You must discuss which theory you feel is most impactful on your philosophy and provide at least one concrete example where you have demonstrated leadership. You can choose ANY theory you can find that resonates with your professional development.
In the Spring of 2018, I was elected president of my Doctor of Physical Therapy (DPT) cohort. Since then, I have gained insight from my professors, clinical instructors, and, most importantly, my peers on how my leadership position should be effective and exemplary. Initially, I practiced more of a transactional leadership role by providing a reward for those who completed a specific task or goal.1,2 For example, the two other class representatives and I are required to gather feedback on the recent trimester courses and present them to the professors as a whole. However, we need to have our classmates complete these feedback forms in a timely manner prior to the meeting. I decided to make a deal with the class by making chocolate chip cookies if everyone had completed their feedback forms on time. Luckily, this worked out for both sides: the professors received quality feedback from the students and everyone received a delicious treat.
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Although, this did not continue for the following trimesters and I needed a different approach. This is when I decided to develop a transformational leadership style, which consisted of empathy, commitment, and having a shared vision in mind with the class.1,2 This specific leadership philosophy provides an emphasis on cooperation with one another and open communication, which are helpful in group work settings.1,2 For instance, currently in the management and leadership course we are working in groups towards a specific objective. We are focusing on how to implement the use of standardized outcome measures in an acute care setting, which should be a strong predictor of a discharge plan and reduce length of stay.3 Even though I may act as the leader of the group, I most likely will not have the best answers or solutions for our task. However, with the transformational model I encourage brainstorming within the group which should help us all come to a shared vision and expectation of our end goal.1
You must also provide a link between the principles embedded within your chosen theory and your chosen profession as a physical therapist. Provide a concrete example.
A physical therapist (PT) is similar to a quarterback, by how they set up a play (plan of care), delegate tasks to others, and work with the patient (football) in achieving their goals (touchdown).4 In other words, a PT works with the patient during the rehabilitative process by managing pain, education, and achieving goals. An article from Rasmussen-Barr et al. interviewed physiotherapists in Sweden on how leadership is used in primary care practice.5 In the article they identified five themes which are correlated with the American Physical Therapy Association (APTA) code of ethics.5,6 The themes of this article consist of building rapport with patients, education on the purpose of physical therapy through evidence and practical knowledge, demonstrating professionalism, and relating physiotherapist practice to being a leader.5 In my opinion, these areas of focus are linked to how a PT exhibits themselves as a leader for patients and in the healthcare field.
The transformational model focuses on four principles: charisma (the leader influences followers by stirring up increased emotions), intellectual stimulation (the leader raises awareness of a situation and invokes the followers to perceive this situation from a different view), individualized consideration (the leader supports and promotes experiences for followers), and inspirational motivation (the leader provides a message to followers in hopes to model a collaborative effort towards a goal).1 During my recent clinical experience at AdventHealth East Orlando (AHEO) acute care hospital, I was able to fully embrace the leadership role for my patients. I developed rapport, a plan of care, and a discharge plan which would benefit the patient with their rehab process. One individual stood out to be difficult by being non-compliant with rehab and required some form of mobility or else further consequences would ensue. This patient refused every time I visited and had the same response, “Not today, I’ll do it tomorrow.” During the third visit with this patient I decided to take a different approach. Instead of asking the patient what I wanted, I inquired a little bit of background on the patient to gain an understanding of who they were and what they were going through. By doing this, I managed to connect with the patient about Philly cheesesteaks and talking about the Vietnam war. By building rapport with the patient, I was able to educate them on exercises as well as the importance of mobility. Shortly after, they were discharged to a setting where they would receive appropriate care to gain independence. This moment during my clinical experience reflects the four constructs of the transformational model of leadership.
Another example where I exhibited this leadership model is during my first clinical rotation at CORA physical therapy. I provided evaluations, set up appropriate plans of care, educated patients, and created attainable goals for patients. There was one patient with a shoulder impingement who seemed anxious that they would never be able to return to their prior level of function. During the evaluation, I asked the patient about their hobbies and what activities they enjoy. The patient stated that they used to play tennis until this occurred, which helped with the making of a few goals. I educated the patient on exercises, how to manage their pain, and provided a handout for them to use at home. By the end of my clinical rotation, this patient had an improved mood and had progressed more than they had expected.
