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PubMedDate not supplied

Measuring the leadership styles and scholarly productivity of nursing department chairpersons.

Self-perceived leadership styles of nursing department chairpersons were correlated with their scholarly productivity. The sample consisted of the 106 nursing department chairpersons from National League for Nursing (NLN)-accredited baccalaureate and higher-degree programs in 10 midwestern states. Hersey and Blanchard's Situational Leadership Model was used as the conceptual framework. Their LEAD-Self instrument was used to measure leadership styles, range, and adaptability. In addition, the Scholarly Productivity Index (SPI) was used to measure the nursing chairpersons' involvement in prepublication and research, publication, editorial, and other scholarly activities. College size and status (public or private) were among the variables examined to assess a relationship or group differences. A majority of nursing department chairpersons viewed themselves as having a "participating" leadership style. Most of the remaining chairpersons viewed themselves as having a "selling" leadership style. Study participants viewed their backup leadership styles to be in a reverse order from their primary leadership styles with the "selling" leadership style the most frequently used backup style and "participating" the second most frequently used style. Chairpersons from public nursing schools reported significantly greater numbers of scholarly activities than did chairpersons from private nursing schools. Chairpersons who had held their positions for less than 5 years tended to have a "participating" leadership style. A majority of nursing department chairpersons in the study reported that they felt institutional pressure to engage in scholarly activities.

Career Mobility↗

PubMed2001

The renaissance of clinical leadership.

The purpose of this work was to explore clinical nursing leadership. The research was based on a critical examination of the leadership themes derived from the nursing literature of the United Kingdom, the United States of America and Australia, between 1992 and 1997. The work was also influenced by the findings from semistructured interviews undertaken with five clinical leaders in nursing from the United Kingdom, and study tours to both the United States of America and Australia. The findings support a proposed leadership model as a basis for further exploration and as a framework for contemplating clinical leadership and leadership preparation. A model is presented that identifies factors which influence leadership styles, such as external environment, internal environment, experience and understanding. Four leadership styles are outlined: transactional, transformational, connective and renaissance. These leadership styles are linked to nursing care approaches. A second model provides a basis for considering power and its impact in the workplace. Based on these findings, the contents of a leadership preparation course are outlined.

Attitude of Health Personnel↗

PubMed1986

Residents' leadership styles and effectiveness as perceived by nurses.

Although physicians are required to act as leaders in a variety of situations, leadership ability and leadership training have been largely ignored by medical educators. The leadership styles and leadership effectiveness of 17 residents in a community hospital were studied as part of a leadership training seminar. Self-ratings and ratings of the residents by nurses who had worked with them were used to assess the residents' leadership style and the nurses' perceptions of the effectiveness of those styles. Styles that emphasized relationships with co-workers (encouraging and coaching styles) predominated over low relationship-oriented styles (delegating and structuring). The nurses perceived individual residents who exhibited encouraging and coaching leadership styles as being distinctly more effective leaders than the residents who exhibited structuring and delegating styles. The residents, however, rated all four styles as similarly effective. Leadership training programs and studies of the type reported here may provide an opportunity for faculty members to help residents learn more appropriate and productive styles of leadership.

Female↗

PubMed2005

Leadership and management training of pediatric intensivists: how do we gain our skills?

