengthen organizational effectiveness the expectations placed on senior faculty are often excessively high (Beck-Frazier, White & McFadden, 2007). Often academic leaders address the resulting work-overload inadequately (Rowley & Sherman, 2003). However, few authors have taken into consideration the specific challenges faced by academic leaders, such as the complex and dynamic social, economic, and political contexts most colleagues and universities are operating in, as well as the consequences of effective or rather ineffective leadership in higher education (Smith & Hughey, 2006). In spite of the enormous importance of effective leadership in higher education, concrete suggestions for specific development programs are scarce (e.g., Arsenault, 2007). This is the challenge in leadership education we will address.

According to Day (2000), the approaches to facilitate effective leadership can be differentiated into “leader” and “leadership” development. To be more specific, he defines leader development as a “purposeful investment in human capital” that typically emphasizes “individual-based knowledge, skills, and abilities” of (future) leaders (p. 584). In contrast, Day (2000) contends that leadership development incorporates the expansion of “the collective capacity of organizational members to engage effectively in organizational roles and processes” and is specifically directed towards “groups of people to learn their way out of problems that could not have been predicted” (p. 582). We agree with this differentiation and apply it to the development programs introduced in this article. Consequently, the purpose of the article is to present two approaches that facilitate effective leadership in higher education, with the first program focusing on the individual level (leader development) and the second program aiming at the development of leadership on a group level (leadership development). Initially, we introduce the general concept of the Center for Leadership and People Management, which offers these programs for senior and junior faculty at Ludwig-Maximilian University (LMU) in Munich, Germany.

The LMU Center for Leadership and People Management

The LMU Center for Leadership and People Management aims to promote researchers’ scientific excellence by facilitating effective leadership and teamwork. The underlying premise of the center is that academic excellence depends not only on researchers’ scientific knowledge and skills, but also on their ability to motivate and lead their staff effectively (Peus & Frey, 2009).

Consequently, the center offers a variety of courses for senior and junior faculty. Course contents as well as methods applied are grounded in scientific evidence. Furthermore, individual coaching sessions are offered to (future) academic leaders. This multilevel approach meets the requirements for creating “good leaders” proposed by Stech (2008). A combination of theoretical education, practical training sessions, and individual developmental activities are recommended (e.g., coaching; Stech, 2008). The contents taught in our courses specifically address the challenges faced by researchers, such as restructuring and internationalization of study programs, financial constraints, or lack of long-term career perspectives. For example, we offer a four-hour introductory course on leadership and motivation for junior and senior faculty to improve their abilities in promoting innovation and academic excellence. The course is followed by a moderated exchange of experiences, which enhances the transfer of the theoretical content into one’s daily work environment.

The program of the LMU Center for Leadership and People Management is based on three pillars. (a) All activities are designed in line with the strategic goals of the university:

  • Academic excellence.
  • Development of young academics.
  • Interdisciplinary cooperation.
  • Internationality.

In the following section, we present two programs offered by the LMU Center for Leadership and People Management, including an individual level approach for leader development of junior faculty and a group level approach for leadership development within university departments.

Development for Future Leaders

Junior faculty as future leaders are a particularly relevant target group for development activities as they profoundly affect tomorrow’s universities. According to the definition provided by Day (2000), junior faculty development can be seen as one specific approach to leader development that is directed towards young talent on an individual level. However, most universities have left the field of developing future leaders untouched and existing programs are rarely based on sound theoretical background such as transactional and transformational leadership (Bass, 1985, 1998; Judge & Piccolo, 2004). Additionally, the evaluation of leadership development activities faces specific challenges (Hannun & Craig, 2008) and as a result, the programs are often not evaluated according to scientific standards (Elmuti, Minnis, & Abebe, 2005). Multilevel evaluation criteria and multiple methods for data collection are lacking, however, they are necessary to improve the validity of evaluations (Hannun & Craig, 2008). Our program, therefore, includes: (a) an examination of individual development over time, (b) evaluation according to multi-level criteria, and (c) the use of multiple methods for data collection. We designed this program with the aim of supporting promising junior faculty with regard to their leadership skills. The program comprises two group workshops and up to three individual coaching sessions per person. All interventions were developed based on theories such as transactional and transformational leadership (Bass, 1985, 1998), justice in teams (Colquitt, Noe, & Jackson, 2002), goal setting (Locke & Latham, 2002), and negotiation and conflict management (Fisher, Ury, & Patton, 1991).

Leader Development Program

Based on the findings from previous workshops, qualitative needs assessments, and a review of research findings, we identified three main areas important to leader development for junior faculty: (a) setting goals and priorities, (b) interpersonal relations, communication, and conflict, and (c) career planning and work-life balance.

A small group of high performing individuals (about 10 persons) were selected to participate in this program based on several inclusion criteria (e.g., publications, relevant work experiences, and previous grants or scholarships).

