Surgeons as Educators A Guide for Academic Development and Teaching Excellence

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• Most important is the timing and symbolism of this message. The time for
  debate is over, the time for action is now. What counts now is action in pursuit
  of the objectives. Here are the goals; here are your roles and responsibilities;
  these are my expectations, and I will hold you and myself accountable to make
  these goals happen.

Here is a summary of the preceeding explanation of how leaders build commit-
ment to goals. By asking open- ended questions and listening to understand people’s
points of view, leaders discover two things. First they discover the interests of the
people—their hopes, fears, insecurities, concerns, and more. They discover people’s
perceptions of what they perceive they have to give up and what they perceive is in
it for them.
The second discovery is a superordinate goal that all the internal stakeholders^29
strongly agree is the most important goal.^30 The leader puts something in front of
people that is significant and that they would be proud to achieve. The solution came
from inside, so there is deep engagement and fair process. It allows the leader to
align the internal stakeholders, so everyone becomes willing to sacrifice some of
their self-interest, and the buy-in is 100%.
This superordinate goal should be perceived as making them better off in one or
more of the following: their careers, their compensation, their practice, their learn-
ing and mastery, or their feeling of taking responsibility for outcomes. After leaders
align stakeholder interests around the more significant goal, implementation begins.
This goal should be something so important it creates hope or confident expectation
that once through the tough situation, things will be much better.
Figure 20.5 depicts the process and the pattern of leadership behavior toward
bulding commitment.

(^29) Stakeholders are individuals, groups, institutions, and organizations that can affect your deci-
sions and/or are affected by your decision-making.
(^30) How to get “willing followers” is the leadership challenge. It is about giving people a choice and
letting them make the decision for themselves without punishment.

2. Listen to their
   ideas, Iucid
   situational
   diagnosis, begin
   to explore/share
   ideas, “what ifs”
   3. Frame and
   explain the
   rationale of your
   decisions and provide
   opportunity for
   clarification


3. & 5. Go to the
   GEMBA, ask
   questions--what
   happened & why
   Low Task behavior High

High

LL

M M

MM

MM

M

M

M M

M

M M

L

M

M M

M

L

M

MMM

M

4. Set expectations: here
   are the results we expect,
   here is your role &
   responsibility-here is
   Fig. 20.5Structure When Building Attention my commitment to you

Commitment to Goals

20 Teaching Surgeons How to Lead