Most formal leadership programming focuses on developing competencies — from managing conflict to leading change. No doubt, effective leaders need an ever-growing set of knowledge and skills — tools and practical guidance on how to use them. But for many institutions, there is a gap between leadership programs and their impact on leaders’ actual thinking and behavior. Saxena (2026), writing in the Journal of Healthcare Leadership, identifies this as an “intent-action gap” — arguing that the problem is less about the quality of leadership programs and more about what they fail to address: the foundational questions that precede skill-building, including clarity of purpose, identity development, and the cultivation of judgment. Each article curated in this issue of Noteworthy offers a different perspective on the same underlying problem. Teaching the how of leadership takes precedence over the why and the who.

Start with Purpose

Underlying the development of leadership competencies, networking, mentoring, and other legitimate means of becoming a better leader is the question: What is my purpose as a leader?

For a faculty member deciding whether to pursue an administrative role, a department chair navigating curriculum reform, or a program director under accreditation pressure, this is not an abstract question. It is the difference between acting with direction and simply reacting to circumstance. While leaders without a clear sense of purpose might be capable responders, they are not strategic thinkers. A mission statement can articulate institutional purpose — and at its best, it does. But personal leadership purpose goes further: it is a living commitment that shapes how one allocates time, what is negotiable and what is not, and how one makes decisions in complex and uncertain situations.

Develop Judgment

A second question follows: Am I developing the right kind of intelligence for the challenges I face?

Leadership development tends to emphasize executable skills and repeatable processes — competency frameworks, change management models, and communication techniques. Writing in EDUCAUSE Review, Diaz describes three important “power skills” for emerging leaders: change management, data fluency, and business acumen (Diaz, 2025). To use these skills where they matter most—those with strategic and long-term consequences—requires developing a different way of seeing and thinking about the environment.

Consider the difference between the two kinds of leadership response. A department chair facing low faculty morale might apply a standard engagement survey and implement recommended interventions — a sound technical approach. A chair exercising genuine judgment reads the situation differently: she recognizes that morale is a symptom, not the problem, and that what the department actually needs is a frank conversation about purpose and direction that no survey will prompt. Or consider a faculty member at a career crossroads who follows a career planning checklist — mapping competencies against available roles — versus one who asks the harder question: which path develops the kind of leader I am genuinely trying to become, in service of what I have claimed to stand for?

These challenges are not solved by applying a formula. Informed by purpose, they are navigated by bringing judgment and experience to bear on what is actually in front of you — in this institution, with these people, at this moment. That kind of intelligence is not a skill. It is a capacity that develops through practice, reflection, and honest engagement over time. It deepens through the habit of asking hard questions and staying with the answers long enough for them to change how you act.

Competence executes well within a known situation. Wisdom reads the situation accurately in the first place — and knows when the situation has changed. This is what separates a strategically wise leader from a strategically competent one.

What Is at Stake

These are prerequisites to strategic thinking, not supplements to it. Institutions are increasingly aware of what is lost when leaders are not developed with this kind of intention. A recent study of faculty leadership development in academic medicine found that lack of career advancement and leadership opportunity is among the primary reasons faculty leave their institutions — and that many leadership pathways remain invisible, inconsistently available, or narrowly defined (Haischer-Rollo et al., 2025). When leaders advance through competence alone — without clarity of purpose or cultivated judgment — they manage well in stable conditions and struggle when the conditions shift.

A Place to Begin

The most important insight about wisdom — from philosophy, from leadership research, and from the experience of effective leaders — is that it grows through deliberate, repeated reflection.

If health professions education is going to develop leaders who are genuinely prepared for what the work requires, it must address not only what leaders do but also who they are becoming in the process. Writing in the fourth century BCE, Aristotle called the capacity to deliberate wisely about what matters — in particular circumstances, in service of genuine purpose — the virtue of prudence. He also insisted it was the one virtue that could not be taught directly. It could only be cultivated through practice over time.

Author: 

Karl Haden, PhD, FACD

President, AAL