  • identification of basic work-related and private values,
  • targeted vs. actual involvement in various areas of life,
  • identification of resources, potential, and strengths,
  • successful work relationships with supervisor and colleagues,
  • self-marketing, and

Methodological focus in the workshop is on group discussions and peer coaching.

The first workshop is followed by up to three individual coaching sessions. According to Arsenault (2007), individual coaching sessions should be part of academic leadership development programs to help participants implement course content in their day-to-day work. Issues discussed during coaching sessions are: individual decision-making, leading and motivating student assistants, and conflict with colleagues. The experienced coaches, all trained team members from LMU Center for Leadership and People Management, use various methods such as behavior modification or systemic coaching tools. The second one-day workshop covers additional issues around career planning and serves as a wrap-up for remaining questions.

Evaluation Concept

The evaluation of the leader development program is challenging because individual characteristics, situational constraints, and post-training motivation influence transfer of training (Cannon-Bowers, Salas, Tannenbaum, & Mathieu, 1995). As a result, we based our evaluation on the revised version of Kirkpatrick’s model for training evaluation (cited in Alliger et al., 1997). It comprises four levels of evaluation criteria: (a) affective and utility reactions, (b) learning – including immediate knowledge, knowledge retention, and behavior/skill demonstration, (c) transfer – indicating on-the-job performance, and (d) results – comprising productivity gains.

In our evaluation of the program the main outcome variables are goal attainment, emotional and behavioral functioning of participants, as well as their satisfaction with the program. Additionally, the relevance of several personality traits such as procrastination, self-efficacy and perseverance is tested as potential moderators of the program’s effectiveness. In addition to self-report data, we also include 360 or 180 degree feedback and qualitative data from interviews with the participants two months after the second workshop. Participants who signed up for the program’s waiting list are used as one control group. In addition, we add a second control group taking part in different courses. The launch of the leader development program was accompanied by great interest among young researchers. The first evaluation results indicate its practical relevance and effectiveness on a variety of evaluation and career measures.

Leadership Development within University Departments

Bensimon and Neumann (1992) state the challenge for an academic leader is to “mold a group of people so that they lead, act, and think together” (p. 281). Taking into account Day’s (2000) definition of “leadership development” as applying to “groups of people” (p. 582), we emphasize the idea that development on a group level is crucial for the facilitation of effective leadership in higher education. As a result, the program is specifically directed towards the improvement of academic performance through the integrated development of leadership and teamwork among university departments.

Leadership Development by “Cooperation Culture”

  • leadership style,
  • communication,
  • conflict management,
  • workload and stress,
  • job motivation and satisfaction, and

Underlying Theoretical Concepts

Transformational and transactional leadership (Bass, 1985, 1998) Transactional leadership describes leadership as a transaction between a leader and a follower based on the clarification of expectations and the rewards for one’s performance. Transformational leadership is assumed to have an effect on performance beyond a leader’s expectations (Judge & Piccolo, 2004). It is directed towards the individual needs and values of the followers.

Team climate for innovation (Anderson & West, 1996) The team climate for innovation is based on four aspects: participative safety, support for innovation, vision, and task orientation. It is assumed that the climate for innovation is especially important for team success and satisfaction.

Intra-group conflict (Jehn, 1995) Intra-group conflict is not necessarily counterproductive: Moderate levels of task conflict, especially in groups with non-routine tasks, can encourage group members to present dissenting viewpoints. However, in the case of relationship conflict, work performance can decline.

Commitment to change (Herscovitch & Meyer, 2002) This concept considers whether employees actually support the implementation of change processes in their working environment or whether they feel pressured to adapt to new standards.

Analysis and Leadership Development

In the first step of this program (see Figure 1), the department’s members receive detailed information about the theoretical background and scientific methodology. During this meeting, particularly relevant issues are discussed and subsequently included in the analysis. The second step involves the administration of two questionnaires (online or paper-pencil). The measurement is split up into two test intervals to ensure the scientific basis of the results by limiting single source and single method bias (Avolio, Yammarino & Bass, 1991). This is followed by the third step , data analysis. Subsequently, the results are presented and discussed with the department head and the team (fourth step). The presentation gives evidence-based suggestions for leadership and teamwork development within the department. For all department heads evaluated by five or more of their team members, individual leadership profiles are prepared. Building on the results, but also considering the expectations of the department’s members, specific methods for the development of leadership and teamwork are implemented as the fifth step (e.g., individual coaching, team workshops, or moderated exchange of experiences).

Step 1: Information and adjustment

of concept, contents, and implementation

Step 2: Data collection

by questionnaires at two times of measurement

Step 5: Leadership development

coaching, team workshops, exchange of experiences etc.