BACKGROUND: Intensivists manage a diverse team of health care professionals. For decades, business literature has recognized the value of leadership and management skills, yet this is relatively unexplored in critical care. OBJECTIVE: Investigate the status of intensivists' preparation for the clinical leadership and management roles that they will assume after medical training. DESIGN: Authoritative business leadership literature was reviewed to identify attributes of successful leadership and management relevant to critical care. A survey was designed to assess the process by which intensivists learn these attributes and to assess their perceived level of preparedness (20 items). Each survey item received a preparedness score structured as a Likert scale (1=not prepared, 5=very prepared), representing the averaged response to each item. In addition, an inadequate preparedness percentage was created representing the percentage of respondents answering "not at all prepared" and "hardly prepared" on the Likert-scaled items. SETTING: Pediatric Critical Care Medicine Board Review Course, Washington, DC, 2004. SUBJECTS: Physician course participants (n=259). INTERVENTION: Survey administration. MEASUREMENTS AND MAIN RESULTS: The response rate was 61% (n = 159). The majority of respondents (69%) had completed fellowship training (median, 1 yr posttraining). Modeling the behavior of other physicians was the dominant technique for leadership and management skill acquisition (86%). The respondents were taught these skills by a variety of sources (attendings, 92%; other fellows, 42%; nurses, 37%; teachers, 20%; residents, 14%). Most (82%) thought that leadership and management training was important or very important, yet only 47% had received any formal training (40% fellowship, 36% residency, 21% medical school, 16% masters, 30% other). Overall, respondents felt only "somewhat prepared" for the 20 leadership and management items surveyed (mean+/- sd of preparedness score, 2.8+/- 0.2). Respondents were least prepared to manage conflict within a team, manage conflict with other groups, and manage stress effectively (preparedness scores of 2.5, 2.4, and 2.6 and inadequate preparedness percentages of 19.5%, 15.7%, and 18.9%, respectively). Respondents were most prepared to "set high standards" (preparedness score=3.3). Of the respondents feeling at least somewhat prepared, only 33% credited medical training as preparing them. CONCLUSIONS: Although leadership and management training was perceived as important to this sample of pediatric generally young intensivists, most feel inadequately prepared for critical aspects of these responsibilities, most notably, stress and conflict management. These findings provide an opportunity for specific curriculum development in leadership and management for those believing these skills should be further refined.

Critical Care↗

PubMed2002

Leadership research in business and health care.

PURPOSE: To summarize research on leadership in the health care and business literature and to identify the outcomes of leadership on individuals, groups, and organizations. METHODS: A computerized search and review of research studies was conducted in the health care and business literature from 1970-1999. Studies were categorized and analyzed according to participants, design, primary topic area, and effects or outcomes of leadership. FINDINGS: Most of the health care and business literature on leadership consisted of anecdotal or theoretical discussion. Only 4.4% (n = 290) of 6,628 articles reviewed were data-based. Further, the largest proportion of the research (120/290, 41.4%) was purely descriptive of the demographic characteristics or personality traits of leaders. Other studies showed the influence of leadership on subordinates (27.9%). Only 15 (5.2%) of 290 research articles include correlations of qualities or styles of leadership with measurable outcomes on the recipients of services or positive changes in organizations. CONCLUSIONS: Research on leadership in the health care and business literature to date has been primarily descriptive. Although work in the social sciences indicates that leadership styles can have a major influence on performance and outcomes, minimal transfer of this work to the health care system is evident. Limited research on leadership and health care outcomes exists, such as changes in patient care or improvements in organizational outputs. In this era of evidence-based practice, such research, although difficult to conduct, is urgently needed.

Commerce↗

PubMed2003

Evaluation of a leadership development intervention.

Parallel to the shortage of clinical nurses is the diminishing pool of nurses who aspire to leadership roles in healthcare. The authors of this paper report on the evaluation of an intervention administered to a group of Canadian nurses designed to assist participants to value leadership and to develop knowledge, skills and attitudes required for effective leadership. A one-group pre-test, post-test quasi-experimental design guided the study. All participants received a five-day residential leadership development intervention. Participants acted as their own controls and were assessed, both immediately before intervention implementation and three months later, on the self- and observer-reported leadership practices as well as self-reported levels of burnout. Results indicated that a concentrated, residential leadership development intervention is effective in strengthening leadership behaviours performed by both already established and aspiring nurse leaders from the perspective of observers, but not from self-reported assessments. No significant changes in self-reported burnout levels were found. It is possible to deliver leadership development interventions to both established and aspiring nurse leaders that result in fairly rapid improvements in observed leadership practices.

