Michael Rowe

What happens when AI joins the leadership team?

podcast2 min read

Leadership Biscuits · Hosted by Sharon Black · 2 September 2026 · 42 min

Recorded July 2026

Sharon Black invited me onto Leadership Biscuits to work through a question her listeners keep running into: what does AI actually ask of the people running health and social care organisations? The short answer is that it asks more of them than delegation. AI reaches into decision-making, workflow, governance, education and patient care, which puts it outside the remit of any single department.

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What we discussed

  • Why AI behaves differently from previous waves of technology change, and why that makes it a leadership problem rather than an IT procurement one
  • Using AI as a thinking partner — something to argue with about a decision — rather than as a faster way to produce documents
  • Whether AI will replace jobs in healthcare, and why augmentation describes what is actually happening more accurately
  • What changes when patients arrive at an appointment having already consulted a capable system
  • Why universities need to rethink assessment rather than defend it
  • How AI exposes the inefficient processes and bottlenecks an organisation had learned to live with
  • Why a culture of experimentation beats a culture of fear, and what leaders have to do to create one
  • The trap of measuring AI adoption by how much AI people use
  • Why leaders need first-hand experience of these systems rather than a consultant’s summary
  • What an organisation built around intelligence as a service might look like

The thread running underneath all of it is whether we are preparing our organisations, and the people in them, for the world that is actually arriving rather than the one we planned for. My own view is that leaders cannot get there by talking about AI. They have to use it, watch where it fails, and find out for themselves where it adds value.

I also said, and still mean, that the most interesting version of this conversation is the one we have in five years, when we can see how much of it we got wrong.

Where this connects

The argument about assessment is developed at length in What is the work?, my RCN Education keynote. The framework behind the integration argument is set out in the one-page guide to the AI in health professions education framework.

Continue reading

  • What is the work?

    A keynote for the Royal College of Nursing's Education conference. Examines how generative AI has severed the inferential chain between assessment artifacts and the learning they were meant to evidence, and what nursing education needs to do structurally in response. The argument moves from the current AI landscape, through the premises of nursing formation, to why discursive responses (policies, declarations) cannot address a structural problem.

  • A theoretical framework for integrating AI into HPE: a one-page guide

    A one-page reference guide for health professions educators. Condenses a theoretically grounded framework into six design principles for integrating AI in ways that support — rather than undermine — the conditions under which professional learning occurs. Each principle includes a brief description and an apply-by prompt for immediate use in learning activity design, curriculum review, or institutional policy.

  • Processing fluency

    Processing fluency is the ease with which the mind takes in information. People read that ease as a sign that something is true, familiar, or good, which is why fluent AI-generated text is persuasive whatever its accuracy, and why markers who equate clear writing with clear thinking need to separate the two.