도전적 시기의 적응적 리더십: 보건의료전문직 교육을 위한 효과적 전략: AMEE Guide No. 148 (Med Teach, 2022)

도전적 시기의 적응적 리더십: 보건의료전문직 교육을 위한 효과적 전략: AMEE Guide No. 148 (Med Teach, 2022)
Adaptive leadership during challenging times: Effective strategies for health professions educators: AMEE Guide No. 148
Judy McKimma,b , Subha Ramanic,d,e , Kirsty Forrestf, Jo Bishopf, Ardi Findyartinig, Chloe Millsh , Mohammed Hassanieni,j, Abdulmonem Al-Hayanik, Paul Jonesl, Vishna Devi Nadarajahm and Greg Radun,o 

 

 

소개
Introduction

보건 전문직(HPE) 교육자는 여러 시스템과 조직에 걸쳐 다수의 학습자와 자격을 갖춘 직원에게 교육을 제공하기 때문에 보건 전문직 교육 리더십은 항상 어려운 과제입니다. 코로나19 팬데믹은 의료 및 보건 전문직 교육 분야의 리더들이 직면한 가장 어려운 상황 중 하나였습니다. 리더들은 '즉석에서' 결정을 내리고 새로운 도전에 적응하는 동시에 자신과 전문 직원, 학자, 학습자, 임상 교사의 안녕을 돌보고 프로그램과 조직의 안정성을 유지해야 했습니다(Nadarajah 외. 2020; Paixão 외. 2020). 팬데믹 기간 동안 리더십에 대해 배운 교훈은 앞으로도 새로운 도전이 계속 발생할 것이므로 의료 교육 리더의 유연성과 적응력이 필요하기 때문에 앞으로 나아가는 데 매우 적합합니다. 
Leadership in health professions education (HPE) is always challenging, as health professions (HP) educators work across multiple systems and organisations to provide training for large numbers of learners and qualified staff. The COVID-19 pandemic has been one of the most challenging situations that leaders in healthcare and health professions education have faced. Leaders have had to make decisions ‘on the fly’ and adapt to new challenges while also attending to the well-being of themselves, their professional staff, academics, learners, clinical teachers, as well as maintaining the stability of programmes and organisations (Nadarajah et al. 2020; Paixão et al. 2020). Lessons learned about leadership during the pandemic are highly relevant as we move forward because new challenges will continue to arise in the future, which will require flexibility and adaptability on the part of healthcare education leaders.

이 가이드에서는 몇 가지 현대적인 리더십 접근 방식과 리더가 이러한 접근 방식에 대한 기술을 개발하는 방법을 소개합니다. 가이드 전반에 걸쳐 전 세계의 실제 사례를 통해 불확실하고 어려운 시기의 리더십에 중점을 두고 다양한 맥락에서 리더십의 측면을 강조합니다.
In this guide, we introduce some contemporary leadership approaches and how a leader might develop skills in these approaches. Throughout the guide, real-life examples are drawn from around the world highlight aspects of leadership in various contexts, with a focus on leadership during uncertain and challenging times.

리더십이란 무엇인가요?
What is leadership?

리더십은 비전과 방향을 설정하고 전달하는 원동력, 에너지 또는 '힘'으로 설명되며, 사람들이 변화를 이루도록 영향력을 행사하고 동기를 부여하는 데 도움을 줍니다(Scouller 2011, Swanwick과 McKimm 2017). 효과적인 리더는 불확실하고 어려운 시기에 필수적인 긍정적인 문화와 분위기를 조성하기 때문에 리더십은 조직의 성공을 위한 핵심 요소입니다. 널리 퍼져 있는 리더십 신화 중 하나는 리더십은 조직 내 지위와 권력을 통해서만 발휘된다는 것입니다. 이는 사실이 아닙니다. 리더십은 프로젝트나 이니셔티브를 이끌거나, 회의에서 안건을 주도하거나, 학생들과의 교실 토론을 주도하는 등 다양한 수준에서 발생할 수 있으며, 실제로 다양한 HP 교육자가 매일 리더십을 발휘하고 있습니다. HP 교육자는 리더와 팔로워로서 개인 내, 대인 관계/팀, 조직 및 시스템 수준에서 어떻게 행동해야 하는지 알고 있어야 합니다.
Leadership is often described as the driving force, energy or ‘power’ that establishes and communicates vision and direction, helping to influence and motivate people towards making a change (Scouller 2011; Swanwick and McKimm 2017). It is a key factor for organisational success, as effective leaders promote a positive culture and climate—a necessity in uncertain and difficult times. One of the pervasive leadership myths is that leadership is solely vested in positional power in an organisation. This is untrue. Leadership can (and does) occur at many levels and is undertaken by a range of HP educators daily, e.g. leading a project or initiative, leading on an item at a meeting, or leading a classroom discussion with students. HP educators need to be aware of how they, as both leaders and followers, operate at the intrapersonal, interpersonal/team, organisational, and system levels.

'리더십 트라이어드'
The ‘leadership triad’

HPE에서는 팀, 서비스, 프로그램, 조직(또는 그 일부인 평가, 레지던트, 연차, 부서장, 연구 활동 등) 내에서 다양한 방식으로 리더십을 발휘할 수 있는 기회가 있습니다. HPE 리더십 활동은 대학이나 학교부터 병원 및 지역사회의 의료 서비스에 이르기까지 다양한 경계를 넘나듭니다. HPE의 '리더십'은 다른 조직 및 부문의 리더십과 많은 유사점을 가지고 있습니다. 리더십은 리더십, 관리, 팔로워십 활동의 역동적인 조합으로 구성되며, '리더십 트라이어드'(McKimm and O'Sullivan 2016)로 알려져 있으며, 학계와 의료 서비스 전반에 걸쳐 개인, 그룹, 조직 간에 그리고 조직 내에서 이루어집니다.
In HPE, people have opportunities to promote leadership in many ways, including within teams, services, programmes, and organisations (or parts of them, such as assessment, residency, year lead, head of the department, or research activities). HPE leadership activities span many boundaries, from universities or schools to health services in hospitals and communities. ‘Leadership’ in HPE has many similarities with leadership in other organisations and sectors. It comprises a dynamic combination of leadership, management, and followership activities, known as the ‘leadership triad’ (McKimm and O'Sullivan 2016), and takes place between and within individuals, groups, and organisations across academia and healthcare services.

전통적 문헌에 반영된 바와 같이 리더십은 조직 내에서 가장 중요한 일련의 활동을 포함하지만, 리더가 효과적이기 위해서는 관리와 팔로워십도 똑같이 중요하다는 점을 강조할 필요가 있습니다(Barrow 외. 2011). 

• 리더십이 비전을 설정하는 반면, '관리'는 비전을 실천하는 데 도움이 되는 일련의 활동에 필요하며, 문제를 식별하고 해결책을 찾는 프로세스에 대한 관심을 포함합니다(McKimm and Jones 2018). 
• 관리는 재정, 커리큘럼 또는 인력 등의 안정성을 제공하여 조직이나 프로그램을 불안정하게 만들지 않으면서도 변화가 이루어질 수 있도록 합니다. 
• 리더를 지지하면서도 리더에게 도전할 수 있는 적극적이고 효과적인 팔로워는 예상되는 변화가 원활하게 이루어질 수 있도록 하는 데 필수적인 요소입니다. 

리더십은 전체 트라이어드 내에서 관계를 구축하고 유지하는 것과 매우 밀접한 관련이 있습니다. HPE 리더는 '리더십 트라이어드'의 세 가지 상호 연결된 위치에 대한 인식과 관련 기술을 결합하여 추종자들을 어려운 여정으로 이끌면서 특정 상황을 인식하는 동시에 강력하고 목적 지향적인 리더십을 제공할 수 있는 가장 좋은 위치에 있을 것입니다. 박스 1에서는 리더십 삼위일체를 실천에 옮긴 예를 제시합니다.
As echoed in the traditional literature, leadership involves the most important set of activities within an organisation; however, it needs to be emphasised that management and followership are equally important for leaders to be effective (Barrow et al. 2011).

• While leadership sets the vision, ‘management’ is necessary for the set of activities that helps put the vision into practice, involving attention to processes that identify problems and help find solutions (McKimm and Jones 2018).
• Management provides stability, for example financial, curricular or workforce, so that changes can be made without destabilising the organisation or programme.
• Active and effective followers, those who support but also may challenge the leader, are an essential part of ensuring that envisaged change happens smoothly.

Leadership is very much about building and maintaining the relationships within the entire triad. An HPE leader will be best placed to provide strong and purposeful leadership if they combine an awareness of, and skills related to, the three interlinked positions in the ‘leadership triad’, taking their followers with them on what might be a difficult journey, while being aware of their specific context. In Box 1, we provide an example of putting the leadership triad into practice.

박스 1 사례 연구: '리더십 삼위일체'를 실천에 옮기다. Box 1 Case study: Putting the ‘leadership triad’ into practice. 한 교육 리더는 멘토링에 대한 열정에 영감을 받아 7개국에서 온 같은 생각을 가진 멘토들로 구성된 커뮤니티 형성을 주도했습니다. 이 그룹은 스피드 멘토링 워크숍을 제공하고 2019년 유럽 의학교육협회(AMEE) 컨퍼런스에서 일대일 멘토링 이니셔티브에 참여했습니다(Ramani 외. 2021). 코로나19 팬데믹으로 인해 이 그룹은 특정 교육 주제 또는 문제에 초점을 맞춘 가상 멘토링 세션을 제공하여 글로벌 대화를 촉진하고 도전 과제와 성공 사례를 공유하는 것을 목표로 삼았습니다(McKimm 외. 2020; Thampy 외. 2020). 이후 이 그룹은 전 세계 더 많은 지역의 교육 리더를 포함하도록 확장되었으며, 현재 핵심 그룹은 11개국의 회원으로 구성되어 있습니다. 리더가 그룹 결성을 주도했지만, 적극적인 팔로워들은 리더에게 조언하고 브레인스토밍에 참여하며 그룹을 위한 실행 계획을 수립합니다. An educational leader, inspired by a passion for mentoring, led the formation of a community comprising like-minded mentors from seven countries. The group offered a speed mentoring workshop and participated in a one-on-one mentoring initiative at the 2019 Association for Medical Education in Europe (AMEE) conference (Ramani et al. 2021). The COVID-19 pandemic spurred this group to offer virtual mentoring sessions, each focusing on a specific educational topic or problem, aiming to stimulate global conversations and share challenges and success stories (McKimm et al. 2020; Thampy et al. 2020). The group has since expanded to include educational leaders from more regions of the world; currently, the core group consists of members from 11 countries. Though a leader initiated the formation of the group, active followers advise the leader, participate in brainstorming, and formulate action plans for the group. 이 '국경을 초월한 멘토' 커뮤니티에서는 리더십, 관리, 팔로워십 역할이 프로젝트에 따라 순환되고, 자기 관리 및 관계 관리와 같은 감성 지능 역량이 그룹을 유지하는 데 중요하며, 긍정 심리학 원칙이 그룹이 작업을 계속하고 승리를 축하하도록 동기를 부여하고, 포용적이고 사람 중심의 리더십이 다양한 관점을 가져올 수 있는 여러 글로벌 지역의 회원을 확장하고 포용하도록 촉진하고, 가장 중요한 심리적 안전의 분위기가 회원들이 서로 멘토링하고 배우도록 장려하는 등 여러 가지 핵심 리더십 원칙을 채택하고 있습니다(Mannion et al. 2015; 맥킴과 매니언 2015; 아민 외. 2018; 맥킴 외. 2020). 마지막으로, 특정 이니셔티브의 리더는 구성원들이 관심사와 시간 제약에 따라 이니셔티브를 주도하거나 참여하거나 심지어 물러날 수 있도록 명시적인 메시지를 보냅니다. Many key leadership principles have been adopted by this ‘mentors across borders’ community: leadership, management, and followership roles are rotated for different projects; emotional intelligence competencies such as self-management and relationship management are critical to maintaining the group; positive psychology principles motivate the group to stay on task and celebrate wins; inclusive and person-centred leadership has stimulated expansion and inclusion of members from different global regions who can bring in different perspectives; and, most importantly, a climate of psychological safety promotes members to mentor and learn from each other (Mannion et al. 2015; McKimm and Mannion 2015; Amin et al. 2018; McKimm et al. 2020). Finally, the leaders of a specific initiative send explicit messages allowing members to lead, participate in, or even step aside based on their interests and time constraints.