Adult↗

PubMed2003

Where are the healthcare leaders" the need for investment in leadership development.

Is there a crisis in healthcare leadership? In order to understand this question we must first look at what is meant by the term leadership. We prize and admire leadership skills, yet we have little understanding of how and why some persons are more effective leaders than others. This paper describes the changing concept of leadership in the context of both corporate and healthcare settings. The approaches taken in corporate leadership development programs are contrasted with the way in which leaders have been developed in healthcare. The authors assert that there are unique characteristics of health systems and organizations that warrant a tailored approach. A new model of developing healthcare leaders is proposed, one that could transform the educational process and improve outcomes. The authors call for a "back to basics" about how adults learn and outline an approach to leadership development in healthcare that includes principles of competency-based development, interdisciplinary and team learning and continuous assessment. Their conclusion is that leadership development is not done solely to improve the leadership skills of one individual but is an essential component of the development of the organization as a whole. Progressive health systems that invest in leadership development for the entire senior management team will have the more significant return on investment in terms of organizational effectiveness.

Administrative Personnel↗

PubMed1988

Management education focuses on new leadership ideas.

A widely accepted new leadership approach concerns transactional and transformational leadership. Transactional leadership consists of planning, implementation, and evaluation. Transformational leadership consists of charisma, intellectual stimulation, and individualized consideration that can motivate followers. The six orientations that characterize the Catholic healthcare ministry imply both types of leadership. Fundamental values, knowledge, and skills required for healthcare organization management are acquired through health administration education. The themes prevalent in today's Catholic healthcare ministry and the leadership qualities they imply are addressed by all aspects of such education: degree programs, field experience, continuing education, and research and consultation. Much of a master's degree program concentrates on transactional leadership because its content is better formulated and easier to teach. The development of transformational leadership qualities during master's study primarily provides a foundation on which students can build. Health administration programs in cooperation with healthcare organizations have created three models for field experience: internships, residencies, and fellowships. Many master's programs deliver continuing education programs for both types of leadership, and research and consultation contribute to this education.

Catholicism↗

PubMed2002

Leadership strategies for department chairs and program directors: a case study approach.

As a part of the 2000-01 American Dental Education Association (ADEA) Leadership Institute, the Leadership Institute Fellows conducted a faculty development workshop for department chairpersons and program directors during the 2001 ADEA Annual Session. A central premise of the workshop was that successful chairpersons and program directors are both effective leaders and effective managers and that leadership and management involve complementary activities. The workshop was case-based. The ADEA Leadership Institute Fellows developed the cases and led roundtable discussions of each case. A group facilitator led large group debriefings to apply management and leadership theory to each case. The purpose of this paper is to review leadership challenges and management concepts as they were applied in a case-based faculty development workshop. The program was structured to address leadership challenges relating to managing people, mission management, conflict recognition, and conflict management. The cases were developed to relate management theories to situations in academic administration. The situations were designed to encourage debate from numerous perspectives. Each case presented general dilemmas that could be addressed from the vantage point of the dean, chair, or individual faculty member. Reinforcing discussion followed and included identification of central issues, key management concepts, and action alternatives. Because of the breadth of possible discussion, group case analyses at the workshop and in the appended case reviews explore only one perspective. This overview article introduces concepts of leadership and management that provide the foundation for analysis of three case studies that follow. These cases address common leadership and management issues in academic dentistry through three typical cases: the frustrated faculty member (case 1), the misdirected faculty member (case 2), and the faculty member stuck in the middle (case 3).

Administrative Personnel↗

PubMed2004

Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students.

Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.

Attitude of Health Personnel↗

PubMedDate not supplied

The effect of nursing leadership on hospital nurses' professional practice behaviors.

