Empowering Leadership Voice

Beyond Leadership Podcast Series

Release Date: July 30, 2026

Expiration Date: July 29, 2029

Estimated Time of Completion: 25 minutes

Empowering Leadership Voice

Beri Ridgeway, MD

Shannon L. Pengel, MSN, RN, NE-BC:

Description

Welcome to L.E.A.D., a special series by Beyond Leadership. L.E.A.D. is an innovative, action-oriented framework built on four human-centered behaviors: Listening, Empathizing, Adapting, and Developing. In this series, we explore how top leaders apply these behaviors to build trust, foster collaboration, promote growth, and connect authentically every day.

This episode will explore how leaders can strengthen their voice, balance advocacy with active listening, and build psychological safety. Through real-world stories and practical insights, this conversation offers actionable guidance for communicating with clarity, authenticity, and impact—especially in complex environments.

Learning Objectives

• Build self-awareness to better align to your audience, while remaining direct and authentic
• Use active listening to ensure everyone feels heard and valued
• Create psychological safety by using specific habits that encourage open sharing

Target Audience

This program is designed for healthcare professionals interested in advancing their leadership skills.

Accreditation

In support of improving patient care, Cleveland Clinic Center for Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC), and Interprofessional Continuing Education (IPCE) Credit to provide continuing education for the healthcare team.

Credit Designation

• American Medical Association (AMA)

Cleveland Clinic Center for Continuing Education designates this internet enduring material for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Participants claiming CME credit from this activity may submit the credit hours to the American Osteopathic Association for Category 2 credit.

• American Nurses Credentialing Center (ANCC)

Cleveland Clinic Center for Continuing Education designates this internet enduring material for a maximum of 0.5 ANCC contact hours.

• American Academy of PAs (AAPA)

Cleveland Clinic Center for Continuing Education has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.5 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.

• Accreditation Council of Pharmacy Education (ACPE)

Cleveland Clinic Center for Continuing Education designates this knowledge-based activity for a maximum of 0.5 hours. Credit will be provided to NABP CPE Monitor within 60 days after the activity completion. Universal Activity Number List:

- Pharmacist UAN: JA0000192-0000-26-041-H99-P

• Interprofessional Continuing Education (IPCE) Credit

This activity was planned by and for the healthcare team, and learners will receive 0.5 Interprofessional Continuing Education (IPCE) credit for learning and change.

• Certificate of Participation

A certificate of participation will be provided to other health care professionals for requesting credits in accordance with their professional boards and/or associations.

Cleveland Clinic Planning Committee

James Stoller, MD, MS
Co-Activity Director
Chair, Education

Cecile Foshee, PhD
Co-Activity Director
Director, Office of Interprofessional Learning

Sawsan Abdel Razig, MD
Chief Academic Officer, Cleveland Clinic Abu Dhabi

Lindsey Amerine, PharmD
Sr. VP, Chief Pharmacy Officer

Lisa Baszynski, DNP
Executive Director, Associate Chief Nursing Officer

Colleen Carroll, MS
Sr. Director of Leadership and Learning

Matthew Donnelly, MBBS (Hons)
VP, Professional Staff Affairs

Mark Hamilton, MD
Cleveland Clinic London

Jospeh Iannotti, MD
Chief of Staff, Cleveland Clinic Florida

Debra Kangisser, PA-C
Office of Interprofessional Learning

Aanchal Kapoor, MD, MEd
Founder and Director of the Medical Intensive Liver Unit

Suchetha Kshettry, MD
Enterprise & Ohio Women’s Professional Staff Association President, (2025-2026)

Christopher Nagel, BA, MA
VP, Leadership and Learning

Silvia Perez Protto, MD
Immediate Women’s Professional Staff Association Past President, (2025)

Ronna Romano, MBA
Office of Interprofessional Learning

Stormy Sweitzer, PhD
Office of Interprofessional Learning

Faculty

Beri Ridgeway, MD
Executive Vice President and Enterprise Chief of Staff
Cleveland Clinic

Shannon L. Pengel, MSN, RN, NE-BC
Vice President, Chief Nursing Officer
Cleveland Clinic Main Campus

Host

Elizabeth Pugel
Global Leadership and Learning Institute

Disclosures

The Cleveland Clinic Center for Continuing Education has implemented a policy to comply with the Accreditation Council for Continuing Medical Education Standards for Integrity and Independence. This activity includes non-clinical content only. In accordance with the Standards for Integrity and Independence, identification, mitigation and disclosure of financial relationships does not apply.

