Chapter 16. Leadership Theory and Application

Dr. Scott is professor and director of Continuing Education in the Department of Pharmaceutical Systems and Policy at West Virginia University School of Pharmacy. She received a B.S. in pharmacy from the University of Kentucky, an M.S. in pharmacy administration from Purdue University, and a Ph.D. in social and administrative pharmacy from the University of Minnesota. Her teaching interests include patient health education, outcomes and quality improvement, pharmacoeconomics, and patient-reported outcomes. Her research interests include health services and health outcomes research, specifically patient-reported outcomes and cost-effectiveness of patient care services and drug therapy; educational research on continuing professional development; and examining the relationship between educational programming and the implementation of pharmacy services. She has been involved actively in pharmacy professional organizations, has served in numerous leadership positions on the state and national levels since 1977, and was selected as an academic leadership fellow for the American Association of Colleges of Pharmacy in 2004.

After completing this chapter, readers will be able to

1. Define leadership and identify qualities needed to be an effective leader.

2. Discuss the integration of organizational culture into leadership models and theories.

3. Explain how leadership theories and models can be used as a guide to promote change within an organization.

4. Identify ways to develop leadership skills in others, such as delegation and the use of leadership evaluative tools.

5. Discuss how to leverage personal strengths to advance an organization.

6. Describe leadership roles within the profession and community for students and pharmacists.

Jennifer Leader is a fourth-year pharmacy student who is involved in several student pharmacy organizations at her college of pharmacy. Recently, she was recognized by her peers and inducted into Phi Lambda Sigma, a pharmacy organization that fosters and recognizes student pharmacist leaders. Jennifer's long-term goal is to become a director of pharmacy or a regional manager or to own her own store. Other goals are to be actively involved in local, state, and national pharmacy organizations and to have a leadership position in one of the pharmacy organizations on both the state and national levels. Based on her leadership class in pharmacy school, Jennifer feels that she has a broad understanding of the concepts of leadership and leadership theories. During her rotations to date, she has encountered several leaders who do not exhibit the leadership styles and skills that she was taught in pharmacy school. Thus, she is thinking that she may need additional leadership development to further self-awareness of her strengths and leadership skills as well as to gain a better understanding on how to interpret the leadership style of others.

1. How is leadership defined? What sorts of things distinguish leading from other seemingly interchangeable terms like supervising or managing?

2. How can leadership theories and models be applied to promote change within an organization?

3. If a person wants to become a leader within the organization or profession, how could they assess or enhance their leadership ability and skills?

4. How are one's personal strengths leveraged to advance the organization and profession?

5. What qualities are needed for effective leadership?

6. How are employees developed to be future leaders of the organization?

7. What leadership styles are important in pharmacy?

8. What types of leadership roles should pharmacists and/or pharmacy students assume?

The hallmarks of effective leadership are important from both a personal and an organizational perspective, and the concepts of leadership have intrigued individuals for centuries. A wealth of literature exists related to the meaning of leadership, qualities of an effective leader, leadership styles, leadership theories, the development of a leader, and other dimensions of leadership.

This chapter builds on the leadership theories related to organizational behavior discussed in Chapter 11. Specifically, this chapter will promote a greater understanding of the definitions and concepts of leadership; qualities of an effective leader; leadership theories and styles; how leadership theories and styles incorporate the organizational culture; how leadership theories are used to make changes within the organization; how to use one's personal strengths to enhance leadership abilities, developing leadership in others, including the pros and cons of delegation; evaluative tools to identify personal leadership style; and leadership roles within the profession and community for students and pharmacists.

Leadership has been described in many ways by many persons, but there exists no universally accepted definition. Carson Dye (2000) confirmed this when he stated, “After all these years … no one is able to articulate a comprehensive, absolute definition of leadership.” Common to many leadership definitions are the following dimensions: Leadership is a learned skill (Dye, 2000; Giuliani, 2002; Maxwell, 2003), adapting principles to circumstances (Axelrod, 1999), a process that focuses on making organizational changes (Kotter, 1990), not controlling people (Autry, 2001), a blend of characteristics and talents that individuals can use to develop into a leader (Lombardi, 2001), and attracting the voluntary commitment of followers to reach for common goals (Kreiter and Kinicki, 1997; Nanus, 1992; Tichy, 1997).