Step 4: Results and discussion

general presentation and individual leadership profile

Step 3: Data analysis

according to underlying theoretical concepts

Figure 1. Process of analysis and leadership development

Conclusions: How to Facilitate Effective Leadership in Higher Education

The purpose of this article was to present two approaches for the facilitation of effective leadership in higher education. The first program focuses on leader development on an individual level, whereas the second program focuses on leadership development on a departmental level.

Exact fit of teaching content.

Use of multiple training methods.

Scientifically-based program evaluation.

Strategic cooperation of leadership educators in higher education.

To date, systematic leadership development plays only a minor role in higher education (Bryman, 2007). We strongly recommend leadership educators to share their present practical experience and empirically based knowledge with each other in order to facilitate systematic leadership development in higher education area around the world.

The development of effective leadership is crucial for performance and success not only in commercial organizations, but also in academia (Bensimon & Neumann, 1992). Many of the methods presented here can be applied in leadership development initiatives in various types of organizations including commercial and non-profit organizations as well as public administrations. Hence, we would like to encourage leadership developers at universities as well as in the business setting to experiment with the application of the described approaches in their specific areas.

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Effective leadership in higher education: a literature review

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... Moreover, preliminary evidence indicates the relevance of transformational leadership for academic institutions (Bryman, 2007) and innovative work (Eisenbeiss, van Knippenberg, & Boerner, 2008). ...

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... The notion of acting as a role model and having credibility mirrors one of the 13 forms of ‘leader behaviours’ identified by Bryman in his meta-analysis of the literature about leadership in higher education (Bryman 2007). ...

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... However, there is a gap in the academic research about leadership in the higher education institutions (HEI) (Bryman, 2007). ...

... According to Bryman (2007), effective leader’s behaviors in HEI are setting direction, communicating it to the staff, having strategic vision, creating positive organizational climate, being considerate and treating staff fairly, being trustworthy and treating staff with integrity, involving… ...

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... Faculty members completed the Multifactor Leadership Questionnaire, which is designed to measure aspects of transformational and transactional leadership (Bass, 1985). ...

... Faculty members completed the Multifactor Leadership Questionnaire, which is designed to measure aspects of transformational and transactional leadership (Bass, 1985 ). ...

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... These findings are consistent with the tendency for idealized influence to exhibit the strongest relationships with effectiveness (Bryman, 1992; Lowe et al., 1996). ...

... Interestingly, the idealized influence score was found to be high relative to other studies (as reported in Lowe et al., 1996), suggesting that this aspect of leadership is particularly important in a university setting. ...

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... In the context of credibility and acting as a role model, this finding concerning idealized influence is significant because it denotes leaders who are ‘admired, respected and trusted’, whose followers ‘identify with and want to emulate their leaders’ (Bass et al , 2003 , p. ...

... In the context of credibility and acting as a role model, this finding concerning idealized influence is significant because it denotes leaders who are ‘admired, respected and trusted’, whose followers ‘identify with and want to emulate their leaders’ (Bass et al., 2003, p. 208). ...

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Why Students Cheat and How Understanding This Can Help Reduce the Frequency of Academic Misconduct in Higher Education: A Literature Review

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  • 1 School of Psychology and Neuroscience, University of St Andrews, St Andrews, KY16 9JP, Scotland, UK.
  • 2 School of Biology, University of St Andrews, St Andrews, KY16 9TH, Scotland, UK.
  • PMID: 38323052
  • PMCID: PMC10653228
  • DOI: 10.59390/LXMJ2920

Academic integrity is fundamental to effective education and learning yet cheating continues to occur in diverse forms within the higher education sector. It is essential that students are educated about, and understand the importance of, good academic practice. Strict standards of academic integrity help to ensure that knowledge is acquired in an honest and ethical manner, creating fairness and equity for students, ultimately enriching the student experience at university and the wider society's trust in the value of university education. This literature review synthesizes the many varied reasons why students cheat, as presented in a large body of existing literature. We then turn our attention to what we can do as educators to help reduce the rates of academic misconduct. Factors influencing the propensity of students to cheat are diverse but relatively well understood. Whilst policing and applying appropriate punishments should be part of institutional responses to academic misconduct, it is clear that this is only part of the solution. We emphasize the need for a much broader range of proactive activities to be brought to bear. Many of these are educational in nature and should have benefits for students, staff and institutions beyond discouraging academic misconduct. Resource implication should not be a barrier to their implementation.

Keywords: academic dishonesty; academic integrity; academic misconduct; cheating; good academic practice; higher education; plagiarism; university education.

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Leadership for an innovative practice role: the dually certified nurse practitioner.

View as pdf A later version of this article appeared in  Nurse Leader ,  Volume 21, Issue 6 , December 2023 . 

