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PubMed2004

Learning for clinical leadership.

Clinical leadership has been acclaimed widely as a major factor influencing the quality of patient care but research has revealed a paucity of preparation for this significant role. Leadership literature has rarely addressed clinical leadership specifically or referred to the difficulties in characterizing effective clinical leaders. The research informing this paper focused on clinical leadership and identified five attributes of effective clinical leaders: creativity, highlighting, influencing, respecting, and supporting. Effective clinical leaders adopted a transformational leadership style and improved care, through others, by including transformational (soft) knowledge as an integral part of their effective practice repertoire. Phronesis is introduced as practical wisdom that is gained through immersion in relevant experience, and as an essential element of preparation for clinical nursing leadership practice. It is argued, that learning to transform care requires opportunities to work within an environment that engenders and supports aspiring leaders. The paper describes the research process, elucidates the attributes through illustrative examples from the research data, and discusses an emergent educational strategy for the development of these attributes by clinicians in their practice environments. The paper also describes the application of this research through an interdisciplinary programme for staff leading teams in both health and social services sectors.

Humans↗
PubMed2005

Transformational leadership: a cascading chain reaction.

Historical influences still permeate contemporary nursing practise. These are mirrored in organizational philosophies, transactional and autocratic leadership styles and disempowered staff. Whilst there is disparity amongst the theorists' definitions of leadership, there is consensus pertaining to the attributes necessary to realize effective leadership. Transformational leadership is heralded as new criterion for nurse managers, and can be achieved through training, education and professional development in key leadership competencies. To achieve a chain reaction, charismatic transformational leaders espouse intellectual stimulation and individual consideration to empower staff and enhance patient care. Nurse managers that develop and foster transformational leadership can surmount oppressive traditions and confidently navigate a complex and rapidly changing health care environment.

Humans↗
PubMed2005

Knowledge is power: using nursing information management and leadership interventions to improve services to patients, clients and users.

AIM: This paper examines the purpose, role and function of information and information management within health care today. It is set within the context of a specialist forensic learning disability setting. BACKGROUND: Changes in politics, government legislation and reforms of the National Health Service (NHS) have created a need to equip managers with the necessary tools and skills to be able to lead and manage effectively. As such there has been a great emphasis upon specialist training, such as the government-driven Leading an Empowered Organisation courses, for nurse managers and nurses with leadership potential. Yet with the drive to generate a new wave culture within the NHS of inspirational leaders, are we still overlooking a critical and key area which is fundamental in achieving and delivering cost effective, quality health care--the area of information management within health care today? METHODS: The processes presented in this paper are structured through a strategic nursing management and leadership performance implementation model, the Clinical Nursing Leadership Learning and Action Process (CLINLAP) model, which facilitates work-based learning and capability development in the reality of everyday clinical activities. Through the model, the emphasis is to make clinical goals specific, roles explicit, processes clear and encourage these activities to be carried out within an environment of open relationships. RESULTS: The use of CLINLAP model assisted as a management and leadership technology to manage change in the workplace so as to improve services to patients in Yelday Lodge. Structured management and leadership interventions led to observable positive change in information management on Yelday Lodge. CONCLUSIONS: The conclusion is that sustained quality information could be embedded in nursing practice at Yelday Lodge or elsewhere by evaluating and discussing the different information management approaches within the practice area through the use of structured management and leadership interventions. The use of the CLINLAP model is recommended for use as a model for managing information, knowledge and communication for results within nursing and health care services.

Budgets↗
PubMed2005

Leadership styles and nursing faculty job satisfaction in Taiwan.

PURPOSE: To examine nursing faculty job satisfaction and their perceptions of nursing deans' and directors' leadership styles, and to explore how the perceptions of leadership styles relate to faculty job satisfaction in Taiwan. METHODS: Descriptive, correlational, and cross-sectional study with self-administered questionnaires. The sample was recruited from 18 nursing programs, and 286 questionnaires were returned. RESULTS: Faculty perceived that Taiwan's nursing deans and directors showed more transformational than transactional leadership. Taiwan's nursing faculty were moderately satisfied in their jobs, and they were more satisfied with deans or directors who practiced the transactional leadership style of contingent reward and the transformational style of individualized consideration. A style with negative effect was passive management by exception. CONCLUSIONS: Three types of leadership behaviors explained significant variance (21.2%) in faculty job satisfaction in Taiwan, indicating the need for further attention to training and development for effective leadership behaviors.