 

 

리더를 위한 도전 과제
Challenges for leaders

우리가 리더십을 개념화하는 방식은 주로 어떤 환경에서든 교육이 제공되는 방식에서 의미 있고 지속 가능한 변화와 개선을 촉진하고 가능하게 하는 것입니다(Buchanan 외. 2004). 이는 HPE 리더의 가장 중요한 임무 중 하나입니다. 이는 단순히 변화를 위한 변화를 의미하는 것이 아니라, 교육에 대한 사고의 광범위한 변화를 인식하고, 아이디어를 자신의 상황에 적용하는 데 있어 번역 또는 '센스 메이킹' 역할을 수행하며, 학습자와 교수진의 어려움과 과제를 적극적으로 파악하고 이에 대한 해결책을 찾는 것을 의미합니다. '평상시'에도 HPE 리더와 교육자는 정기적이고 일상적으로 다양한 문제를 처리해야 합니다(표 1 참조).

The way we conceptualise leadership is primarily about facilitating and enabling meaningful and sustainable change and improvement in the way education is provided in whatever setting (Buchanan et al. 2004). This is one of the most important tasks of the HPE leader. This does not mean making changes simply for the sake of it but is about being aware of the broader shifts in thinking about education, taking a translational or ‘sense-making’ role in bringing ideas to your own context, being proactive in identifying struggles and challenges for learners and faculty and finding solutions to these. Even in ‘normal’ times, HPE leaders and educators must deal with a range of issues on a regular and routine basis (see Table 1).

어려운 시기의 리더십 접근 방식
Leadership approaches in challenging times

코로나19 팬데믹 기간 동안 변화는 내부에서 촉진된 것이 아니라 외부에서 강요된 것이었습니다. 전 세계의 HPE 리더, 학습자, 직원은 이러한 변화의 동인을 통제할 수 없었으며 대신 전례 없는 도전, 큰 불확실성, 위기를 관리하는 방법을 적응하고 배워야 했습니다(Nadarajah 외. 2020). 이를 위해서는 다양한 리더십 접근 방식이 필요했습니다(Kotter 2007; Kanter 2020). 표 2에는 리더십이 작동하는 네 가지 수준, 어려운 시기에 도움이 되는 접근 방식, 그리고 이러한 접근 방식을 돕기 위해 리더가 개발할 수 있는 기술이 나열되어 있습니다. 
During the COVID-19 pandemic, change was not stimulated from within but instead imposed from outside. HPE leaders, learners, and staff around the world had no control over these change drivers but instead had to adapt and learn how to manage unprecedented challenges, great uncertainty, and crises (Nadarajah et al. 2020). This required different leadership approaches (Kotter 2007; Kanter 2020). Table 2 lists the four levels in which leadership operates, approaches that are helpful during challenging times, and the skills that leaders can develop to help with these approaches.

이제 각 수준에 따른 구체적인 리더십 접근 방식을 뒷받침하는 몇 가지 이론적 원칙에 대해 논의하겠습니다. 다음 섹션에서는 이러한 원칙을 실무에 적용하는 방법과 필요한 기술을 개발하는 방법에 대한 예를 다룹니다.
We will now discuss some theoretical principles underpinning specific leadership approaches under each of the levels we operate in. The following section addresses the application of these principles to practice with examples of how to build the skills required.

개인 내적 수준(자아): 정서적 및 사회적 지능 개발하기
The intrapersonal level (self): developing emotional and social intelligence

연구에 따르면 직업이나 위치에 관계없이 가장 성공적인 리더는 높은 수준의 감성 지능을 가지고 있는 것으로 나타났습니다(Boyatzis 2008). 성공적인 리더십의 지표로서 감성 지능(EI)은 1990년대에 다니엘 골먼에 의해 처음 논의되었습니다. 그는 인성, 비전, 결단력, 지능과 같은 기술만으로는 성공적인 리더가 될 수 없으며 자기 인식, 자기 조절, 동기 부여, 공감, 사회적 기술도 그에 못지않게 중요하다는 결론을 내렸습니다(Goleman 1998). 보야치스와 골먼은 함께 가장 성공적인 리더들의 핵심 속성을 분석하기 시작했습니다. 정서적 및 사회적 지능의 12가지 역량은 네 가지 영역으로 설명되었습니다(Boyatzis 2009). 네 가지 영역은 자기 인식, 자기 관리, 사회적 인식, 관계 관리입니다. 리더가 이끄는 사람들의 그룹을 관리하기 위해서는 네 가지 영역의 EI 역량이 모두 필수적입니다(상자 2 참조). 
Research indicates that the most successful leaders, regardless of profession or location, have a high degree of emotional intelligence (Boyatzis 2008). Emotional intelligence (EI) as a marker of successful leadership was first discussed by Daniel Goleman in the 1990s. He concluded that skills such as toughness, vision, determination, and intelligence were not enough to be a successful leader and that the skills of self-awareness, self-regulation, motivation, empathy, and social skills were equally, if not more, important (Goleman 1998). Together, Boyatzis and Goleman went on to analyse the core attributes among the most successful leaders. Twelve competencies of emotional and social intelligence were described under four domains (Boyatzis 2009). The four domains are: self-awareness, self-management, social awareness, and relationship management. All four domains of EI competencies are essential for leaders to manage the groups of people they lead (see Box 2).

박스 2 네 가지 EI 영역의 영향력. Box 2 The impact of the four EI domains. 1. 자기 인식을 통해 리더는 자신의 가정과 편견, 그리고 이것이 세계관에 어떤 영향을 미치는지 인식할 수 있습니다. 2. 자기 관리는 행동에 앞서 생각하고, (부정적인 감정을 다스리는 데 필수적인) 자신의 감정과 반응을 관리할 수 있는 능력을 촉진합니다. 3. 사회적 인식은 리더가 팀을 구성하는 개인을 이해하고 관점과 성격의 차이를 인식할 수 있게 해줍니다. 4. 관계 관리는 다양한 관점을 수용하고 인재를 육성하며 개인, 팀, 조직의 잠재력과 생산성을 극대화하는 데 필수적입니다. 멘토링과 코칭 기술은 이 영역에 속합니다. Self-awareness allows leaders to recognise their assumptions and biases, and how these affect their worldview. Self-management promotes thought before action and the ability to manage own emotions and reactions, essential for reigning in negative emotion. Social awareness allows leaders to understand the individuals who make up their team and recognise differences in viewpoints and personalities. Relationship management is essential to welcome a variety of perspectives, nurture talent, and maximise the potential and productivity of individuals, teams, and the organisation. Mentoring and coaching skills fall under this domain

EI 역량은 리더가 변화를 주도하고 관리하는 데 유용한 가이드입니다. 그러나 리더가 속한 조직과 사회 문화에 따라 가장 효과적인 특정 행동은 달라질 수 있습니다. 리더, 직원, 학습자의 구성이 다양성을 특징으로 하는 교육기관은 팀원 개개인이 공통의 목표를 향해 일할 때에도 서로 다른 신체 언어와 감정적 반응을 보일 수 있다는 점을 인식해야 합니다.
EI competencies are a useful guide to leaders in leading and managing change. However, the specific behaviours that are most effective depending on the organisational and societal culture within which the leader is situated. Institutions that feature diversity in the composition of their leaders, staff, and learners should recognise that individuals on a team might have different body language and emotional reactions even when working towards a common goal.

대인관계 수준(다른 사람과 함께 일하기): 진정성 있고 포용적이며 원초적인 리더십
The interpersonal level (working with others): authentic, inclusive, and primal leadership

항상 그렇지만 특히 변화무쌍하고 불확실한 시기에는 사람들이 리더에게 원하는 것은 진정성 있는 목소리입니다. 팔로워들은 리더가 자신의 이야기를 경청하고, 자신의 우려를 진지하게 받아들이고 있으며, 변화를 주도하고 관리할 수 있는 전문성과 권한을 가지고 있다고 느끼기를 원합니다. 리더는 팔로워가 리더를 어떻게 보고, 관계를 맺고, 신뢰하는지에 따라 만들어지고 유지됩니다(Uhl-Bien 및 Carsten 2018). 팔로워는 리더가 자신을 안전하게 지켜줄 수 있고 함께 '그 안에' 있다고 느끼면 매우 위험한 상황(예: 전쟁)에도 리더를 따를 것입니다(Sinek 2014).
At all times, but especially in changing and uncertain times, what people want from their leaders is an authentic voice. Followers want to feel that their leaders are listening, taking their concerns seriously and that they have the expertise and authority to lead and manage change. Leaders are created and maintained by how their followers see, relate to, and trust them (Uhl-Bien and Carsten 2018). Followers will follow their leaders into highly unsafe situations (such as war) if they feel their leaders can keep them safe and that they are ‘in it’ together (Sinek 2014).

불확실한 시대에 필요한 리더십에 대한 적절한 접근법으로 원초적이고 진정성 있는 리더십이 주목받고 있습니다. '원초적 리더십'이라는 용어는 리더의 영향력(정서적 수준)과 그에 따른 행동이 조직 내 다른 모든 사람의 참여, 동기 부여 및 행동에 강력한 영향을 미친다는 것을 나타내기 위해 만들어졌습니다. '리더의 기분은 말 그대로 전염성이 있으며 비즈니스 전체에 빠르고 끝없이 퍼집니다'(Goleman 외. 2001, 44쪽). 
Primal and authentic leadership have come to the fore as relevant approaches to leadership required for uncertain times. The term ‘primal leadership’ was coined to indicate that the affect (emotional level) of a leader and resulting behaviours have a powerful effect on engagement, motivation, and behaviours of everyone else within their organisation: ‘the leader’s mood is literally contagious, spreading quickly and inexorably throughout the business; (Goleman et al. 2001, p. 44).

