Enhancing Leadership Training Through an Experiential Approach: An Online Model for the 21st Century

Abstract

Billions of dollars are spent annually on leadership training and development courses. Unfortunately, this training, both at organizational and university levels, does not appear to consistently result in significant adult learning or better organizational performance. These programs tend to focus on the theories of leadership within closed classroom environments and sometimes present case studies to encourage application of knowledge. The content is typically dissociated from both context and leadership experiences and a “one size fits all” approach is adopted. This approach does not account for the corporate culture that is unique to every organization, even every department. In this innovation in practice article, we present a leadership practicum course tailored for adult learners that provides an experiential approach to leadership training enhanced by expert coaching. Initial results indicate that health care professionals appreciate the ability to transfer theory to practice and the feedback they receive from expert coaches. We present the practicum course and provide two cases to explicate the process; we share initial findings from the course and end with our next steps.

Keywords

leadership training experiential training professionals on-the-job training just-in-time teaching

Introduction

Lifelong learning is big business. In 2019, the global spending on workforce training reached US$370.3 billion with an average of US$1,200 invested per learner (“68 Training,” 2020). Within this training landscape, almost US$50 billion was spent on leadership development (Prokopeak, 2018). Organizations recognize the importance of leadership training and annually invest about US$4,000 in executive education per person (St. John & Loutfi, 2021). In addition to organizational training, hundreds of courses and degrees on leadership are offered by colleges and universities. Practicing professionals, adult learners, participate in leadership training programs for retraining or reskilling or in preparation to assume leadership roles. Unfortunately, this training, both at organizational and university levels, does not appear to result in better organizational performance and organizations do not see a consistent return on investment (Beer et al., 2016). Without an application of what they have learned, there is no successful transfer of learning as a result of participating in these leadership programs (Caffarella, 2002).

Several reasons have been identified to explain the inability of leadership programs to consistently effect change. The overarching problem may be the design of the leadership programs themselves. Usually, a person might participate in a week-long leadership development retreat or enroll in leadership courses at universities. They are taught the theories of leadership within closed classroom environments and presented with case studies to encourage application of knowledge. Within this model, unfortunately, the content is typically dissociated from the context and a “one size fits all” approach is adopted. This approach does not account for the corporate culture that is unique to every organization, even every department. In addition, there is often a lot of emphasis on theory that is disconnected from action, and thus participants find it difficult to apply their new knowledge and skills within their actual work environments (Beer et al., 2016). Furthermore, these leadership development programs require participants to take time off work and, in some cases, travel. Such time commitment can be prohibitive for many working adults and many find themselves unable to participate.

Recognizing the shortcomings of these traditional leadership training programs, the Center for Health Professions Education (C-HPE) at the Uniformed Services University (USU) designed a leadership practicum course, for working adults, based on Kolb’s experiential learning theory (ELT; Kolb, 2014) and enhanced by expert coaching. We begin this innovation in practice article with an overview of our program; we then describe the practicum course and provide two cases to explicate the process; we share initial findings from the course and end with our next steps.

Context

C-HPE primarily serves active-duty military health professionals (such as dentists, nurses, and physicians). As these learners can be deployed at any time and are at work locations located around the world, the C-HPE offers blended online certificate, masters, and doctorate programs. The blended programs offer flexibility for our learners who are quintessential adult returning learners ranging in ages from 23 to 64 years. They are part-time learners with full-time jobs and family commitments.

Leadership is a key competency for health care professionals as they work in interprofessional team environments and are expected to care for their patients and guide both patients and their families. Therefore, the C-HPE offers several leadership courses that are tailored to enhance health professionals’ leadership competencies (see Table 1). These courses use a scaffolded approach to leadership education providing complementary experiences (Stoller, 2013). Working from a zone of proximal development perspective (Vygotsky, 1978), learners begin with traditional leadership courses where they learn leadership theories and principles but also are asked to apply them to their specific work experiences and discuss implications with their course peers. Next, they participate in a leadership seminar course that focuses on the application of leadership principles, practices, and theory by presenting individual leadership case studies and working through them in peer groups. The final course in this progression is the leadership practicum that is the focus of this article.

Table 1.