Adult↗
PubMed2005

Presidential leadership.

This chapter reviews psychological theories of leadership and selected literature on the American presidency to highlight key psychological principles of presidential leadership. Psychological theories, framed by the principles of leadership outlined by Freud (1921), include those of Burns (1978, 2003) on transformational leadership, Bass (1997) and House & Shamir (1993) on charismatic and transformational leadership, Gardner (1995) on stories of identity, Hogg (2001, 2003) on social identity, and Tyler & Lind (1992) on procedural justice. The discussion of presidential scholarship considers work by Barber (1992) on presidential character, Simonton (1986, 1987) on presidential personality and success, Skowronek (1997) on reconstructive politics, and Winter (1987) on presidential motive profiles. These studies suggest that followers have high expectations for presidents and that successful presidential leadership depends on opportunity, high levels of activity, intelligence, optimistic resilience, and flexibility.

Character↗
PubMedDate not supplied

Evaluating transformational leadership skills of hospice executives.

Health care is a rapidly changing environment requiring a high level of leadership skills by executive level personnel. The hospice industry is experiencing the same rapid changes; however, the changes have been experienced over the brief span of 25 years. Highly skilled hospice executives are a necessity for the growth and long-term survival of hospice care. This descriptive study was conducted to evaluate the leadership skills of hospice executives. The study population consisted of hospice executives who were members of the state hospice organization in Ohio and/or licensed by the state (88 hospice providers). Three questionnaires were utilized for collecting data. These questionnaires collected data on transformational leadership skills of participants, participants' personal demographics, and their employer's organizational demographics. Forty-seven hospice executives responded (53%). Key findings reported were high levels of transformational leadership skills (mean, 3.39), increased use of laissez-faire skills with years of hospice experience (P = .57), and positive reward being a frequent leadership technique utilized (mean, 3.29). In addition, this was the first study of leadership skills of hospice executives and the first formal collection of personal demographic data about hospice executives.

Administrative Personnel↗
PubMed2006

Evolutionary origins of leadership and followership.

Drawing upon evolutionary logic, leadership is reconceptualized in terms of the outcome of strategic interactions among individuals who are following different, yet complementary, decision rules to solve recurrent coordination problems. This article uses the vast psychological literature on leadership as a database to test several evolutionary hypotheses about the origins of leadership and followership in humans. As expected, leadership correlates with initiative taking, trait measures of intelligence, specific task competencies, and several indicators of generosity. The review finds no link between leadership and dominance. The evolutionary analysis accounts for reliable age, health, and sex differences in leadership emergence. In general, evolutionary theory provides a useful, integrative framework for studying leader-follower relationships and generates various novel research hypotheses.

Biological Evolution↗
PubMedDate not supplied

Nurse managers in Australia: mentoring, leadership and career progression.

Identification of those leadership qualities which nurses believe led to their successful attainment of a nursing management position may help in understanding how to identify and foster leadership potential amongst nursing staff. This study asked nurse managers to indicate the important factors which influenced and facilitated their entry to management positions with a particular reference to the development of leadership characteristics. The results suggest that the leadership qualities we expect nurse managers to display evolve in a largely random way. Additionally, there is evidence that the development of leadership skills and attainment of management positions remains fragmented and random in nature. Because of this, individual nurse managers develop leadership skills almost by default using informal strategies to learn and develop. These findings should provide direction to educational providers and senior managers who seek to develop future leaders and managers.

Attitude of Health Personnel↗
PubMed1996

Leadership personnel needs in the education of deaf and hard of hearing children: results of two national surveys.

During the summer of 1994, 64 university teacher preparation programs in deaf education and 62 instructional programs providing direct services to deaf and hard of hearing students participated in surveys designed to evaluate the effectiveness of the content and delivery system of Gallaudet University's Doctoral Program in Deaf Education in terms of meeting the need for leadership personnel in the field. Survey questions addressed the supply of doctoral level leadership personnel for recently advertised university or school leadership positions. Other questions addressed strategies university teacher preparation programs could use to attract more currently employed leadership personnel for Ph.D. study, and better prepare future them for positions as researchers or teacher educators in the education of deaf and hard of hearing students. Data support the need for additional leadership personnel for faculty positions in university teacher preparation programs and in instructional programs. Data also provide direction for teacher preparation programs to better address the need for leadership personnel in the field.

