Sue Campbell, School of Medicine, Dentistry and Nursing

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This session was carried out in April 2024 at QEUH TLC with year 3 student nurses and previously with 4^th year student nurses as part of a leadership and management module.

Brief summary of the case study

This blog post will focus on a case study that was used with undergraduate nursing students to demonstrate the important role of followership while working in healthcare teams. Literature has a dominance on the role of leaders and within healthcare there are various awards for outstanding leaders. The aim of the session is to explore the role of followers and how they have both the opportunity and the responsibility to affect organisational outcomes.

The origami frog activity is simple enough that an understanding of the interdependent roles played by leaders and followers can be demonstrated, in particular the direct effect of follower behaviours on process and task outcomes. The learning experience provides enough complexity for students to see that working together increases the chances of an effective outcome which can be reached in a 50 minute class session.

Preparation

There are a number of resources that are prepared in advance. This includes:

• Multi coloured index cards (best if the weight of paper rather than card; 20 per group)
• Instructions on how to make an origami frog for each group
• Individual instructions for each student organised by group                                                                                   
• Sample origami frog
• PowerPoint slide with task

Task

Produce as many high-quality origami frogs in 10 minutes as possible

Instructions

• Make the origami frogs using only the enclosed index cards
• Use the origami frog instruction sheet to guide you
• Product test each frog’s quality by verifying that it can complete 2 jumps
• Label each acceptable frog with your team’s logo

Carrying out the activity   

The classroom needs to be an active learning space so students can sit in groups round a table.

Students are divided into groups of about 5 students per group. Each group appoints a leader and the remaining students are followers. Pre-prepared instructions are given for each group with the leader of each group unaware of the instructions given to their ‘followers’. For example, in group A the leader will read that they ‘are leading a group of effective followers which has worked together previously and have previously completed a complex task’. Follower A instructions will say that they ‘are an effective follower. Your leader recognises your value to achieving the goal.’ You have completed previous tasks successfully’. The leader of Group B leader instructions are that ‘they are leading a group of passive followers. You have worked together previously. Your followers need constant supervision and direction and do not take initiative’. Followers in group B are told to ‘be passive followers. You have worked with this leader on previous tasks. The leader does not welcomed suggestions and is ready to blame others if the task fails’. Group C leaders are just told they are the leader for this task and followers in group C are told they are passive followers.  Other groups will have followers where some are told to be active and others passive followers. (See instructions sent to leaders and followers.)

Do remind students to stay in their roles – it may be frustrating for those who like being creative to act as passive followers.  

After 10 minutes the number of origami frogs produced from each group is totalled and posted for all to see.

Post activity discussion

• Did the leaders work out what type of followers they had and if so did this affect their leadership styles? If the leaders did work out what type of follower they had, what were the clues that made them alert to this? Did any group adopt an ‘assembly line’ approach if they had group members who weren’t as proficient at origami? How might that help a team?
• Are the leader, follower and goal interdependent?
• Can developing effective followers be a useful way to support organisational goal achievement and how might you do this? What approaches to leadership might be useful here?

To conclude it is useful to show the Derek Sivers YouTube video to demonstrate the important role of the first follower – Derek Sivers Dancing Guy

What worked well?

This activity stimulated interesting discussion with all students participating.

References

Pollard CL, Wild C (2014). Nursing leadership competencies: Low-fidelity simulation as a teaching strategy. Nurse Education in Practice 14 620-626 http://dx.doi.org/10.1016/j.nepr.2014.06.006

Sronce R and Arendt LA (2009). Demonstrating the Interplay of Leaders and Followers: An Experiential Exercise. Journal of Management Education Vol 33 No 6 pp 699-724 10.1177/1052562908330726