The board game that helps everyone recognise they’re a leader

Nursing staff across all bands and roles take the lead – but often without recognising it

Nursing staff across all bands and roles take the lead in many areas – but often without recognising it

  • It’s common for nursing staff to take the lead – while struggling to see themselves as leaders
  • Researcher devised a board game to help health visitors discuss and reflect on the issue
  • Everyone can demonstrate leadership, whatever their role in an organisation

Leading is an everyday event for health visitors. Picture: iStock

How can you bring theories of leadership alive, particularly for those who don’t see themselves as leaders?

That was the quandary faced by Karen Stansfield, whose doctoral research focused on how health visitors understand leadership. ‘We’ve had 20 years of policies on how nurses and health visitors need to strengthen their leadership, yet we still don’t seem to be achieving as much as we would like,’ says Dr Stansfield, who was education lead at the Institute of Health Visiting (IHV), before taking up a post as associate dean in enterprise and engagement at Salford University last May.

In the community, leadership can seem invisible

Her studies showed that while health visitors had a strong professional profile, they lacked a separate leadership identity. ‘You have to see yourself as a leader to be a leader – and if you don’t think you’re a leader, you won’t be one,’ says Dr Stansfield.

‘The downside is that you won’t seek out experiences and opportunities for leadership. It’s common in healthcare that people will say they are a nurse or a health visitor before they say they are a leader, even though we know how important leadership is in our profession.’

In addition, Dr Stansfield's research involving focus groups of health visitors demonstrated they found it difficult to articulate exactly what they were leading. ‘It took a long time for them to recognise themselves as leaders, even though they are very experienced professionals doing amazing work,’ says Dr Stansfield.

‘In health visiting particularly, they don’t have a defined role. Leadership in the community can be quite invisible, especially in comparison to managers of wards, so it can become an unconscious activity that they don’t see themselves doing.’

‘We had people initially saying they couldn’t possibly chair a meeting because they weren’t a doctor or a senior practitioner, but their attitudes really shifted’

Karen Stansfield

Based on her findings and the leadership model she has developed, she created a tailored programme, supported by funding from the Burdett Trust for Nursing. It incorporates two days’ face-to-face training, plus three action learning sets, all undertaken over a six-month period.

The aim was to help participants express succinctly the areas where they demonstrate leadership, for example, working with complex families, community development, inequalities in public health, or immunisation programmes.

‘They didn’t see it as leadership, just something they did as a professional,’ says Dr Stansfield. ‘But if they can articulate where they are leaders, they can look for opportunities to take it further.’ The programme has been transformative, she believes. ‘We had people initially saying they couldn’t possibly chair a meeting because they weren’t a doctor or a senior practitioner, but their attitudes really shifted,’ she says.

An evidence-based resource

Karen Stansfield.

Yet what she had thought was a simple theoretical model proved more difficult than she’d anticipated to put into practice. ‘They still needed a lot of support,’ says Dr Stansfield. ‘I began to think how I could make the model easier and quicker to understand.’ She came up with the idea of a board game, underpinned by evidence, and gained extra funding from the Burdett Trust to develop it.

‘There’s a lot of evidence about the use of games in education, although initially I wondered whether an online game might work better,’ says Dr Stansfield. ‘But one of the best things about it being a board game is communication. It’s a trigger for people to respond differently, with different debates, and it also helps reinvigorate people’s learning and understanding, after they’ve been on the course.

‘People seem to love board games and it makes them feel very connected, learning from each other. Often at the end, they would say that they didn’t realise they knew as much as they did, so it builds their confidence too.’ 

‘What the game does is take the theories and ask what they might mean to you, in your own context, making it much easier to understand’

Dr Stansfield

It’s also good fun to play, says Dr Stansfield. ‘I’m very passionate about leadership, but if you don’t feel that way, and it’s just something you’re learning about because you have to do it, it can be a very dry subject,’ she says. ‘What the game does is take the theories and ask what they might mean to you, in your own context, making it much easier to understand.’

For IHV projects and evaluation lead Vicky Gilroy, the game’s adaptability is among its key attributes. ‘It’s a versatile tool that supports understanding of leadership at both a personal and organisational level,’ she says.

‘You can play it in different ways. I’ve even used it as an ice-breaker, asking just a couple of the questions.’ Other suggestions include using it to help prepare for promotion and as part of revalidation, with participants writing a reflective account after playing it.

The Leadership Game.

How the Leadership Game works

The Leadership Game is suitable for anyone working in health and social care who wants to understand the practicalities of collective leadership.

It aims to help players learn about leadership roles and skills, building successful teams, communication and trust, and managing change.

Two teams of between two and 12 players throw a dice to make their moves on a board, which has three sections based on Dr Stansfield’s leadership model.

These are:

  • Context of leadership: ‘I lead on this’
  • Purpose: ‘Why I am leading on this’
  • Behaviours: ‘What do I need to demonstrate or role-model?’

‘What I found was, if all those three elements came together, they would help health visitors to make a difference,’ explains Dr Stansfield. ‘It strengthens both their professional and leadership identities.’

Once players land on a square, the opposing team will pick a card that asks one of 70 questions. Team members confer, coming up with their final answer, while opponents decide whether they have done enough to gain a point. Questions may be true or false; ask participants to describe a concept such as ‘what is collective leadership?’; explore specific topics, such as, ‘what three things make teams effective?’; or examine knowledge on key health policies.

Each game is timed, lasting up to 60 minutes, and the team with the most points wins.

The Leadership Game costs £80 plus VAT


Prompt for reflective debate

The response from the 200 or so people who have played it so far has been overwhelmingly positive, says Ms Gilroy, who is seconded to the IHV from Northumbria University, where she is a lecturer in professional leadership and managing change.

‘We’re all leaders… It doesn’t matter what level you are in an organisation, you need to recognise your own leadership capability’

Vicky Gilroy, projects and evaluation lead, Institute for Health Visiting

‘The feedback we’ve had highlights the richness of the discussions, with participants developing a shared understanding of concepts, terminology and ideas,’ she says. ‘Having watched people playing it, you can see it enables really good reflective debates, which people don’t usually have the opportunity for when they’re at work.’ One person commented: ‘I’m like a little meercat. My head is up now, looking out, and I can see things differently.’

Crucially, Ms Gilroy believes the game reinforces the idea that everyone is involved in leadership and that it is a collective responsibility. ‘We’re all leaders and we all have that within us,’ says Ms Gilroy. ‘It doesn’t matter what level you are in an organisation, you need to recognise your own leadership capability.

‘For instance, when you’re having a conversation with a family, you are leading them in a direction and what you do and say makes a difference. How you project, with authority and empathy, is really important. That’s leadership. Yet we don’t acknowledge it – we think it’s something others do. We need to demystify it. Part of becoming a leader is recognising you have a voice.’

Lynne Pearce is a health journalist

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