Nurse leaders have repeatedly called for an expansion of nursing education, research, and clinical practice to identify and meet the social and healthcare needs of diverse and vulnerable populations. The National Institute of Nursing Research’s mission calls for optimizing health and advancing health equity through five lenses, as reflected in their new strategic plan: Health Equity, Social Determinants of Health, Population and Community Health, Prevention and Health Promotion, and Systems and Models of Care. 1 Further, the National Academy of Medicine’s (formerly the Institute of Medicine) reports on the Future of Nursing specifically call for nurses to provide care and to lead or contribute to solutions for vulnerable populations. These national nursing priorities build upon a foundation established by Berwick and colleagues 4 which advanced our understanding that access to culturally- based care should be provided where people live and be available when they need it.

Programs preparing nurse practitioners are ideally suited to respond to these calls to action. Important innovations are emerging in Doctor of Nursing Practice (DNP) programs. These changes are due to three main factors: First, growing market demands, especially the dearth of psychiatric providers; second, an increasing number of registered nurses entering DNP programs who wish to pursue dual certification; and finally, more current nurse practitioners (NPs) are returning to earn post-master’s degree certification in a second specialty. 5,6 Dual certification DNP curricula are comprehensive and challenging. Successful graduates have the knowledge, expertise, and skills to positively impact patient outcomes within the increasingly complex healthcare infrastructure. Although there are many plans of study for dual certification, of particular interest for this article are NPs with dual certification in primary care and psychiatry (PC/PMHNP). These NPs are exceptionally well qualified to provide and lead care for patients across the lifespan and with varying levels of acuity as well as high needs/high-cost patients 7 in institutional and community-based settings. Primary care settings and rural communities with compromised accessibility to specialty care such as psychiatry stand to benefit from incorporating a dually certified PC/PMHNP.  The purpose of this paper is to inform nurse leaders about this emerging role and provide tangible ways on how nurse leaders can support implementation. 

Introducing the Dually Certified Practitioner Role  

Nationally, approximately 20% of Americans experience a mental illness yearly, but only half are treated 8 Lack of care is a consequence of many factors including costs/coverage, too few care providers, and the stigma of receiving psychiatric care. The consequences of having a mental illness are high and include increased comorbidity risks for cardiovascular and metabolic diseases, substance use disorders, and other illnesses adversely affecting quality of life. Moreover, the COVID-19 pandemic amplified preexisting psychiatric disorders and increased anxiety and depression in the general public.

Access to mental health care is particularly challenging due to limited available mental health facilities. Dual PC/PMHNP providers in primary care settings increase access to mental health services by reducing the stigma attached to seeking services in a psychiatric setting, reducing wait times associated with referrals, and decreasing the need for persons seeking mental health care to negotiate additional schedules and relationships. National data indicate a decrease in primary care physicians’ growth by approximately 7% while nurse practitioner growth is expected to increase by 40% over the next decade, particularly amongst the care of rural and underserved populations. 9  Consequently, NPs have unique opportunities to address common challenges for practicing in rural settings in the care of patients with complex chronic physical and mental health conditions.

NPs are a source of affordable, quality, and trustworthy healthcare and are recognized for their expertise in preventive care. They are also highly effective at optimizing the patient experience, improving patient outcomes, and minimizing costs for the care of complex patients.  Dual-track NP programs that combine primary care and psychiatric mental health care by advanced practice nurses were first developed in 1997. 10 The combination of primary care and psychiatric mental health NP preparation enables the integration of medical and behavioral health care promotion, prevention, and management. The integration of primary and mental health care also facilitates holistic care, allowing providers to evaluate the effectiveness of medical and psychiatric therapies on the whole patient. 11

NP academic program curricula follow closely the National Organization of Nurse Practitioner Faculty (NONPF) Core Competencies that provide a foundation for NP role expectations and are aligned with the American Association of College of Nursing (AACN) Essentials for graduate nursing education. 12,13 Population-specific competencies (e.g., FNP, PMHNP) are also provided by NONPF to ensure clinical expertise preparation required for certification and entry into practice. 14 Curriculum design for dual NP programs has not been standardized, allowing academic institution flexibility in program design. Moreover, there is a lack of consensus amongst nursing academicians about the structure and makeup of a dual NP program.  Many regulatory bodies (state boards of nursing and certification bodies) do not track whether individuals have more than one NP certification, or if they do, make it publicly available. 

The University of Iowa College of Nursing has offered dual-track NP programming amongst the 8 specialty tracks since 2015 with 18 BSN-DNP dual graduates and specifically 13 PC/PMHNP graduates at the time of this publication.  Evaluations from graduates reveal high satisfaction with dual-track preparation with few disadvantages that included additional rigor and tuition requirements. 6 A pilot program, supported by funding from a Telligen Community grant in 2022, developed and implemented additional coursework and practicum experiences with a focus on integrative care for PC/PMHNP dual program students.  

The remainder of the paper focuses on benefits, barriers, and implementation of the dually certified PC/PMHNP role. Content is based on the literature and authors’ clinical experiences in the role. We include illustrative examples that reflect our practice observations and leadership in developing and implementing the role. 

