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We examine how leaders can become more self-aware in one graduate program that helped students develop their leadership competencies and become more accurate in their self-assessment of those competencies.

The Master of Science in Executive Leadership and Organizational Change program was created in response to the challenge of developing and accessing leaders in emotional and social intelligence competencies.

The analysis of student self-assessments and assessments by others at the beginning and end of the program provided the data for our research, showing empirical evidence of leadership development and improvement.

The study examined students in one program at one university so the generalizability of results is not clear. We have no way to rule out other experiences students had during the two-year period. We chose a single approach to measuring accuracy of self-assessment, future research may compare the results from a variety of approaches to this measurement issue.

We describe the program that helped students develop leadership competencies, develop the self-awareness necessary to take action as a leader and calibrate a more accurate self-assessment of leadership competencies over a two-year period.

We demonstrate how one leadership development program can help all students become more accurate in their self-assessments. We do not need different development programs to help one group of leaders gain confidence and another for leaders who are overly confident. An educational curriculum can foster transformational learning that enables ongoing leader development (Petriglieri, Wood, & Petriglieri, 2011). Academic programs can create experiences that help students develop and increase their self-awareness so that they are confident enough to put their learning into action. Like effective leadership development programs (Van Velsor, McCauley, Ruderman, & Ruderman, 2010), management education programs can incorporate assessment, feedback and support so that students become the effective and outstanding leaders the world needs.

Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons?

An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above.

The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways.

This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations.

Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary.

Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.