Deafness↗
PubMed2001

Development and evaluation of a leadership program for veterinary students.

Leadership skills are important for many facets of professional life, but no known leadership training programs exist in North American veterinary schools. It was the purpose of this project to develop, deliver, and evaluate a leadership program for first-year veterinary students. Leadership attributes emphasized in the course included effective communication, openness to learning from others, self-awareness, commitment beyond self-interest, motivation, decision making, understanding issue complexity, and team building. The five-day course was delivered to 21 new veterinary students randomly selected just prior to their first-year orientation in the fall of 2000. Participants ranked themselves higher than non-participants in a post-course evaluation on their ability to be effective leaders. Participants reported an increase in self-confidence and a clearer understanding of their leadership roles. Participants also noted new support systems among co-participants and expressed a new ability to consider complex issues more broadly. Most reported that they frequently used enhanced skills in giving and receiving feedback and team building. Other leadership tools identified as valuable included negotiation, group dynamics, a structured approach to problem solving, time management, and an awareness of personal learning style preferences as a means to improve communication.

Female↗
PubMed2002

An exercise in leadership training for veterinary students aiming for careers in biomedical research.

A group discussion on the theme of "leadership" has been a central event in the annual Cornell Leadership Program for Veterinary Students since 1990. However, these discussions were often unfocused and did not readily demonstrate the leadership skills of distinguished guests who were invited to participate. Since 1998, a new format for this session has been developed in which students and guests are assigned individual roles in a scenario that is unfolded by a moderator over two to three hours. This role-playing exercise ensures that every student is obliged to participate and has an opportunity to practice such leadership skills as critical thinking, verbal communication, and decision making under pressure and with inadequate information. The distinguished guests, in their assigned roles, are able to interact freely with the student fellows and thus demonstrate their expertise as experienced leaders. This challenging experience has become an enjoyable part of the 10-week Leadership Program and one that shows the importance of leadership skills for those who aspire to careers in the biomedical sciences.

Animals↗
PubMed1990

Leadership: by the pros, for the novice.

Leadership, communication, motivation and conflict resolution strategies shared during Leadership Day gave new meaning to these theoretical concepts. Leadership Day proved to be an effective teaching strategy for socializing our nursing leadership students into the real world of today's nursing. This united effort between leaders in practice and leaders in education enhanced the success of this proactive approach. The presenters' personification of nursing leadership and management concepts, as well as the descriptions of specific "how to" strategies, provided a valuable ingredient for reinforcing the theoretical concepts. Leadership Day was so successful that we began making plans immediately to expand the event to include all senior nursing students the following year.

Education, Nursing, Baccalaureate↗
PubMed2001

Academic leadership style predictors for nursing faculty job satisfaction in Taiwan.

The purpose of this study was to examine the influence of nursing deans' and nursing directors' transformational and transactional leadership styles on nursing faculty job satisfaction in baccalaureate and associate degree nursing programs in Taiwan. The study provides a mechanism by which nursing deans or nursing directors can obtain feedback from nursing faculty about leadership styles. Such feedback can then serve as the basis for further development of academic nursing leadership potential in Taiwan. The theory of transformational versus transactional leadership style guided this study. A cross-sectional mailed survey design was conducted. A convenience sample of 233 nursing faculty participated in this study. Idealized influence, intellectual stimulation, and contingent reward leadership styles significantly and positively predicted job satisfaction. However, active management-by-exception significantly and negatively predicted job satisfaction. Nursing leaders should implement effective leadership styles. Study implications for nursing education administration, limitations, and recommendations for future studies were discussed.

Adult↗
PubMed2006

Nursing directors' leadership styles and faculty members' job satisfaction in Taiwan.

Nursing leaders in Taiwan seldom receive the leadership training necessary to lead an academic organization. As a result, leaders may experience burn out, and dissatisfaction among faculty may increase. This study examined nursing faculty members' perceptions of nursing directors' leadership and their job satisfaction levels to understand how perceptions of leadership styles related to job satisfaction in Taiwan. This descriptive, correlational, cross-sectional study used self-administered questionnaires. Transformational leadership theory supported the research framework. Nine schools with nursing programs awarding diplomas to students participated in this study. A total of 175 questionnaires were returned (72% response rate). The findings indicated that Taiwan's nursing directors tend to display transformational leadership more frequently in their workplaces and that Taiwan's nursing faculty members are moderately satisfied in their jobs. In addition, nursing faculty in Taiwan are more satisfied with directors who practice the leadership style of attributed idealized influence.