Benefits Associated with the Dual Practitioner Role

Systems that employ dually certified nurse practitioners receive many benefits. These include a holistic approach, decreased stigma, patient empowerment through education and relationships, cross-system care across the care trajectory, and consultant expertise, as described next.  

Holistic approach

Many patients with physical conditions have co-occurring psychiatric conditions which impact both hospitalization and cost. 15, 16  The PC/PMHNP can address both the psychiatric and physical conditions yielding less fragmentation. 

The visit becomes holistic when the patient is empowered to think, “What do I need today?” For example, the visit might be for psychiatric medication management follow-up, but the patient says, “My meds are doing well, but my throat is sore and my knee is bothering me.”  The NP can shift and let the patient drive the visit. This is particularly important for people with serious mental illness (SMI) and substance use disorder whose most frequent contact is with psychiatry. If I were working only in a psychiatry office, I could only address psychiatric concerns, whereas in an integrated practice, I can address the whole person. We know physical health concerns are often underreported and under-addressed in people with SMI, so having the capacity for patients to bring up other health concerns is helpful. It reduces visits, builds trust and I can pick up on what might be a small issue before it becomes something bigger.

Streamlined care fosters efficiency, safety, and cost-effectiveness

Patients with co-occurring physical and psychiatric symptoms have higher healthcare utilization and thus are more costly to treat. 17 Further, they may be unaware of the connection between mental health symptoms and somatic expressions, or of how mental health symptoms can worsen medical conditions and vice versa. As a result, they are at risk for duplication of services and polypharmacy.  

Consider the case of a woman with post-traumatic stress disorder (PTSD) and major depressive disorder who was seen after a negative workup in the ER for chest discomfort. The NP and the woman worked together to process the episode, evaluating a recent trigger attributed to her PTSD. Moving forward the NP and the patient have a new way of talking about physical symptoms and PTSD-related anxiety. The NP can investigate any future somatic concerns and conduct a physical exam and, as appropriate, link somatic symptoms, (e.g., headache, chest pain) to increased anxiety. This reduces duplication of services, multiple visits and decreases the risk of inappropriate polypharmacy. 

Streamlined care can also benefit the larger system. Mergers are happening between hospital systems and community mental health. NPs can seamlessly move between community systems (e.g., residential care facilities, group homes, family settings) and institutionally based settings such as hospitals and nursing homes. Further, they can advocate and communicate with many disciplines as patients move across care settings. Additionally, dually certified NPs can serve as consultants, provide case reviews and collaborate with other health professionals within the health care system.

A more streamlined approach to care means patients do not work as hard to get what they need. 17 Having only one healthcare provider can minimize confusion, increase trust, and promote appropriate engagement in healthcare which may diminish ER visits and hospitalizations. This has the potential to lower costs, but rigorous cost evaluation studies are needed. 

Stigma reduction

Persons with mental illness are particularly vulnerable to the adverse effects of stigma such as shame, isolation, hopelessness, and discrimination. 18  

People are embarrassed to bring up their psychiatric concerns but when they know that I am also a psychiatric provider, they are relieved. I see the mental health concerns and can normalize symptoms and come up with a plan. Further, they are seeing me in a primary care office and don’t have to go to the psychiatry office, which is destigmatizing.

Dually certified PC/PMHNP are “empowerment enablers”

Patient empowerment 19 can be enhanced through working with a dually certified PC/PMHNP. As described below, the NP’s holistic lens contributed to efficiency, patient empowerment, and enhanced job satisfaction.  

I have seen growth in patient self-awareness and understanding of their own health. Nursing excels at taking time to provide patient education and promote self-management, but when we approach this through dual role/holistic services, patients gain an understanding of how their symptoms or day-to-day health is not an isolated representation of one problem, but rather a whole-body expression of what is going on. For example, if a patient living with diabetes and depression presents with an increase in average blood sugar readings they have a better understanding of how the two are interconnected --it sets us up to have a very different conversation as provider and patient than if I was only treating one condition and not the other. It is very rewarding to see patients empowered by understanding their own body/health. 

Barriers to Implementing the Role

Several issues arise as barriers in the implementation of the dual cert role. These include constraints in the practice environment, practice logistics, and issues with full practice authority.

Practice environment

Because many healthcare administrators are unaware of this emerging role, it takes creativity and vision to inform them of the benefits of hiring a dually certified NP. One effective means to eliminate/minimize this barrier is to engage a physician or medical director champion.  

The medical director quickly realized my vision for the dual role. If he hadn’t embraced the full capacity of the dual-prepared NP provider, I could have been reduced to primarily serving as either an FNP or PMHNP rather than the opportunity to use both at the same time.

Practice logistics

Issues with scheduling, appointment times, electronic health records, billing, and reimbursement may impede dually certified NP in maximizing their role. The NP often sees complex patients who require longer than a 15-minute appointment, especially when there is a need for collaboration with other disciplines. Further, some electronic health records may have automatic access restrictions on psychiatric notes which poses a barrier to communication for enacting full team-based care. 