진정성 있는 리더십은 리더가 자신의 강점을 활용하고 자신의 약점과 편견을 인식하는 데 중점을 둡니다(Avolio and Gardner 2005, Sosik 외. 2009, Cardiff 외. 2018, Hollander 2012). 진정한 리더는 문제에 대한 다양한 관점을 적극적으로 모색하고 주변 사람들의 의견을 소중히 여기고 경청하는 모습을 보여줍니다. 또한 리더는 지적 겸손, 실수 인정, 비판과 다른 관점으로부터의 학습, 한계를 극복하기 위한 다른 사람의 기여를 인정하고 구하는 특성을 보여야 합니다. 이러한 리더십 스타일은 EI 역량과 밀접한 관련이 있지만, 리더의 관점이 팀원들의 기분, 행동, 업무 완수, 결과적으로 팀원들의 직업적 성취감과 웰빙에 어떤 영향을 미치는지에 초점을 맞추고 있습니다. 긍정적인 전망은 이 접근 방식의 핵심 요소이지만, 진정성 또한 필요합니다. 
Authentic leadership is very much focused on the leader drawing from their own strengths and being aware of their own weaknesses and biases (Avolio and Gardner 2005; Sosik et al. 2009; Cardiff et al. 2018; Hollander 2012). Authentic leaders proactively seek a range of perspectives on issues and demonstrate that they value and listen to those around them. Leaders also need to demonstrate traits of intellectual humility, admitting mistakes, learning from criticism and different points of view, and acknowledging and seeking contributions from others to overcome limitations. Though this leadership style is closely related to EI competencies, the focus is on how a leader’s outlook impacts their team members’ moods, behaviours, task completion, and consequently their sense of professional fulfilment and well-being. While a positive outlook is a key component of this approach, it is also necessary to be authentic.

복잡한 조직 또는 시스템 수준: 적응적 리더십
The complex organisational or system level: Adaptive leadership

복잡계 사고 접근법은 시스템 내 모든 주체들의 상호의존성과 상호관계를 명백히 인정하고, '단순한' 규칙이나 변화가 큰 효과를 가져올 수 있으며, 시스템의 한 부분의 변화가 시스템 전체에 예기치 않은 결과를 초래할 수 있다는 렌즈를 제공합니다(Till 외. 2016; Obolensky 2017).
A complex system thinking approach provides a lens that overtly acknowledges the interdependency and interrelationships of all agents within the system, that ‘simple’ rules or changes can lead to large effects, and that a change in one part of the system can have unanticipated consequences throughout the system (Till et al. 2016; Obolensky 2017).

우리는 VUCA(변동성, 불확실성, 복잡성, 모호성, Worley and Jules 2020) 및 RUPT(급변성, 불확실성, 역설성, 얽힘, Till et al. 2016)의 세계에 살고 있으므로 변화하고 복잡한 상황에 적응할 수 있을 만큼 유연하고 민첩한 리더십이 요구되는 것입니다. 적응적 리더십(Heifetz 외. 2009; Randall and Coakley 2007)은 특히 복잡한 시스템이나 상황에서의 리더십에 초점을 맞추며, 변화, 불확실성, 위기에 대응하는 방법을 생각할 때 유용합니다. 이 접근법은 복잡하고 급변하는 환경에 대한 적응의 중요성을 강조하고 합의된 목표를 달성할 수 있는 조직적 여건을 조성합니다(Hodges and Gill 2014). 적응적 문제는 일반적으로 모호하고 복잡하며 '사악한' 문제입니다. 적응적 리더십 접근법의 창시자인 Ronald Heifetz와 Marty Linsky는 효과적인 적응적 리더십의 네 가지 기본 원칙을 다음과 같이 정의했습니다: 
We live in a VUCA (Volatile, Uncertain, Complex, Ambiguous; Worley and Jules 2020) and RUPT (Rapid, Uncertain, Paradoxical, Tangled; Till et al. 2016) world; therefore, the HPE leadership needed is one that is flexible and agile enough to adapt to changing and complex circumstances. Adaptive leadership (Heifetz et al. 2009; Randall and Coakley 2007) is specifically focused on leadership in complex systems or situations and is helpful when thinking about how to respond to change, uncertainty, and crisis. This approach emphasises the importance of adaptation to a complex and rapidly changing environment and creates the organisational conditions to achieve agreed goals (Hodges and Gill 2014). Adaptive problems are usually vague, complex, and ‘wicked’. The creators of the adaptive leadership approach, Ronald Heifetz and Marty Linsky, defined four foundational principles of effective adaptive leadership, which are: 

1. 조직의 정의: 적응형 리더는 조직의 모든 구성원의 의견을 들을 수 있는 환경을 조성합니다. 조직의 의견은 적응형 리더십에 필수적입니다.
   Organisational justice: Adaptive leaders create an environment in which every member of the organisation can be heard. Organisational input is integral to adaptive leadership.
2. 감성 지능: 적응형 리더십은 관계를 중시합니다.
   Emotional intelligence: Adaptive leadership values relationships.
3. 개발: 적응형 리더는 조직 변화의 과정을 통해 동료와 직원이 배우고 성장할 수 있도록 지원합니다.
   Development: Adaptive leaders empower their colleagues and employees to learn and grow through the process of organisational change
4. 인성: 적응형 리더는 윤리적 책임감과 도덕성을 보여줍니다. 이들은 커뮤니케이션 스타일이 투명하며 팀원들에게 동일한 기준을 적용합니다.
   Character: Adaptive leaders demonstrate ethical responsibility and morality. They are transparent in their communication style and hold themselves to the same standards to which they hold their team.

진정한 리더십과 마찬가지로 이러한 차원은 EI 역량과 많은 유사점이 있습니다. 적응형 리더십에서 가장 유용한 개념 중 하나는 '소중한 것'과 '소모적인 것'을 구분하는 능력입니다(Heifetz 외. 2009). '소중한 것'은 조직에 매우 중요한 것으로, 교육에서는 학습자 자신, 교수진, 교육 제공의 질, 조직의 핵심 가치 등이 포함되며, 위기와 변화에 대응할 때 이들에 대한 초점을 잃지 않아야 합니다. 적응형 리더는 무엇이 소중한지 인식하고 이를 보호하고 육성할 수 있도록 합니다.
Like authentic leadership, these dimensions have many parallels with EI competencies. One of the most useful concepts in adaptive leadership is the ability to diagnose the ‘precious’ from the ‘expendable’ (Heifetz et al. 2009). The ‘precious’ is what is vitally important to the organisation; in education, this includes the learners themselves, the faculty, the quality of educational provision, and the core values of the organisation; you do not want to lose the focus on these as you respond to crisis and change. Adaptive leaders recognise what is precious and make sure that this is looked after and nurtured.

글로벌 생태계 수준: 메타, 에코, 재생 리더십
The global eco-system level: Meta, eco, and regenerative leadership

메타 리더십
Meta-leadership

메타 리더십은 뉴욕 9/11 테러와 뉴올리언스 허리케인 카트리나 대응과 같은 위기 상황에서 리더를 관찰하고 분석하여 최근의 가장 큰 도전 과제 중 일부에서 탄생했습니다. 최근의 팬데믹 역시 의료계와 의료 교육에 있어서는 위기 상황입니다. 메타 리더십은 변혁적 리더십, 공유 리더십, 팔로워십, 복합적 적응 리더십 등 다양한 리더십 이론을 활용하고 통합합니다(Marcus 외. 2015). 메타 리더십은 조직 내 및 조직 간 환경에서 [서로 다른 이해관계자 간의 연결성을 창출하는 경계를 아우르는 리더십]에 중점을 둡니다. 이러한 방식으로 이러한 '메타 리더'는 다른 사람에게 영향을 미치고 자신의 통제 범위를 넘어 변화를 활성화하는 데 관심을 갖습니다. Marcus 등(2008)은 메타리더가 자신에게 요구되는 것보다 더 넓은 목적에 의해 움직이며, 따라서 조직의 장벽을 '초월'할 수 있다고 설명합니다. 이들은 메타 리더십의 차원을 다음과 같이 설명합니다:
Born out of some of the biggest recent challenges, meta-leadership was described through observation and analysis of leaders in crisis circumstances such as the September 11 attacks in New York and the response to Hurricane Katrina in New Orleans. The recent pandemic is also such a crisis for healthcare and for healthcare education. Meta-leadership draws upon and integrates a wide range of leadership theories including transformational leadership, shared leadership, followership, and complex adaptive leadership (Marcus et al. 2015). Meta-leadership is focused on boundary-spanning leadership that generates connectivity among disparate stakeholders in both intra- and inter-organisational settings. In this way, these ‘meta-leaders’ are concerned with influencing others and activating change beyond the established lines of their own control. Marcus et al. (2008) describe that they are driven by a wider purpose than what has been asked of them and can thus ‘transcend’ organisational barriers. They describe the dimensions of meta-leadership as follows:

메타 리더십의 차원
The Dimensions of Meta-Leadership

1. 사람(자기 지식, 인식, 규제): 메타리더는 높은 자기 인식, 자기 인식, 자기 규제를 발달시킵니다.
   The person (self-knowledge, awareness, and regulation): Meta-leaders develop high self-awareness, self-knowledge, and self-regulation.
2. 상황(리더십의 맥락 파악): 메타리더는 종종 불완전한 정보를 가지고 상황을 매핑하여 무슨 일이 일어나고 있는지, 이해관계자는 누구인지, 다음에 일어날 가능성이 있는 일은 무엇인지, 중요한 선택 포인트와 행동 옵션은 무엇인지 파악합니다.
   The situation (discerning the context for leadership): With often incomplete information, the meta-leader maps the situation to determine what is happening, who are the stakeholders, what is likely to happen next, and what are the critical choice points and options for action.
3. 연결(긍정적이고 생산적인 관계 육성): 메타 리더는 앞으로 나아갈 방향을 제시하고, 결정을 내리고, 그 결정을 실행하며, 폭넓은 참여와 지원을 이끌어내기 위해 효과적으로 소통합니다.
   The connection (fostering positive, productive relationships): The meta-leader charts a course forward, making decisions, operationalising those decisions, and communicating effectively to recruit wide engagement and support.

의료 및 교육 분야에서 우리의 행동과 행동을 이끄는 기본 가치는 타인(종종 취약한 사람들과 커뮤니티)의 개발과 보살핌에 대한 책임이 있기 때문에 기본이 됩니다. 환경윤리 및 재생 리더십 접근법은 리더가 이러한 핵심 가치를 파악하고 이를 실제로 구현하는 방법을 파악하는 데 도움이 됩니다.
In healthcare and education, the underpinning values that drive our behaviours and actions are fundamental as we are responsible for the development and care of other, often vulnerable people and communities. Eco-ethical and regenerative leadership approaches help leaders to identify these core values and how to implement them in practice.