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Discuss how your attitudes and behaviors are currently impacted by your leadership philosophy. Provide a concrete example.
Regarding the transformational model, my behavior has helped direct patients with appropriate care and alleviate any fears or worries they may have. An article by Chou sums up the transformational style as, “…arouses team spirit, reframes stressful events into developmental opportunities, and inspires others to perceive difficult situations as meaningful challenges necessary for developing one’s professional and personal skills.”7 To put this in perspective, a patient who had recently experienced a fractured hip due to a fall will have mixed emotions about what lies ahead for them. They will be scared to move from the bed or chair and frightened to even leave the house. The PT is there to erase those premonitions and help improve confidence in the patient. During my recent clinical at AHEO acute care, there was a patient who had underwent a lower leg amputation after an auto accident. Prior to entering the room, I noticed that the patient looked sad and gloomy with the window blinds closed and no lights on. I walked in, introduced myself, and sat down at eye level next to the patient. I explained why I was there, how I was going to help them, and, more importantly, alleviated any fears they had by listening. After the patient had agreed with me, they smiled and said, “alright kid, what’s the catch?” I told them that there wasn’t any magic involve, but I did mention how the rehab process is like being on a boat sailing across the Atlantic ocean from America to Ireland. It is a long ride with some turbulence here and there, yet you will be satisfied with the end result. Throughout the next few visits, the patient was in a brighter mood and talked with me about sports or other common interests we had. Shortly after working with the patient, they were discharged to an appropriate facility so that they may achieve the next step, which was to be fitted for a prosthetic limb. With the transformational model, I was able to turn this individual’s perspective of their situation into an optimistic view. In my opinion, I believe by listening and focusing on the whole person in a situation like this can assist with their outlook and rehab potential. Empowering others into living an optimal quality of life is something that brings me joy, which I believe I succeeded with this patient.
Identify any changes you anticipate working towards in your final year of graduate work at AHU, given your leadership philosophy, and provide an example.
Communication, organization, and flexibility are a few of my strengths to which have been beneficial to me throughout my DPT career. They have assisted me as cohort president and being successful in the classroom as well as working with patients in the clinic. As cohort president I have been able to communicate with my classmates about upcoming conferences, continuing education courses, and volunteer opportunities to enhance professionalism. In the clinic, I have been able to communicate with patients by performing a thorough evaluation, providing patient education on various topics guiding patients towards independence, and listening to any comments or concerns they may have.
References
- Ledlow GR, Stephens JH, R2 digital library. Leadership for Health Professionals: Theory, Skills, and Applications. Third ed. Burlington, MA: Jones & Bartlett Learning; 2018.
- Saravo B, Netzel J, Kiesewetter J. The need for strong clinical leaders – transformational and transactional leadership as a framework for resident leadership training. PLoS One. 2017;12(8). https://resource.ahu.edu/login?url=https://search-proquest-com.resource.ahu.edu/docview/1932356162?accountid=35793. doi: http://dx.doi.org.resource.ahu.edu/10.1371/journal.pone.0183019.
- Thorpe ER, Garrett KB, Smith AM, Reneker JC, Phillips RS. Outcome Measure Scores Predict Discharge Destination in Patients With Acute and Subacute Stroke: A Systematic Review and Series of Meta-analyses. Journal of Neurologic Physical Therapy. 2018;42:2-11.
- Coleman C. Leading the Musculoskeletal Team: Physical Therapists are Healthcare Quarterbacks. CovalentCareers, Inc. https://covalentcareers.com/resources/healthcare-quarterbacks/. Published May 4, 2017. Accessed July 6, 2019.
- Rasmussen-Barr E, Savage M, & Knorring MV. How does leadership manifest in the patient–therapist interaction among physiotherapists in primary health care? A qualitative study. Physiotherapy Theory and Practice. 2018: 1-9. DOI: 10.1080/09593985.2018.1474984
- Code of ethics for the physical therapist. Apta.org. http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/HOD/Ethics/CodeofEthics.pdf. Accessed July 5, 2019.
- Chou P. Transformational leadership and employee’s behavioral support for organizational change. European Journal of Business and Management. Taiwan, R.O.C.: IIISTE; 2015. Vol. 7, No.3, 1-14.
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