Critical pedagogy in a health service management development programme: Can 'critically thinking' managers change the NHS management culture?

摘要

Purpose - Management development programmes available to NHS managers focus on arnperformance orientation and sustain a culture of managerial and medical domination. This paperrnaims to question whether it is possible to consider NHS management development from a criticalrn(empowerment culture) perspective. Features of the critical management studies approach (CMS) arernidentified. A new MSc is evaluated against these characteristics, examining the teaching and learningrnprocesses and students' perceptions of the programme. The aim is to develop critical thinkers who canrnreturn to their organizations and challenge existing power structures and practices to change localrncultures and enhance health services.rnDesign/methodology/approach - Empirical research employed anonymous studentrnquestionnaires and a focus group.rnFindings - Student evaluations suggest the MSc can deliver a critical pedagogy and help managersrnunderstand issues of power and empowerment, challenge dominant cultures, innovate and effectrnsmall, local changes in the NHS culture.rnResearch limitaions/implications - There is a need to continue evaluating the programme andrninclude other stakeholders. Longitudinal research should assess the impact of the managers' changedrnvalues, attitudes and behaviours on colleagues, clients and the local cultures.rnPractical implications - The paper identifies some of the tensions of developing "critical" healthrnservice managers, and the problems they encounter back in the "uncritical" NHS context, as well asrnsome of the challenges in "facilitating" a critical curriculum. It questions the ethics of developing (orrnnot) a critical perspective in a local context unfamiliar with CMS.rnOriginality/value - Management development in the NHS largely ignores critical pedagogy. Thisrnpaper makes a small and unique contribution to understanding how developing "critically thinking"rnmanagers can challenge the dominant culture. However, the limitations of such a small-scale study andrnethical implications are noted.