Even though there are many leadership definitions, Komvies et al. (1998) noted several basic assumptions about leadership that are incorporated into the preceding definitions. These assumptions are that leadership is a learned behavior, is teachable, occurs at all levels of the organization, does not require a charismatic personality, is a relational process, is culturally influenced, requires followership, involves purposeful change that satisfies collective needs and aspirations, includes the components of effectiveness and ethics, and develops over life.

Leadership is an important concept that transcends all health care professions. The acceptance of this role by all health care professionals is vital to the invention of new technologies and dosage forms, changes in the delivery of health care, enhancement of patient outcomes and quality of life, and success of their specific health care organization. The opportunities for pharmacists to be leaders in their practice setting, the pharmacy profession, and the community are plentiful. Leadership is a critical component for positive change within pharmacy organizations and the profession.

Leadership theories help us to understand the leadership style of your immediate supervisor and other administrators. Understanding leadership theory and leadership styles enables us to identify the personal values and vision that guide the organization's management team. It also provides insight into employers' expectations of their employees.

The leadership theories discussed in Chapter 11 were trait, behavioral (i.e., autocratic, democratic, and laissez fare), situational or contingency based, transactional, and transformational. The majority of these theories are transactional in nature; however, transformational leadership is used more often to implement innovation and change within the profession and achievement of organizational goals (Bass, 1985). Building on Chapter 11, leadership theories and phases that incorporate an organization's culture into leadership models and theories are emerging in the health care industry and other organizations to address the implementation of change in a dynamic and competitive environment. Some leadership theories focus on the individual, such as servant and strengths-based leadership, and the value of these related to the organization's leadership team. On the contrary, the four-frame model for reframing organizations emphasizes the importance of using the abilities and skills of all members of the leadership team to overcome deficits in an individual's abilities and skills to accomplish the organization's vision and mission.

Organizational Culture

Leadership models and theories that incorporate organizational culture are becoming increasingly important (Ledlow and Coppala, 2011). To understand this phenomenon, it is important to understand the definition of culture. Schein's (1992) definition of culture is more formal. He states that culture is “a pattern of shared basic assumptions that a group learned as it solved its problems of external adaptation and integration, that has worked well enough to be considered valid and therefore be taught to new members as the correct way to perceive, think, and feel in relation to those problems.” Less formal definitions of culture are “a set of important understandings (often unstated) that members of a community share in common” (Sathe, 1985) or “as the way we do things around here” (Deal and Kennedy, 1982).

Bolman and Deal (2003) noted that there are still controversies as to the relationship between culture and leadership. Some areas of disagreement include “Do leaders shape culture or are they shaped by it?” “Do organizations with strong cultures outperform those relying on policies and rules?” and “Does success breed a cohesive culture or does culture breed success?” (Bolman and Deal, 2003). Where Ledlow and Coppola (2011) emphasize the importance of incorporating organizational culture into leadership theories and models. They noted that these models “require leaders to determine, develop, and maintain an organizational culture that best meet the expectations—if not thrive—in the external environment.” After all, culture of an organization also includes its language/communication, citizenship behaviors, power structure, the way things get accomplished, mores, esprit de corps, and many other components. Nonetheless, there are strong links between leadership and culture. Even though several leadership phases or models are emerging that incorporate organizational culture and leadership, only two of these will be discussed in this chapter. These are the culture creation contingency leadership (CCCL) phase and the dynamic culture leadership (DCL) model.

Culture Creation Contingency Leadership

CCCL is defined by Ledlow and Coppala (2011) as a phase “which combines situational or contingency leadership with organizational culture creation, refinement and enhancement.” In this phase, leaders of the organization predefine the organization's culture based on the needs of the external environment for the purpose of achieving success within the organization. In contrast to situational leadership described in Chapter 11, leaders are more proactive than reactive, since they predetermine the organizational culture.

