This paper describes a qualitative observational study of how a work based learning masters leadership development programme for middle managers in health and social care in the UK introduced students to key aspects of delivering innovation, through a formative assignment on contemporary architectural design. Action learning and activity theoretical approaches were used to enable students to explore common principles of leading the delivery of innovation. Between 2001 and 2013 a total of 89 students in 7 cohorts completed the assignment. Evaluation lent support for the view that the assignment provided a powerful learning experience for many. Several students found the creativity, determination and dedication of architects, designers and structural engineers inspirational in their ability to translate a creative idea into a completed artefact, deploy resources and negotiate complex demands of stakeholders. Others expressed varying levels of self-empowerment as regards their capacity for fostering an equivalent creativity in self and others. Theoretical approaches in addition to activity theory, including Engeström’s concepts of stabilisation knowledge and possibility knowledge, are discussed to explain these differing outcomes and to clarify the challenges and opportunities for educational developers seeking to utilise cross-disciplinary, creative approaches in curriculum design.