CME Disclaimer

The information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by The Cleveland Clinic Foundation. In no event will The Cleveland Clinic Foundation be liable for any decision made or action taken in reliance upon the information provided through this CME activity.

HOW TO OBTAIN AMA PRA Category 1 Credits™, ANCC, AAPA, ACPE, IPCE Contact Hours OR CERTIFICATE OF PARTICIPATION:

Go to:

http://cce.ccf.org/ccecme/process?site_code=main&activity_session_code=EKCE02706

to log into myCME and begin the activity evaluation and print your certificate. If you need assistance, contact the CME office at myCME@ccf.org

Copyright © 2026 The Cleveland Clinic Foundation. All Rights Reserved.

Podcast Transcript

Kelly Hancock, DNP, RN, NE-BC, FAAN:

Hello and welcome to Beyond Leadership, a Cleveland Clinic podcast where we explore the many dimensions of leadership. I'm Kelly Hancock, Executive Vice President, Chief Caregiver, and Administrative Officer here at Cleveland Clinic, and I'm thrilled to have you join us. In this podcast series, we'll feature conversations with remarkable thinkers and uncover how their insights and experiences are shaping the future of leadership in healthcare. Now let's turn it over to our host, who will guide us through today's enlightening conversation.

Elizabeth Pugel:

Hello everyone, and welcome to today's episode. I am your host, Elizabeth Pugel, and this is Beyond Leadership. Today we will be discussing empowering leadership voice. Leadership isn't about the vision, it is about speaking in ways that engage others, balancing advocacy and listening, while fostering psychological safety and clearing the barriers that can silence voices. Together, we will explore how to evaluate communication strengths, master the balance between assertiveness and listening, and overcome common barriers like low confidence and fear of judgment. I am joined today by Dr. Beri Ridgeway, Executive Vice President and Enterprise Chief of Staff.

Beri Ridgeway, MD:

Great to be here. Thank you.

Elizabeth Pugel:

Welcome. And Shannon Pengel, Vice President and Chief Nursing Officer.

Shannon L. Pengel, MSN, RN, NE-BC:

Thank you so much for having me today. I am so excited to be here.

Elizabeth Pugel:

I'm excited for our conversation. So, today we will explore how to evaluate communication strengths, master the balance between assertiveness and listening, and overcome common barriers like low confidence and fear of judgment.

So, let's start at the foundation, ourselves. Effective leadership communication begins with self-awareness. It is about knowing your own voice, understanding your strengths, and knowing when and how to adapt your message. Especially when leading in a global environment where cultural norms can vary greatly. So, let's dig into how leaders understand and apply their own voice in different settings. Beri, how do you assess your own communication strengths as a leader?

Beri Ridgeway, MD:

Communication is one of the most important parts of really any leadership job. You can come up with that idea. You can have the vision and with the hopes of execution, but if you don't communicate that properly, people won't understand the why and won't be able to really do their job or be part of that solution. It's one of the most challenging parts of my job, and assessing how I do it or don't do it well, I look at the outcome. Meaning is it clear that people received the message? Is it clear that they understood the why? And also, are they aligned with sort of where we're going? I think other than that, it's hard to, you can look at metrics and other pieces and parts of it, but it never really informs me as much as the true impact of that intention. So, I look at the really the outcome, but it is something that I just want to say at baseline is really hard to do and I'm hypercritical all the time about it and always looking for ways to improve.

Elizabeth Pugel:

Can you share an example where your communication style worked well or perhaps didn't in a global environment?