Dynamic Culture Leadership Model

The DCL model (Ledlow and Coppala, 2011) incorporates the organizational culture's development process with transformational and transactional leadership theories discussed in Chapter 11. The DCL model is robust in the fact that the leadership team and management team are aligned to ensure that the knowledge, skills, and abilities of all individuals are utilized while maintaining an appropriate organizational culture (Ledlow and Coppala, 2011). The DCL model processes consist of six constructs: communication improvement; strategic planning; decision-making alignment; employee enhancement; knowledge management and organizational learning; and evaluating, reflecting, and retooling. The theory behind the model is that with process repetition and consistency, the organizational culture will align with the leadership's vision and respond to dynamic changes in the environment. An example of this is the strategic plan of ABC pharmacy to include the addition of disease management programs. After conducting a needs assessment to determine the disease state(s) on which to focus, the pharmacy owner/manager identifies diabetes as being the most prevalent in the pharmacy's patient population. Prior to implementation of the program, all pharmacists are sent to a diabetes certificate program. After the program is implemented and established, the pharmacy implements other patient care programs such as smoking cessation or asthma so that their pharmacy will remain competitive in the marketplace.

A model used to respond to change by many organizations is Kotter's (1996) eight-step process for leading change. This process is based on the premises that change does not occur within the organizations due to barriers or errors created by the leadership. These barriers are allowing too much complacency, failing to create a sufficiently powerful guiding coalition, underestimating the power of vision, undercommunicating the vision by a factor of 10 (or 100 or even 1,000), permitting obstacles to block the new vision, failing to create short-term wins, declaring victory too soon, and neglecting to anchor changes firmly in the corporate culture (Kotter, 1996). Any or all of these errors can have a negative effect on the success of the organization in a dynamic and competitive environment. Heller (1999) emphasizes the importance on addressing changes within the organization in a systematic way. Kotter's eight-step processes are listed in Table 16-1 and offer a systematic way to implementing change in the organization and addresses how to avoid the errors noted earlier. Prior to implementing a change, administrators must know how the change is going to affect them, their team, and organization and be able to relate the change to the vision and mission of the organization. Osborne (2008) echoes the importance of making this connection so that individuals understand their role and conflict is avoided (Bolman and Deal, 2003). When staff understand their role, they are also more likely to commit to the change (Osborne, 2008). Based on the above example, the addition of a diabetes management program is a big change for the employees in ABC pharmacy. To gain acceptance for the change, the administrator must communicate to all employees the importance of the diabetes management program to the organization and the patients it serves, the employees' role in the implementation and success of the program, and how the program relates to the vision and mission of the organization.

Servant Leadership

Servant leadership is a term coined by Robert Greenleaf in 1970, and it has been studied and expanded on by other authors, such as Covey et al. (1998), Autry (2001), and Martin (2002). It is based on the philosophy that an individual's first desire is to serve. Later, the individual makes a conscious decision to lead (Greenleaf, 2002). Authors have identified many characteristics that are important in the development of servant leaders. Larry Spear, chief executive officer (CEO) of the Greenleaf Center, identified ten principles of servant leadership (10 Principles of Servant Leadership, 2010) based on Greenleaf's original writings. These characteristics are listening, empathy, healing, persuasion, awareness, conceptualization, foresight, stewardship, commitment to the growth of people, and building community (Spears, 2003). Autry (2001) noted that servant leaders have a deeper connection to their work, and the connection transcends power and money. In his writings, he discusses several other characteristics of a servant leader. These are to be authentic (i.e., the same person in every circumstance), vulnerable (i.e., to realize that you are not in total control but depend on others), accepting (i.e., to focus on ideas presented, not on the person), present (i.e., available, centered, and grounded), and useful (i.e., caring, useful, and creating a meaningful workplace). An example of a pharmacist exhibiting servant leadership is one who establishes a health care program including medication management to the homeless or underserved population. The program was established from their passion and desire to serve this population of people. By establishing the program, the individual emerged as a leader in this area, since communities relied on this individual to establish similar programs within the state.