Another barrier that dual-certified NPs face is changing the paradigm from volume-based to quality and value-based reimbursement. Billing and coding professionals based in primary care may not be prepared to support the added coding capacities that the dual cert NP possesses such as the counseling codes available to the psychiatric provider.

Full practice authority

Lack of full practice authority is a barrier to implementation of the dual cert role. In states where NPs require collaborative practice agreements, the NP with dual certification would require two physicians of varied specialties to practice. 

Facilitating Role Awareness and Adoption

Although there are many benefits to this role, it is still not well recognized nor understood.  Before this role can be widely adopted, an evidence base of improved clinical outcomes and cost-effectiveness must be provided to healthcare system leaders.  None of the currently published manuscripts on the dually certified role address cost nor systematically evaluate outcomes of the role. 

The dually certified NP must be able to confidently articulate their emerging role to health system administrators, medical leadership, members of the healthcare team, and patients.

It’s about owning the role and educating. When I am meeting with a patient for the first time, I introduce myself stating, “I am fully certified for family practice and psychiatric mental health. I have some patients I see for one or the other and some patients I see for both.” Often the patient is coming to me for one or the other because they don’t even know that such a thing exists. So, taking 20-30 seconds to explain my role to patients in this way has grown my dual/holistic practice. They often respond, “Oh, I didn’t know you could do that.” And typically, by the end of the visit they have decided to establish care with me for both services. 

Dually prepared nurse practitioners have an obligation to enhance awareness through the dissemination of information about the role. Dissemination can be by presentations, discussions, and publications in arenas where nurse executives and hospital administrators are likely to read and convene. 

NPs must also collect data on their own practice. Data on patient outcomes and satisfaction and cost savings will help validate the effectiveness of their role. NPs can also collect data on their insurance reimbursements using psychiatric counseling codes (e.g., 90833) to demonstrate the value of allowing extended appointment times and the financial benefits of quality over quantity. Partnering with health system administration leadership, schools of nursing and health services researchers is essential to foster role adoption and needed policy changes.

Future Directions

This is a new role that requires a vision of non-fragmented care for high-cost, complex patients with co-occurring mental health and physical health care needs. Nurse leaders can impact implementation of the role through a variety of means. These include advocating to Medicaid for dual-certified NP-led demonstration projects for high-cost patients, such as people with schizophrenia; expansion of dual cert programs at colleges of nursing nationwide; and promoting presentations/ posters related to dual cert roles and outcome studies at professional conferences. Nursing regulatory leaders in state and national boards of nursing, certification centers, and credentialing bodies play a particularly important role in assisting with gathering data on those NPs who maintain dual certification. Nurse leaders must also spearhead efforts to establish full practice authority through working in collaboration with their state and national boards of nursing, professional nursing organizations, and legislators. In states where there is already full scope of practice, they must remain vigilant for encroachments into full scope of practice.

As noted, national reports such as the Future of Nursing, encouraged the provision of care by nurses especially to vulnerable populations. Dually certified NPs are ideally prepared to provide care to high-needs/high-cost patients. 

This article is a beginning step to elucidating the dual certification role. Much more is needed to expand educational programs and the full practice of dually certified NPs. Most particularly we lack an evidence base on cost-effectiveness and patient outcomes. This is where nursing leaders in academic, regulation, and healthcare systems can collaborate to pave the way and expand program offerings, enhance awareness, and promote employment of dual certified NPs.

Acknowledgment

The authors wish to acknowledge Christopher Sang for his support in editing the manuscript.  

  • The National Institute of Nursing Research 2022–2026 Strategic Plan (2022).  https://www.ninr.nih.gov/aboutninr/ninr-mission-and-strategic-plan
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National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on the Future of Nursing 2020–2030, Flaubert JL, Le Menestrel S, Williams DR, Wakefield MK, eds. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity . Washington (DC): National Academies Press (US); May 11, 2021.

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Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration) (2022).  https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report

Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners (U.S. Department of Labor) (2023).   https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm

Dyer JG, Hammill K, Regan-Kubinski MJ, Yurick A, Kobert S. The psychiatric-primary care nurse practitioner: a futuristic model for advanced practice psychiatric-mental health nursing. Arch Psychiatr Nurs . Feb 1997;11(1):2-12. doi:10.1016/s0883-9417(97)80044-1

Blount A. Introduction to integrated primary care. In: Blount A, ed. Integrated Primary Care: The Future of Medical and Mental Health Collaboration . 1st ed. Norton; 1998:1-43.