Beri Ridgeway, MD:

One of the things that happened early on in my leadership career was when I was first a department chair and we needed to implement a new program that was mandated by the state where we offered long-acting reversible contraception at the time of birth. It was a very quick turnaround on that ask that then was complex with Epic and other things. And then ultimately getting the providers ahead of time to talk about it and then ultimately consent and offer it and document it so that we could be compliant. And it was a huge lift at the time, and I remembered, oh my gosh, I'm gonna communicate this. We're gonna do it in a meeting. We're gonna send written communication, we're gonna send that multiple times. We even created an old school poster board, like one of those science fair [Trifold <laugh>] trifold, thank you, poster board about it.

And I was like, I nailed this becausefor me to even bring it up again, I felt almost nauseated because I had talked about this so much. So, the day, of course, it hits July 1st, the worst day in medicine for to start something, and I go there to just check in and be like are we set? Is it all settled? Are we good? And multiple people the day is what is this? What are we doing? And I thought, oh my gosh, how are people not in the know about this? And the lesson for me was that despite using sort of the playbook of multiple modes of communication, multiple times, different voices, there's still gonna be groups of people where the message doesn't reach, and how to in real time be there to make sure that they can, whether it's implement the program or make the right decision and understand the why.

Shannon L. Pengel, MSN, RN, NE-BC:

It's funny, I think I'm a very tactical operational communicator. To your point, we need to do A, B, and C. Here's how we're going to do it. Everyone go off and do as I say. And that does not work when you have an audience that is large, that has a lot of opinions, a lot of cultural beliefs, and I know I had to pivot in my leadership journey to understand when to be motivational and inspiring versus tactical and operational. There's a time and place for both, but you also have to, to Beri's earlier point, really have to understand the why. Why are we [implementing this change? And I think that was an early identified mistake for me. I wasn't as good at explaining why as I was about how we were gonna get there. So, I think that's definitely a lesson that I learned along the way.

Elizabeth Pugel:

So, Shannon, what role does authenticity play in finding, in using your leadership voice?

Shannon L. Pengel, MSN, RN, NE-BC:

Well, I think this is a key concept in everything that we do. Communication, how we show up every day for our caregivers and our patients. Authenticity plays a huge part. Hearing people, hearing where they are, hearing their concerns, and really offering to them that genuine concern about where they are and how you're gonna help them fix their situation or their barrier. And that really fosters trust with our caregivers. If they know that they can go to their leader with good news, bad news, or I just need help, and they're gonna have an authentic response to that. They will begin to trust you more and more. They will become more and more resilient because they know they can escalate those issues to you. But the minute you are not authentic, people can see right through that. Especially when you're dealing with caregivers or families or colleagues that are maybe highly emotional about a topic. They will see right through it if you are not showing your authentic self. And that will, in my experience, tends to escalate things a little bit more instead of bringing down to the core problem that you're trying to solve.

Elizabeth Pugel:

So, self-awareness and strengths are one part of the equation, but leadership voice isn't only about what you say, it's also about how you listen. Let's explore the importance of listening as a leadership skill. Listening is just as important as advocacy. Leaders must be able to communicate a clear vision while also creating space for others to contribute, ensuring alignment across the team.

So Beri, how do you strike that balance between speaking up with clarity and listening with intention?

Beri Ridgeway, MD:

One cannot underemphasize the importance of listening. In many cases, and this took a while for me to learn, but people just want to be heard. There are of course, in a dream, I would love a solution to everything. But for the most part, in our organization, we're so fortunate they understand the reality of our jobs, the constraints and other things. And they want their opinion to be heard. They wanna be valued. And that listening is so critical to do that. They're not necessarily waiting for a solution. And I remember early on in my leadership journey, everything that came at me, I was like, what's a solution for this? How do I fix it? And over time, a lot of people would come up and just say, oh, I actually just wanted you to hear about this or for you to know this, or to see the suffering that I'm having. And that, for me, was really important. And ultimately, as you start managing more and more people and have larger structures, those endpoint pieces are important parts of a bigger puzzle as you think of the larger solutions. So, for me, I really value listening and making sure that the individual feels heard and in many cases, they're not really asking for my opinion anyway.

Elizabeth Pugel:

Shannon, can you share some techniques that help leaders ensure their vision is clearly understood by others?