Leadership Competencies.

L1. Reflect on practice	Engage in reflective practice that supports teamwork and continued scholarship
L2. Collaborate in teams	Build and/or lead disciplinary, interdisciplinary, and interprofessional teams
L3. Apply leadership theory	Apply leadership and management theories, principles, and strategies to instructional contexts and other educational settings in health professions education
L4. Negotiate and resolve	Employ and help others develop negotiation, conflict resolution, and other leadership and management skills within relevant health systems and other professional settings
L5. Mentor and develop	Mentor and/or support the development of educational program leaders (e.g., key faculty course directors, clerkship directors, program directors, and/or fellowship directors) with an emphasis on the challenges facing the Military Health System (MHS)

Method

Self-directed learning proposes that adult learners prefer to learn experientially (Garrison, 1997). They want their learning to be immediately applicable in their lives and they want their learning to have a problem-solving dimension. In our practicum model, the learning occurs in situations that learners are involved in within their workplaces. The learning is contextualized to their unique organization and personalized to the learner’s immediate needs.

The leadership practicum is completely learner-driven and is conceptually based on the adult learning theories of Kolb’s ELT (Kolb, 2014), self-directed learning (Garrison, 1997), and deliberate practice theory (Ericsson et al., 2007). Kolb’s (2014) ELT grounds adult learning in experience and prioritizes the process of the learning. ELT aims for transformative learning as an adult adapts to the world around them. The practicum course takes a learner from concrete experience to reflective observation, abstract conceptualization, and active experimentation (Kolb, 2014) while encouraging learners to assume control of their learning process in a self-directed learning approach (Garrison, 1997). Deliberate practice builds on these foundational theories and looks at improving existing skills under the guidance of a coach while working to extend the range of skills (Ericsson et al., 2007).

We use a structured approach to executing our practicum (see Figure 1).

Figure 1.

Practicum process.

To begin, a learner completes a leadership competency survey (see Online Appendix A). In this reflective exercise, the learner identifies leadership competencies they want to enhance in themselves with the practicum course. Next, the learner consults with the practicum course director to identify leadership activities in their workplace that would enhance the identified competencies. The learner then develops a learning agreement that identifies specific objectives they want to accomplish through the practicum activity (see Online Appendix B). Meanwhile, the practicum course director identifies a C-HPE faculty member with expertise in the specific area to serve as practicum preceptor. The practicum preceptor then coaches the learner through the activity. After the activity is completed, the learner debriefs with the practicum preceptor and critically assesses whether the practicum activity objectives were met and identifies areas for improvement. A learner can participate in multiple practicum activities and the process is repeated if the learner wants to work on additional leadership competencies.

We present two cases of the typical leadership practicum life cycle to illustrate its implementation.

Case 1

A learner, K, completed the competency survey and noted that she wanted to improve leadership competencies L2 (Collaborate in teams) and L4 (Negotiate and resolve). In her consultation with the practicum course director, she realized that an upcoming workshop series that she was organizing for her department required her to collaborate in teams and would involve negotiation skills. K used the learning agreement to identify specific objectives for herself that would align with these competencies. See Online Appendix B for sample learning agreement.

The practicum course director connected K with a C-HPE faculty who would serve as her practicum preceptor for the activity. K set up a meeting with the practicum preceptor, and in the initial meeting, she outlined her objectives. She also described the team she would be working with and the challenges she might face. With the practicum preceptor’s guidance, K drew on her knowledge of leadership theories and discussed how she could handle potential challenges.

After a month, K met with her practicum preceptor again and explained how the project was progressing. She reflected on how she had been working with her team and mentioned the difficulties she was having in working with one team member. The practicum preceptor provided suggestions and K developed a plan of action. After 2 weeks, she met with the practicum preceptor again to talk through negotiating between various participant groups as she finalized the workshop series.

A week after the workshop series had concluded, K met with her practicum preceptor again for the practicum debrief. During this meeting, the preceptor circled back to the objectives that K had identified in her learning agreement. K critically reflected on what skillsets she thought she had improved and also identified areas for development. The practicum preceptor provided feedback on the personal development that she had seen in K through the process.

