Purpose: This study aims to examine the long-term impact of leader-member exchange (LMX) on employee safety behavior. It proposes a conceptual model that includes the mediating role of job satisfaction (JS) in the relationship between LMX and safety behaviors, regarding safety compliance behavior (SCB) and safety participation behavior (SPB).
Design/methodology/approach: Data were collected from 325 health-care workers across public hospitals in Algeria at three waves. Data were analyzed with partial least square structural equation modeling.
Findings: The findings revealed that LMX positively influenced employees' job satisfaction. However, the relationship between LMX and SCB was found to be mediated by job satisfaction. LMX was not directly related to both dimensions of safety behavior, whereas JS was positively associated with safety compliance and safety participation.
Originality/value: This is the first paper, to the best of the authors' knowledge, to report on the significant mediating role of JS on the reciprocal process used to exchange resources between leaders and subordinates and safety behaviors among health-care workers, thereby filling an important research gap in existing literature.
Purpose: This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors' leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle-income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.
Design/methodology/approach: This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants' knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick's model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.
Findings: The workshop yielded positive results, as evidenced by participants' increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.
Originality/value: The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.
Purpose: The purpose of this paper is to provide a systematic review of the current state of physician leadership. Theory of expert leadership (TEL) was applied to explore the effects of physician inherent knowledge, industry experience and leadership capabilities on leader behaviors and outcomes.
Design/methodology/approach: This review (August 2011-February 2022) applied the preferred reporting items for systematic review and meta-analysis strategy. Our search began with 3,537 studies and a final sample of 12 articles.
Findings: The findings offer a number of studies that note the relationship between physician leadership and the three dimensions of TEL. How influential these are on leadership behaviors and health-related outcomes varies. We also found a number of studies that described general physician leadership behaviors that were not directly linked to factors of TEL, as well as two additional themes: leader identity and trust.
Originality/value: To the best of the authors' knowledge, this is the first systematic review that has applied a highly cited theory (i.e. TEL) to the data and the first that has focused solely on a U.S. population. These findings offer healthcare organizations insight into the potential strengths and challenges of physician leadership.
Purpose: The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT).
Design/methodology/approach: A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants' responses to the question "please tell us about the impact of your overall experience", which culminated in a combined corpus of 75,053 words.
Findings: Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact.
Research limitations/implications: This in-depth qualitative evaluation of participants' feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice.
Originality/value: Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments.
Purpose: The purpose of this study is to evaluate the effects of nursing students' personality traits and leadership orientations on their career adaptability.
Design/methodology/approach: A total of 322 nursing students were enrolled in this cross-sectional study. The methods used to collect data included the semi-structured data collection form, five factors personality scale, leadership orientation scale and career adaptation-abilities scale.
Findings: The regression model created to determine the effects of personality traits and leadership orientations on the students' career adaptability proved to be highly insightful. The students' leadership orientations have a statistically significant effect on their career adaptability score, with an explanatory coefficient of 43.1% and personality traits accounted for 18% of the career adaptability.
Originality/value: The results of this study indicated that leadership orientations and personality traits of the students exerted effects on the career adaptability of nursing students. Developing the leadership orientations of nursing students and being aware of their personality traits will contribute positively to the development of their career adaptability and strengthen the health system.
Purpose: This study aims to analyze the structure of publications on transformational leadership in nursing and determine its evolution process through a bibliometric analysis.
Design/methodology/approach: It is a descriptive bibliometric study. Data were collected on October 24, 2022, from the Web of Science and analyzed using Excel, VOSviewer, HistCite and Bibliometrix R programs.
Findings: A total of 348 studies conducted by 962 authors and published between 1990 and 2021 were included. It was found that 84.5% of these publications were original articles and 97.7% were published in English. The studies are from 82 different journals and were carried out by researchers from 43 countries. The most productive country was the USA (n = 151).
Research limitations/implications: Only one database was used to search for studies. The searches were limited to the nursing category, and only studies published up to 2021 were included. Another important point is that, although there were no language limitations for the field literature search, English keywords were used; thus, the search can be considered semi-limited. It is believed that more comprehensive search strategies may generate different findings.
Originality/value: Two main themes were identified as the studies carried out in the field of transformational leadership in nursing, generally, directly or indirectly addressed the effects of this style of leadership either on nurses' performance/job satisfaction or on quality care/patient safety; however, a gap was observed in the literature in the area of nursing education. Researchers can be inspired by the results of the present study, by learning about the focus of published research on transformational leadership, which will encourage them to plan new studies to improve nursing education, nursing care, nursing management and working conditions of nurses. Through the results of this study, it is also possible to learn about countries and researchers for possible collaborations in future studies.
Purpose: This paper aims to synthesize health-care leaders' experiences of the competencies required for crisis management.
Design/methodology/approach: The systematic review followed the joanna briggs institute (JBI) guidance for systematic reviews of qualitative evidence. The search strategy included free text words and medical subject headings and peer-reviewed qualitative studies published in English, Finnish and Swedish and was not limited by year or country of publication. The databases searched in March 2022 were Scopus, PubMed, CINAHL, ABI/INFORM and the Finnish database Medic. Gray literature was searched using MedNar and EBSCO Open Dissertations. Studies were screened by title and abstract (n = 9,014) and full text (n = 43), and their quality was assessed by two independent reviewers. Eight studies were included. The data was analyzed using meta-aggregation.
Findings: Fifty-one findings (themes and subthemes) were extracted, and 11 categories were created based on their similarities. Five synthesized findings were developed: the competence to comprehend the operational environment; the competence to stay resilient amidst change; the competence to adapt to and manage change; the competence to manage and take care of staff; and the competence to co-operate and communicate with diverse stakeholders.
Originality/value: This systematic review produced novel information about health-care leaders' experiences of the competencies required for crisis management during COVID-19. This study complements the field of research into crisis management in health care by introducing five original and unique competency clusters required for crisis management during the acute phase of COVID-19.
Purpose: This study aimed to describe nurse leaders' experiences of remote leadership in health care sector.
Design/methodology/approach: Semistructured interviews were conducted among nurse leaders (N = 12) between January and March 2022. All of the interviewees had experiences of remote leadership and worked as immediate - (n = 5) or middle-level (n = 7) leaders in health care organizations across four provinces in Finland. The collected data were analyzed by inductive content analysis.
Findings: The leaders had experienced a rapid transition to remote leadership and highlighted the need for guidelines and joint discussions with different stakeholders. The interviewees felt that working life has changed in the last two years and that remote leadership will now be a key part of leadership in health care. The leaders' experiences highlighted how important trust is in remote leadership. Furthermore, the interviewees pointed out a need for face-to-face contact and described other good practices for remote leadership. Overseeing work-related well-being was also stressed as important in the remote context; however, the interviewees expressed a need for instructions and tools concerning the management of employee well-being. The sudden change to remote leadership was not only described as interesting but also challenging, which has affected the leaders' work-related well-being. Support - both from the organization and other employees - was found to be crucial to health care leaders' work-related well-being.
Originality/value: The current study complements the little-researched topic of remote leadership in the health care sector. The results provide insights that can be used to develop remote leadership and/or guide future research.
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