MCH Leadership Competency Resources
Developed by Ginny Reed
Leadership is a frequently studied topic in the psychological and business literatures. Searches of electronic databases using ‘leadership’ as a keyword find many thousands of entries. Similarly, searches for materials relevant to the assessment of leadership find large numbers of entries.
To be considered for initial inclusion in this document, the materials had to meet several criteria:
• the material needed to focus on one or more of the skills listed for a particular competency
• the material needed to describe either a measurement instrument or theory that could support the creation of such an instrument
• the material had to be publicly available, that is, where the item is not a commercial entity available for purchase
• the material needed either psychometric information about its properties as a measure or, particularly in the case of material found only on the Web, a high degree of face validity
In addition to the measurement information for each of the leadership competencies, the literature search uncovered a number of measures of general leadership. Several of these measures are included for consideration, either in part or as a complete entity.
The materials initially described were identified for consideration by MCH interdisciplinary training programs. Many of these materials are copyrighted and thus, may not be copied, distributed, transmitted, or published without the express written permission of the copyright owner. It is the responsibility of each user to ascertain whether materials may be freely used or whether such permission is needed.
MCH Leadership Competency 1: MCH Knowledge Base
SKILLS
Basic. Through participation in this program, a participant will:
• Use data to identify issues related to the health status of a particular MCH population group.
• Describe health disparities within MCH populations and offer strategies to address them.
Advanced. With more experience and building on the basic skills, MCH leaders will:
• Demonstrate the use of a systems approach to explain the interactions among individuals, groups, organizations and communities.
• Assess the effectiveness of an existing program for specific MCH population groups.
Each of the skills listed for the MCH leadership competency of MCH Knowledge Base could be assessed by a single written research assignment. While this could technically fulfill the competency requirements, it is much more likely that the intent is for trainees to demonstrate that they regularly and consistently integrate these skills into their practice.
Thus, while a written research assignment may be an important component of MCH interdisciplinary training for a variety of reasons, ongoing assessment of knowledge should be an inherent part of the assessment process of all competency skills.
Knowledge may be assessed either directly or indirectly. Direct assessment would include modalities such as oral presentations and written exams. Indirect assessment would view the learner’s actions and the outcomes of these actions and, if found to be appropriate, would assume that the necessary knowledge was present to be acted upon.
Resources
Portfolios
Portfolios are collections of information that can be used to evaluate MCH knowledge in action.
Portfolios include materials prepared by a learner to demonstrate learning in response to a plan. There is increasing evidence of the utility of portfolios for assessment of learning and for competency assurance in health care.
For a portfolio to be effective, it should include:
• a learning plan that contains specific goals and objectives
• materials that demonstrate achievement relative to the learning plan
• learner reflections
• learner and faculty evaluations of the material
The ACGME, in its draft Toolbox of Assessment Methods, provides some information about the properties and uses of portfolios for assessment.
Information at:
http://www.acgme.org/outcome/assess/toolbox.asp
MCH Leadership Competency 2: Self-reflection
SKILLS
Basic. Through participation in this program, a participant will:
• Share thoughts, ideas, and feelings effectively in discussions, meetings, and presentations with diverse individuals and groups.
• Write clearly and effectively to express information about issues and services that affect MCH population groups.
• Understand nonverbal communication cues in self and others.
• Synthesize and translate MCH knowledge into understandable information
• Listen attentively and actively.
• Tailor information for the intended audience(s) (consumers, policymakers, clinical, public, etc.) by using appropriate communication modalities (verbal, written, nonverbal).
• Provide constructive feedback to colleagues, presenters, and students.
• Develop and share MCH “stories” that are compelling and resonate with intended
audiences.
Advanced. With more experience and building on the basic skills, MCH leaders will:
• Demonstrate the ability to communicate clearly through effective presentations and written scholarship about MCH populations, issues, and/or services and articulate a shared vision for improved health status of MCH populations.
• Employ a repertoire of communication skills that includes disseminating information in a crisis, explaining health risks, and relaying difficult news.
• Refine active listening skills to understand and evaluate the information shared by others.
