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Chapter 2REVIEW OF RELATEDLITERATURE AND STUDIESLeadershipAccording to Black (2015) that the leadership of Higher Educationinstitutions has been placed under increasing scrutiny since the 1980’s withthe expansion of student numbers, changes in funding for students places,increased marketization and student choice, and continuing globalization of thesector.  In this climate of change HigherEducation institutions have been required to consider how to develop theirleaders and what might be appropriate leadership behavior to enable adaptationto these new circumstances.  When thevarious paradigms of leadership encountered in the Higher Education sector arecompared with established leadership theory and practice it is possible toidentify further intricacies in the development of Higher Educationleaders.  Further consideration ofpracticalities within Higher Education identifies whether competence frameworksmight assist in leadership development. An examination of a recently-developed comprehensive framework ofleadership capabilities applied in an alternative sector leads to an evaluationas to whether the same constructs apply to the demands placed upon leaders inHigher Education.  Analysis demonstratesthat, with minor changes in terminology, the constructs remain appropriate andvalid.

  The definition of activities andbehaviors offer insight into how Higher Education leaders could be developedand therefore form a potential framework of leadership capabilities for HigherEducation. In the same study, Black (2015) mentioned that leaders in HEinstitutions have to examine how to better lead their organizations, and mustalso find approaches which fit best in the HE context; i.e. the most effectiveleadership approach.  However, this isnot straightforward since there is no clear consensus on definition of leadership(Kennedy, 1994) and the parallel and sometimes interweaving evolution ofleadership ideologies complicate the picture. Over the past 100 years several broad philosophies have emerged and canbe seen to persist in various guises in modern organizations:1) “command-and-control” leadership has proliferated since the 19thcentury industrial era, drawing on rules, incentives, threats, contracts, andstandards (Macdonald, 1998) evolving into quasi-military concepts through the1940s (Kennedy, 1994).  This “scientificmanagement” approach focuses on efficiency of the organizational “machine”,managers make decisions, specialists work in separate functions, and work iscontinually simplified.

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2) “behavioral” theories emerged in the 1950s , based upon more completeconsiderations of human nature and motivation (McGregor, 1957; Herzberg, 1976).3) “transactional-transformational” models in the 1970s (Burns, 1978; Bass,1997) involve reinforcement of performance (“transactional” behavior),alongside understanding followers, and building their self-worth and focus(“transformational” behavior).4) “transformational leadership” and the emphasis of transformationalbehavior has become the sole dominant paradigm over the past 20 years (Kennedy,1994; Tourish, 2008).  Leaders areportrayed as heroes and encouraged to transform the loyalties and behaviors oftheir staff through a shared organizational culture.5)  “systems thinking” was applied tomanagement in the 1920s (Shewhart, 1931) and further developed in the 1940s byDeming(1982).  In order to examine the relevance of leadership constructs within the HEenvironment it is necessary to compare the existing understanding of leadershipwith HE alongside contemporary leadership theory and practice.  In conclusion, current frameworks of leadership for the Higher Educationsector do not encompass all of the behaviors expressed in establishedleadership literature.

  Higher Educationleaders need a combination of leadership and management competencies in orderto address the challenges faced in the sector; separation of these facets uscounterproductive and will not address the negative impact of managerialismperceived within the institutions.  Theframework developed in this analysis offers a suitable range of approaches forleaders in HE.  Within a changing worldof an effective leader must be both student and teacher (Kotter, 1996): alwayshungry to learn more about how to enthuse, engage and empower those who follow.  For staff in academic positions, becoming a”learner” may be uncomfortable, so these individuals should be encouraged,through the active, visible and credible example of seniors and peers, toappreciate the benefits and necessity of personal leadership development.Odivwri JE (2015), for any organization to survive, appropriate impactof leadership on the employee must be followed.

 It was inferred that democratic or participative types of leadership isthe best of all the leadership styles because of the benefits that will bederived from it by the employees amid the overall result to the organization asa whole.  This study also shows that itis necessary to effect changes in impact of leadership when the need arises inan organization in order to enhance performance.  Furthermore, when there is good leadershipthere will be corporate behavior by the employee, targets will be met andultimately there will satisfaction on the part of the employee and theemployers.In a study conducted by Kedir and Geleta (2017), it’s primary objectivewas to assess the degree to which transformational leadership was practiced inthe technical vocational education and training institutions (TVETIs) ofEthiopia.

