Leadership Foundations

Cheng-Kai Kao, MD
Associate Professor of Medicine
University of Chicago Medical Center
Instructor Introduction
Cheng-Kai Kao, MD FACP SFHM
▪ Born and Grew up in Kaohsiung, Taiwan
▪ Studied Medicine at National Taiwan University
▪ Board certified in Clinical Informatics in 2014
▪ D4Lab Fellow at University of Chicago Booth

▪ Academic Hospitalist at University of Chicago

▪ Chief Clinical Informatics Innovation Officer
▪ Medical Director, Office of International Programs
▪ Principal Investigator of Phase III Drug Trials
▪ Course Instructor at Pritzker and Graham schools

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TA Introduction
Bradley Carlson, MD MScBMI

• Recent graduate of University of Chicago

medical school
• Recent graduate of MScBMI
• Current anesthesiology resident at Northwestern

• Email: bcarlson3@uchicago.edu

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Student Introduction

• Please briefly introduce yourself regarding your background and career plan

• Share your experiences in leadership and/or innovation if applicable

• Tell us what you expect to learn from this course

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Leadership and Innovation
Course Overview
Course Outline Mindsets &
Skillsets
• Week 1: Leadership Foundations (6/12) Manager
• Week 2: Team Building (6/19: Juneteenth)
• Week 3: Leading for All (6/26)
• Week 4: Organizational Culture and Change Management (7/3: Leader
remote)
• Week 5: Healthcare Innovation
• Week 6: Design Thinking
Innovator
• Week 7: Project Management and Strategic Planning
• Week 8: Negotiation and Communication Strategy
• Week 9: Overview of Entrepreneurship
Entrepreneur
• Week 10: Final Presentation

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Grading

• 10% Attendance

• 20% Leadership Journals x2 (due week 2 and week 9)

• 20% Class Participation in Discussion & In-class Activities

• 20% Group Case Study Presentation

• 30% Group Final Project Presentation

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Weekly Class Schedule
Randomized Groups

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Reference Books

Weekly readings available in Canvas > Modules

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Week 1 Scenario

• You are a current student of the MScBMI program,

who was just hired to be a team lead in a health IT
company to lead a small team of analysts.

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Leadership Foundations
Class Discussion

What, in your opinion, is the difference between a leader

and a manager?

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Leadership versus Management

Source: John Kotter’s A Force for Change: How Leadership Differs from Management, (1990). | 14
Leader versus Manager

https://www.youtube.com/watch?v=nSUJwmPQEyg | 15
Does Leadership in the Healthcare Informatics
Space Differ From Other Fields?
• Multiple stakeholders with complex relationships

• Worker stress and burnout

• Strict regulatory environment

• Big data

• New care / payment models

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Clinical Informatics Subspecialty Board
▪ Approved by American Board of Medical Specialties (ABMS) in 2011
▪ Clinical Informatics (CI) is a subspecialty to all ABMS member boards
▪ First CI board exam started in 2013
▪ Completion of a two-year ACGME-accredited informatics fellowship
will be required to sit for the board starting in 2025.
▪ The University of Chicago was approved by ACGME for a new
clinical informatics fellowship program which launched in 2018.
▪ Outline of the board exam:
• Fundamental Knowledge and Skills (20%)
• Improving Care Delivery and Outcomes (30%)
• Enterprise Information Systems (15%)
• Data Governance and Data Analytics (15%)
• Leadership and Professionalism (20%)

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Clinical Informatics Board Exam Content

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Source: https://www.theabpm.org/become-certified/exam-content/clinical-informatics-content-outline/
Leadership Theories
Leadership Studies Over the Years

Source: Evolution of leadership theory. BMJ Leader. | 20

Leadership Studies Over the Years
Trait Era: Leadership is about having the right “stuff”

Behavioral / Skills Era: Leadership skills can be learned and applied

universally (not specific to any situation or environment)

Situational / Style Era: Leadership depends on the situation you’re in;

leaders need to adapt their leading style to meet the environment

New Leadership Era: Leadership is complex, dynamic and

challenging - focusing on only one dimension doesn’t capture it all

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Are Leaders Born or Made?
• King Arthur and the pulling-sword-from-stone selection process

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Great Man Theory (1840s)
• The great man theory is a 19th-century idea according to which history can be
largely explained by the impact of great men, or heroes; highly influential and
unique individuals who, due to their natural attributes, such as superior
intellect, heroic courage, extraordinary leadership abilities or divine inspiration,
have a decisive historical effect.
• The theory is primarily attributed to the Scottish philosopher and essayist
Thomas Carlyle who gave a series of lectures on heroism in 1840, later
published as On Heroes, Hero-Worship, and The Heroic in History. He is
popularly quoted as saying, “The history of the world is but the biography of
great men.”

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Early Trait Theory (1920s)
• After industrial revolution, it was clear that leaders weren’t just heroes and
rulers. At the turn of the twentieth century, we were starting to understand the
nuances of management and what it meant to be more strategic in leading.