• Craft a convincing MCH story designed to motivate constituents and policymakers to take action.
Resources
Self-Monitoring Scale (Revised)
Lennox and Wolfe's Revision of Snyder's Self-Monitoring Scale consists of 13 items designed to evaluate a learner's ability to "modify self-presentation" and "sensitivity to the expressive behavior of others". The authors recommend a six-point scoring system that ranges from 'always false' to 'always true.' The questions contained in the scale may be useful in prompting learners to focus on specific components of self-monitoring that then could be addressed further, for example, by using a portfolio.
Information at:
Lennox, R. D., & Wolfe, R. N. (1984). Revision of the self-monitoring scale. Journal of Personality and Social Psychology, 46(6): 1349-64.
Coaching Connection
The Government of Canada provides extensive web-based materials on coaching. Their seven-item self-reflective exercise is designed to help learners identify areas that may impede their leadership effectiveness. This exercise may be useful in prompting learners to focus on specific components of leadership effectiveness that then could be addressed further, for example, by using a portfolio.
Information at:
http://coaching.gc.ca/practices/transforming_your_leadership_e.asp
DIAND Self-Assessment
The Department of Indian Affairs and Northern Development (DIAND) of Canada provides extensive resources for training and assessment of six leadership competencies: communication, team building and facilitation, win-win negotiation, flexibility and innovation, risk taking, and seeing the big picture. Some of these competencies map to some of the MCH leadership competencies.
The DIAND Self-Assessment exercise is designed for learners to rate themselves on a variety of skills related to the competencies and to supplement their ratings by describing recent examples. DIAND suggests that such information can then be used as the basis for individual learning plans.
This tool may be very useful in helping MCH interdisciplinary trainees to self-reflect in a targeted way and to further explore the results, perhaps using a portfolio approach.
Information at:
www.ainc-inac.gc.ca/pr/pub/selfas_e.pdf
Rumination-Reflection Questionnaire
While the ability to self-reflect is considered a core competency of MCH leadership, the ability to think introspectively has another side. Studies have found that higher private self-consciousness is associated with increased levels of psychological distress. The 28-item Rumination-Reflection Questionnaire (RRQ) was designed to assess the distinction between "neurotic self-attentiveness, or rumination, and intellectual self-attentiveness, or reflection."
Information at:
Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five-factor model of personality: Distinguishing rumination from reflection. Journal of Personality and Social Psychology, 76(2): 284-304.
Portfolios
Portfolios are collections of information that can be used to evaluate MCH knowledge in action.
Portfolios include materials prepared by a learner to demonstrate learning in response to a plan. There is increasing evidence of the utility of portfolios for assessment of learning and for competency assurance in health care.
For a portfolio to be effective, it should include:
• a learning plan that contains specific goals and objectives
• materials that demonstrate achievement relative to the learning plan
• learner reflections
• learner and faculty evaluations of the material
The ACGME, in its draft Toolbox of Assessment Methods, provides some information about the properties and uses of portfolios for assessment.
Information at:
http://www.acgme.org/outcome/assess/toolbox.asp
MCH Leadership Competency 3: Ethics and Professionalism
SKILLS
Basic. Through participation in this program, a participant will:
• Identify and address ethical issues in patient care, human subjects research, and public health theory and practice.
• Describe the ethical implications of health disparities within MCH populations.
• Interact with others and solve problems in an ethical manner.
Advanced. With more experience and building on the basic skills, MCH leaders will:
• Identify ethical dilemmas and issues that affect MCH population groups and initiate and
act as catalyst for the discussion of these dilemmas and issues.
• Consider the culture and values of communities in the development of polices, programs, and practices that may affect them.
• Describe the ethical implications of health disparities within MCH populations and propose strategies to address them.
• Document evidence of continuous learning and improvement.
Resources
Portfolios
Portfolios are collections of information that can be used to evaluate MCH knowledge in action.
Portfolios include materials prepared by a learner to demonstrate learning in response to a plan. There is increasing evidence of the utility of portfolios for assessment of learning and for competency assurance in health care.