OBJECTIVE: To understand the effect of unit-level nursing leadership on the relationship of structural empowerment and nursing self-efficacy to professional nursing practice behaviors. BACKGROUND: Nursing leadership at both organizational and unit levels is a major influence on professional nursing practice. The interaction between environmental factors, such as structural empowerment and unit-based nursing leadership, and self-efficacy for nursing practice may determine whether a nurse's practice behaviors are either professional or more task-focused. METHODS: A nonexperimental, comparative survey design was used. Instruments included the Conditions for Work Effectiveness-II, Caring Efficacy Scale, Manager's Activities Scale, and Nurse Activity Scale. Multigroup path analysis demonstrated the effects of strong and weak nursing leadership on variables of interest. RESULTS: Nursing leadership contributed to the effects of empowerment and self-efficacy on practice behaviors. Strong nursing leadership also contributed to an additional relationship between empowerment and self-efficacy. Nursing leadership helped to explain 46% of the variance in nursing practice behaviors overall. CONCLUSIONS: Nurses may be able to practice more professionally when they perceive strong nursing leadership. By providing more access to structural empowerment factors for staff, strong unit-level nursing leadership may also influence nurses' self-efficacy, which in turn leads to more professional practice behaviors.

Adult↗

PubMedDate not supplied

A study of nurse leadership.

Little research has been undertaken on the leadership effectiveness of head (charge) nurses or on the preparation needed for this position. This descriptive correlational study explored the relationships between leadership effectiveness of head nurses and several educational and career variables. The study, which was undertaken in the northwest of USA, should be relevant to Australian nurses. Findings indicated that previous leadership experience (in school, college, community or professional committees) and nursing management experience prior to assuming the present head nurse position were positively related to the level of leadership effectiveness. A negative relationship was found between the length of time in the present position and the level of leadership effectiveness. The best combination of variables for predicting leadership effectiveness of head nurses, in order of the proportion of contribution, was found to be: previous nursing management experience; leadership continuing education; length of time in the present position; previous leadership experience and level of nursing education. These variables were found to positively influence leadership effectiveness, with the exception of length of time in the present position which was found to have a negative influence.

Adult↗

PubMed2000

Five-factor model of personality and transformational leadership.

This study linked traits from the 5-factor model of personality (the Big 5) to transformational leadership behavior. Neuroticism, Extraversion, Openness to Experience, and Agreeableness were hypothesized to predict transformational leadership. Results based on 14 samples of leaders from over 200 organizations revealed that Extraversion and Agreeableness positively predicted transformational leadership; Openness to Experience was positively correlated with transformational leadership, but its effect disappeared once the influence of the other traits was controlled. Neuroticism and Conscientiousness were unrelated to transformational leadership. Results further indicated that specific facets of the Big 5 traits predicted transformational leadership less well than the general constructs. Finally, transformational leadership behavior predicted a number of outcomes reflecting leader effectiveness, controlling for the effect of transactional leadership.

Adult↗

PubMed2006

Divergent effects of transformational and passive leadership on employee safety.

The authors concurrently examined the impact of safety-specific transformational leadership and safety-specific passive leadership on safety outcomes. First, the authors demonstrated via confirmatory factor analysis that safety-specific transformational leadership and safety-specific passive leadership are empirically distinct constructs. Second, using hierarchical regression, the authors illustrated, contrary to a stated corollary of transformational leadership theory (B. M. Bass, 1997), that passive leadership contributes incrementally to the prediction of organizationally relevant outcomes, in this case safety-related variables, beyond transformational leadership alone. Third, further analyses via structural equation modeling showed that both transformational and passive leadership have opposite effects on safety climate and safety consciousness, and these variables, in turn, predict safety events and injuries. Implications for research and application are discussed.

Administrative Personnel↗

PubMed2001

Leadership, organizational stress, and emotional exhaustion among hospital nursing staff.