환경 윤리적 리더십
Eco-ethical leadership

맥킴과 맥린(2020)은 지속 가능한 보건 전문직 교육과 관행의 필요성에 대한 리더의 생각을 집중시키는 '환경 윤리적' 리더십 접근법의 사례를 제시합니다. 환경윤리적 리더십은 지속 가능성, 가치, 협력, 정의, 옹호, 그리고 필요한 경우 행동주의를 중심으로 하는 통합적 접근 방식입니다. 상자 3에는 '환경 윤리적' 리더십의 주요 특징이 나와 있습니다.
McKimm and McLean (2020) make the case for an ‘eco-ethical’ leadership approach that focuses leaders’ minds on the need for sustainable health professions education and practices. Eco-ethical leadership is an integrated approach centred around sustainability, values, collaboration, justice, advocacy and, when required, activism. Box 3 lists key features of ‘eco-ethical’ leadership.

상자 3 보건 전문직 교육을 위한 '환경 윤리적' 리더십 접근법의 주요 특징. Box 3 Key features of an ‘eco-ethical’ leadership approach for health professions education. 환경 윤리적 리더는 다음과 같은 가치와 신념을 보유하고, 일상적인 행동과 행동을 통해 보여주고, 표현합니다: Eco-ethical leaders hold, display (through day-to-day behaviours and actions), and articulate the following values and beliefs: 지구와 자원의 청지기적 책임에 대한 도덕적 의무를 가지고 행동합니다. 자신의 행동에 책임을 지고, 옹호나 행동주의가 필요한 시기를 인식합니다. 개인적으로나 업무적으로 환경적으로 지속 가능한 실천의 롤 모델링. 환경, 조직, 지역사회의 지속 가능성 및 재생에 대한 헌신을 보여줍니다. 인지적 복잡성을 연습하고 역동적인 시스템 관점에서 세상을 바라봅니다. 경청, 신뢰, 네트워킹, 정보 및 권한 공유, 소통, 분야와 직종 간, 직종 내 협업을 통해 의미 있는 변화를 이끌어낼 수 있는 가장 강력한 방법은 집단 지성이라고 믿습니다. 포용성과 사회 및 생태적 정의를 구현하는 사회 문화적, 생태적 가치를 보여줍니다. 변화에 대한 진정성 있고, 사람 중심적이며, 공감하고, 자비로운 접근 방식을 취하고, 변화를 만드는 것은 어렵고, 사람들은 서로를 지지하고 작은 변화처럼 보일 수 있는 것을 축하해야 한다는 것을 인식합니다. A moral duty to act in terms of taking responsibility for stewardship of the planet and its resources. Being accountable for their actions, recognising when advocacy or activism is needed. Role modelling environmentally sustainable practice, both personally and professionally. Demonstrating commitment to environmental, organisational, and community sustainability and regeneration. Practising cognitive complexity and seeing the world from a dynamic systems perspective. Believing that collective intelligence is the most powerful way to engender meaningful change though listening, trust, networking, sharing information and power, communicating, and working collaboratively across and within disciplines and professions. Demonstrating socio-cultural and ecological values that embody inclusivity and social and ecological justice. Taking an authentic, person-centred, empathic, and compassionate approach to change, recognising that making changes is difficult, and that people need to support one another and celebrate what might seem to be small changes.

재생적 리더십
Regenerative leadership

팬데믹에 대한 HPE의 대응과 관련된 또 다른 접근 방식은 '재생적' 리더십입니다(Hutchins and Storm 2019). 재생적 리더십은 우리가 살고 있는 취약한 생태계에 대한 인간의 노력이 미치는 영향을 인정하고 줄이는 방식으로 조직과 조직 내 사람들을 육성하는 데 도움을 줄 의무를 리더에게 부여합니다. 지속 가능한 미래는 우리가 항상 해왔던 방식으로 일을 계속하는 것이 아니라 적극적으로 재생을 추구하는 것에 의존하는 미래로 상상됩니다. 이는 웰빙, 협업, 공동 창의성을 강조하고 모든 사람의 기여를 소중히 여김으로써 달성할 수 있습니다.
Another approach relevant to HPE and its response to the pandemic is that of ‘regenerative’ leadership (Hutchins and Storm 2019). Regenerative leadership places a duty on the leader to help nurture organisations and the people within them, in such a way that acknowledges and reduces the impact of human endeavour on the fragile eco-systems in which we live. A sustainable future is envisaged as one that relies on actively pursuing regeneration, rather than continuing to do things the way we always have. This is achieved through an emphasis on wellbeing, collaboration, co-creativity, and valuing everyone’s contribution.

리더십 실천을 개선하려면 어떻게 해야 하나요?
How can I improve my leadership practice?

이론적 접근법을 실제로 적용하기 위한 전략도 희망하는 리더가 탐구해야 합니다. 때때로 압도적으로 느껴질 수 있는 일련의 문제와 변화에 대처하기 위한 개인 전략을 개발하는 것은 모든 리더에게 필수적이며, 이러한 전략이 없으면 사기와 인내심이 떨어지고 심지어 스트레스와 탈진으로 이어질 수 있습니다. 이 섹션에서는 근성, 신뢰, 논리, 공감, 취약성, 편견에 대한 인식, 적응력 향상, 글로벌 사고 등 리더가 집중할 수 있는 영역에 대해 소개합니다. 모든 수준의 상호작용은 리더의 행동이나 대응 방식에 영향을 받기 때문에 이 섹션에서는 네 가지 수준(표 2)의 맥락에서 함께 고려합니다. 
Strategies for applying theoretical approaches in practice must also be explored by the hopeful leader. Developing personal strategies to deal with what can sometimes feel an overwhelming series of issues and changes is essential for any leader; without these, morale and patience can dip, even leading to stress and burnout. In this section, we present the following area's leaders can focus on: grit, trust, logic, empathy, vulnerability, awareness of bias, becoming more adaptive, and thinking globally. These are considered in the context of the four levels (Table 2) together in this section, as interactions at any level will be influenced by the way you behave or respond.

그릿
Grit

리더는 종종 자신의 능력을 벗어났다고 느낄 수 있지만, 회복탄력성과 '그릿'(Duckworth와 Duckworth 2016)을 바탕으로 한 걸음 더 나아가 자신이 책임지고 있는 사람들에게 효과적인 리더십을 제공해야 합니다. 그릿은 열정과 끈기라는 두 가지 핵심 자질의 조합으로 정의됩니다.

• 열정은 개인이 목표의 우선순위를 정할 수 있게 해주고,
• 끈기는 도전에 직면했을 때 끈질기게 목표를 추구하도록 촉진합니다(Duckworth 외. 2007; Duckworth와 Gross 2014).

어려운 상황과 좌절 속에서 그릿을 발휘하는 리더는 영감을 주는 롤모델이 되고, 팀원들에게 동기를 부여하며, 결과적으로 팀원들의 그릿을 더욱 향상시킵니다. 내부 동기를 부여하고 그릿을 향상시키기 위한 리더십 전략에는 암묵적인 역할 모델링, 성공 사례와 고난에 대한 명시적인 공유, 열정과 비전을 투명하게 전달하는 것 등이 포함됩니다(Ribeiro 외. 2020).
While leaders may often feel out of their depth, they must draw upon their resilience and ‘grit’ (Duckworth and Duckworth 2016), step up and provide effective leadership to the people they are responsible for. Grit is defined as the combination of two key qualities: passion and persistence.

• Passion allows individuals to prioritise goals, and
• persistence promotes the tenacious pursuit of goals in the face of challenges (Duckworth et al. 2007; Duckworth and Gross 2014).

Leaders who demonstrate grit during challenging circumstances and setbacks serve as inspiring role models, motivate their team members, and in turn enhance their grit even further. Leadership strategies to drive internal motivation and enhance grit can include implicit role modelling, explicit sharing of stories of successes and their struggles, and transparency in communicating their passion and vision (Ribeiro et al. 2020).

상자 4의 예는 리더십 신뢰도가 오랜 세월에 걸쳐 구축되는 경우가 많으며 그릿이 필요하다는 것을 보여줍니다. 리더의 비전에서 시작하여 비전을 실행하고(그 과정에서 조직의 정책과 절차를 탐색하는 방법을 배우며) 실무의 변화를 이끌어내는 단계로 나아갑니다.
The example in Box 4 illustrates how leadership credibility is often built over many years and requires grit. It starts with the leader’s vision, moves on to implementing the vision, (in the meantime, learning how to navigate organisational policies and procedures), and results in practice change.

박스 4 사례 연구: 비전에서 실천의 변화로. Box 4 Case study: From vision to changing practice. '평가가 학습을 이끈다'는 조지 밀러(George E. Miller)의 고전적인 명제는 많은 의과대학과 의학교육자들이 소속 기관의 평가 품질을 개선하도록 영감을 주었습니다(Wood 2009). 또한 이 사례 연구의 저자가 10년 이상 성공적인 평가 여정을 시작하도록 영감을 주었습니다. 그 여정은 2009년에 인도 루디아나에 있는 크리스천 의과대학의 지역 FAIMER 연구소에 커리큘럼 프로젝트를 제출하는 것으로 시작되었습니다(CMCL-FAIMER). 이 프로젝트는 사우디아라비아 킹 압둘아지즈 대학교(KAU) 의과대학의 학생 평가 프로세스를 표준화하고 품질을 개선하는 것을 목표로 했습니다. 프로젝트가 성공적으로 수행된 후, 그 성과를 문서화하여 널리 전파하여 혜택을 극대화하고 공유했습니다. 이러한 학술적 작업은 평가의 전체 과정을 문서화하기 위한 시험 워크시트 개발, KAU에서 평가에 관한 수십 개의 교육 과정 실시, 평가에 관한 교육용 YouTube 동영상 제작, 국내외 회의 및 컨퍼런스에서 프로젝트 발표, 학생 평가 표준화를 위한 6단계 발표 등 다양한 형태로 이루어졌습니다(Hassanien 및 Abou-Kamer 2018). ‘Assessment drives learning’, the classic statement of George E. Miller, has inspired many medical schools and medical educators to improve the quality of assessment at their institution (Wood 2009). It also inspired the writer of this case study to embark on a successful journey in assessment for more than ten years. The journey started in the year 2009 by submitting a curricular project to the regional FAIMER institute in Christian Medical College in Ludhiana in India (CMCL-FAIMER). The project aimed at standardising and improving the quality of the process of student assessment in the Faculty of Medicine at King Abdulaziz University (KAU), in Saudi Arabia. After successful implementation of the project, the achievement was written up and disseminated widely to maximize and share the benefits. These scholarly works took different forms which included: developing an exam worksheet to document the whole process of assessment, conducting tens of training courses on assessment in KAU, creating educational YouTube videos on assessment (Hassanien and Abou-Kamer 2018) presenting the project in national and international meetings and conferences, and publishing six steps for standardising student assessment (Hassanien 2018). 변화를 지속하기 위한 가장 중요한 단계는 KAU 시험 및 학생 평가 정책을 개발하고 학부에 평가 부서를 설립하여 프로세스를 제도화하는 것이었습니다. 2019년 약학부는 전체 평가 프로세스를 감독하고 학생 평가에 대한 대내외 검증을 보장하기 위해 평가 부서를 설립하는 데 앞장섰습니다. 변화와 개선은 결과를 얻기까지 수년이 걸릴 수 있지만, 비전을 전달하고 끈기를 가지고 가능한 모든 기회를 활용하면 지속 가능하고 효과적인 노력을 할 수 있습니다. 변화의 지속 가능성을 위한 가장 중요하고 중요한 단계는 변화가 단순히 한시적인 '프로젝트'가 아니라 교육기관의 문화에 내재화되어 업무 수행 방식이 되도록 하는 것입니다. The most important step to sustain the change was done by institutionalising the process through developing the KAU examination and student assessment policy and establishing assessment units in faculties. In 2019, The Faculty of Pharmacy took the initiative to establish its assessment unit to oversee the entire assessment process and to ensure the internal and external verification of student assessment. Change and improvement may take years to give results, but communicating the vision, persistence, and utilising all possible opportunities will make efforts sustainable and effective. The most important and crucial step for change sustainability is to ensure it is embedded in the culture of the institution, so it becomes the accepted way of doing things and not merely a time-limited ‘project’.