Adult↗
PubMedDate not supplied

Effects of leadership style and group dynamics on enjoyment of physical activity.

PURPOSE: The primary purpose of this study was to examine the independent and combined effects of leadership style and group dynamics on the enjoyment of physical activity. DESIGN: A completely randomized 2 x 2 factorial design was used in which the manipulation of "leadership style" (socially enriched vs. bland) was crossed with a manipulation of "group dynamics" (socially enriched vs. bland). SETTING: The study was conducted in an aerobics studio on a university campus. SUBJECTS: The sample included 48 male and 42 female undergraduate students who were moderately active. INTERVENTION: Each participant was involved in a single session of step aerobics. A female graduate student provided either an enriched or bland series of interactions to manipulate leadership style, and a trained group of planted undergraduates was used to promote either an enriched or bland group environment. MEASURES: The outcome measures of interest were enjoyment and the probability of engaging in a similar activity in the future. RESULTS: Participants in the enriched leadership style plus enriched group dynamics condition reported higher enjoyment than did participants in the other three conditions. On average, the level of enjoyment was 22.07% higher in this condition than in the other three conditions (p < .001). The probability of future involvement was 13.93% higher for participants in the enriched group environment, irrespective of leadership style (p < .03). CONCLUSIONS: Enjoyment during physical activity is optimized when a positive and supportive leadership style is coupled with an enriched and supportive group environment. Future research is required to extend these findings to other activities and populations.

Adult↗
PubMedDate not supplied

An evaluation of the RCN Clinical Leadership Development Programme: Part 1.

AIM: The RCN Clinical Leadership Development Programme was set up in 1995 and sought to identify how clinical nurses in recognised leadership positions could improve the quality of patient care. METHOD: The programme was tested on four senior nurses and 24 ward sisters in four acute hospital trusts in England over an 18-month period. The primary research question was whether the intervention improved the clinical leadership skills of participants. A pre-test/post-test design incorporating action research was deployed. RESULTS: On a number of leadership dimensions, ward sisters' and senior nurses' performance had significantly improved. Five key themes emerged from the process data documenting the journey towards more effective clinical leadership: managing self; managing the team; patient-centred care; networking; and becoming more politically aware. There was evidence to show that patient care had also improved as measured by the way nursing care was organised; by patients' accounts of care they received and by documented improvements nurses carried out as a result of direct observation of care. CONCLUSION: From the results of the study, it appears that there is a need for more effective clinical leadership development programmes for nurses to achieve better patient-centred care.

Education, Nursing, Continuing↗
PubMedDate not supplied

An evaluation of the RCN Clinical Leadership Development Programme: Part 2.

AIM: The RCN Clinical Leadership Development Programme was set up in 1995 and sought to identify how clinical nurses in recognised leadership positions could improve the quality of patient care. METHOD: The programme was tested on four senior nurses and 24 ward sisters in four acute hospital trusts in England over an 18-month period. The primary research question was whether the intervention improved the clinical leadership skills of participants. A pre-test/post-test design incorporating action research was deployed. RESULTS: On a number of leadership dimensions, ward sisters' and senior nurses' performance had significantly improved. Five key themes emerged from the process data documenting the journey towards more effective clinical leadership: managing self; managing the team; patient-centred care; networking; and becoming more politically aware. There was evidence to show that patient care had also improved as measured by the way nursing care was organised; by patients' accounts of care they received and by documented improvements nurses carried out as a result of direct observation of care. CONCLUSION: From the results of the study, it appears that there is a need for more effective clinical leadership development programmes for nurses to achieve better patient-centred care.

Education, Nursing, Continuing↗
PubMedDate not supplied

Servant leadership.

As corporations are eagerly pursuing reengineering and reorganization, leadership functions are changing to champion these efforts. Traditionally, organizations have had a "top-down" management approach, however, there is a gradual shift to other leadership models. Servant leadership is being successfully implemented in many settings. Servant leadership, first popularized by Robert Greenleaf in 1970, puts serving others as the number one priority. Ten characteristics of a servant leader include: Listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people, and building community. Both servant leadership and the chaos theory have in common the central tenet of relationships. Since America is now approximately 80 percent a "service-economy," servant leadership can greatly benefit the individual employees, as well as help to facilitate the organization's pursuit of its changing strategic plans.

Empathy↗