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Article
Publication date: 27 November 2023

Else Marie Lysfjord and Siv Skarstein

This study aims to examine nurses’ motivation for leadership and explore important challenges nurses face in leadership positions.

Abstract

Purpose

This study aims to examine nurses’ motivation for leadership and explore important challenges nurses face in leadership positions.

Design/methodology/approach

Semi-structured interviews were conducted with 20 nurses in leading positions. Thematic analysis was used to analyse the data.

Findings

Nurse leaders are recruited from clinical settings, and the transition process from clinical nurse to leader is demanding. Their motivation for leadership seems to be in human values and caring for others. Lack of strategic focus might be a challenge. Nurses in leadership positions emphasize the importance of good relationships with the staff and require an increased focus on strategic leadership.

Research limitations/implications

Studies have revealed the frustration associated with the role of a nursing leader. According to an evaluation of a clinical leadership development programme, nurses were found to be inadequately prepared for their roles. They had not experienced positive role models, they felt overwhelmed and they regarded colleagues and nursing management structures as unsupportive. There is a need for further research into effective measures to strengthen nurse managers.

Practical implications

The role of leaders has changed over time. There are now increasing requirements and objectives with regard to laws, action plans, improvement projects and cost-effectiveness. A nurse leader has both many tasks and great responsibility. Good leadership relies on skilled nurse leaders meeting statutory requirements in patient care and delivering good quality and patient-safe services. Engaging in process-oriented guidance, such as mentoring, is one way to become more aware of oneself as a professional leader (Mathena, 2002).

Originality/value

By identifying and understanding the specific challenges that nurse leaders face, this study can contribute to the development of interventions and strategies to improve leadership practices, thereby enhancing organizational effectiveness.

Details

Leadership in Health Services, vol. 37 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 9 October 2023

Leodoro J. Labrague, Sulaiman Al Sabei, Omar Al Rawajfah, Ikram Ali Burney and Raeda Abu AlRub

This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in…

Abstract

Purpose

This study aims to examine the level of intention to pursue formal nursing leadership roles among millennial nurses and to identify the different factors that may play a role in their intentions to pursue such roles.

Design/methodology/approach

This study used a multi-center, cross-sectional research design. Registered nurses born between 1980 and 2000 (n = 1,377) who worked in 23 acute care hospitals in Oman were included in this study. Data were analyzed using descriptive statistics and multiple linear regression. Data were collected between July 2019 and January 2020.

Findings

Nearly 70% of millennial nurses researched their intention for career advancement to assume nursing leadership responsibility. Factors associated with nurses’ intention to pursue formal nursing leadership roles were the type of nursing degree held (having a bachelor of science in nursing degree), type of hospital facility affiliation (teaching hospital), previous leadership experience, structural empowerment (access to support, opportunity and resources), work satisfaction and job burnout.

Originality/value

Millennial nurses, who represent the largest segment of the nursing workforce, have begun assuming nursing management and leadership roles; however, little is known about the factors affecting their intentions to pursue these roles. The findings of this study revealed different factors (both modifiable and nonmodifiable) influencing millennial nurses’ intentions to pursue formal leadership roles.

Details

Leadership in Health Services, vol. 37 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 7 September 2023

Benjamin Ajibade and Catherine Hayes

The aim of the study is to explore perceptions of the impact of assessment feedback by international undergraduate nursing students. Research to date indicates that summative…

Abstract

Purpose

The aim of the study is to explore perceptions of the impact of assessment feedback by international undergraduate nursing students. Research to date indicates that summative assessment feedback may impact significantly on student achievement but if it is undertaken sub optimally or does not provide students with the opportunity to engage with the process and reflexively respond, it can also be exceptionally damaging to the learning experience.

Design/methodology/approach

A scoping exercise of overall student feedback experience was initially collated via the adoption of an Interpretive Phenomenological Approach (IPA). Participants were recruited via purposive sampling and the LEGO® Serious Play® method was used to collect data. Analysis with Quirkos software was used to examine the salience as well as commonality of findings as an integral part of a recognised five-step thematic analytical approach.

Findings

Feedback was perceived, by students, as significantly impacting factor in relation to their overall progression, attainment and retention rates. Themes generated from the findings evidenced student perceptions that summative feedback is a positive driver and source of motivation for academic success and progression. It was perceived that levels of attainment were related to the clarity, quality and individualised nature of feedback that students received and that this was perceived to be evident in their final grades. These were accompanied by perceptions that feedback clarity also determined the potential of breaking down perceived student barriers to learning, their perceived capacity for effective assignment planning and preparation and the likelihood of them having any positive collective or individual interpersonal relationships with their tutors. Summarised, students perceived that feedback ought to lead to student empowerment in managing their studies and as such it ought to be clear, straightforward and non-ambiguous.

Research limitations/implications

The methodological design of the study means that generalisability from its findings was never intended or possible. However, there may be the potential transferability of findings to similar institutions and contexts of nurse education with students who have similar demographic profiling. The study was also a means of providing an insight into the lived experience of students which could be used in the prospective adaptation of feedback mechanisms for staff at a local level within Higher Education.

Practical implications

The study reveals the perceived impact of gamification as a mechanism of summative assessment as conveyed by a designated group of students. Whilst specific recommendations for change can only be made within the context specificity of the research, there may be aspects of the findings which are potentially transferable to other similar contexts of Higher Education delivery whose pedagogical approaches mirror those in operation at the institution where the research was undertaken. It became apparent that the standardisation of feedback approaches offered many opportunities to improve existing systems. The issue of monitoring workloads is also of significance in terms of the level and degree of summative assessment and feedback that academic staff can undertake.