Strengths-Based Leadership

Strengths-based leadership is based on the theory of positive psychology. The theory implies that individuals are more effective leaders when they become aware of and understand their unique talents and capitalize on these strengths (Hendricks, 2001). Talents, knowledge, and skills of the individual are the basis for strength-based leadership. Talents are naturally unique to each individual and can be maximized by knowledge and skill development (Buckingham, 2005; Buckingham and Clinton, 2001; Coffman and Gonzalez-Molins, 2002). Research in this area has been conducted by Gallup University (2011) using interviews of great leaders and a Web-based assessment tool to determine the importance of using strength-based leadership in the workplace. An evaluative tool (StrengthsFinder Profile, 2011) to assess an individual's strength and the importance of identifying their strengths is discussed later in the chapter (see Section “Leadership Evaluative Tools”).

Bolman and Deal (2003) present another concept of leadership style that incorporates the use of frames to maximize the success of the organization. Frames are defined as “windows on the world of leadership and management. A good frame makes it easier to know what you are up against and what you can do about it.” These authors further noted that “frames [are] like maps; frames are both windows on a territory and tools for navigation. Every tool has distinctive strengths and limitations. The right tool makes the job easier, but the wrong one just gets in the way” (Bolman and Deal, 2003). These frames are an essential part of the leadership process and are labeled structural, human resources, political, and symbolic. Most leaders will not exhibit strengths in all four frames. The key is for the leader of an organization to surround himself or herself with individuals who have strengths in the other frames to maximize the success of their organization.

Structural leaders do homework; rethink the relationship of structure, strategy, and environment; and focus on implementation. On the contrary, human resources leaders believe in people and communicate their beliefs. They are visible, accessible, empower others, and refer to employees as partners or associates. Political leaders clarify what they want and what they can get. They persuade first, negotiate second, and coerce only if necessary. Symbolic leaders lead by example, offer plausible interpretations of experience, communicate a vision, tell stories, and respect and use history. Reframing leadership is a leadership style that will be valuable in assisting future leaders to create new opportunities within their environments. For example, the CEO of ABC Pharmacy may have strengths related to the human resources frame (e.g., communication, relator, and connectedness) but is weak in skills related to the political frame such as negotiation and competitiveness. As the CEO, he or she would want another pharmacist on their administrative staff who has these skills. The CEO should then assign all tasks involving negotiations to this individual. By supplementing the administrative staff with individuals who supplement your own strengths, the organization is more likely to be successful.

Recent authors (Ahoy, 2007; Buckingham, 2005, Maxwell, 1995) have identified five hallmark characteristics of effective leaders. These are modeling, mentoring, motivating, monitoring, and multiplying successes (i.e., reproducing future leaders). Leaders must be role models within the organization because employees will model the role they exhibit. They are also mentors by teaching other employees on the workings of the organizations and guiding their employee development. Administrators with good leadership abilities motivate employees to be responsible for their performance within the organization. Responsible employees assist leaders in helping the organization grow and succeed. The administrator must monitor the operations of the organization on a daily basis to ensure that the organization remains efficient and effective. Multiplying success refers to the fact when individuals are given greater responsibility for and control of their own work; they are more likely to work toward improving the organization. Ahoy (2007) noted that other characteristics, such as empowering, guiding, and coaching others while delegating responsibility, are also important characteristics of leadership. The W. K. Kellogg Foundation Report (2000) indicated that collaboration between administrators and employees, shared purpose, respect, and an enhanced learning environment are also important to the success of organizations.

Additional qualities frequently mentioned include vision (Ahoy, 2007; Bolman and Deal, 2003), integrity (Maxwell, 1995), communicating a vision effectively (Clifford and Cavanaugh, 1985; Kouzes and Posner, 1987), commitment (Bolman and Deal, 2003; Clifford and Cavanaugh, 1985; Collins, 2001; W. K. Kellogg Foundation Report, 2000), positive attitude (Maxwell, 1995), confidence (Maxwell, 1995), character (Maxwell, 1995), passion (Bolman and Deal, 2003; Clifford and Cavanaugh, 1985; Collins, 2001), (Bolman and Deal, 2003; Kotter, 1990; Kouzes and Posner, 1987; Nanus, 1992), honesty (Bolman and Deal, 2003), relationship building (Coleman, 2002; Kotter, 1990; Kouzes and Posner, 1987; Nanus, 1992), charisma (Denny, 2002), team spirit (Barnes et al., 2002), creativity (Dave, 2002), being ethical (Keim, 2002), courage (Haverson, 2002), networking (Malinchak, 2002), self-knowledge (W. K. Kellogg Foundation Report, 2000), authenticity/integrity (W. K. Kellogg Foundation Report, 2000), empathy/understanding of others (W. K. Kellogg Foundation Report, 2000), and competence (W. K. Kellogg Foundation Report, 2000).

