The Need for Listening Leaders : Academic Medicine (2024)

In a world beset by a pandemic, epidemics, and health disparities, the need for strong and effective leadership is strikingly evident and urgent. Through advances in science, clinical and health system innovation, education, and community and public health efforts, leadership in academic medicine and more broadly in academia plays an increasingly important role in this time of overlapping crises. ^1,2 More than ever, effective, listening leaders are of vital importance.

Leadership has been described as “the art of getting people to want to do what must be done.” ³ A complex art, leadership is exercised on multiple levels, interpersonally and longitudinally. ^4,5 Leaders must collect, interpret, and synthesize information and take responsibility for challenging decisions that can greatly affect individuals, teams, and organizations. Leaders possess “ ‘the capacity to translate vision into reality,’ ” influencing others to maximize effort to achieve a goal. ⁶

Leadership relies on the leader’s attunement, both to other people and to larger contexts. ⁷ In this editorial, we emphasize listening as a necessary component of effective leadership and speak to the need for “listening leaders” in academic medicine.

Listening is a powerful tool, helping leaders to acquire the information necessary to decide, act, and influence. In this effort, the listening leader seeks out others’ perspectives to complete the tasks necessary to attain a shared goal. By listening respectfully, we posit, the listening leader demonstrates the virtues of curiosity and empathy that, in academic medicine, are instrumental in developing vibrant, high-trust, and well-functioning health systems and academic environments.

Listening takes time. And listening deserves our investment of effort. ⁸ Listening is crucial when information is not at hand or is unknowable, as we encountered with the COVID-19 pandemic. Listening is also crucial when different experiences and points of view are vital to developing approaches to complex issues that affect many stakeholders. Listening becomes imperative when such issues represent burdens that are disproportionately or inequitably carried across groups. ⁹ These situations require participatory and incremental engagement that is based, fundamentally, on listening. In the increasingly complex academic workplace, and amid global crises, leaders frequently encounter scenarios that call for more listening to reach shared understanding and consensus about goals and strategies.

Listening enables a leader to understand the perspective of another and respond empathetically. This reflective process can expand a leader’s scope of awareness and build trust with individuals and groups. Cultures of trust are required to respond to adaptive challenges such as the COVID-19 pandemic. ¹ As stated by Fernandez and Shaw, ^1(p42)

Building relationships and establishing mutual trust in a crisis is not easy, and requires that academic leaders be authentic and engage in active listening without judgment, accept advice and criticism, and communicate their views transparently by speaking from the heart, while promoting psychological safety.

Listening leaders demonstrate respect for the reality of others’ experiences and claims to knowledge. By seeking, honoring, and integrating broad perspectives into a larger effort, listening leaders combat the problem of organizational silence. ¹⁰ Productive, generative dialogue occurs when others feel included and valued, which invigorates belonging and makes work more meaningful. Intellectual investment in others not only allows for better-informed decisions but also helps others develop as strong collaborators and leaders within an organization.

Seeking multiple perspectives through listening enhances the quality of leadership decisions. Broad perspective-taking helps to avoid missteps and blind spots. ¹⁰ While decision-making power may rest in the hands of one individual, the effects of a decision are interrelated and their outcomes are jointly or collectively shared. Seeking multiple perspectives demonstrates respect for others and acknowledges the interdependence of human organizations and knowledge creation.

Good listening is a skill: it can be strengthened with practice. A good listener habitually chooses to thoughtfully receive and value the messages imparted by others, with the goal of seeking understanding. Good listeners are present and attentive in the conversation. They listen actively by summarizing or synthesizing information and by asking clarifying questions. ¹¹ Good listeners demonstrate understanding and attunement by fostering dialogue and engagement.

Effective leadership results in influence. We emphasize the role of listening and the deeper issue of attunement because these are critical to effective leadership in academic medicine. We suggest that listening leaders are especially important in times of crisis, when organizational adaptation, ¹ along with learning, sharing perspectives, and fostering trust, are so very crucial to making a difference. And that difference really matters when saving human lives and improving human health are the goals, as is the case in our current world replete with a pandemic, epidemics, and health disparities.

If listening and leadership skills can be cultivated independently, how can one become a listening leader? We can first borrow from the wisdom of clinicians engaged in “deep listening” with their patients. ^11,12 Academic and business leaders, moreover, suggest techniques such as paying attention, withholding judgment, reflecting back to the speaker, clarifying, summarizing, and sharing. ^13,14 We suggest approaching listening conversations with open hearts and minds, combining these techniques with authentic curiosity, empathy, and a willingness to learn. Each conversation is a chance to build understanding and trust with our colleagues and to strengthen our ability to lead effectively.

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