title: Critical pedagogy in a health service management development programme: can "critically thinking" managers change the NHS management culture?
abstract: OBJECTIVE
  Management development programmes available to NHS managers focus on a performance orientation and sustain a culture of managerial and medical domination. This paper aims to question whether it is possible to consider NHS management development from a critical (empowerment culture) perspective. Features of the critical management studies approach (CMS) are identified. A new MSc is evaluated against these characteristics, examining the teaching and learning processes and students' perceptions of the programme. The aim is to develop critical thinkers who can return to their organizations and challenge existing power structures and practices to change local cultures and enhance health services.
  
  
  METHODS
  Empirical research employed anonymous student questionnaires and a focus group.
  
  
  RESULTS
  Student evaluations suggest the MSc can deliver a critical pedagogy and help managers understand issues of power and empowerment, challenge dominant cultures, innovate and effect small, local changes in the NHS culture.
  
  
  CONCLUSIONS
  There is a need to continue evaluating the programme and include other stakeholders. Longitudinal research should assess the impact of the managers' changed values, attitudes and behaviours on colleagues, clients and the local cultures.
  
  
  CONCLUSIONS
  The paper identifies some of the tensions of developing "critical" health service managers, and the problems they encounter back in the "uncritical" NHS context, as well as some of the challenges in "facilitating" a critical curriculum. It questions the ethics of developing (or not) a critical perspective in a local context unfamiliar with CMS.
  
  
  CONCLUSIONS
  Management development in the NHS largely ignores critical pedagogy. This paper makes a small and unique contribution to understanding how developing "critically thinking" managers can challenge the dominant culture. However, the limitations of such a small-scale study and ethical implications are noted.
authors.affiliation: Bangor Business School, Bangor University, Bangor, UK. sally.sambrook@bangor.ac.uk
authors.forename: Sally
authors.initials: S
authors.lastname: Sambrook
mesh_terms: D004493:Education; D017144:Focus Groups; D006270:Health Facility Administrators / Q000193:education*; D006298:Health Services Administration; D006801:Humans; D007857:Leadership; D015279:Organizational Culture; D013192:Staff Development / Q000458:organization & administration*; D013222:State Medicine; D011795:Surveys and Questionnaires; D013850:Thinking; D006113:United Kingdom