After decades of research and thousands of interviews with great leaders, Gallup University research discovered seven challenges, referred to as the “seven demands of leadership” that leaders must meet to maximize their leadership impact on an organizations and critical to their leadership success (Conchie, 2004). These challenges are visioning, mentoring, knowing self, making sense of experience, maximizing values, building a constituency, and challenging experience.

A prevailing myth about leadership is that it is innate or, in other words, something with which you are born. In the definitions of leadership above, many great leaders stated that leadership is a learned behavior (Dye, 2000; Giuliani, 2002; Maxwell, 2003). Maxwell (2003) classified four levels of leadership based on the concept that leadership is a learned behavior. These are the leading leader, the learned leader, the latent leader, and the limited leader. Each category is based on the individual's level of leadership and desire to become a leader. The classifications vary along a continuum from being born with leadership qualities (the leading leader) to the leader who has had little or no exposure to leadership (the limited leader). Other characteristics used to classify an individual into a specific category depend on whether the individual has seen leadership modeled, has had leadership training, and has the desire to be a leader. In all four classifications, the only characteristic not acquired is “born with leadership qualities.” Thus, any individual with the desire to be a leader can develop his or her leadership skills. Mason and Wetherbee (2004) noted two assumptions of leadership development. The first emphasizes the preceding point that leaders can be developed through education and training. The second is that management differs from leadership and that managers can be transformed into leaders.

Dye (2000) identified four stages in the growth of leadership. Individuals in Stage 1 do not think that leadership is their job, and they resist leadership development (unconscious incompetence). Stage 2 refers to individuals being consciously incompetent or who have the desire to grow and improve but may not realize it until they lose their job. Stage 3 is conscious competence, where individuals are competent but are not seen as strong leaders. They need the opportunity to practice skills and continue learning. Stage 4 refers to unconscious competence and is the ultimate stage of leadership. In this stage, an individual's leadership skills are smooth and happen without hesitation.

A different concept to enhancing leadership effectiveness was presented by Jim Collins (2001) in his book, Good to Great. He encouraged the development of a “stop doing” list by business leaders. Collins's rationale for this concept is that leaders lead busy lives with many “to do” lists. By developing a “stop doing” list, leaders can channel their resources into a few focused areas.

Maxwell (2003) developed a workbook to correspond to the material presented in his book, The 21 Irrefutable Laws of Leadership, to aid in the development of leaders. The workbook provides multiple instruments that individuals can employ for the purpose of identifying strengths related to leadership skills, such as vision, relationship building, coaching, and connectivity. This is a good place to begin to identify your strengths as a leader. The results can be used in the development of a more elaborate leadership development plan. Reliable and valid instruments have been developed to identify an individual's personality style and skills related to the resolutions of conflicts, critical thinking, motivation, and personal strengths.

Strengths-based development at the individual level is a more recent model for leadership development. There are three steps in the development process. First, an individual's talents are identified, and the person is made aware of these talents. Second, the individual begins to integrate these into his or her daily routines, shares with other members of the organization, and identifies ways to maximize his or her strengths. Last, a behavior change occurs as the individual is able to tie his or her successes to his or her themes of talent (Clifton and Harter, 2003). Being cognizant of your own strengths and leadership skills enhances your ability to develop leadership in others.

Developing Leadership in Others

Stanley (2003) stated, “Sometimes it really is easier and less time-consuming to do things yourself than to train someone else.” But leadership is not always about getting things done “right.” Leadership is about getting things done through other people. In Covey's (1989) The 7 Habits of Highly Effective People, he notes that transferring responsibility or delegation results in growth for both the individual and the organization.