Faculties NOoNP. NONPF’s Nurse Practitioner Role Core Competencies . 2022. https://www.nonpf.org/general/custom.asp?page=NP_Role_Core_CompetenciesAmerican

Nursing AoCo. The Essentials: Core Competencies for Professional Nursing Education . 2021. https://www.aacnnursing.org/essentials

Faculties NOoNP. NONPF’s Population-Focused Nurse Practitioner Competencies . 2013. www.nonpf.org/resource/resmgr/np_competencies_&_ntf_standards/compilation_pop_focus_comps.pdf

Figueroa JF, Phelan J, Orav EJ, Patel V, Jha AK. Association of mental health disorders with health care spending in the medicare population. JAMA Netw Open . Mar 2 2020;3(3):e201210. doi:10.1001/jamanetworkopen.2020.1210

Launders N, Dotsikas K, Marston L, Price G, Osborn DPJ, Hayes JF. The impact of comorbid severe mental illness and common chronic physical health conditions on hospitalisation: A systematic review and meta-analysis. PLoS One . 2022;17(8):e0272498. doi:10.1371/journal.pone.0272498

Ezell JM, Cabassa LJ, Siantz E. Contours of usual care: meeting the medical needs of diverse people with serious mental illness. J Health Care Poor Underserved . Nov 2013;24(4):1552-73. doi:10.1353/hpu.2013.0158

Pescosolido BA, Halpern-Manners A, Luo L, Perry B. Trends in public stigma of mental illness in the US, 1996-2018. JAMA Netw Open . Dec 1 2021;4(12):e2140202. doi:10.1001/jamanetworkopen.2021.40202

Bailo L, Guiddi P, Vergani L, Marton G, Pravettoni G. The patient perspective: investigating patient empowerment enablers and barriers within the oncological care process.  Ecancermedicalscience . 2019;13:912. Published 2019 Mar 28. doi:10.3332/ecancer.2019.912

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COMMENTS

  1. Effective leadership in higher education: a literature review

    Abstract. This article is a review of the literature concerned with leadership effectiveness in higher education at departmental level. The literature derives from publications from three countries: the UK, the USA and Australia.

  2. Effective Leadership in Higher Education: A Literature Review

    Effective Leadership in Higher Education: A Literature Review December 2007 Authors: Alan Bryman Request full-text Abstract This article is a review of the literature concerned with...

  3. Effective leadership in higher education: a literature review

    Effective leadership in higher education: a literature review A. Bryman Published 1 December 2007 Education Studies in Higher Education This article is a review of the literature concerned with leadership effectiveness in higher education at departmental level.

  4. Effective Leadership in Higher Education: A Review of Leadership Style

    Effective Leadership in Higher Education: A Review of Leadership Style Preferences among Faculty and Staff within the United States Open Journal of Leadership 08 (02):58-74 License CC BY 4.0...

  5. Leadership development in Higher Education: A literature review and

    Leadership development in Higher Education: A literature review and implications for programme redesign Sue Dopson, Ewan Ferlie, Gerry McGivern, Michael D. Fischer, Mahima Mitra, Jean Ledger, Sonja Behrens First published: 06 December 2018 https://doi.org/10.1111/hequ.12194 Citations: 32 Read the full text PDF Tools Share Abstract

  6. (PDF) Leadership Development in Higher Education: A Literature Review

    Leadership Development in Higher Education: A Literature Review and Implications for Programme Redesign Authors: Stephanie Dopson Centers for Disease Control United States Ewan Ferlie...

  7. [PDF] Effective Leadership in Higher Education: A Review of Leadership

    This causal-comparative study reviewed the leadership style preferences of faculty and staff from participating higher education institutions (HEI). A total of 146 participants completed the Leadership Style Questionnaire (LSQ), a research instrument consisting of demographic questions and the Vannsimpco Leadership Survey (VLS). A single factor, one-way ANOVA (analysis of variance) was ...

  8. Research Into Leadership in Higher Education: A Systematic Review

    Using systematic review methods, this chapter interrogates and synthesises the research literature on leadership in higher education in terms of its meanings, application and practice, and the issues and critiques raised. It concludes that research into leadership in higher education has been both extensive and global in nature, identifying a ...

  9. Effective Leadership in Higher Education

    Reports Effective Leadership in Higher Education - Final Report A review of literature, and examination of interview data, examining leadership and leadership behaviours which are associated with effectiveness in HE.

  10. Effective leadership in higher education : The

    Research suggests that leaders and leadership play a critical role in a university's success (Bryman, 2009; Scott, Coates & Anderson, 2008). Despite this assertion there is little empirical evidence to suggest what effective leadership in a higher education context entails. This study was an attempt to address this gap by examining leadership from a perspective of the interrelationships and ...

  11. Leadership Researchers on Leadership in Higher Education

    Bryman, A. (2007a) `Effective Leadership in Higher Education: A Literature Review', Studies in Higher Education 32: 693-710. Google Scholar Bryman, A. (2007b) `Barriers to Integrating Quantitative and Qualitative Research', Journal of Mixed Methods Research 1(1): 8-22.