The study found that five transformational leadership models werebeing practiced low or below average in the TVET institutions.  But, when the models were independentlyconsidered, the variable enabling others to act and model the way were ratedrelatively high whereas the remaining three leadership practices, inspiring ashared vision, challenging the process and encouraging the heart were rated lowby the respondents. The result shows that majority of the trainers in theTVETIs were not satisfied with the leaders ‘engagement in the five leadershippractice of Kouzes and Prosner’s transformational leadership models.  Leaders ‘failure to effectively lead changeand innovation, lack of professional support for TVETI leaders and theirincapability to use various approaches in securing and utilizing resources werethe major problems hindered effective implementation of change in theinstitutions. According to Kouzes and Prosner (1995), there are ver 225 definitions ofleadership found in literature but no one claims the word on “defining” theterm.  Scholars have defined leadershipin a ways that works best for his/her work with students, managers, governmentofficials, community organizers, health care providers, and educationaladministrators. Kouzes andProsner developed a model of leadership that consists of what they call it “TheFive Practices”. These are challenging the process, inspiring shared vision,enabling others to act, modeling the way, and encouraging the heart (Kouzes andProsner, 2002).

  Based on their researchproject with successful leaders, for over almost 20 years, Kouzes and Prosnersuggested that leadership is not a position, but a collection of practices andbehaviors.  They also concluded thatleadership is a compulsory skill that can be learned by everyone.  The operationalization of these fiveleadership practices is presented as follows:Model the wayModeling means being prepared to go first, living the behaviors theywant others to adopt before asking them to adopt them.  Because, people will believe not what theyhear leaders say, but what they see their leaders consistently do.  This also refers to the leader as an ethicalrole model.  The leader must not onlyinspire others but also uses his/her office to advance institutional goalsrather than personal ones.  Great leadersshould serve as an example to others.

  Inrespect to this they should be committed to set an example for others bybehaving in ways that are consistent with their stated values and to clarifyvalues by finding their voice and affirming shared ideas.  The model the way practice is described asconsisting of the establishment of principles that are concerned with the waypeople (including constituents, peers, colleagues, and customers) should betreated, and the way goals should be followed. Leaders create standards of excellence and then set an example forothers to follow.  Since the prospect ofcomplex change can overwhelm people and stifle action, leaders set interimgoals so that people followers can achieve small “wins “as they work towardlarger objectives. Leaders also unravel bureaucracy when it impedes action;they put up signposts when people are unsure of where to go or how to getthere; and they create opportunities for victory (Kouzes and Prosner, 2002).Inspiring a shared visionInspiring a vision involves looking at the future with passion in orderto make a difference and persuade others to own this vision.  Inspiring a shared vision is an importantaspect of leadership because leaders are expected to create and communicatedorganizational direction (Snee and Hoeri, 2004).

The “inspire a shared vision “practice was describes as being whenfollowers believe passionately that their leader can make a difference.  Leaders envision the future, creating anideal and unique image of waht the organization can become.  Through their magnetism and quiet persuasion,leaders enlist others in their dreams.

 Leaders breathe life into their visions and get people to see excitingpossibilities for the future (Kouzes and Prosner, 2002).Inspiring shared vision is vital for bringing people in any organizationtogether to foster a commitment to a shared future they seek to create. Bothvisionary and transformational leaders passionately believe that they can makea difference by envisioning the future and creating an ideal and unique imageof what the organization can become.

 They inspire such a vision in their followers with a positive andhopeful outlook.  They generateenthusiasm and excitement for the common vision from others through genuinenessand skillful use of metaphors, symbols, positive language, and personal energy(Kouzes and Prosnes, 1995, 2002).Challenge the processChallenging the process suggests that leaders shouldn’t be content to do”business as usual”. It includes encouraging others to think and takerisk.  Leaders thrive on and learn fromadversity and difficult situations.  Theyare risk takers who regard failure as a useful chance to learn and innovate ifnot caused by poor performance. Effective leaders are also early adopters of innovation.

  They seek out things that appear to work andthen insist that they are improved. Kouzes and Prosner (2002) describe the challenge to the process practiceas being the search for opportunities to change the status quo.  Leaders look for innovative ways to improvethe organization.  In doing so, theyexperiment and take risks.  Fortransformational leaders, challenging the process is a way of life.  By either creating new ideas, leaders showwillingness to challenge the system so as to turn these ideas into actions andto get new products, processes, and services (Kouzes and Prosner, 1995, 2002).