Delegating responsibilities and tasks to other individual(s) or team(s) within the organization not only develops staff (Heller, 1999) but also increases time for meeting your own responsibilities (Heller, 1999), allowing for better time management (Heller, 1999; Yaverbaum and Sherman, 2008). Delegation also empowers the staff to take responsibility for obtaining the organization's goals (Yaverbaum and Sherman, 2008). This contribution by the individual to the organization gives him or her a greater sense of self-worth, confidence in their leadership ability, and commitment to the success of the overall organization.

Even though a leader delegates responsibilities and tasks to other individuals or teams, many administrators still tend to micromanage (Heller, 1999; Yaverbaum and Sherman, 2008) by retaining overall responsibility for the task or project. Administrators must find a balance between micromanaging a project and task and outlining their expectations and outcomes (Yaverbaum and Sherman, 2008). This is important for leaders to remember; otherwise, they increase the risk of stifling the creativity (DeCoske et al., 2011) of individuals within the organization.

As an administrator, you also have the responsibility to develop future leaders to ensure the continual success of your organization. Conger (1992) and Conger and Benjamin (1999) identified four types of leadership development used in corporations. These are skills building training (e.g., practice exercises for skills, simulations, lectures, and video case studies), intensive feedback programs (e.g., observational exercises, survey and verbal feedback, and fellow colleagues), conceptual approaches (e.g., written and video case studies, lectures on conceptual models, and discussion groups), and personal growth approaches (e.g., teamwork, risk taking, and personal values exploration). Other types of leadership development used are mentoring, coaching, and profile evaluative instruments.

Numerous leadership evaluative tools help individuals increase self-awareness, recognize interpersonal communication skills, and identify thinking skills. Some of the most commonly used evaluative tools are the Myers–Briggs Type Indicator (MBTI) (Myers and Briggs, 1988), the Strength Deployment Inventory (SDI) (Scudder, 1996), the Watson–Glaser Critical Thinking Appraisal (WGCTA) (Watson and Glaser, 2000), the Thomas Kilmann Conflict Mode Instrument (TKI) (Kilmann and Kilmann, 1972), StrengthsFinder Profile (Buckingham and Clifton, 2001), 360-Degree Feedback (2011), and Q12.

Myers–Briggs Type Indicator

The Myers–Briggs Type Indicator (MBTI) personality inventory was developed in the 1940s by Isabel Myers and Katherine Briggs. The instrument was based on Carl Jung's theory of psychological types introduced in 1920. Jung's theory indicates that random behavior variation is due to differences in the way individuals prefer to use their perception and judgment. The instrument identifies an individual's preference for the four dichotomies specified in Jung's theory. These are favorite world (i.e., extroversion or introversion), information (i.e., sensing or intuition), decisions (i.e., thinking or feeling), and structure (i.e., judging or perceiving). Your answers to questions comprising the inventory are used to place you into 1 of 16 personality types. It is assumed that none of the personality types is “better” or “superior” to others. As such, the purpose of the feedback is to help you to understand and appreciate differences between people (Myers and Briggs, 1988).

Currently, there are two MBTI forms, MBTI Step I and MBTI Step II. MBTI Step I (Form M) consists of 93 questions and is based on preferences, whereas MBTI Step II (Form Q) consists of 144 questions. Feedback from this form provides a broader picture related to communication, decision making, and ability to deal with change and conflict. The MBTI, after more than 70 years, continues to be the most popular personality measure for understanding individual differences and helping a person to uncover different methods to use when interacting with other people (Myers and Briggs, 1988). Identification of your personality style is important in interacting with other members of your organization. Feedback from this tool provides tips on interacting with individuals who exhibit a different personality style. By knowing how to interact with individuals with different personality styles, the organization can grow, and conflicts can be avoided.

