Understanding Health Professions Education Leadership Through a Pacific Cultural Lens: An Interpretivist Case Study.

Background
Health Professions Education (HPE) leadership is necessary for success at the individual, team and institutional level. Many leadership theories exist based mainly on Western perspectives, however, Pacific HPE leadership has not been investigated. Furthermore, leadership theory that informs faculty development has been mainly based on interviews alone. Faculty development is required in the Pacific where HPE is emerging. Therefore, this research aimed to understand Pacific HPE leaders’ perspectives through multiple data collection tools to develop substantive theory. The theory will guide faculty development in this setting and add a fresh perspective to the international HPE leadership discourse.
Methods
Using an interpretivist case study methodology, seven HPE leaders were purposefully recruited. Rich Pictures, Zoom interviews and reflective journals were utilised as data collection tools. Participants drew a picture on ‘Being an HPE leader’ and subsequently explained their picture. Over a six-month period they additionally reflected on leadership events in their journals. Codes and themes were interpreted using Miles and Huberman’s approach and further conceptualised into three leadership styles. Member checking was utilised to improve trustworthiness.
Results
All participant leaders had the common aim of graduating competent and compassionate graduates and wanting to leave a legacy, however, their secondary aims, strategies and attributes differed. Metaphors were assigned to each of the three HPE leadership styles identified: The ‘Bridge’- helping students from novice to competent; the ‘Coconut Tree’- multiple roles and sturdy in the storm; and the ‘Drua Canoe’ – steering towards the vision. Overall, although participants often found leadership overwhelming and challenging, they were convicted by a sense of purpose and hope to improve the system and build others capacity. They aimed to achieve this through communication and collaboration, whilst being humble and empathetic.
Discussion
Rich Pictures, interviews and reflective journals allowed HPE leaders to reflect on ‘Being an HPE Leader’ and revealed tacit perspectives. Data interpretation aligned with participants’ perspectives allowing HPE leadership to be viewed through a cultural lens. This study suggests there may be different styles of leadership, in the Pacific context, depending on the aims, strategies and attributes of different HPE leaders. Although specific to the Pacific some aspects may resonate in other contexts. Rich Pictures, interviews and reflective journals assisted in interpreting three HPE leadership styles in the Pacific context. Leadership in HPE needs to be further explored in other cultural contexts to fully understand the different styles of leadership based on their aims, strategies and attributes. This may have implications for career advice and leadership development.