For a portfolio to be effective, it should include:
• a learning plan that contains specific goals and objectives
• materials that demonstrate achievement relative to the learning plan
• learner reflections
• learner and faculty evaluations of the material
The ACGME, in its draft Toolbox of Assessment Methods, provides some information about the properties and uses of portfolios for assessment.
Information at:
http://www.acgme.org/outcome/assess/toolbox.asp
360-degree assessment
As a group, professional and ethical skills may be assessed from the perspectives of the various participants with whom one interacts in the setting of interest. This type of assessment, known as 360-degree assessment, relies on the judgments of individuals at various levels - supervisors, peers, subordinates, and in some instances, clients - to provide a complete picture of the learner's skills.
While this type of assessment has been used more in business organizations than in health care, the ACGME, in its table of toolbox methods, suggests that 360-degree ratings are a desirable way to assess a number of competencies. The ACGME's Toolbox of Assessment Methods provides some information about the properties and uses of portfolios for assessment.
Research to date shows that, in general, comprehensive feedback such as that provided in a 360-degree assessment, can improve performance. While the notion that comprehensive feedback such as that gathered in a 360-degree assessment will inform and influence behavior is attractive, research to date shows that the realization of this utility is guarded. Atwater and Brett (2005) studied ratings by others, self-ratings, and motivation. They found that leaders who were rated low by others were more motivated to make change if they self-rated themselves higher, that is, if they over-rated themselves, than leaders who agreed with the low ratings bestowed by others. Morgan and his colleagues (2005) noted that, "The underpinning assumption in the adoption of 360° feedback is that it heightens an individual's self-awareness by highlighting differences between how participants see themselves and how others see them. This statement implies that awareness motivates development and improves performance." Their study found that this was not the case in that the desired self-awareness was not achieved in the organizational setting where the study was conducted.
Caveats aside, the MCHB may want to consider developing a 360-degree instrument to assess some components of leadership, for example, behaviors related to ethics and professionalism. In the meantime, collecting assessment information from the perspectives represented by multiple others offers one way to gather a more complete picture of the learner's skills.
Information at:
http://www.acgme.org/outcome/assess/toolbox.asp
Atwater, L. E. & Brett, J. F. (2005). Antecedents and consequences of reactions to developmental 360-degree feedback. Journal of Vocational Behavior. 66: 532-48.
Morgan, A., Cannan, K., & Cullinane, J. (2005). 360-degree feedback: A critical enquiry. Personnel Review. 34(6): 663-80.
Case studies
Case studies provide a way to evaluate learners' skills by use of standardized experiences that ask the learner to describe the ways in which she or he would respond to specific situations. Case studies could be useful in assessing the ability of learners to identify ethical dilemmas in the delivery of health care.
MCH Leadership Competency 4: Critical Thinking
SKILLS
Basic. Through participation in this program, a participant will:
• Use population data to assist in determining the needs of a population for the purposes of designing programs, formulating policy, and conducting research or training.
• Use a standard approach to the critical review of research articles, addressing such issues as study design, sample size, confidence intervals, and use of appropriate statistical tests.
• Formulate a focused and important practice, research or policy question.
Advanced. With more experience and building on the basic skills, MCH leaders will:
• Apply important evidence-based practice guidelines and policies in their field.
• Identify practices and policies that are not evidence-based but are of sufficient promise that they can be used in situations where actions are needed.
• Formulate hypotheses or research questions, retrieve information and pertinent data and evidence, complete a comparative analysis, and draw appropriate conclusions to solve a
problem.
• Compile pertinent data to develop an evidence-based practice or policy.
• Translate research findings to meet the needs of different audiences.
• Discuss various strategies, including supportive evidence, for the implementation of a policy.
Resources
Portfolios
Portfolios are collections of information that can be used to evaluate MCH knowledge in action.
Portfolios include materials prepared by a learner to demonstrate learning in response to a plan. There is increasing evidence of the utility of portfolios for assessment of learning and for competency assurance in health care.
For a portfolio to be effective, it should include:
• a learning plan that contains specific goals and objectives
• materials that demonstrate achievement relative to the learning plan