The Strength Deployment Inventory

The Strength Deployment Inventory (SDI) is based on relationship awareness theory. This theory implies that individual relationships can be improved and/or transformed by a better understanding not only of themselves but also of others through the creation of shared meanings (Noce, 1999; Porter, 1996). The SDI differs from other instruments assessing an individual's behavior in that an individual's motivation value system is also assessed. Values are assessed when things are going well for an individual, as well as when the person faces conflict. The questions are self-scored and worded to measure behaviors and the motivations and values that underlie those behaviors. Some applications of the SDI are conflict management, enhanced awareness of self and others, development of communication and negotiation skills, team building, and leadership development. It also includes instructions for drawing a visual representation of an individual's SDI results (Jones, 1976). This information is important because leaders must build relationships within the organization for the organization to grow and succeed.

The Watson–Glaser Critical Thinking Appraisal

The Watson–Glaser Critical Thinking Appraisal (WGCTA) is the most commonly used tool in business today to assess critical thinking skills. It assesses inference, recognition of assumptions, deduction, interpretation, and evaluation of arguments skills (Watson and Glaser, 2000). The WGCTA has been used extensively in business settings to determine hiring, promotion, and development of individuals for succession planning of a company. It is believed that high-potential performers with good critical thinking skills use sound decision making (Watson and Glaser, 2000).

Individuals being assessed are asked to evaluate reading passages that include statements, problems, arguments, and interpretations. When completed, a single score is determined for each individual. The score and information related to interpretation of the score are then provided to the individual. Since critical thinking skills are important in all organizations, individuals need to have critical thinking skills or develop this skill to be an effective leader. As the pharmacy profession requires pharmacists to use critical thinking skills daily, the WGCTA is an excellent tool to assess an employee's skill in this area.

The Thomas Kilmann Conflict Mode Instrument

The Thomas Kilmann Conflict Mode Instrument (TKI) was developed to assess an individual's preferred mode of five conflict-handling styles. These are avoiding, accommodating, competing, compromising, and collaborating. Individuals completing the instrument are forced to choose between two possible statements that describe their most likely behavior in a given situation. Responses then are transferred to a scoring sheet, and scores are totaled for each of the five modes of conflict resolution. Feedback allows individuals to determine their primary mode of conflict resolution and to identify situations when other modes of conflict resolution might be more effective. This is important in an organizational setting because leaders may be faced with a variety of conflicts that need to be resolved by different techniques.

The StrengthsFinder Profile

The StrengthsFinder Profile was developed by the Gallup Organization (Buckingham and Clifton, 2001) to identify the strengths that an individual possesses. The profile actually measures an individual's themes of talents. Since strengths are a result of talents, knowledge, and skills, a profile of various talent themes can be developed for an individual (Buckingham and Clifton, 2001). The profile consists of a pair of statements. The responses are then sorted. The feedback lists your five most dominant patterns of behavior. These are referred to as your signature theme. Research by Gallup University has identified 34 themes.

The book “Now, Discover Your Strengths” by Buckingham and Clifton (2001) discusses development of the profile and describes each of the signature themes in depth. A second version of the StrengthsFinder Profile was released in the fall of 2007. Version 2 can be accessed by using the personal identification code in the back jacket of the book “Now, Discover Your Strengths: StrengthsFinder Profile 2.0” (Rath, 2007). By knowing their strengths and the strengths of their employees, leaders can assign individuals' responsibilities based on their strengths, resulting in a more effective and successful organization.

360-Degree Feedback

This is a performance appraisal tool focusing on leadership effectiveness, planning, and teamwork (Edwards and Even, 1996). The system or process ultimately helps individuals to be more effective managers and/or leaders by better understanding their overall strengths and weaknesses (Chapter 15). There is a self-evaluation and a peer evaluation. Employees (i.e., managers, peers, and staff) provide their perceptions on a broad range of workplace competencies. Participants use a rating scale to respond to the questions in addition to providing written comments. Afterwards, responses for each category of employees (e.g., peers) are collated to ensure anonymity. Feedback is provided on the difference between the self-evaluation and peer evaluation in relation to leadership skills such as listening, goal setting, and planning. The feedback is provided in a format such that the individual can create a development plan. An advantage of the 360-Degree Feedback is that it can also be used as a development tool for nonmanagers (DeBare, 1997). Even though nonmanagers have no staff reporting directly to them, feedback from coworkers can be useful in helping them to be more effective in their current position. Second, it serves as a development tool for individuals aspiring to move into an administrative position. By identifying their strengths and areas for improvement, they can adjust their behaviors or develop new skills to be effective leaders within the organization and excel in their jobs.