• In the July 1928 issue of The Journal of Abnormal and Social Psychology,
researcher W.H. Cowley wrote, ‘The approach to the study of leadership
usually has been and perhaps always must be through the study of traits.
Leadership obviously is not a simple trait but rather a complex of main traits
fashioned together as a unity. An adequate appraisal of leadership would
reduce this complex to its individual units, and any study of leadership to be of
value should produce a list of traits which go together to make the leader.
(Cowley 1928)’

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Trait Theory
• Trait theory has sought to identify the consistent qualities and characteristics of
people in leadership roles.

• Early theories were criticized for being circumstantial. In 1948, after years of
experiments and studies, researcher Ralph Stogdill determined that leadership
exists between persons in a social situation, and that persons who are leaders
in one situation may not necessarily be leaders in other situations (Stogdill,
1948).

• The theory recently received new life as a means of explaining the success of
certain successful individuals, specifically to account for the vision, charisma,
etc.

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Studies of Leadership Traits & Characteristics

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Skills Theory
• While Trait Theory - focuses on innate and largely fixed qualities,

Skills Theory
• focuses on qualities that can be learned and developed.
• based on a capability model because it examines the relationship between a
leader’s knowledge and skills (i.e., capabilities) and the leader’s performance.
• implies that many people have the potential for leadership. If people are
capable of learning from their experiences, they can acquire leadership skills.
• similar to trait theory, skills theory have never arrived at a definitive list, but has
changed as new successful leadership styles have emerged and been
popularized.

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Skills Theory - Three Skills Approach
• Technical skill: knowledge about and proficiency in a specific type of work or
activity. It includes competencies in a specialized area, analytical ability, and
the ability to use appropriate tools and techniques.
• Human skill: knowledge about and ability to work with people. It is quite
different from technical skill, which has to do with working with things. It entails
being aware of one’s own perspective on issues and, at the same time, being
aware of the perspective of others. Leaders with human skills adapt their own
ideas to those of others.
• Conceptual skills: involve the ability to work with ideas. A leader with
conceptual skills is comfortable talking about the ideas that shape an
organization and the intricacies involved, as well as works easily with
abstractions and hypothetical notions.. He or she is good at putting the
company’s goals into words and can understand and express the economic
principles that affect the company.

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Behavioral Theory (1950s)
• As a reaction to the trait theories, The Behavioral Theory looks not at the traits
or abilities of leaders, but their behavior. Two behavior categories were
created:
– Task behavior: facilitates goals and accomplishment of leaders and
followers

– Relationship behavior: helps followers feel more comfortable around the

leader and about the organization.

• From this, management training in different leadership styles became popular,

including Blake and Mouton’s Managerial Grid.

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Blake and Mouton’s Managerial Grid
• This grid is based on two different behavioral dimensions to consider when
accomplishing a task:

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Contingency Theory / Situational Leadership

• The Situational Leadership Model, developed by Paul Hersey and Ken

Blanchard, states that different tasks and different people require different kinds
of leadership. They list four degrees of Performance Readiness (or Maturity):
1. M1—(lowest maturity) lack skills to perform the job at hand
2. M2—willing to work at the task, novice and enthusiastic
3. M3—experienced, but lack confidence to take responsibility
4. M4—mature, willing to do the task and take responsibility for it.
• These maturity levels roughly correlate with four levels of Supervision
1. S1—Directing; the manager tells the subordinate exactly how to do the task
2. S2—Coaching; the manager is providing direction but is working with the
subordinate on the task
3. S3—Supporting; the manager and subordinate employ shared decision making
4. S4—Delegating; the manager is still involved in monitoring the process, but the
subordinate makes most of the decisions.

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Transactional Leadership Theory
• Transactional leaders set clear
expectations for subordinates for their
duties and rewards. They use rewards
and punishments for motivation.

• For example, the leader offers a

promotion to the employees in
exchange for effort and performance.

• Maslows Hierarchy of Needs:

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Other Theories
• Transformational Leadership Theory

• Leader-Member Exchange Theory

• Participative Leadership Theory

• Servant Leadership Theory

• Many others

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Class Discussion

Of the mentioned leadership theories, which one do you like the

most and why?

• Great man theory

• Trait theory
• Skills theory
• Behavioral Theory / Blake and Mouton’s Managerial Grid
• Contingency Theory / Situational Leadership
• Transactional Leadership Theory
Let’s Take a 20-min Break

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Leadership Feedback

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Self Leadership and Emotional
Competencies
Class Discussion

If leadership is about leading people (others), why does it

matter that we know ourselves?

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What Makes A Leader?
• IQ and technical skills as “threshold capacities”. Effective leaders are differentiated
by a high degree of Emotional Intelligence (EI or EQ)- the ability to understand,
use, and manage your emotions in positive ways to relieve stress, communicate
effectively, empathize with others, overcome challenges and defuse conflict.

• EI skills can be developed and strengthened through practice, including the

practice of personal reflection (how you see yourself) and receiving feedback from
others (how others see you).