STUDY'S RATIONALE AND OBJECTIVES: We examined the effect of work stressors and head nurses' transactional and transformational leadership on the levels of emotional exhaustion experienced among their staff. METHODOLOGICAL DESIGN AND RESEARCH METHODS: A questionnaire was sent to all nurses of a university hospital. Usable returns were received from 625 nurses, giving a response rate of 39.2%. Data were treated using correlational analyses and multiple regression. The latter modelled stressors and leadership as predictors of nurses' reported emotional exhaustion. MEASURES: Work stressors were assessed using the Nursing Stress Scale (NSS) which comprises 34 items divided into three subscales (referring to stress from the physical, psychological, and social environment), and the role ambiguity (three items) and conflict (three items) scales. Leadership was measured with the Multifactor Leadership Questionnaire. RESULTS: In regression analyses, work stressors as a whole were found to explain 22% of the variance in emotional exhaustion whereas leadership dimensions explained 9% of the variance in that outcome measure. Stress emanating from the physical and social environment, role ambiguity, and active management-by-exception leadership were significantly associated with increased levels of emotional exhaustion. Transformational and contingent reward leadership did not influence emotional exhaustion. LIMITATIONS: A limitation of this study is that it considered only the emotional exhaustion dimension of burnout. Also, as data were cross-sectional in nature, conclusions regarding the direction of causality among variables cannot be drawn. CONCLUSIONS: This study provided, for the first time, a test of the influence of leadership on burnout among nurses, taking into account the role of work stressors. Future research is needed to examine if the effects reported herein can be replicated using the two other dimensions of burnout (depersonalization and reduced personal accomplishment).

Adult↗

PubMed2001

Leadership behaviours: effects on job satisfaction, productivity and organizational commitment.

BACKGROUND: Research in the west has shown that job satisfaction, productivity and organizational commitment are affected by leadership behaviours. The purpose of this study is to determine the effect of leadership behaviours on employee outcomes in Singapore. Very little research related to this subject has been done in health care settings in this country. The comparison of the results of the different types of settings and samples will allow a better understanding of the relationship between leadership behaviours and employee outcomes and thus help to determine if leadership is worth the extra effort. METHOD: The study explored the relationships between five leadership behaviours identified by Kouzes and Posner and the employee outcomes of registered nurses practising in the general wards, intensive care units and the coronary care unit in an acute hospital. Survey questionnaires were used to elicit responses from 100 registered nurses and 20 managers belonging to the organization. Data collected included demographic characteristics and the degree to which the five types of leadership behaviours were used as perceived by the nurse managers and the registered nurses. In addition, the level of nurse job satisfaction, the degree of productivity and the extent of organizational commitment are described. FINDINGS: The findings show a similar trend to the original studies in the United States of America. Use of leadership behaviours and employee outcomes were significantly correlated. The regression results indicate that 29% of job satisfaction, 22% of organizational commitment and 9% of productivity were explained by the use of leadership behaviours. Recommendations are made in the light of these findings.

Adolescent↗

PubMed1999

Improving care requires leadership in nursing.

The purpose of this paper is to provide a model of leadership in nursing. The model outlines factors that influence leadership styles, discusses approaches to leadership and the impact of the leadership style on nursing care. The model is based on a critical examination of the current leadership themes from nursing literature in the UK, USA and Australia, between 1992 and 1997, and the findings from semi-structured interviews with five leaders in nursing. These findings help support the proposed leadership model as a basis for further exploration and as a framework for thinking about leadership and leadership preparation.

Attitude of Health Personnel↗

PubMed1998

Transformational leadership and the hospice R.N. case manager: a new critical pathway.

This article asserts that in light of changing conditions in the healthcare environment, transformational leadership is the most appropriate leadership style for the hospice registered nurse case manager. The author defines transformational leadership and, tracing from early leadership theories, demonstrates how the transformational-transactional leadership paradigm emerged from preceding leadership theories. The components of transformational leadership--transformational behavior and transformational characteristics--are linked to hospice theory and hospice-specific nursing practices. The expanding role of the hospice R.N. case manager is addressed in light of transformational leadership and culture building. Specific actions are proposed in the arenas of research, education, and community, corporate, and legislative involvement.

Case Management↗