Resilient #MedEd #Leaders: Using a Co-leadership Dyad Model to Increase the Density of Connections (Part 2)

By Felix Ankel (@felixankel) and Jeanette Augustson (@JenAugustson)

This is the second of four posts in the #meded leadership series, all focusing on developing resilient education programs that are able to handle system stress. The four topics include:

  1. Identifying clear values
  2. Maximizing the density of connections (The topic of this post)
  3. Maximizing the ability to bend
  4. Incorporating systematic reflective practice

Co-leadership models have existed since Republican Rome. For 400 years, the Roman leadership model was a dyad consisting of a patrician (noble) and a plebian (commoner). Physician/administrator dyad leadership teams date back to 1908, when Will Mayo, MD, and Harry Harwick recognized that joint leadership is more effective than single leadership in integrative healthcare delivery.

Productive dyads allow for continuous reflection, better decisions, and more effective problem solving. Cognitive biases sometimes become prejudices that push others away, decreasing potential connection and collaborative opportunity. Effective dyads help mitigate the co-leaders’ cognitive biases, especially anchoring and confirmation biases. Dyads also help the co-leaders calibrate each other’s emotional state when faced with conflict-prone situations. This results in an approach that moves the mind-set up the Senn Delaney “mood elevator” from judgment and defensiveness to creativity and resourcefulness. This new mind-set allows for more efficient trust network development.

Ultimately, effective dyads perfect a system of reflection-in-action that allows for continuous adaptive learning.

Our dyad experience, which follows, show how leadership dyads can increase the density of connections within systems and serve as a foundation in building resilient educational systems.

Jen’s Experience: Diversity of Thought and Skills

A couple of years ago, I had my first experience working in a dyad leadership model. Initially, it was an opportunity to lead through a partnership in which each of us brought different skills and strengths to the task. Some of my strengths included planning, communication, and implementation. My partner had a wealth of expertise in the programs we were leading, as well as strengths in strategy and vision development. Together, we complimented each other with our diversity of thought, skills, and experience.

As our partnership evolved, I saw our leadership become much more than two people with complimentary skill sets working together on common goals. First, I found that I was approaching challenges and opportunities in a more thoughtful, elevated manner. Through dialogue with my dyad partner—benefiting from his experiences and observations as well as my own—I was more confident that my decisions and actions were on point. Second, my own awareness about my leadership style and strengths increased. In certain situations, my partner was leaning on me for strengths I hadn’t recognized before, and I likewise leaned on him.

Finally, our effectiveness in working with others to accomplish our goals increased. We both had professional networks and relationships that we brought to our common efforts. I also believe that as others saw us working in partnership, their trust and support grew, since they recognized that we were applying our combined skills and expertise to a challenge. It is this density of connections that elevated and accelerated support for our efforts.

Felix’s Experience: Fostering Communication and Partnership Building

I came into a dyad leadership structure after decades of being in a typical #meded singular leadership design. My focus had been on developing and fostering expertise that focused on medical knowledge and individual exceptionalism rather than the Institute for Healthcare Improvement’s Triple Aim framework and teaming behavior. In my new environment, I felt confident in my content knowledge and methods of information transfer. I felt less confident in my ability to construct a #meded narrative and communication platform that was understandable to a heterogeneous group of stakeholders, many of whom had only peripheral engagement with #meded.

My dyad partner had a wealth of experience in areas such as planning, finance, human resources, and board relations. Initially, we invested a great deal of time and energy in a “dyad boot camp” that accelerated our on-the-fly learning. Both of us attended all meetings and worked collaboratively on all projects, which allowed us to prepare together, observe together, and reflect together. Soon, we were able to divide up our responsibilities and speak for each other.

The dyad model and upfront immersion allowed me to become a quick study in the cultural norms of an integrated health care system. I learned the new language, leadership, management, and communication styles of a large organization and became more effective. The melding of both of our networks also increased the density of our #meded connections, both within and outside our system, and facilitated rapid partnership building.

Tips for effective leadership dyads:

  1. “Be present” in the partnership: Actively listen, consult, reflect, and make decisions together
  2. Have clear roles, responsibilities, and rules of engagement
  3. Reflect on your own strengths and the areas for which you may want to lean on your dyad partner
  4. Share your professional networks and foster shared relationships
  5. Make it a personal goal to ensure your dyad partner is successful; you will have the most influence on his or her experience of work
  6. Remember that dyads reflect the goals of the system they are leading, not the desires of two individuals
  7. Educate others on dyads. Dyad leadership models may be tricky for others to navigate


David Sally.  Co-leadership: Lessons from Republican Rome. California Management Review 44(4) 84-99, 2002.

David Schoen. The reflective practitioner: How professionals think in action. 1984.

Larry Senn.  Up the mood elevator: Your guide to success without stress. 2012.

Image by ePublicist, via Flickr under Creative Commons License CC2.0