 

신뢰
Trust

Frei와 Morriss(2020)는 신뢰에는 논리, 공감, 진정성이라는 세 가지 동인이 있으며, 이 세 가지가 함께 신뢰의 삼각형을 이룬다고 설명합니다. 모든 리더는 특히 위기 상황에서 흔들리는 동인(삼각형의 한 점)을 하나 이상 가지고 있으며, 이 중 하나가 너무 약하면 신뢰가 떨어집니다(그림 1).
Frei and Morriss (2020) describe trust as having three drivers: logic, empathy, and authenticity, which together make up a triangle of trust. All leaders will have at least one driver (one point of the triangle) they falter on, especially in a crisis, and when one of these is too weak, trust falls (Figure 1).

논리 Logic

리더는 자신의 전문성을 보여주되 이기적이지 않아야 하며, 해당 산업에 대해 잘 알아야 합니다. 이는 다른 팀원들에게 신뢰감을 주는 것이 핵심입니다. 좋은 질문을 던지고, 통찰력 있는 제안을 하고, 핵심 가치를 반영한 결정을 내리는 리더를 직장 내 예로 들 수 있습니다. 또한 커뮤니케이션에 대한 일관성과 명확성이 요구됩니다.
Leaders need to show their expertise, but not be egotistical, and know their industry. This is all about being credible to other members of the team. Workplace examples include leaders asking good questions, offering insightful suggestions and decisions reflecting their core values. Consistency and clarity around communication are also expected.

공감 Empathy

사람들은 배려하는 것으로 인식되고 연민과 연결을 보여주고 공유하는 리더를 신뢰하는 경향이 있습니다. 이는 다른 사람이 말할 때 휴대전화를 보지 않거나 회의에서 다른 사람의 말을 경청하는 것만큼이나 간단할 수 있습니다. '정서적 자본'이라는 개념은 부르디외의 사회적 실천 이론(부르디외 1986)에서 등장했습니다. 연구에 따르면 정서적 자본이 높은 기관의 업무 성과가 더 높은 것으로 나타났습니다. 이러한 자본은 거창한 감동적인 강연이 아니라 인정받기, 미소 짓기, 잡담 나누기, 감사하기 등 긍정적인 미시적 행동에 의해 구축됩니다. 연구에 따르면 정서적 자본을 구축하면 직장에서의 좌절로 인한 부정적인 영향을 완충할 수 있다고 합니다. Frei의 연구에 따르면 이 지점은 가장 큰 '흔들림'이 있는 지점, 즉 리더가 가장 많이 실수하는 지점이라고 설명합니다.
People tend to trust leaders who are perceived as caring and who show and share compassion and connection; this can be as simple as not looking at your phone or watching in meetings when others are speaking. The concept of ‘emotional capital’ emerged from Bourdieu’s theory of social practice (Bourdieu 1986). Studies have shown that institutions, where emotional capital is high, have an increase in work performance. This capital is not built on grandiose displays of inspiring talks but by positive micro-behaviors: being acknowledged, smiled at, engaging in small talk, or being thanked. Research shows that building emotional capital can also buffer the negative effects of setbacks at work. Frei’s work describes this point as the one with the biggest ‘wobbles’, i.e. the one that leaders get wrong the most.

진정성 Authenticity

사람들은 리더가 실제 나와 상호작용하고 있다고 믿을 때 리더를 신뢰하는 경향이 있습니다. 누군가가 진정성 있는 사람인지 아닌지는 직감으로 알 수 있는 경우가 많지만, 일관성, 자신의 가치관에 따라 행동, 책임감, 불필요한 동료의 압력에 굴복하지 않는 것과 같은 특징이 있습니다. 그러나 가장 강력한 특성은 자신의 지저분한 부분을 보여주는 것, 즉 취약성을 드러내고 포용하는 것입니다.
People tend to trust leaders when they believe they are interacting with the real you. Knowing whether someone is being authentic is often a gut feeling, but there are characteristics such as being consistent, acting according to one’s own values, taking responsibility, and not giving in to needless peer pressure. However, the most powerful characteristic is showing the messy parts of yourself, i.e. showing and embracing vulnerability.

취약성
Vulnerability

다니엘 코일은 성공적인 팀이나 조직이 강조해야 할 세 가지 기술, 즉 모두를 위한 안전한 환경, 취약성 공유, 공동의 목표 수립 요건을 설명합니다(Coyle 2018). 취약성의 기술, 즉 실패했을 때 다른 사람들과 공유하는 것, 즉 '학습의 첫 시도'는 시간이 지남에 따라 신뢰를 쌓을 수 있습니다. 이러한 개념은 용기 있는 대화와 취약성에 기대는 것을 강조하는 브레네 브라운의 리더십 연구와 밀접하게 일치하며, 이러한 취약성 공유는 리더로부터 시작되어야 합니다(Brown 2012). 취약성은 사람들이 심리적으로 안전하다고 느낄 때만 장려될 수 있으며(Edmondson 2018), 이는 모든 사람이 부정적인 결과나 당혹감에 대한 두려움 없이 아이디어, 질문, 우려 사항을 자유롭게 말하거나 실수를 인정할 수 있다고 믿는 환경을 조성하는 데 달려 있습니다. 이는 다양성과 포용성의 이점을 극대화할 수 있도록 팀이 다양할 때 점점 더 중요해지고 있습니다(Barrow 외. 2015).
Daniel Coyle describes three skills a successful team or organisation needs to emphasise: a safe environment for all, sharing vulnerability, and the requirement to establish common goals (Coyle 2018). The skill of vulnerability, i.e. to share with others when you FAIL, or your ‘First Attempt In Learning’, will build trust over time. These concepts align closely with Brené Brown’s research on leadership, where she highlights courageous conversations and leaning into vulnerability and that this sharing of vulnerability must start with the leader (Brown 2012). Vulnerability can only be encouraged when people feel psychologically safe (Edmondson 2018), which hinges on creating an environment where everyone believes they can freely speak up with ideas, questions, concerns, or acknowledge mistakes without fear of negative consequences or embarrassment. This is increasingly important when teams are diverse so that the benefits of diversity, as well as inclusivity, can be maximised (Barrow et al. 2015).

편견에 대한 인식
Awareness of biases

무의식적(암묵적) 편견은 모든 사람의 무의식 속에 존재하며 무의식적으로 의사 결정이나 판단에 영향을 미칩니다. 편견은 경험, 양육, 문화, 주변 환경 등 '삶'에 노출되는 동안 자연스럽게 형성되거나 발전합니다. 이러한 편견은 의도하지 않았고 반드시 나쁜 것은 아니지만 현대 사회에서 차별에 기여하는 경우에는 해결해야 합니다. 이러한 편견은 우리의 행동과 동료와의 상호 작용에 영향을 미칠 수 있습니다(Marcelin 외. 2019; Teal 외. 2012). 무의식적 편견을 해결하려면 편견을 인식하고 이해해야 합니다(Liao and Thomas 2020; Velarde 외. 2022). 암묵적 연상 테스트와 같이 도움이 될 수 있는 설문조사와 공인된 도구가 있습니다. 서로 다른 사회적 집단에 속한 사람들 사이에서 자신의 검사 결과에 대해 토론하는 것은 다른 관점을 공유할 수 있는 안전한 환경에서 특히 효과적입니다. 편견 리터러시를 증진하기 위해 촉진된 토론을 활용하면 직장에서의 편견을 최소화하는 데 효과적일 수 있습니다. 편견은 학습자뿐만 아니라 리더에게도 나타날 수 있으며, 그 예는 상자 5에 자세히 나와 있습니다.
Unconscious (implicit) biases are part of everyone's unconscious minds that unknowingly influence decisions or judgements. They are shaped or develop naturally during exposure to ‘life’: experiences, upbringing, culture, and surrounding environments. They are unintentional and not necessarily bad but need to be addressed when they contribute to discrimination in modern society. These biases can affect our behaviours and the interactions we have with colleagues (Marcelin et al. 2019; Teal et al. 2012). Addressing unconscious biases requires that one must recognise and understand them (Liao and Thomas 2020; Velarde et al. 2022). There are surveys and recognised instruments such as the Implicit Association Test that can be of help. Discussion of one’s test results amongst those in dissimilar social groups is particularly powerful in a safe environment that allows alternative viewpoints to be shared. Utilising facilitated discussions to promote bias literacy can be effective in minimising bias in the workplace. Biases are shown by learners as well as leaders, an example of which is detailed in Box 5.

상자 5 학습자 편견. Box 5 Learner biases. 최근 발표된 논문(Khasan 외. 2020)에 따르면, 천연자원 생태학에 관한 학부 온라인 강좌의 136명의 학생은 성에 따라 남성 또는 여성 조교(TA)를 '배정'받았습니다. 그러나 여성 박사 과정 학생인 카잔은 실제로 모든 학생의 조교였습니다. 조교의 '성별'은 학생들에게 제공된 가짜 이름, 사진, 짧은 약력을 바탕으로 결정되었습니다. 과정을 마친 후 학생들은 조교가 여성이라고 생각했을 때와 남성이라고 생각했을 때를 비교했을 때 5배나 더 부정적인 평가를 내렸습니다. 하노버 리서치(2013)의 2013년 보고서에서는 교수진을 평가할 때 학생 편견 문제를 줄이고 잠재적으로 제거할 수 있는 기회를 설명합니다. 이 연구에서는 내면화된 편견이 5점 척도에서 여성 교수에게는 최대 0.4점, 흑인 교수에게는 최대 0.6점의 불이익을 주며, 평가도 학대나 괴롭힘으로 변질될 수 있다고 강조했습니다. 이 검토에서는 교수진이 구체적인 질문을 하고, 수업 중에 종이에 평가를 관리하며, 평가 양식에 암묵적 편견에 대한 정보를 포함할 것을 권장합니다(Finelter-Rosenbluh 2020). In a recent publication (Khasan et al. 2020), 136 students in an undergraduate online course on natural resource ecology were ‘assigned’ either a male or female teaching assistant (TA), dependent on their surnames. However, a female Ph.D. student Khazan was really the TA for everyone. The TA’s ‘gender’ was based on fake names, photographs and a short biography made available to students. On completion of the course, students gave the TA five times as many negative evaluations when they believed that she was a woman compared to when they thought she was a man. A 2013 report by Hanover research (2013) outlines opportunities to reduce and potentially eliminate the problem of student bias when evaluating faculty. Their review highlighted that internalised bias penalise female faculty by up to 0.4 and Black faculty by up to 0.6 on a 5-point scale, with evaluations also becoming abusive and bullying. The review recommends that faculty ask concrete questions, administer evaluations on paper during class and include information about implicit bias within evaluations forms (Finelter-Rosenbluh 2020).