Shannon L. Pengel, MSN, RN, NE-BC:

I think, it kind of goes back to that clear, transparent communication that Beri was referring to at the beginning. There are multiple formats that we've all learned how to communicate, but do people truly understand the expectations that you have? I think it is a whole 'nother area of opportunity. So, one of the things that I've been doing a lot more of is really, again, setting those clear expectations by asking for feedback. Tell me what you heard, what are your next steps so that I can ensure that we're completely aligned with the next steps of whatever project that we're working on. I think there's also a time where you also as a leader have to say, we talked about this, we were clear. That's a hard balance when you talk about listening and authenticity. But also, there is a part of communication that is holding people accountable to the expectations of their role as a leader.

Elizabeth Pugel:

Can you share an example where listening changed or strengthened your vision?

Shannon L. Pengel, MSN, RN, NE-BC:

So, after COVID, I formed a group of frontline caregivers. As you know, it was a very challenging time on healthcare workers during COVID. It was a very different time and place to lead after COVID. And what I found is they needed to be listened to, to your point Beri, they really needed to express how they were feeling. And I had to sit back and listen and I couldn't react. I had to take in everything that they were distressed about to your point and really think about how I was gonna respond. And I was very thoughtful to hear everyone out in the room put together a thoughtful response. And that actually helped me share my vision with that group in a better way. Because I took everything that they told me, I organized it, and then I developed a strategy and vision to be able to help them with the barriers that they were facing. And this group really appreciated it. They really felt like they were heard. I took what they had to say and applied some actions to it. And I think that was one strategy that I used that was really successful.

Elizabeth Pugel:

Beri, what strategies help leaders prevent their voice from overpowering others in the room?

Beri Ridgeway, MD:

One thing I try to do is not speak first. And that is something that sometimes is very hard to do, especially when you're in the situation, often the one being addressed. But I find that in certain groups, especially newer groups where there's not maybe that psychological safety, or relationships haven't been built appropriately, or had enough time to build those relationships, that when the leader speaks first, it sets the tone. And it's very hard for people to use their own voice, or dissent, or share their true opinion. So, I try not to speak first. I try to let others go, and then I try to make sure that then I can finish and make sure that my viewpoint is shared. Because at the end of the day, that's part of my job is sharing that opinion or viewpoint. I also try to call on people, often people in certain groups, there'll be a core that do a lot of the communicating. And so, I make sure that people have an opportunity to say, oh, hey, what are your thoughts? Or I'd love to hear from you what we haven't heard, what you think yet, so that everyone's voice can be heard and that it's not just me doing the talking necessarily.

Elizabeth Pugel:

We've touched on vision and listening and as Beri just mentioned, true leadership voice involves psychological safety, making sure people feel they can speak up without fear. So, let's look at some barriers that hold people back. Even strong communicators face barriers, low confidence, fear of judgment or organizational hierarchies that discourage speaking up. Leaders have to actively remove those barriers. Shannon, what are some of the most common barriers you've seen that prevent people from speaking up?

Shannon L. Pengel, MSN, RN, NE-BC:

Well, I think you touched on a number of them. There's the, the culture, there's the hierarchy, especially within medicine. And when I think of my clinical background, I practiced a lot in emergency response. And so, as a nurse, I would walk into a room oftentimes with a lot of very specialized providers, and I would have a thought of what was going on with a patient. And I had to learn how to speak up, and do it in a way that did not put people on the defensive that really collaborated with providers. Using those key words of, I'm concerned about this. What do you think? How can we collaborate and rule this particular complication out? So, I think that is definitely a technique that you can use when communicating with different levels of leadership.

I also think it's really important to understand the audience and understand the voice. So, I used a clinical example, but in my role as the chief nursing officer, I'm in a lot of conversations with, let's use the example of surgeons and they may have a particular goal of that conversation. And it's really important for me to step back, listen, understand what they're trying to achieve, and then really lay out a proposal or a plan for them. So, I think it depends on what kind of situation you're in, but I think always being collaborative, never putting people on the defensive and really trying to assist people to achieve their goals.

Elizabeth Pugel:

Beri, how can leaders support someone who struggles with confidence?