Case 2

D was a medical school faculty who was experienced in academic writing and publication. He was called to collaborate with a junior faculty on a journal publication. Given his personal experience, he realized that he could mentor and develop his junior colleague. However, he was apprehensive as he had never done this before. He met with the practicum course director explaining that he needed expert advice and felt that he would benefit from a practicum activity. The practicum course director introduced D to a C-HPE faculty practicum preceptor with many years of mentoring experience in this area.

D set up regular meetings with the practicum preceptor. During their meetings, D outlined his interactions with the junior faculty, and they discussed how he could improve his mentoring skills, thereby helping his junior colleague. Once the article had been submitted for publication, D met with the practicum preceptor for the debriefing. They talked about the experience and what he had learned through the process.

Unpacking the Practicum

The practicum moves through the four stages of ELT (Kolb, 2014). A concrete experience at the workplace begins the practicum learning cycle. Through self-reflection, the learner identifies personal leadership competencies they would like to enhance. This provides a task with a well-defined goal and an intrinsic motivation to improve (Ericsson, 2008). Brookfield (2017) noted that repeated practice is insufficient if the same poor behavior is being repeated. For transformative change to take place, we need to challenge personal beliefs and patterns of behavior. The practicum preceptor helps with this.

Meetings with the practicum preceptors are loosely based on the ACHIEVE coaching model (Dembkowski & Eldridge, 2003):

Assess the current situation—The practicum preceptor poses open-ended questions and encourages the learner to provide a holistic overview of the situation.

Creatively brainstorm alternatives—The practicum preceptor works with the learner to consider the situation from other perspectives.

Hone goals—The learner works to develop specific actionable goals.

Initiate options—With the goals in mind, the learner thinks through the challenge and brainstorms ideas on how to handle the situation. This provides space for the learner to draw on leadership theories and develop ideas informed by evidence-based practice and theory. The learner is encouraged to reflect on personal assumptions and biases that might be influencing their choice of options.

Evaluate options—The practicum preceptor then leads the learner to assess the options critically and identify one or two options to implement.

Validate an action program design—The learner develops an implementation plan.

Encourage momentum—The practicum preceptor maintains open lines of communication so the learner can reach out at any time and feels supported through the process.

The model provides a frame for reflection and abstract conceptualization (Kolb, 2014) and helps preceptors have meaningful and productive conversations with the learners.

Guided by deliberate practice, preceptors provide learners with regular feedback, and as learners actively experiment (Kolb, 2014) with a new approach or strategy, they have opportunities for repetition and gradually refining their performance (Ericsson, 2008). Figure 2 provides a visualization of Kolb’s stages and the alignment of practicum activities within these stages.

Figure 2.

Alignment of practicum activities with Kolb’s four step process.

Finally, the practicum course is conducted from a distance through online technologies. This allows learners to apply skills within their workplace and removes the necessity to travel. An added benefit is that the practicum preceptor can be anywhere in the world. Without geographical limitations, we can draw from a larger pool of faculty to serve as preceptors.

Findings

Data for this practicum course have been collected via course enrollments and course evaluations. This research was approved by the USU Institutional Review Board (Protocol DBS.2020.188). Analysis of data has been conducted using MS Excel 365.

The course enrollment data were analyzed and the results are presented in Table 2. Since fall 2018, 55 learners have participated in 81 leadership activities. Leading or working in teams has been the most popular activity (42%). However, only about half (53%) of these activities have focused solely on a leadership activity. The other 47% of team-based leadership activities were leadership skills in combination with other skills such as reviewing grants, preparing conference presentations, and so on. As our learners are health professional educators, many of them are involved in designing courses or workshops or in reviewing or developing curriculum. These activities contained embedded leadership competencies and 39.5% of leadership practicum activities have involved course or workshop development, whereas 18.5% of the activities involved curriculum review or development. In total, only 22% of the activities have focused purely on leadership activities; 88% have involved activities where the leadership skills are embedded within other tasks.

Table 2.

Distribution of Leadership Practicum Activities.

