PURPOSE: What constitutes effective leadership in a collaborative effort to achieve enduring curricular and student career changes? This question was investigated as part of a larger evaluation of the W. K. Kellogg Foundation's Community Partnership Health Professions Education, a five-year initiative involving projects at seven sites. The goal was to produce more primary care health providers by making enduring curricular change. METHOD: Data were collected from participants with respect to predictors of project success and leaders' use of 16 behaviors via telephone interviews, mailed surveys, and focus groups. Focus groups also gathered project leaders' views of skills and knowledge necessary for effective leadership. RESULTS: Leadership strategies associated with positive outcomes were: consistent leader; use of multiple cognitive frames, especially a human resource frame; use of a broad range of leadership behaviors, particularly participative governance and cultural influence; and a majority of community representatives on the partnership board. The primary leader, compared with a leadership team, is most influential in achieving positive outcomes. CONCLUSION: Effective leaders use a broad array of behaviors, but particularly emphasize the use of participative governance and culture/value-influencing behaviors. In addition, the more frequent use of these behaviors compared with the use of organizational power behaviors is important. It is helpful to perceive the project from a human-relations frame and at least one other frame. Using a leadership team can be helpful, especially in building coalitions, but the importance of the primary leader's behaviors to project outcomes is striking.
(C) 1999 Association of American Medical Colleges