Beri Ridgeway, MD:

I think recognition and understanding of the why is super important because I may think they struggle with confidence, but it may be that they have a fear of public speaking, or that they have been shot down before in conversations. And so, I try to really understand what the situation is. And I'll often give people feedback wow, with your role in the enterprise, it's gonna be really important that you show up this way and that your voice is heard 'cause you're representing so many people. And then try to get to a solution around that. Would it help if I call on you? Do you wanna go to a public speaking course? How do we get around those barriers? I try not to assume the issue behind it. And some people are just so respectful of hierarchy that it makes it really hard for them to overcome that. Another thing that I really try to prevent is group think, because in a room it can be very easy for everyone to share that opinion. So, I'll often ask even to someone, okay, it sounds like we're all in agreement. If people were not in agreement, what would they say? And so, to give them almost a hypothetical way to speak up without fear of going against the grain or the group.

Shannon L. Pengel, MSN, RN, NE-BC:

Sometimes I'll ask, what am I not thinking of?

We are all in alignment, but what, what are we not anticipating here? And sometimes those that don't have the confidence to speak up will raise their hand and say, “Did you think about this?” And, and then it actually helps the group to really come to the best decision and conclusion.

Elizabeth Pugel:

Shannon, do you have any additional best practices for how you approach a team member who seems hesitant to speak up?

Shannon L. Pengel, MSN, RN, NE-BC:

I think really understanding their strengths and what they bring to the team is really important. And I know on my team I have a group of different types of leaders. Some are very operational, some are very data driven, some are very people driven. And so, understanding that all of those strengths is important as a leader. So, when I see a blind spot, I can call on my people leader and say, what am I not thinking of? And then that helps them speak up too. So really understanding and kind of calling on them. To your point, Dr. Ridgeway, I think you mentioned that as a best practice to really hear from them and pull that out and you have to maintain that psychological safety if you're gonna do that.

Elizabeth Pugel:

Beri, what are some practical steps that leaders can take to build psychological safety in everyday interactions?

Beri Ridgeway, MD:

For me, it's about building authentic relationships. And I put a lot of time and effort into that because when the table stakes are low, it's the time to understand that person as a person, as a profession, as part of our organization. And having that relationship at the baseline of everything you do allows it when times get tough or you have to have those critical conversations or crucial conversations. And so, my effort is really upfront so that then when I have to have it, I feel comfortable and I can just be very upfront and direct because I know that they will understand that we have a great relationship. This isn't about them personally. It's not an attack. And I think that's the time to create psychological safety is in those relationships. In bigger groups, it's a little bit harder to do that. Over time it can be done. But then in the room, I think it's important when a group is having a conversation that you are very intentional about calling people out so that they can share their opinion. But also, if sometimes those conversations turn, I'm also calling people out of okay, that's not how we're gonna continue the conversation. I would never say something that's inappropriate. But to say let's pause for a second here. I want to make sure so and so can talk. Or we need to bring this down a few notches. So that the group itself and the conversation doesn't get out of hand. 'cause that'll really shut down all appropriate and meaningful conversation.

Elizabeth Pugel:

And Shannon, same question. What practical steps can you recommend that leaders take to build that psychological safety?

Shannon L. Pengel, MSN, RN, NE-BC:

Being very transparent and vulnerable yourself as a leader is really important. If you're gonna build psychological safety, sometimes you need to also talk about your vulnerabilities and how you are feeling to get the rest of the group to speak up. And I mentioned the group that I got together of our frontline caregivers. There was a lot of transparent communication that I also shared back with them to get more information out of them. So, I think it's just important as a leader to be authentic, but also to be very transparent and sometimes vulnerable to help people feel comfortable. We're all in this together. Nobody has the perfect solution. Just because I'm sitting in this seat as the leader does not mean I have the best solution. And making sure people understand that.

Elizabeth Pugel:

What role does empathy play in building psychological safety?

Shannon L. Pengel, MSN, RN, NE-BC:

I feel this is very important in all the work that we do, but I look at situations that Dr. Ridgeway and I deal with on a daily basis. And a lot of it is highly emotional and it's really important to understand where that person is coming from, empathize with what they're going through, regardless of what the concern is, and try to help, I think Beri used the term, bring them down a little bit so that you can get to more of the solution driven conversation. So, I think it's very important and I think your emotional intelligence and ability to be able to really understand where someone is in the moment is really important as a leader. Because you don't want to elevate the situation even more. You want to be able to empathize with them and help them to a solution.