 

적응력 높이기
Becoming more adaptive

적응형 리더는 상황이나 조직의 외부 또는 그 이상의 관점을 취할 수 있는 사람입니다. 적응형 리더는 '댄스 플로어에서 내려 발코니로 나가는'(Heifetz와 Linsky 2002) 리더로, 사람과 시스템이 어떻게 작동하는지에 대한 이해를 통해 지속 가능한 변화를 촉진하고, 서로 상호작용하여 변화를 함께 만들어갈 수 있습니다(Obolensky 2017). 이러한 리더는 자신과 팀이 불확실성과 모호성을 가지고 일할 수 있는 안전한 공간을 조성하고, 새로운 변화를 창출하기 위해 '치열한 대화'를 할 수 있습니다. 상자 6에서는 코로나19 팬데믹 기간 동안 적응형 리더십이 어떻게 작동했는지를 보여주는 조직과 시스템 전반에 걸친 리더십의 사례를 간략히 소개합니다.
Adaptive leaders are those who can take a perspective from outside or above the situation or organization. Adaptive leaders ‘get off the dance floor and go to the balcony’ (Heifetz and Linsky 2002), can facilitate sustainable change through their understanding of how people and systems work, and interact with one another to co-create change (Obolensky 2017). Such leaders are able to create safe spaces for both themselves and their teams to work with uncertainty and ambiguity and have ‘fierce conversations’ in order to generate emergent change. In Box 6 we outline an example of leadership enacted across an organisation and system which highlights how adaptive leadership operated in action during the COVID-19 pandemic.

박스 6 위기 속 조직과 시스템의 도전: 행동하는 적응적 리더십 Box 6 Organisation and system challenge in crisis: Adaptive leadership in action. HPE 리더는 고등 교육 및 의료 산업의 상호 의존성을 반영하는 환경에서 고도의 규제를 받고 공공 또는 민간 기관으로 운영되는 조직과 시스템에서 근무합니다. HPE 리더는 점점 더 많은 기업 책임을 지고 있으며, 대학에 대한 공적 자금 지원 감소로 인해 재정 및 자원 관리에 대한 통찰력을 갖춰야 합니다. 공공의 이익을 위해 봉사하는 조직의 리더로서 HPE 리더는 높은 사회적 지위를 가지고 있습니다. 또한 다양성, 포용성, 형평성을 증진하는 좋은 거버넌스, 책임성, 운영 시스템에 대한 집중적인 조사를 받고 있습니다(McKimm and McLean, 2020). HPE 리더가 근무하는 조직과 시스템은 매우 복잡한 환경입니다. 현재의 팬데믹 및 기타 위기로 인해 조직은 적응하고 필요한 조치를 취하여 기능을 유지하고 미래를 위한 새로운 규범을 설정해야 합니다(Ashokka 외. 2020). HPE leaders work in organisations and systems that are highly regulated and operate as either public or private entities in settings that reflect the interdependence of both the higher education and healthcare industry. HPE leaders increasingly have corporate responsibilities and are expected to have financial and resource management acumen due to reduced public funding for universities. As leaders of organisations that serve public interests, HPE leaders have high social standing. They are also under intense scrutiny for good governance, accountability and operating systems that promote diversity, inclusivity, and equity (McKimm and McLean, 2020). The organisations and systems in which HPE leaders work is a highly complex environments. The current pandemic and other crises force the organisations to adapt and take necessary measures to keep functioning as well to set new norms for the future (Ashokka et al. 2020). 아시아에서는 코로나19 팬데믹 기간 동안 주요 중앙 결정을 내리기 위해 전담 대응팀이 구성되었습니다. 이 팀은 기술에 적응한 의학교육과 평가를 제공하는 데 있어 조율된 조치를 통합하는 동시에 임상 실습 학생, 레지던트, 모든 교직원을 위해 높은 안전 기준에 따라 가능한 한 임상 과제를 할당하려고 노력했습니다. 대응팀은 팬데믹 기간 동안 지역 정부의 전반적인 대응 시스템을 세심하게 활용했습니다. 이러한 적응적 접근 방식은 기관의 집단주의, 계층적 시스템의 적절한 사용, 혼란스러운 상황에서 불확실성을 줄이려는 시도를 반영하여 적시에 충분한 정보를 바탕으로 한 결정을 내릴 수 있게 했습니다(Ashokka 외. 2020; Lazarus 외. 2020). 일부 리소스 제한에도 불구하고 팬데믹 기간 동안 최전선에서 일하는 새로 졸업한 의사를 지원하기 위해 신속한 대응을 위한 대규모 온라인 공개 강좌를 개설하기 위해 적응적 접근 방식을 취하기도 했습니다(Findyartini 외. 2021). In an Asian setting, a dedicated response team was set up to provide key central decisions during the COVID-19 pandemic. This team was able to consolidate coordinated actions in delivering technology-adapted medical education and assessment while still attempting to allocate clinical assignments where possible with high safety standards for students in clinical years, residents, and all staff members. The response team employed the overall response system during the pandemic from the local government meticulously. Such an adaptive approach allowed for timely and well-informed decisions which reflected institutional collectivism, the appropriate use of the hierarchical system and attempts to reduce the uncertainty during a chaotic situation (Ashokka et al. 2020; Lazarus et al. 2020). Despite some resource limitations, the adaptive approach was also taken to create a fast response Massive Open Online Course to support newly graduated medical doctors working at the frontlines during the pandemic (Findyartini et al. 2021).

박스 7에서는 조직과 시스템 전반에 걸쳐 시행된 리더십의 또 다른 사례를 소개합니다. 이 사례는 한 조직이 외부 변화와 변화하는 이해관계자의 요구에 대응하여 교육자를 위한 전문 표준 프레임워크를 도입하기 위한 비전을 개발하고 제정하는 과정을 설명합니다. 팬데믹 시기가 아닌 안정적인 시기였으며, 품질 개선이라는 접근 방식을 활용했습니다.
In Box 7 we lay out another example of leadership enacted across an organisation and system. This one describes the way in which an organisation developed and enacted a vision to introduce a professional standards framework for educators in response to external shifts and changing stakeholder demands. This was during a stable time, not during a pandemic, and draws on an approach of quality improvement.

박스 7 고등교육의 질 향상: 조직 및 시스템 변화. Box 7 Improving the quality of higher education: Organisational and system change. 지난 10년 동안 학습, 교수 및 학생 경험의 질을 개선하려는 시장의 힘, 이해관계자의 요구 및 발전에 자극을 받아 주로 영국, 호주, 뉴질랜드, 아일랜드 등 서구를 중심으로 대학 교직원을 위한 여러 전문 표준 프레임워크가 시행되었습니다. 사우디아라비아의 킹 압둘아지즈 대학교(KAU)는 대학에서 일하는 교직원을 위한 전문 표준 프레임워크를 개발하면 대학 부문 전반에서 학습 및 교수의 질을 표준화하고 개선하는 데 도움이 될 것이라는 사실을 파악했습니다. Over the last decade, stimulated by market forces, stakeholder demands and developments to improve the quality of learning, teaching and the student experience, several professional standards frameworks have been implemented for university staff, primarily in the West (e.g. the UK, Australia, New Zealand, and Ireland). In Saudi Arabia, King Abdulaziz University (KAU) identified that developing a professional standards framework for academics working in universities would help standardise and improve the quality of learning and teaching across the university sector. KAU의 리더들은 지역 및 더 넓은 사우디 국가적 맥락에 적합한 전문 표준 프레임워크를 개발하는 데 앞장섰습니다. 이 프레임워크는 KAU 고유의 것이지만 모범 사례와 증거에 기반한 주요 국제적 모범 사례를 반영하고 있습니다(Al-Youbi 외. 2021). 프로젝트가 제기하는 기술적 과제를 해결하기 위한 일환으로, 일련의 정책과 절차는 리더와 교사가 채용, 교수진 개발 및 훈련, 평가 및 성과 평가, 승진에 전문 표준 프레임워크를 사용할 수 있도록 돕습니다. Leaders at KAU took the initiative to develop a professional standard framework suitable for the local and the wider Saudi national context. This framework is unique to KAU yet reflects key international exemplars grounded in best practice and evidence (Al-Youbi et al. 2021). As part of addressing the technical challenges posed by the project, a set of policies and procedures help leaders and teachers to use the professional standard framework for recruitment, faculty development and training, appraisal and performance evaluation and promotion.

 

글로벌 사고
Thinking globally

글로벌 생태계 전반에서 리더십을 발휘하고자 할 때 개인이 혼자서 이를 시도하는 것은 불가능하기 때문에 협업과 글로벌 실천 커뮤니티 형성이 필수적입니다. 아래에 자세히 설명된 HPE의 프로그램 개발에서 포용적이고 글로벌한 리더십을 발휘한 사례는 협업이 실천 커뮤니티를 강화하고 확장하는 데 어떻게 도움이 되는지 잘 보여줍니다.
When trying to enact leadership across global ecosystems, it is impossible for individuals to attempt to do this on their own, therefore collaboration and forming global communities of practice are essential. An example of inclusive and global leadership in the development of a programme for HPEs, detailed below, highlights how collaboration helps strengthen and expand a community of practice.

환경윤리 및 재생 리더십에 필요한 많은 기술에는 책임감, 옹호, 행동주의에 대한 이해가 필요합니다. 모든 사람이 활동가가 되지는 않겠지만(혹은 되어야만 하는 것은 아닙니다), 때로는 복잡한 시스템에서 권력과 정치에 적극적으로 개입해야 할 때가 있습니다. 책임감, 옹호, 행동주의의 모든 기술에는 핵심 가치를 행동으로 옮기고 이를 일상적인 행동에 통합하는 것이 포함됩니다. 표 3은 핵심 가치와 이를 행동으로 보여주는 방법, 필요한 훈련 및 교육을 사례와 함께 보여줍니다.
For many of the skills required for eco-ethical and regenerative leadership, an understanding of accountability, advocacy, and activism is required. Not everyone will (or should?) become an activist, but when we feel very strongly, sometimes we must step up and work actively with power and politics in complex systems. All the skills of accountability, advocacy and activism involve putting core values into action and incorporating these into everyday behaviours. Table 3 shows the core values and how these might be displayed in action, the training and education required, with examples.

