First Look

April 3, 2012

Leadership Training For Young Doctors

It stands to reason that medical doctors take on a variety of leadership roles in the course of a workday, and that effective clinical leadership is essential to good patient care. Yet few residency programs focus on leadership skills, according to Daniel Mark Blumenthal, Kenneth Richard Lee Bernard, Jordan David Bohnen, and Richard Bohmer. In the April issue of Academic Medicine, they make the case for formal leadership development programs for new clinicians. Read "Addressing the Leadership Gap in Medicine: Residents' Need for Systematic Leadership Development Training."

Gaining Time By Giving It Away

In her old song "Magic Penny," folk artist Malvina Reynolds sang, "Love is something if you give it away; you end up having more." A forthcoming article in Psychological Science indicates that the same is true of time. In "Giving Time Gives You Time," Cassie Mogliner, Zoe Chance, and Michael I. Norton report that spending time helping others increases feelings of time affluence—even more so than gaining an unexpected bonus of "free" time. "Our results indicate that spending time prosocially is more effective in relieving the pressure of time," they write. "When individuals feel time-constrained, they should become more generous with their time - despite their inclination to be less so."

Customer Visits For Entrepreneurs

Often the best way to assess demand for a new product or venture is to pay an in-person visit to a potential customer. In the industry note "Customer Visits for Entrepreneurs," Frank V. Cespedes discusses the criteria for selecting sites to visit, how to plan for a visit, what to ask and do while there, and how to debrief afterward.

— Carmen Nobel


Addressing the Leadership Gap in Medicine: Residents' Need for Systematic Leadership Development Training


All clinicians take on leadership responsibilities when delivering care. Evidence suggests that effective clinical leadership yields superior clinical outcomes. However, few residency programs systematically teach all residents how to lead, and many clinicians are inadequately prepared to meet their day-to-day clinical leadership responsibilities. The purpose of this article is twofold: first, to make the case for the need to refocus residency education around the development of outstanding "frontline" clinical leaders and, second, to provide an evidence-based framework for designing formal leadership development programs for residents. The authors first present a definition of clinical leadership and highlight evidence that effective frontline clinical leadership improves both clinical outcomes and satisfaction for patients and providers. The authors then discuss the health care "leadership gap" and describe barriers to implementing leadership development training in health care. Next, they present evidence that leaders are not just "born" but, rather, can be "made" and offer a set of best practices to facilitate the design of leadership development programs. Finally, the authors suggest approaches to mitigating barriers to implementing leadership development programs and highlight the major reasons why health care delivery organizations, residency programs, and national accreditation bodies must make comprehensive leadership education an explicit goal of residency training.

The Confederacy of Heterogeneous Software Organizations and Heterogeneous Developers: Field Experimental Evidence on Sorting and Worker Effort


Software development occurs in a patchwork or "confederacy" of different types of institutions (universities, small start-ups, multinational enterprises, government agencies, etc.) utilizing varied work approaches. Here we speculate on one possible explanation for this organizational heterogeneity: it may reflect inherent heterogeneity of the software workforce, in terms of which kinds of organizations individual workers prefer to work within ("institutional preference"). We take very preliminary steps towards investigating this possibility by devising a novel 10-day field experiment to estimate the differences in behavior that are created by sorting workers into their preferred institutional regimes versus having them unsorted. The experiment involved assigning 1,040 elite software developers to either a competitive or a cooperative work regime to create software for NASA's Space Life Sciences Directorate. Half of the subjects-the "sorted" group-were assigned according to their institutional preferences; the other half-the "unsorted" group-were assigned without regard to their preferences. Assignment was done in a manner where sorted and unsorted groups had identical distributions of raw problem-solving ability. We find a remarkably large effect of institutional preference-based sorting on the effort exerted. Sorting on institutional preferences roughly doubled effort within the competitive regime and increased effort by roughly half in the cooperative regime, while accounting for incentives. Our experimental approach and results indicate the importance of accounting for worker preferences in creative activities that drive the rate and direction of inventive activity in the economy.


Collaborating Across Cultures: Cultural Metacognition and Affect-Based Trust in Creative Collaboration


We propose that managers' awareness of their own and others' cultural assumptions (cultural metacognition) enables them to develop affect-based trust in their relationships with people from different cultures, enabling creative collaboration. Study 1, a multi-rater assessment of managerial performance, found that managers higher in metacognitive cultural intelligence (CQ) were rated as more effective in intercultural creative collaboration by managers from other cultures. Study 2, a social network survey, found that managers lower in metacognitive CQ engaged in less sharing of new ideas in their intercultural ties but not intracultural ties. Study 3 required participants to work collaboratively with a non-acquaintance from another culture and found that higher metacognitive CQ engendered greater idea sharing and creative performance, so long as they were allowed a personal conversation prior to the task. The effects of metacognitive CQ in enhancing creative collaboration were mediated by affect-based trust in Studies 2 and 3.

Giving Time Gives You Time


Four experiments reveal a counterintuitive solution to the common problem of feeling that one does not have enough time: giving some of it away. Although people's objective amount of time cannot be increased (there are only 24 hours in a day), this research demonstrates that people's subjective sense of time affluence can be increased: compared with wasting time, spending time on oneself, and even gaining a windfall of "free" time, spending time on others increases feelings of time affluence. The impact of giving time on feelings of time affluence is driven by a boosted sense of self-efficacy-such that giving time makes people more willing to commit to future engagements despite their busy schedules.

