Abstract/Summary

This thesis embraces a participatory and complexity perspective to further understanding of complexity leadership in a healthcare organisation during a period of turbulent change. It uses the co-operative inquiry articulation of action research to create an adaptive space to facilitate the adaptive process of complexity leadership development in medical consultants. Using the Shani and Pasmore (1982) complete theory of action research (context, quality of relationships, quality of the action research process and dual outcomes) the transcontextuality of the research was explored through global, national, local and personal perspectives. Through preunderstanding activities and analysis of multiple sources of data, it was revealed that medical consultants felt isolated and disenfranchised and desired to collaborate together for change. Colleagues transitioned to become co-researchers who then participated in six cycles of action research through a dynamic, emergent process of change and knowledge production, where data were generated through action and reflection-in-action and reflection-on-action. The co-operative inquiry created the rich connections necessary to explore areas of mutual concern and share ideas and information and take action to solve some of the problems identified. By creating the necessary structures, processes and events, adaptive outcomes of new complexity leadership skills and behaviours with an enhanced experience emerged. Through the inquiry, it became apparent that consultants’ basic needs were not being met, a form of organisational injustice. There were four inquiry outcomes that corresponded with the four forms of knowing: experiential, presentational, propositional and practical. Personal transformations occurred through engagement with the focus and process of the inquiry. Co-researchers presented insight about leading in complexity through oral and verbal modes of presentation. The co-created propositional report which was generated at the conclusion of the inquiry was informative about leading in complexity and what it meant for us as a group (and me in my dual roles as researcher and organisational member) and it provided commentary on the inquiry outcomes and described the method of inquiry. Co-inquirers demonstrated the practical skills of transformative action and complexity leadership skills. Through the subsequent integrative meta-cycle, two overarching themes were identified as necessary for leading in complexity in our organisation: the development of communicative space and the enactment of teamwork. Using the themes and subthemes that emerged from the reflexive thematic analysis, a dynamic framework for the creation of adaptive space to enable complexity leadership development emerged. The co-operative inquiry process enabled co-researchers to recalibrate perspectives concerning the nature of our organisation and our world. This research challenges the characteristic reductive thinking of healthcare improvement. Whilst in complex healthcare organisations the impact of an intervention may be unpredictable, this inquiry opened the communicative adaptive space in a complex system and allowed new leadership skills and behaviours to emerge. The findings of this research may help scholars and practitioners to effectively engage with, explore and intervene in a complex system and enhance our understanding of complex systems and leadership.