Enabling others to actEnabling others to act is fostering collaboration and empowerment.  It refers to leaders involving others inplanning and giving them freedom of choice in the decision-making process.  Enabling others to act allows followers to dotheir job and to realize their full potential. Transformational leaders strive to create an atmosphere of trust andhuman dignity and to help each person feel capable and powerful.  They consider the needs and interests ofothers and let them feel as if they carry ownership and responsibility in theorganization.  Kouzes and Prosner (2002)describe the  “enable others to  act ” practice as a means of fosteringcollaboration and building spirited teams.

 Leaders actively involve others. They understand that mutual respect is what sustains extraordinaryefforts; they strive to create an atmosphere of trust and human dignity. Theystrengthen others, making each person feel capable and powerful. Encouraging the heartPeople often need encouragement and motivation to achieve the goals setby the organization.  Successful leadershave high expectations for themselves and their employees.

  Their credibility is based on their record ofachievements, dedication, and daily demonstrations of what and how things needto be done.  By influencing employeemotivation, leaders attach rewards and recognition to job performance.Exemplary or visionary leaders play a special role in the celebrating ofindividual or group achievements, because they are the most prominentpersonality in the organization and serve as role models.  By celebrating achievements together, leaderslet people feel that they are part of the group and part of somethingsignificant.  When leaders encouragetheir employees through recognition and celebration, they inspire them toperform better.  In order to keep hopeand determination alive, leaders recognize the contributions that individualsmake.  In every winning team, the membersneed to share in the rewards of their efforts, so leaders celebrateaccomplishments.

  Leaders make peoplefeel like heroes (Kouzes and Prosner, 1995, 2002).The study used Kouzes and Prosner’s transformational leadership model toassess the leader’s practices.  In otherwords, in this study the degree of the leaders’ effectiveness was investigatedin terms of the above-presented five best practices of transformationalleadership model.  Garwe (2014) analyzed the indicators determining provision of qualityhigher education in state and private universities and how they are influencedby institutional leadership. This study identified six major issues thatuniversity Vice Chancellors had grapple with in order to ensure qualityeducational provision.  One issue wasproviding effective leadership.

  Inconclusion, the study revealed the need for university leaders to embracechanges and work with their staff to achieve institutional goals.  The results confirmed the hypothesis thateffective leadership will have a positive impact on service quality inuniversities.  This will thus impact onthe competitive advantage which, in turn, will then lead to the long-termsustainability of the institution.Al-Safran, (2014) studied on the possible relationship between theschool outcome and its administration leadership style.  The two indicators are used to measure theschool outcome are the students ‘academic achievement and the principals ‘influenceon the school’s curriculum.  Thestudents’ academic achievement is a direct measure of the school outcome, whilethe school curriculum is an indirect indicator.

Medical Technology EducationIn the Philippines, Medical Technology was introduced by the 26thMedical Laboratory of the 6th United States Army before the end ofWorld War II in September 1945.  TheLaboratory was established at 208 Quiricada St. Sta. Cruz, Manila where thePunlic Health Laboratory is presently located.In February of 1945, the training of high school graduates to work aslaboratory technician started.

However, in June 1945, the 6th UnitedStates Army left the laboratory.  It was on October 1, 1945 when the medical laboratory now also known asthe Public Health was formally organized under the leadership of Dr. Pio deRoda.

  The training of medicaltechnicians started in 1974 under Dr. Pio de Roda and Dr. Prudencia C. Sta.Ana.  In 1954, Dr. Pio de Roda instructedDr.

Sta. Ana to prepare a syllabus of training for the medical technicians thatthe formal six-month training period was required and certificate of completionwas give to successful trainees.  Lateron, Dr. Tirso Briones joined the two doctors in the training program at thePublic Health Laboratory. Medical Technology Education in the country is continuouslyevolving.  In the advent of technology,changing socials needs, providing health care services and new attitude towardshospitalizations brought about the changes in the role of medical technologists.