모든 수준의 리더가 자신의 가치를 리더십에 통합한 매우 시사적이고 시급한 사례로는 학생과 의사의 기후 변화 운동이 있습니다(상자 9). 현재의 기후 위기는 곧 건강 위기입니다. 예를 들어, 영국의 일반의협의회(2018)의 의사의 의무에 따르면 의사는 환자의 안전, 존엄성 또는 편안함이 침해될 수 있다고 생각되면 즉각적인 조치를 취해야 하므로, 많은 의사들이 개인적, 직업적 생태 발자국을 최소화하기 위해 노력하면서 '행동주의'에 의지하는 것은 놀라운 일이 아닙니다.
A highly topical and urgent example of how leaders (at all levels) have incorporated their values into leadership is that of student and doctor climate change activism (Box 9). The current climate crisis is a health crisis (https://www.who.int/news-room/photo-story/photo-story-detail/urgent-health-challenges-for-the-next-decade). Since, for example, the UK’s General Medical Council (2018) Duties of a Doctor requires that doctors take prompt action if they think that patient safety, dignity, or comfort may be compromised, it is not surprising that many doctors are resorting to ‘activism’ while also striving to minimising their personal and professional ecological footprints.

박스 8 의학교육의 AMEE 전문가 자격증. Box 8 The AMEE Specialist Certificate in Medical Education. 수년 동안 AMEE는 연례 학술대회 기간 중 또는 그 이전에 열리는 교육 과정에 참여할 수 있는 기회를 제공해 왔습니다. 이를 통해 참가자들은 다양한 ESME 인증서 중 하나를 취득할 수 있으며, 이 중 다수는 학교 및 기관 수준에서 공신력 있는 성취 증명서로 인정받고 있습니다. 지난 몇 년 동안 전 세계 여러 국가에서 추가적인 온라인 및 주제별 과정이 제공되었습니다. 교수진이 학생 및/또는 수련의를 계속 가르칠 수 있도록 의학교육에 대한 기본 자격을 갖추어야 한다는 압력이 증가하고 있지만, 많은 교육자, 특히 추가 임상 및 학업 책임이 있는 교육자나 자원이 부족한 환경에 있는 교육자는 이러한 자격을 갖추지 못하고 있습니다. For many years AMEE has provided opportunities to participate in courses held during or prior to the annual conference. These allow participants to obtain one of the various ESME Certificates, many of which are recognised at the school and institutional level as a credible certificates of achievement. Over the last few years, additional online and subject-specific courses have been delivered in various countries around the world. There is increasing pressure upon faculty to have a basic qualification in medical education, which allows them to continue teaching their students and/or trainees, however, these are not available for many educators, particularly those with additional clinical and academic responsibilities and those in low resource settings. 2018년, 전 세계 교육자들의 요구를 해결하고 이들이 글로벌 실무 커뮤니티로 진출할 수 있도록 돕기 위해 일부 ESME 과정을 AMEE 의학 교육 전문가 자격증으로 통합하는 방안이 제안되어 합의되었습니다. AMEE 전문가 인증서는 의학교육에 대한 시간, 자금 또는 학위 수여 프로그램을 이용할 수 없는 개인에게 상황과 경력 목표에 맞게 개별적으로 조정할 수 있는 유연한 프로그램을 제공함으로써 국제적으로 인정받는 의학교육 인증서를 취득할 수 있는 기회를 제공하는 것을 목표로 합니다. 이 인증서는 AMEE에서 인정하는 4개의 과정으로 구성되어 있으며, 이를 통해 개인이 지정된 학습 결과를 달성했음을 증명할 수 있습니다. 이러한 과정은 전 세계의 다양한 컨퍼런스(AMEE 연례 컨퍼런스 포함) 및 기타 장소에서 온라인으로 운영됩니다. 현재까지 수백 명의 교육자가 자격증을 취득했거나 취득을 위해 노력하고 있으며, 자격증이 자신감, 역량 및 경력에 긍정적인 영향을 미치고 있다고 보고하고 있습니다. In 2018, it was proposed and agreed to combine some of the ESME courses into an AMEE Specialist Certificate in Medical Education aimed at addressing the needs of educators globally and helping them to move into the global community of practice. The AMEE Specialist Certificate aims to give individuals (who may not have the time, funding for or access to award bearing programmes in medical education) opportunities to gain an internationally recognised Certificate in Medical Education, through the provision of a flexible programme, which can be individually tailored to suit circumstances and career aspirations. The Certificate comprises four courses recognised by AMEE, which together demonstrate that an individual has achieved the specified learning outcomes. Such courses are run online, around the world at various conferences (including the AMEE annual conference) and in other locations. To date, hundreds of educators have obtained or are working towards their Certificate and reporting that this is having a positive impact on their confidence, competence, and careers.

 

박스 9 학생과 의사의 기후 변화 운동. Box 9 Student and doctor climate change activism. 학교 학생, 보건 전공 학생 및 보건 전문가들이 '활동가'가 되어 정부에 긴급한 조치를 취하도록 로비를 벌이고 있습니다. 예를 들면 다음과 같습니다: School students, health professional students and health professionals have become ‘activists’, lobbying governments to take urgent action. Examples include: #미래를 위한 금요일: 2018년 8월, 15세 소녀 그레타 툰베리가 기후를 위한 학교 파업을 시작하면서 시작된 글로벌 기후 파업 운동입니다. #FridaysforFuture: A global climate strike movement that began in August 2018 when 15-year-old Greta Thunberg began a school strike for climate. 국제 의과대학 학생회 연맹: 건강 문제에 관한 정책 문서를 발표하고 국가별 국제 회의에 참석하는 등 활발한 활동을 펼치고 있습니다. 최근 정책 문서로는 건강 형평성, 건강 비상사태(2020년 8월), 건강, 환경 및 기후 변화(2020년 3월)가 있습니다. The International Federation of Medical Students’ Association: Active in terms of publishing policy documents on health issues and attending national international meetings. Recent policy documents include Health Equity, Health Emergencies (Aug 2020) and Health, Environment and Climate Change (March 2020). 멸종 반란을 위한 의사들: 웹사이트에는 다음과 같이 적혀 있습니다: ".... 기후 변화가 임박한 공중 보건 재앙임을 인식하고, 멸종 반란과 함께 시민 불복종에 착수하기로 결정했습니다." Doctors for Extinction Rebellion: On their website, they write the following: “…. Appreciating that Climate Change is an impending public health catastrophe, have decided to undertake Civil Disobedience with Extinction Rebellion”

 

상자 10 캐나다의 수평적 및 수직적 리더십 개발. Box 10 Horizontal and vertical leadership development in Canada. "RCPSC와 캐나다 의과대학 학부협회(AFMC)는 리더십 교육을 UGME(MD 교육)와 PGME(레지던트 교육) 모두에서 중점적으로 고려할 것을 권장했습니다. "직업적 책임, 자기 인식, 피드백 제공 및 받기, 갈등 해결, 변화 관리, 리더, 조력자 또는 팀원으로서 팀의 일원으로 일하는 것"에 초점을 맞출 것을 권장했습니다.  대부분의 프로그램은 리더십 교육의 일부로 캐나다 의사협회(CMA)에서 제공하는 것과 같은 활동을 포함한 선택적 활동에 대한 접근을 용이하게 합니다:  레지던트와 의사를 위한 리더십 교육은 일반적으로 유료 과정(https://joulecma.ca/learn. . . )을 통해 제공됩니다. “RCPSC and the Association of Faculties of Medicine of Canada (AFMC) have recommended that leadership training be considered a focus in both UGME (MD training) and PGME (residency training). The recommendation was to focus on “professional responsibilities, self-awareness, providing and receiving feedback, conflict resolution, change management, and working as part of a team as a leader, facilitator, or team member.”  The majority of programs facilitate access to optional activities as part of their leadership offer which include activities such as these provided by the Canadian Medical Association (CMA):  https://www.cma.ca/physician-wellness-hub/resources/leadership-professional-development/leadership-development-courses-for-medical-students-and-residents. . . .  Training in leadership for residents and physicians is usually facilitated through fee-paying courses (https://joulecma.ca/learn. . . . ). 리더십 개발은 캐나다의 학부 의학교육(UGME)의 커리큘럼에도 포함되어 있습니다. 다음은 오타와 대학교의 예입니다:   Leadership development is also included in the curricula in undergraduate medical education (UGME) in Canada. This is an example from the University of Ottawa:  https://med.uottawa.ca/undergraduate/education/social-accountability/associated-programs/leadership. . . .

박스 11 리더십에 대한 문화적 관점. Box 11 Cultural perspectives on leadership. 리더십에 대한 동남아시아의 관점 South-East Asian perspectives on leadership 동남아시아 국가에서는 문화적 가치가 강력하게 자리 잡고 있으며 삶의 모든 측면에 영향을 미칩니다. 이 지역 국가들의 다양한 인종, 지리적 분포, 정부 정책, 교육 및 의료 시스템으로 인해 보건 전문직 교육에서 문화적 가치가 리더십에 미치는 영향을 논의하기 위해서는 포괄적인 이해와 역동적인 접근이 필요합니다. 호프스테드의 문화적 가치에 따르면 이 지역은 높은 권력 거리 또는 위계질서, 집단주의, 불확실성 회피, 장기적 지향, 남성성과 여성성의 균형이 특징이며, 이를 잘 인식하고 관리하는 리더가 있어야 필요한 변화가 일어날 수 있습니다. Cultural values are strongly held and influence all aspects of life in South-East Asian countries. With diverse ethnicities, geographical distribution, governmental policies, education and healthcare systems in the countries within this region, discussing the impact of cultural values on leadership in health professions’ education requires comprehensive understanding and a dynamic approach. Based on Hofstede’s cultural values, this region is characterised by high power-distance or hierarchy; collectivism; uncertainty avoidance; long-term orientation, and a balance of masculinity and femininity, which are best aware and managed with by the adaptive leaders hence necessary changes can take place. 리더십에 대한 중동의 관점 Middle Eastern perspectives on leadership 중동 아랍 국가들은 신뢰에 뿌리를 둔 독특한 문화 유산을 가지고 있습니다. 개인은 일반적으로 꾸란의 원칙에 따라 자신의 유산을 소중히 여기고 종교적 신념과 중요한 관계를 보존합니다. 이러한 문화는 중동의 일반적인 리더십 스타일과 리더와 추종자 간의 관계를 규정하는 요소에 큰 영향을 미칩니다. 이러한 관점에서 볼 때 중동 리더십 스타일의 고유한 특징은 다음과 같습니다: 높은 권력-거리, 탁월함을 바탕으로 한 신뢰 구축, 모든 사람에게 사명과 역할이 있음, 개방적인 문화, 개별 의사 결정과 협의의 균형. Middle Eastern Arab countries have a unique cultural heritage that is rooted in trust. Individuals are generally guided by the Quran's principles: they value their heritage and preserve their religious beliefs and relationships of importance. This culture has a profound effect on the common leadership styles in the Middle East and on the factors regulating the relationships between leaders and their followers. From this perspective, the following are unique characteristics for the middle eastern leadership style: high power-distance; trust is built based on excellence; every person has a mission and a role to play; an open-door culture, and balance consultation with individual decision-making.