  12. Three perspectives on leadership in higher education ...

    There is a fragmented and complex literature about higher education leadership representing a diversity of ideological perspectives about its nature and purposes. Internationally, the literature has been strongly shaped by the importation of concepts and theories from management studies and a tradition of scholarship led by university leader-researchers. Drawing on an extensive literature ...

  13. Effective Leadership in Higher Education: A Literature Review

    This article is a review of the literature concerned with leadership effectiveness in higher education at departmental level. The literature derives from publications from three countries: the UK, the USA and Australia.

  14. A review on leadership and leadership development in educational

    The present review was conducted to summarise the existing literature and discover lacunae in school leadership research in preschools, primary and secondary schools. 75 studies focusing on leadership theories, characteristics of effective school leadership and school leaders' professional development were included and analysed.

  15. Effective Leadership Development in Higher Education: Individual and

    In spite of the enormous importance of effective leadership in higher education, concrete suggestions for specific development programs are scarce (e.g., Arsenault, 2007). This is the challenge in leadership education we will address. ... Effective leadership in higher education: A literature review. Studies in Higher Education, 32, 693-710.

  16. A systematic review and framework for digital leadership research

    Digital leadership in higher education is a sub-field of research that rapidly evolved from e-leadership studies. The practice of effective digital leadership in higher education is urgently needed to keep up with changing demands and opportunities. Yet limited knowledge exists of how it is defined, how it operates and relates to institutional ...

  17. Effective Academic Leadership: Key Aspects of Leader Behavior in Higher

    Currently, effective leadership plays an important role in improving the context of higher education. Policy makers, leaders, and university staff considered the effective leadership as determining a factor for management of universities. Although effective leadership is examined by many researchers, to the best of author knowledge, only a few references in the literature systematically ...

  18. PDF Educational Leadership In Higher Education: A Scientific Literature Review

    Review Of The Scientific Literature 2.1Universities as academic leadership multipliers Leadership that is required in the higher education is reffered to as Academic leadership [1]. According to these authors [1], academic leaders should motivate and inspire other faculty members.

  19. Effective Leadership in Quality Assurance for Higher Education: A

    The literature review is conducted to establish a solid theoretical foundation and to identify key concepts, frameworks, and trends related to leadership and quality assurance in higher education ...

  20. Effective leadership in higher education: a literature review

    01 Feb 2013 TL;DR: In this article, a multilevel analysis of the relationship between transformational leadership, trust in supervisor and team, job satisfaction, and team performance was performed on 360 employees from 39 academic teams.

  21. Developing Meaningful Internationalisation that Impacts Students

    Research about the internationalisation of higher education has expanded rapidly in recent decades with few attempts to map available evidence. ... Developing Meaningful Internationalisation that Impacts Students' Outcomes in Higher Education: A Scoping Review of the Literature 2011-2022 ... Internationalised activities are effective when ...

  22. The intellectual structure of the literature on sustainability

    The bibliometric review offers empirically-based insights into the evolution and current status of the literature on sustainability leadership in higher education. The findings can be used as a benchmark against which future developments in this knowledge base can be assessed.

  23. Why Students Cheat and How Understanding This Can Help Reduce ...

    Strict standards of academic integrity help to ensure that knowledge is acquired in an honest and ethical manner, creating fairness and equity for students, ultimately enriching the student experience at university and the wider society's trust in the value of university education. This literature review synthesizes the many varied reasons why ...

  24. (PDF) Transformational Leadership in Education: Review of Literature

    Therefore, the aim of this research is to provide a review of the literature that focuses on leadership in education and ways to transform the educational systems so that policymakers,...

  25. Leadership in Higher Education

    Accelerate your leadership in higher education. The Leadership in Higher Education (LHE) prepares multidimensional leaders through the combination of theory and hands-on experience. Our graduates are ready for leadership positions at community colleges, universities, and nonprofit organizations. You will learn how to address the complexities of ...

  26. Effective Leadership in Quality Assurance for Higher Education: A

    The importance of quality assurance for higher education and the effective leadership role in assuring the quality of higher education institution is provided based on qualitative approach with literature study method and the findings are 10 attributes of effective leadership in quality assurances. Leadership plays key role in quality assurance effort. Higher education institution needs to be ...

  27. PDF Effective Leadership in Quality Assurance for Higher Education: A

    [11] A. Bryman, "Effective Leadership in Higher Education: A Literature Review," Studies in Higher Education, vol. 32, pp. 693-710, 2007. [12] H. Gardner, Changing Minds: The Art and Science ...

  28. Leadership for an innovative practice role: the dually certified nurse

    The remainder of the paper focuses on benefits, barriers, and implementation of the dually certified PC/PMHNP role. Content is based on the literature and authors' clinical experiences in the role. We include illustrative examples that reflect our practice observations and leadership in developing and implementing the role.