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Dr. Dilan Ellegala, a visiting neurosurgeon at Tanzania's Haydom Lutheran Hospital, needed to perform a craniotomy on a patient – essentially removing part of the skull with a surgical saw to allow the blood to drain. Since the hospital lacked even basic surgical tools, he bought a wood saw from a local farmer, sterilized it and successfully performed the operation and saved the patient's life. One problem solved. But the bigger issue remained: how could one develop capacity in Tanzania's healthcare system, where there are only three neurosurgeons in a country of 50 million?
Dr. Ellegala's solution was simple but controversial – train local medical workers (doctors, assistants, senior nurses) to do basic neurosurgery. His colleagues thought he was out of his mind. Neurosurgeons are at the top of the healthcare food chain, spending as long as a decade after their medical degree training under intense pressure. One false move with a scalpel and a patient could lose their memory, be paralyzed or die. But Ellegala was convinced that if you trained medical staff for a targeted set of basic neurosurgery skills – be it performing a craniotomy or inserting a shunt – they could competently perform the task. The results became Ellegala's Train Forward model, and it's been nothing short of transformational. Now, local Tanzanian medical staff are performing successful neurosurgeries comparable to the standards of other hospitals, and they're also teaching others.
Of course, neurosurgeons in Tanzania may seem far removed from the daily realities of running a business, but strip away the obvious differences and you can find clear parallels. Organizations across all industries – from healthcare to publicly traded companies – are struggling with leadership capacity gaps at all levels. We're already seeing an exodus of senior leaders who are retiring and taking critical capabilities that take years to develop with them. At the other end, many leaders are feeling pulled into the weeds, having to pick up the slack left by the hollowing out of middle management and cost cutting at the front line.
Leaders at all levels are under stress to meet crushing demands with limited resources to deliver. Could it be that the solution to the bandwidth problem is lying in plain sight?
The answer may lie in a powerful learning strategy called "scaffolding" that Dr. Ellegala used to rapidly build expertise in neurosurgery in non-medical staff. Like training wheels on a bicycle that are slowly raised as the rider gets better at balancing, Scaffolding is a proven development approach that anyone can use to rapidly learn complex skills – whether it's neurosurgery or leadership - and in doing so, create more leadership capability at all levels across the organization.
The principles of effective scaffolding include the following:
Have a clear purpose and direction: While Dr. Ellegala was targeting complex but focused neurosurgery skills, he was not developing general medical practitioners. Similarly, there's no such thing as training to become an athlete. Athletes train in specific sports like running or tennis and target a domain to excel at. Psychologist Anders Erickson, who has studied experts in different domains, found that they are clear on what they're trying to excel in and have specific, well-defined goals for improvement.
Likewise, many leadership development approaches often fail to deliver because they focus on developing generic leadership capabilities, rather than focusing on specific skills.
I met a very successful leader who had one behaviour she would commit to practicing for one month. She focused only on that single behaviour – improving her influencing by tailoring her message to her audience and working on her delivery over the next 30 days. Then, when she felt she mastered it, she would choose the next influence skill to focus on. The lesson? Be specific. Like learning to be a faster runner, focus on becoming better at a particular leadership skill, such as collaboration or strategic thinking. Learn the behaviours and commit to practicing those, and only those, until they become automatic before moving on to the next capability.
Work at the edge (with support): Select a doable task that is in your zone of "proximal development." That's a mouthful, but what it really means is that you seek an opportunity that scares you just enough and where you can't simply rely on what you know to get you through. To get medical staff used to the idea of brain surgery, Dr. Ellegala first had his medical assistants touch the exposed brain of a live patient. Next, he had them assist in the more complex surgery tasks, and over time allowed them to take on more of the process, just like raising the training wheels on the bicycle.
Lawyers who practice the same law for 30 years may actually get worse over time if they do not continually push themselves to apply new knowledge and take on cases that are at the edge of their competence. Top performers regularly go outside their comfort zone and take on challenges that are just beyond their level of capability – a significant stretch but not so much so that they risk complete failure. I once coached a highly successful executive who was trained as a lawyer. Although she was chief legal counsel, she also took on portfolios she knew nothing about, leading corporate strategy and eventually the HR function. Those experiences stretched skills she never would have developed had she stayed with what she knew.
Learn from the best: Every domain has its experts – they have walked the path before and have figured out how to succeed. There is nothing that will accelerate your leadership expertise more than having a true leadership expert coach you and provide targeted feedback; it's like a great piano teacher who can tell you when your hand position is off.
Since many leadership abilities, like strategic thinking, are cognitive skills, you also need to understand how great leaders think when they approach complex tasks. At a recent leadership program, when we asked the CEO to share in detail what he thought and felt when making a complex decision such as expanding into a new market, other senior leaders gained powerful insights as they listened while he thought aloud.
Give it your full attention: Finally, control is everything. Like an Olympic ice skater, mental focus, monitoring each action and adjusting one's approach based on feedback is essential at each moment. Cultivating mindfulness – training yourself to be fully in the moment and focused on the task at hand – is an essential skill to accelerating learning. The best brain surgeons, top athletes and even world-class opera singers are exceptional at constantly observing themselves and identifying opportunities to improve their performance.
There are vast reservoirs of untapped leadership potential in all organizations, and the improved use of scaffolding as a learning strategy may be one way to address the crushing leadership demands organizations are struggling with.
Organizations are certainly resource-constrained, but much of that may be a mindset rather than reality. We may need to simply look at the challenge differently, in the same way Dr. Ellegala did in Tanzania. And in doing so, to borrow the words of Susan Peters, GE's senior HR leader, "we will all rise together."
Rick Lash is a senior client partner with the Korn Ferry Hay Group leadership and talent practice in Toronto.