리더의 존재와 리더 되기
Being and becoming a leader

방대한 양의 이론과 관리 모델, 그리고 끊임없이 변화하는 환경은 HPE 리더가 '리더가 되는 것'(Souba, 2011)과 '리더십 활동을 수행하는 것'을 매우 어렵게 만들 수 있습니다. 

• 리더가 '되는 것'은 여기서 논의한 많은 리더십 접근법과 기법을 일상 업무에 통합하는 것을 포함하지만,
• 리더가 '되어가는 것'은 리더로서의 정체성을 개발하는 과정(의식적, 무의식적)을 포함합니다(Maile 외. 2019).

The sheer volume of theories and management models, plus the constantly changing environment in which HPE leaders have to work can make ‘being and becoming a leader’ Souba, 2011) as well as ‘doing leadership activities’ very difficult.

• ‘Being’ a leader involves incorporating many of the leadership approaches and techniques discussed here into everyday practice, whereas
• ‘becoming’ a leader involves a process (conscious and unconscious) of developing an identity as a leader (Maile et al. 2019).

Petrie의 연구는 이를 맥락에 맞게 설명하는 데 도움이 됩니다. 그는 리더십 개발의 두 가지 유형, 즉 수평적 리더십과 수직적 리더십을 설명합니다(Petrie 2014). 
Petrie’s work helps put this into context. He describes two types of leadership development: horizontal and vertical (Petrie 2014). 

• 수평적 리더십 개발은 개념, 모델 및 사용 가능한 도구를 포함하여 리더십 이론에 대한 지식을 늘리는 것입니다. 여기에는 점점 더 많은 수의 대학원 자격증이 포함됩니다. 리더가 경험을 쌓고 공식적인 학습을 시작하면 수직적 리더십 개발의 원칙을 활용하는 것을 목표로 삼아야 합니다. 여기에는 리더십의 맥락에서 자신과 자신이 직면한 도전에 대해 배우는 것이 포함됩니다.
  Horizontal leadership development is about increasing your knowledge of the theory of leadership including the concepts, models, and tools available. This includes postgraduate qualifications of which there are increasing numbers on offer. As leaders begin to gain experience and possibly undertake some formal learning, they should aim to utilise the principles of vertical leadership development. This involves learning about yourself in the context of leadership and the challenges you face.
• 수직적 리더십에서 리더는 자신이 직면한 도전('뜨거운 경험')을 성찰과 대화를 통해 '감각화'하고, 현재 상황에 대해 '충돌하는 관점'에 개방적인 태도를 취함으로써 어떻게 개선하거나 다르게 행동할 수 있는지 분석합니다. 의도적인 성찰과 대화는 임포스터 감정을 완화하고, 리더십에 대한 자신감과 유능함을 키우며, '실용적인 지혜'를 개발하여 궁극적으로 우리의 가치를 실천할 수 있다고 느끼는 데 도움이 될 수 있습니다. 서로 다른 관점이 충돌하는 예는 아래 예시에서 볼 수 있듯이 세계 여러 지역에서 나타나는 다양한 리더십 가치와 스타일에서 잘 드러납니다.
  In vertical leadership, leaders use the challenges they meet (‘heat experiences’), to analyse how they might improve or do things differently through ‘sense-making’ of the experience (through reflection and conversation) and being open to ‘colliding perspectives’ about what is going on. Purposeful reflection and conversations can help us alleviate imposter feelings and become more confident and competent at leadership, developing our ‘practical wisdom’, and ultimately feeling able to live out our values. An example of colliding perspectives is highlighted by the different leadership values and styles displayed in different regions of the world, illustrated by the example below.

코칭과 멘토링을 찾는 것은 정확하고 정직한 자기 성찰을 촉진하고 성장 마인드를 개발할 수 있는 충돌하는 관점에 열려 있는 풍부한 예입니다(Dweck 2016). 이는 수직적 리더십 개발의 또 다른 예입니다. 멘토링 관계는 멘티와 멘토 모두에게 중요합니다. HPE 리더는 대부분 멘토의 역할을 맡지만, 리더십 개발에서는 기꺼이 멘티의 역할을 맡을 수 있어야 합니다. 궁극적으로 이러한 멘토링 이니셔티브는 조직에 도움이 됩니다. Burgess 외(2018)의 검토에 따르면 멘토링 관계의 모든 이해관계자가 얻을 수 있는 이점을 고려하고 아래 표 4에 요약했습니다.
Seeking coaching and mentoring are rich examples of being open to colliding perspectives that can facilitate accurate and honest self-reflection and develop a growth mindset (Dweck 2016). This is another example of vertical leadership development. Mentoring relationships are important for both mentee and mentor. HPE leaders mostly take on the role of a mentor, however, in leadership development, they need to be willing to take on a mentee role. Ultimately, these mentoring initiatives benefit the organisation. Based on the review by Burgess et al. (2018), the benefits for all stakeholders of mentoring relationships are considered and summarised in Table 4 below.

 

 

결론
Conclusion

이 가이드에서는 리더십의 여러 이론적 측면을 살펴보고 리더, 관리자, 팔로워가 문제와 도전에 어떻게 대처할 수 있는지에 대한 예를 제공했습니다. 리더십은 다양한 수준(개인 내, 대인관계/팀, 조직 및 시스템 수준)에서 발생하며, 리더는 이러한 수준에 익숙해지고 능숙하게 대처할 수 있어야 합니다. 리더십은 학부 단계부터 공식적으로 가르쳐야 하며, 교육자의 커리어를 통해 지속적으로 재교육하여 사람들이 리더십과 팔로워십 역할을 적절히 수행하고 여러 전문가로 구성된 팀에서 일할 수 있도록 준비시켜야 합니다. 모든 리더는 다른 사람들이 변화를 일으키도록 영향력을 발휘할 수 있도록 신뢰할 수 있어야 하므로, 교육자는 시간을 들여 자신이 근무하는 맥락을 이해하여 HPE를 구성하는 다양한 교육 및 의료 시스템 내에서 그리고 그 시스템 전반에서 일할 수 있어야 합니다.
In this guide, we have explored many theoretical aspects of leadership and provided examples of how leaders, managers and followers might address issues and challenges. Leadership takes place at various levels (the intrapersonal, interpersonal/team, organisational and system levels) and leaders need to become familiar with and adept at navigating these levels. Leadership needs to be formally taught right from the undergraduate stage and refreshed throughout an educator’s career so that people are equipped to take on leadership and followership roles appropriately and work in multi-professional teams. Any leader needs to be credible to influence others towards making change, therefore educators need to take time to understand the context in which they work so that they can work within and across the various education and healthcare systems that comprise HPE.

직장에서의 평생 학습은 지속적인 리더십 개발에서 가장 큰 부분을 차지하며, 이를 통해 다양한 리더십 활동과 상황에서 효과적으로 대처할 수 있는 경험과 실용적인 지혜를 얻을 수 있습니다. 리더십은 또한 매우 개인적인 것으로, 모든 사람이 다르므로 각자의 강점을 발휘해야 합니다. 자신과 자신의 가치관을 이해하는 것은 감성 지능, 근성, 진정성을 키우고 리더로서 어디에 관심을 집중할지 결정할 수 있도록 하는 데 필수적입니다. 여기에는 때때로 난간을 넘어서거나, 첫 번째 팔로워가 되거나, 옹호를 넘어 행동주의로 나아가는 것이 포함될 수 있습니다. 어떤 분야에서 어떤 리더십을 발휘하든, 이 가이드가 여러분의 발전을 위한 몇 가지 아이디어를 제공하고 보건 전문직 교육에서의 리더십에 대해 더 자세히 알아보는 데 도움이 되기를 바랍니다.
Lifelong learning in the workplace forms the greatest part by far of ongoing leadership development; this is where you gain the experience and the practical wisdom to be effective in a wider range of leadership activities and situations. Leadership is also very personal; everyone is different and should play to their strengths. Understanding yourself and your values is essential so that you can work on and nurture your emotional intelligence, grit and authenticity and decide where you want to focus your attention as a leader. This may involve stepping above the parapet sometimes, being the first follower, or moving beyond advocacy to activism. Wherever and whatever you decide to lead on, we hope this guide has provided some ideas for your development and inspired you to learn more about leadership in health professions education.

---

 

 

Med Teach. 2023 Feb;45(2):128-138. doi: 10.1080/0142159X.2022.2057288. Epub 2022 May 11.

 

 

Adaptive leadership during challenging times: Effective strategies for health professions educators: AMEE Guide No. 148

Judy McKimm 1 2, Subha Ramani 3 4 5, Kirsty Forrest 6, Jo Bishop 6, Ardi Findyartini 7, Chloe Mills 8, Mohammed Hassanien 9 10, Abdulmonem Al-Hayani 11, Paul Jones 12, Vishna Devi Nadarajah 13, Greg Radu 14 15

Affiliations collapse

1Swansea University Medical School, Wales, UK.

2Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia.

3Harvard Medical School, Boston, USA.

4Massachusetts General Hospital Institute for Health Professions Education, Boston, USE.

5Honorary Professor of Medical Education, University of Manchester, Manchester, UK.

6Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.

7Head of Medical Education Unit and Head of Cluster, Centre for Medical Education, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.

8Department of Applied Linguistics, Swansea University, Swansea, UK.

9Department of Clinical Biochemistry & Medicasl Education, College of Pharmacy Practice, King Abdulaziz University, Jeddah, Saudi Arabia.

10College of Medicine, Tanta University, Tanta, Egypt.

11Anatomy, Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

12Faculty of Medicine & Health Sciences, Swansea University, Swansea, UK.

13Institutional Development at the International Medical University, Kuala Lumpur, Malaysia.

14Departement of Psychiatry, Memorial University, St. Clare's Hospital, St. John's, Canada.

15Department of Health and Community Services, Government of Newfoundland and Labrador, St John's, Canada.

PMID: 35543323

DOI: 10.1080/0142159X.2022.2057288

 

Abstract

Leadership and management are becoming increasingly recognised as vital for high-performing organisations and teams in health professions education. It is often difficult for those embarking on leadership activities (as well as more experienced leaders) to find their way through the volume of literature and generic information on the topic. This guide aims to provide a framework for developing educators' understanding of leadership, management, and followership in the context of health professions education. It explains many relevant approaches to leadership and suggests various strategies through which educators can develop their practice to become more effective.

Keywords: Health professions education; followership; leadership; management.