Q12

The Q12 was developed by the Gallup Organization (Gallup Organization, 1999; Coffman and Gonzalez-Molins, 2002) to determine the level of employees' engagement within the organization. The Q12 assesses 12 key dimensions that describe a great workplace (Gallup Organization, 1999). The report from the Q12 instrument identifies how the leader's management style influences the perception of team members and engagement of employees. This information is important to leaders within the organization because disengaged employees are often not productive, which eventually may lead to a decline in the success of the organization.

Pharmacists and pharmacy students have unlimited opportunities to become leaders within their individual practice settings; pharmacy professional organizations on the local, state, and national levels; the overall health care profession; and their communities. Leaders will make changes within their practice setting prior to other pharmacists within their immediate vicinity, such as implementing medication therapy management (MTM) services or providing a new pharmacy service in the hospital. Other professional leadership opportunities include being an officer in local, state, and/or national pharmacy organizations. Community leadership roles involve community organizations such as the Lion's Club and Rotary Club, public health initiatives, and political involvement. Students can be leaders in their student pharmacy organizations by providing services to local community organizations and providing disease management services such as blood pressure, cholesterol, and glucose screening to the citizens within their local communities and state. Leadership in each of these areas is important to provide effective patient care, to enhance the quality of life of patients, to advance the profession of pharmacy, to make for a healthier community, and to advance your own self-worth and actualization.

Jennifer Leader is a month away from graduation. On her last two rotations, her preceptors have modeled the qualities of an effective leader that Jennifer learned about in pharmacy school. She has talked extensively to both individuals about serving as a mentor when she graduates from pharmacy school. Her preceptors suggested that she be willing to accept a supervisory position in her selected practice setting on graduation. Several types of leadership development were recommended to enhance Jennifer's leadership skills. These include exploring the opportunities to attend a leadership development program with her future employer; becoming active in her local, state, and national organizations for the purpose of networking and building relationships with other pharmacists; identifying who administers the different leadership evaluative tools such as StrengthsFinder and Myers–Briggs; and attending a pharmacy leadership program such as the American College of Clinical Pharmacy (ACCP) Academy Leadership and Management Certificate Program (2011), American Society of Health-System Pharmacists (ASHP) Conference for Leaders in Health-System Pharmacists (2011), ASHP Leadership Institute, experiential programs in association management and leadership (such as with the American Pharmacists Association), and/or other pharmacy leadership programs. The results from the leadership evaluative instruments will help Jennifer to develop a plan to enhance her leadership skills. This will also be the beginning of a process to realize her goal of becoming a pharmacy leader within her practice setting and in professional pharmacy associations on the state and national levels.

Pharmacists have assumed administrative and leadership roles in their practice settings, profession, and communities. However, opportunities for pharmacists to demonstrate leadership have never been greater or more needed. This is occurring as a result of changes in the provision of health care such as MTM and the invention of new technologies. Employers will be seeking pharmacists who can be leaders in this changing environment so that patients will receive the best quality of care. Leadership resources are plentiful, and many tools are available to assist individuals in developing their leadership skills. Resources are available in both print- and Web-based format. Other resources include leadership development programs and evaluative tools. Recent evaluative instruments provide feedback on a pharmacist's strengths. Once an individual knows his or her strengths, the information can be used to maximize his or her strengths, resulting in greater successes. Pharmacists are encouraged to use these resources not only for their own leadership development but also to develop leadership skills in others.

1. What are the challenges to becoming a leader? What characteristics of an effective leader mentioned in this chapter do you currently possess? How might you acquire or improve on some others?

2. What is the importance of developing insight into your personal leadership style?

3. Which of the evaluative tools mentioned in this chapter do you feel might be of most benefit to you? Why?

4. As a leader, how do you help to promote change within the profession and in your practice setting?

5. How comfortable are you with delegating things to others? What are some factors that might keep you from delegating certain responsibilities? How might this be improved?