Only leadership competency (such as Mentor and develop)	N = 18/81
Leading or working in teams (in combination with other competencies such as reviewing grants or presenting at conferences)	N = 34
Curriculum review or development (incorporating leadership competencies such as Collaborate in teams)	N = 15
Development of courses or workshops (incorporating leadership competencies such as Collaborate in teams)	N = 32

Learner responses to two questions in their course evaluations were analyzed: (a) What worked well in the practicum? (b) What could be improved in the practicum? These responses were provided anonymously. The results were thematically categorized as shown in Table 3. Learner feedback on the practicum course has been overwhelmingly positive. The practicum activity is learner-driven and guided by their interaction with the practicum preceptor. The practicum preceptor plays a pivotal role in the success of the practicum activity and this was recognized by the learners. They commented on the flexibility and availability of preceptors and the commitment of preceptors. They also appreciated the real-world context of the practicum and the feedback they received from the practicum preceptors.

Table 3.

Themes From Learner Feedback.

Availability and flexibility of preceptors	• Even from across the country, I found my HPE advisors to be always readily available. • Staff availability, support and flexibility has also been great! • Flexibility of the faculty in working with me • I really appreciated the flexibility. • [Instructor] was always available for any questions that I had
Commitment of preceptors	• Dedicated faculty who take on anything! • Willingness of the faculty to serve as supervisors.
Real-world experience and feedback provided by preceptors	• Allowed me to practice leadership and instruction in medical education. • Ability to apply the theoretical knowledge gained from the HPE coursework to a meaningful project. • Very much related to my everyday work, enjoyed having mentoring for some of these experiences • Opportunity to pursue something meaningful to my work and receive feedback • Practicum provided an opportunity to experience these unexpected barriers and challenges that real life poses. • The main strength is having the ability to work with HPE mentors, as part of a team on a “real world” experience • I received helpful and constructive feedback during practicum • Direct guidance and feedback from mentor

Availability and Flexibility

The practicum course is offered online, and learners are situated around the world. Working with preceptors necessitates navigating disparate time zones such as between Okinawa, Japan, and Maryland, USA, or between the east coast and west coast of the United States. As one learner noted, “Even from across the country, I found my HPE advisors to be always readily available.” Our learners are part-time learners and their availability is limited by work commitments. Being sensitive to this, they were appreciative of “[s]taff availability, support and flexibility.”

Commitment

C-HPE faculty take on practicum precepting as a part of their workload, but the need to be available and flexible puts pressure on them. As educators themselves, our learners appeared to be attuned to what was being required of faculty in their role as preceptors. Therefore, they commended the “Dedicated faculty who take on anything!” and the “willingness of the faculty to serve as supervisors.”

Real-World Experience and Feedback

The ability to work on projects in the real world and receive feedback on their performance was seen as a huge advantage of the leadership practicum. Learners appreciated the “opportunity to pursue something meaningful to [their] work and receive feedback.” As adult learners, they embraced the “ability to apply the theoretical knowledge gained from the HPE coursework to a meaningful project.” However, it was not merely the real-world context. Rather, it was the “[d]irect guidance and feedback” they received from preceptors for performance in this context that added value to the practicum. Hence, “[t]he main strength is having the ability to work with HPE mentors, as part of a team on a ‘real world’ experience.”

Discussion

Our adult learner–centered leadership practicum model has been successful so far in bridging the gap between theory and practice. We believe this is due to several reasons: (a) learning is contextualized; (b) it uses a coaching model; (c) it is personalized just-in-time, teaching; and (d) it is offered online providing flexibility for learners.

Traditional leadership programs use a “one-size-fits-all” prepackaged model that never bridges the skills transfer gap (Moldoveanu & Narayandas, 2019). Although these programs provide theoretical knowledge of leadership, they can fall short in contextualizing the learning. Caffarella (2002) theorized that transfer of learning is maximized when the learning stimulus closely aligns with the real-world environment. Our leadership practicum course has proved successful in bridging the skills transfer gap because the learning occurs within the actual work environment. One learner mentioned that the “[p]racticum provided an opportunity to experience [the] unexpected barriers and challenges that real life poses.”