Beri Ridgeway, MD:

I couldn't agree more. I think it's an interesting thing. Often people will fear that if they empathize, they're yielding or they're agreeing with maybe a point that, in the end, isn't to their core in agreement. But I think they're actually two totally separate things. There's essentially like seeing them as a person, empathizing their opinion, their situation, and then allowing that to happen and really understanding that it's completely disconnected from ultimately the conversation and the solution at hand.

Shannon L. Pengel, MSN, RN, NE-BC:

Mm-hmm I agree. Yeah. Very, very much. So.

Elizabeth Pugel:

We've covered a lot of ground today from evaluating our own strengths, balancing advocacy with listening to the critical work of removing barriers. As we wrap up, I'd love to get both of your final thoughts on the topic. Beri, I'll start with you. What's the one piece of advice you'd give a leader who wants to continue developing their voice?

Beri Ridgeway, MD:

I would say just do more of it. Believe it or not, when I was a medical student, I had a fear of public speaking and I think of what I do now in my job, and I think how am I that same person? And it just came from absolute repetition, making a million mistakes, examining those mistakes and iterations over time. And then the only other piece of advice I would give on this is understanding your audience. That is so critical, and I see that as a blind spot that many people have is they have perfected sort of one way of communication. And in that, depending on the audience, it can fall totally flat. And so, understanding that audience and focusing on a little bit less the content and more the delivery are those two pieces, the audience, and then how to actually land communication with them, I think is the biggest learning lesson that I've had over time.

Elizabeth Pugel:

Shannon, what is the one piece of advice you'd give a leader trying to strengthen their communication voice?

Shannon L. Pengel, MSN, RN, NE-BC:

I think very similar to Beri. I too hated public speaking when I started in this role. And I can remember my first town hall, which was in front of about 300 people and being terrified. And I had to learn from that. I had to get feedback, I had to ask for feedback, and then I had to adjust and keep trying. So, I think we all make mistakes and struggle, and that's okay, but asking for that feedback is really important. Having a trusted mentor is also something that can be a very valuable tool. When someone is really paying attention to your words, they're able to give you that feedback and really clarify the message that you were trying to give. And then to Beri's point about knowing your audience, and I think that is absolutely a very big blind spot of many new leaders. And also, that helps you develop your empathy. If you really know your audience, you, you're empathizing with them and you're putting yourself in their shoes, and that allows you to actively listen to what they're trying to say and the message that they're trying to get across.

Elizabeth Pugel:

One final question today, Beri, I'll start with you. If listeners could practice just one skill tomorrow to better balance advocacy and listening, what should it be?

Beri Ridgeway, MD:

Whether it's one person, a small group, or a large group, it's that connection that is, I would say, to focus on that the message, the impact ultimately will land, but it's that connection that's critical.

Elizabeth Pugel:

And Shannon?

Shannon L. Pengel, MSN, RN, NE-BC:

Yeah, I think I'd add one other adjective to that, an authentic connection to people, to groups, to teams. The relationships that you build every day are gonna be key to your success as a leader. Many times you're interacting with folks on a daily basis in a very positive way, but then when you need to really have the team behind you, that's when those authentic relationships come into play.

Elizabeth Pugel:

This has been a great conversation around building our leadership voice. I'd like to thank Dr. Ridgeway and Shannon Pengel for joining us today. And thank you to our listeners for joining us today.

Keep leaning into your strengths, balancing clear, assertive direction with genuine listening. And remember, challenges like low confidence or fear of judgment are common even in leadership roles. What matters is continuing to practice, reflect, and grow. If this episode helps shift your perspective, share it with a colleague and subscribe to our podcast for more conversations that support your leadership journey. Until next time, keep leading with clarity, courage, and heart. I'm Elizabeth Pugel, stay curious.

This concludes another episode of Beyond Leadership. You can find additional podcast episodes on our website, clevelandclinic.org/beyondleadership, or subscribe to the podcast on iTunes, Google Play, Spotify, or wherever you get your podcasts.