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Framework of Emotional Competencies

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Self-Awareness Cluster
Understanding Feelings and Accurate Self-Assessment

• Emotional Self-Awareness = recognizing one’s own feelings and how they

affect one’s performance.

• Accurate Self-Awareness = the key to realizing one’s own strengths and

weaknesses.

• Self-Confidence = a stronger predictor of high performance than the level of

skill or previous training.

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Self-Management Cluster
Managing Internal States, Impulses, and Resources
• Emotional Self-Control: manifests largely as the absence of distress and
disruptive feelings. e.g. being unfazed in stressful situations or dealing with a
hostile person in a collected manner.
• Trustworthiness: letting others know your values and principles, intentions
and feelings, and acting in ways that are consistent with them.
• Conscientiousness: comporting oneself in a careful, self-disciplined and
scrupulous manner in attending to responsibilities.
• Adaptability: superior performers in management ranks are open to new
information and can let go of old assumptions. They show emotional resilience
when faced with uncertain conditions.
• Initiative: taking anticipatory action to avoid problems before they happen or to
take advantage of opportunities before they are visible to others.

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Social Awareness
Reading People and Groups Accurately
• Empathy: an astute awareness of others’ emotions, concerns, and needs. The
empathetic individual can read emotional currents, picking up on nonverbal
cues. Empathy requires self-awareness; our understanding of others’ feelings
flows from awareness of our own feelings.
• Service Orientation: the ability to identify a client’s unstated needs or
concerns and match them to products or services. The long-term relations are
emphasized or short-term gains. Applies to team members and co-workers as
well.
• Organizational Awareness: the ability to read the currents of emotions and
political realities in groups. This competency is vital in behind-the- scenes
networking and coalition building.

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Relationship Management
Inducing Desirable Responses in Others
• Developing others: sensing people’s development needs and bolstering their
abilities. Mentorship, coaching.
• Influence: handling emotions in others effectively and persuasively. Sense
reactions in others and fine-tune a response to move interaction in the best
direction.
• Communication: deal with difficult situations straightforwardly, listen well and
welcome sharing information fully, foster open communication and stay
receptive to bad news.
• Conflict management: spot trouble as it is brewing and take steps to calm
those involved. Listening and empathy are crucial accompanying skills.
• Visionary Leadership: draws on a range of competencies to inspire others to
work towards common goals. Articulate and generate enthusiasm for shared
vision and mission.

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Emotional Competencies

What stands out for you? Any examples?

Do you see any competencies as more important or necessary today? Or in healthcare?

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Authentic Leadership
• Authentic leadership is a theory that discusses about the idea that leaders are
seen as genuine and real. This theory was created by Bill George in his book
'Authentic Leadership' published in 2003.

• Authentic Leadership model focuses on 5 distinct qualities that authentic

leaders have or may develop:
1. Sense of purpose
2. Distinct values
3. Relationship building
4. Goals and self-discipline
5. Genuine heart

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Randomized Groups

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 Breakout Discussion and Reporting Out

Share some of the following with your group members:

1. What kind of leader do you want to be?
2. Which people and experiences in life had the greatest impact on you?
3. How do you know yourself?

Discuss the following and select one member to report out to the class:
1. What steps can we take to become a better leader?
2. What pros and cons do you see to be an authentic leader?

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SWOT Analysis
SWOT Analysis

 Structured planning method used to

evaluate the Strengths, Weaknesses,
Opportunities, and Threats involved in
a project or in a business venture.

 A SWOT analysis can be carried out

for a product, place, industry or
person. It involves specifying the
objective of the business venture or
project and identifying the internal
and external factors that are
favorable and unfavorable to
achieving that objective.

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Group Exercise (15 mins)

 Please create a SWOT

analysis for Starbucks
(15 mins)

 Report out to the class

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SWOT for Starbucks
Strengths Weaknesses
• Strong brand recognition • Generalized standards for most products; not
• Clients love the atmosphere customized to local tastes
• Present all over the world • High employee turnover
• Extensive and superb global supply chain • Higher price points; not easily affordable in all
management countries
• Diversified business through subsidiaries • Imitable products
• Good mobile app and mobile payment services • People who stay in store but do not buy coffee

Opportunities
• Expansion in Asia, the Middle East, and Africa
• Diversification of product mix
• Partnerships or alliances with other firms
Threats
• Saturation of the US market
• Healthier lifestyle trends
• Competition from low-cost coffee sellers
• Imitation
• Independent coffeehouse movements
• Negative media exposure
• Prevalence of home appliances

Source: http://panmore.com/starbucks-coffee-swot-analysis
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Personal SWOT Analysis
 Ask yourself these questions to determine your internal and external
factors such as:

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Personal SWOT Analysis Example

Source: Cornerstone
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Week 2 Required Reading

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Questions and Comments

Cheng-Kai Kao, MD

Email: ckkao@bsd.uchicago.edu
Linkedin: www.linkedin.com/in/ckkao