The practicum preceptors in our program assume the role of coach rather than mentor. Mentoring has proved to positively impact the development of leadership skills in mentees (Tracey & Nicholl, 2007). However, mentoring has an element of program compliance focusing on program and organizational rules and procedures (Solansky, 2010). Coaching goes beyond this and our preceptors focus on empowering learner “thoughts, beliefs, goals, and actions to achieve desired, extraordinary results” (Reiss, 2007, p. 13). Preceptors are C-HPE faculty who have an established trust relationship with the learners. Furthermore, as preceptors are external to the organization, learners feel more comfortable in candidly sharing their experiences and asking for help. The preceptor can also bring a more objective lens to the situation as they are outside it.

Our leadership practicum course uses a 21st-century learning model where adult education is personalized and adaptive (Moldoveanu & Narayandas, 2019) and is not tied to geographic location. Preceptors work with learners on problems that learners themselves have identified and the content of their interactions is adapted to the specific needs of the learner. Working with learners through leadership situations that they are experiencing in their workplace makes the instruction relevant and meaningful. Most leadership challenges experienced in the workplace involve “relational, communicative, and affective skills” that traditional programs do not address (Moldoveanu & Narayandas, 2019, p. 5). Our practicum course, by its very nature, prioritizes these leadership challenges.

Cost considerations are accelerating the adoption of online learning. By offering our practicum course online, we have been able to provide flexibility and accessibility to busy health care professionals. This online offering also ensured that instructional continuity was maintained through the period of social distancing resulting from the COVID-19 pandemic. The online platform also opens the potential for bringing in experts from around the world to serve as preceptors.

There are two considerations for implementation of our practicum course that need to be acknowledged. First, a dedicated practicum course director is needed. The success of the practicum course relies on the successful match between preceptor and learners. This matching is handled by our practicum course director who oversees the administration of the course. The practicum course director tracks individual learners and their activities and provides structure to an intrinsically fluid course. As one learner stated, “Guidance from the [practicum course director] was very helpful in ensuring that the activity was appropriate and properly accounted for.”

Second, the evaluation of the course currently reaches up to Kirkpatrick’s Level 3 where we study change in learner behavior and practice (Kirkpatrick & Kirkpatrick, 2006). However, this is self-reported data and therefore not optimal. Moving forward, we aim to implement a 360° assessment incorporating feedback from learners’ supervisor/s at their workplaces. We hope that this will enable us to evaluate the program at Kirkpatrick’s Level 4 of organizational change (Kirkpatrick & Kirkpatrick, 2006).

Conclusion

Higher education continues to face financial difficulties exacerbated by decreased funding and declining enrollment numbers (Wiley Education Services, n.d.). To remain relevant in a world that is embracing personalized, socialized, and adaptive learning, institutions need to rethink their educational models. Offering courses online is becoming a necessity as universities draw in more adult learners who want flexibility in their education. Universities also need to demonstrate the value of the education they provide. The ability of graduates to seamlessly transfer learning to their workplace is a clear testament to the success of an educational program. The practicum course we have outlined provides an alternate model that has a high return on investment. It meets the needs of the learner and the organization by developing learners who are prepared to face the challenges of the organization.

Supplemental Material

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Footnotes

Disclaimer

The opinions and assertions expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Uniformed Services University, the Department of Defense, or the Henry M. Jackson Foundation for Military Medicine.

Conflict of Interest

The author(s) declared no potential conflicts of interest with respect to the authorship and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Anita Samuel

Supplemental Material

Supplemental material for this article is available online.

Author Biographies

Anita Samuel, PhD, is the Assistant Director of Distance Learning and an assistant professor with the Center for Health Professions Education at the Uniformed Services University. She earned her doctorate in Urban Education with a specialization in Administrative Leadership in Adult, Continuing, and Higher Education and her research lies at the intersection of online education and faculty development.

Steven J. Durning, MD, PhD, is a professor of medicine and pathology at the Uniformed Services University and is the Director of the Center for Health Professions Education. He received his MD degree from the University of Pittsburgh and he practices general internal medicine. He received his PhD from Maastricht University, which addressed the influence of contextual factors on clinical reasoning. As an educator, he mentors graduate students and faculty, teaches in the HPE program and also directs a second year medical school course on clinical reasoning. Dr. Durning holds appointments in the departments of medicine and pathology.

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