  Recognizing the important role of medicaltechnologists in the health care systems along with other health professionals,therefore, professionals should continually update their knowledge, and valuesto keep up with the constant pace of change.Educational institutions for the medical technology profession are alsoaffected by these changes. There is a continuous updating of curriculum toconform to the changes in the profession while maintaining or improving thequality of education.  However, the maintenanceof high standards of academic excellence and the production of competentgraduates are two of the major problems encountered by higher educationinstitutions (HEIs).Pasia, et. Al.

(2014) mentioned, with academic excellence in mind,schools submit for voluntary accreditation as practiced today along withimproving performance in licensure examinations.  The former Professional RegulationCommissioner Hermogenes Pobre stressed that “every professional is forged onthe anvil of education; he is as competent as the kind of education with whichhe is fashioned.” Therefore, providing quality education is a primordial goalof every institution.Pasia, et. Al. (2014) At San Pedro College, success in licensureexamination is an important outcome measure in assessing the effectiveness ofan educational program.

  While San PedroCollege (SPC) MT graduates comprise most of the work force in both public andprivate laboratory health facilities in Davao City, for the last five years,though the school produced topnotchers in the Medical Technologist LicensureExamination given by the PRC, it is observed that the performance of thegraduates is not consistently at par or above the national passing percentage.  School performance in licensure examinationis an important outcome measure assessing the effectiveness of an educationalprogram, Hence graduates of HEIs in Medical Technology are challenged toperform in the medical technology licensure exam at par with the nationalpassing percentage.  Graduates of an institutionwith a high passing percentage are regarded as highly competent because of thekind of education they get from the institution (dela Pena et al., 2007)Accreditation System for Higher Education Institutions in thePhilippines        According to the CHED Memorandum Order(CMO) No.

1 (2005), also known as the Revised Policies and Guidelines onVoluntary Accreditation in Aid of Quality and Excellence in Higher Education,emphasizes the encouragement of “the use of voluntary non-governmentalaccreditation systems”, which lines out a set of policies in full support of anaccrediting agency’s practices towards regulation.  Two accrediting bodies were stated in theCMO: FAAP which consists of the Association of Christian Schools, Colleges andUniversities Accrediting Agency, Inc. (ACSU-AAI), PAASCU, and PACU-COA and theNational Network of Quality Accrediting Agencies (NNQAA), which is inclusive ofAACCUP and the Association of Local Colleges and Universities Commission onAccreditation (ALCUCOA).  All processes,policies, frameworks, and systems of accreditation created by theabovementioned bodies must be forwarded for approval to CHED.        As mandated by the Higher Education Actof 1994, the Department of Education, Culture and Sports (DECS) was dividedinto three sectors, one which was the Commission on Higher Education(CHED).

  CHED was then given the autonomyto become the supreme organization over and above accrediting agencies (Arcelo,2003; Corpus, 2003).Accreditation Practices        Accreditation of an HEI in thePhilippines merits autonomy, while other forms of quality assessment meritfunding and subsidy, as opposed to what other countries practice.  As aforementioned, accreditation ofindividual programs and/or institutions is voluntary on the part of the HEIs,albeit being highly encouraged by CHED (Padua, 2003).  Each accrediting agency follows slightlydifferent practices from the rest.

 Ordonez and Arcelo (2003) illustrate the procedure taken by accreditingagencies.  Generally, all agenciessubscribe to two steps in accreditation, which are (1) self-study by theassigned department for accreditation, typically in the form of a survey whichis tailor-fit to the HEIs framework, and (2) an on-site assessment byrepresentatives from the accrediting agency.  Synthesis of Related Literature and Studies        The above mentioned review of relatedliterature and studies showed that in many points different leadership styles,practices, skills, and behavior affect the performance of an organizations suchas public and private schools, colleges, and universities.  This study is focused on the description ofleadership styles of the deans and program heads and how they affect theperformance of the school, colleges, and universities offering medicaltechnology education in the country.         The study conducted by Kedir and Geleta isseen closely related to the present study to which it dealt with the practicesof transformational leadership in technical vocational institution and traininginstitutions.  In the same study, thefive leadership practices were used to assess how effective the leaders were.Another similar study done by Go and Je that leadership impacts significantlyon employee performance and participative leadership styles helps to improveperformance among employee.

        Moreover, in a study by Al-Safran et alshowed that there were direct and indirect relationships between principal’sleadership and school outcome which is related to the present study for whichit focused on leadership styles and the school outcomes.                                                

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