Download the paper: chance norton.pdf


Cases & Course Materials

Pitching Business Opportunities

Lynda M. Applegate, William R. Kerr, and Alexis Brownell
Harvard Business School Note 811-086

This note can be used to develop a business plan pitch for a new venture.

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Domino's Pizza

David E. Bell, Phillip Andrews, and Mary Shelman
Harvard Business School Case 512-004

Domino's Pizza is the world's second largest pizza company with 9,436 stores globally, 95% of which are franchised. Domino's franchisees in the U.S. market were able to purchase fresh dough, cheese, pizza toppings, and other menu ingredients and store supplies directly from the company-owned supply chain system. When commodity prices became more volatile in 2007 and 2008, executives at Domino's changed the way they worked with suppliers and franchisees to manage costs and risks and better leverage the assets of the supply chain system. As the company prepared to accelerate international growth in 2011 and beyond, executives contemplated how to best apply their purchasing and supply chain knowledge into new international markets.

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Customer Visits for Entrepreneurs

Frank V. Cespedes
Harvard Business School Note 812-098

Provides practical guidelines for conducting customer visits to explore and validate demand for an entrepreneurial offering. Reviews conditions under which visits will yield superior insights, compared to other research methods. Describes criteria for selecting visit sites, how to plan for visits, how to conduct them most effectively, and how to debrief after visits. The note is, therefore, relevant to MBA, Executive Education, Field Study, or project contexts where the focus is start-ups, entrepreneurial management, new product development, business development, or innovation.

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Integrated Assurance at Philips Electronics N.V.

Robert G. Eccles and Daniela Saltzman
Harvard Business School Case 412-054

Philips Electronics is a leader in integrated reporting. In 2010 it produced its third generation report. Since its first report in 2008, Philips' integrated reports and its integrated reporting website had grown in sophistication. In planning for its integrated report for 2011, the company is exploring the issues that will need to be addressed in order to produce an integrated report. KPMG is the company's auditor for both the financial and nonfinancial information contained in the integrated report, but these are covered by separate assurance opinions. Among the challenges of providing an integrated audit is getting the internal measurement and control systems for nonfinancial information to be of the same quality as for financial information. A further challenge is that the cultures of the finance function and those who work in sustainability are very different.

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Poles Apart on PZU (A)

Francesca Gino, Vincent Dessain, Karol Misztal, and Michael Khayyat
Harvard Business School Case 912-013

In October 2008, Andrzej Klesyk, CEO of Poland's largest insurer PZU, reflected on possible ways of resolving a decade-long cross-border shareholder conflict at his company. Owned 55% by the Polish State Treasury and 33% by the Dutch insurer Eureko as of October 2008, PZU was a highly profitable company and Poland's biggest asset holder. Eureko aimed at majority ownership of PZU as the building block of its Eastern European expansion strategy. The Treasury, however, was reluctant to forfeit control of the country's crown jewels. Several rounds of negotiations and international arbitration failed to resolve the conflict, leading to a progressive breach of trust. Was there anything Klesyk could do to break this international and multilateral stalemate?

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Poles Apart on PZU (B)

Francesca Gino, Vincent Dessain, Karol Misztal, and Michael Khayyat
Harvard Business School Supplement 912-014

In September 2008, the Polish State Treasury and the Dutch insurer Eureko were wondering if they were ready to reach an amicable solution on PZU. If so, for how much and under what conditions should they settle so that they, as well as PZU, are satisfied? If not, what other potential alternatives might exist?

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Poles Apart on PZU (C)

Francesca Gino, Vincent Dessain, Karol Misztal, and Michael Khayyat
Harvard Business School Supplement 912-015

After a decade-long dispute with the Polish State Treasury, in October 2009 the Dutch insurer Eureko agreed to exit PZU in exchange for compensation. Who was the biggest beneficiary of the settlement: Eureko, the Treasury, or PZU itself?

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What's the Deal with LivingSocial?

Michael I. Norton, Luc Wathieu, Betsy Page Sigman, and Marco Bertini
Harvard Business School Case 512-065

Tim O'Shaughnessy, the 29-year-old CEO of LivingSocial, is growing a revolutionary worldwide business of "daily deals"- in which retailers offer a heavily discounted product or service available for purchase for brief (often 24-hour) windows. The case explores the complicated sharing of risks and rewards between LivingSocial, participating retailers, and customers, focusing on the return on investment in both the short- and longer-term for LivingSocial's retail partners. In addition, given the rapid growth of the daily deals space and the accompanying proliferation of competitors, including Groupon and, the case focuses on the need for constant innovation in product offerings to maintain differentiation from copycats.

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Citibank: Weathering the Commercial Real Estate Crisis of the Early 1990s

Julie M. Wulf and Ian McKown Cornell
Harvard Business School Case 712-446

As the commercial real estate market began to crash in early 1990, heavily exposed banks like Citibank and Chase Manhattan were left largely undercapitalized. John Reed, Citibank chairman and CEO, was caught off guard by the sudden market plunge. While Reed struggled to maintain the capital reserve of his bank, further weaknesses within Citi began to emerge. In addition to missing the coming of the real estate crisis, Citi had had poorly managed internal operations, overvalued acquisitions, and grown heavy from organizational excess. The poor management left Citi in the care of federal regulators worried about the bank's solvency. The case examines the roots of these problems and the steps taken by Reed to return the bank to a well-managed and stable institution.

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