Originality/value

The study revealed the perceived magnitude of assessment feedback on progression, attainment and retention rates, alongside the perceived need for a universal feedback template and the opportunity to provide audio-video feedback. This study adds to existing knowledge in the field of pedagogic practice about both the execution of LEGO® Serious Play® as a research methodology and why the perceptions of feedback as articulated and illuminated by a group of contemporary nursing students ought to matter in the context of Higher Education.

Details

Higher Education, Skills and Work-Based Learning, vol. 14 no. 2
Type: Research Article
ISSN: 2042-3896

Keywords

Content available
Article
Publication date: 9 October 2023

Leodoro J. Labrague

This study aims to appraise and synthesize evidence examining the effects of toxic leadership on the nursing workforce and patient safety outcomes.

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Abstract

Purpose

This study aims to appraise and synthesize evidence examining the effects of toxic leadership on the nursing workforce and patient safety outcomes.

Design/methodology/approach

This is a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Five electronic databases (SCOPUS, PubMed, Web of Science, CINAHL and Psych INFO) were searched to identify relevant articles. Two independent researchers conducted the data extraction and appraisal. A content analysis was used to identify toxic leadership outcomes.

Findings

The initial literature search identified 376 articles, 16 of which were deemed relevant to the final review. Results of the content analysis identified 31 outcomes, which were clustered into five themes: satisfaction with work; relationship with organization; psychological state and well-being; productivity and performance; and patient safety outcomes. Seven mediators between toxic leadership and five outcomes were identified in the included studies.

Practical implications

Organizational strategies to improve outcomes in the nursing workforce should involve measures to build and develop positive leadership and prevent toxic behaviors among nurse managers through theory-driven strategies, human resource management efforts and relevant policy.

Originality/value

The review findings have provided modest evidence suggesting that working under a leader who exhibits toxic behaviors may have adverse consequences in the nursing workforce; however, more research examining if this leadership style influences patient safety and care outcomes is warranted.

Details

Leadership in Health Services, vol. 37 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Open Access
Article
Publication date: 14 November 2023

Bernice Skytt, Hans Högberg and Maria Engström

The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.

Abstract

Purpose

The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.

Design/methodology/approach

Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).

Findings

The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.

Originality/value

The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 9 June 2023

Pierre-Luc Fournier, Lionel Bahl, Desirée H. van Dun, Kevin J. Johnson and Jean Cadieux

The complexity and uncertainty of healthcare operations increasingly require agility to safeguard a high quality of care. Using a microfoundations of dynamic capabilities…

Abstract

Purpose

The complexity and uncertainty of healthcare operations increasingly require agility to safeguard a high quality of care. Using a microfoundations of dynamic capabilities perspective, this study investigates the effects of nurses' implicit voice theories (IVTs) on the behaviors that influence their individual agility.

Design/methodology/approach

This research uses quantitative survey data collected from 2,552 Canadian nurses during the fourth wave of the Covid-19 pandemic in the fall of 2021. Structural equation modeling is used to test a conceptual model that hypothesizes the effects of three different IVTs on nurses' creativity, spontaneity, agility and the quality of care they deliver to patients.

Findings

The results reveal that voice-inhibiting cognitions (like “suggestions are criticisms for higher-ups”, “I first need a solution or solid data”, and “speaking up has negative repercussions”) negatively impact nurses' creativity and spontaneity in crafting solutions to problems they face daily. In turn, this affects nurses' individual agility as they attempt to adapt to changing circumstances and, ultimately, the quality of care they provide to their patients.

Practical implications

Even if organizations have little control over employees' pre-held beliefs regarding voice, they can still reverse them by developing and nurturing a voice-welcoming culture to boost their workers' agility.

Originality/value

This study combines two theoretical frameworks, voice theory and dynamic capabilities theory, to study how individual-level factors (cognitions and behaviors) contribute to nurses' individual agility and the quality of care they provide to their patients. It answers the recent calls of scholars to study the mechanisms through which healthcare operations can develop and sustain dynamic capabilities, such as agility, and better face the “new normal”.

Details

International Journal of Operations & Production Management, vol. 44 no. 5
Type: Research Article
ISSN: 0144-3577

Keywords

Article
Publication date: 28 March 2023

Yupeng Lin and Zhonggen Yu

The application of artificial intelligence chatbots is an emerging trend in educational technology studies for its multi-faceted advantages. However, the existing studies rarely…

1687

Abstract

Purpose

The application of artificial intelligence chatbots is an emerging trend in educational technology studies for its multi-faceted advantages. However, the existing studies rarely take a perspective of educational technology application to evaluate the application of chatbots to educational contexts. This study aims to bridge the research gap by taking an educational perspective to review the existing literature on artificial intelligence chatbots.

Design/methodology/approach

This study combines bibliometric analysis and citation network analysis: a bibliometric analysis through visualization of keyword, authors, organizations and countries and a citation network analysis based on literature clustering.

Findings

Educational applications of chatbots are still rising in post-COVID-19 learning environments. Popular research issues on this topic include technological advancements, students’ perception of chatbots and effectiveness of chatbots in different educational contexts. Originating from similar technological and theoretical foundations, chatbots are primarily applied to language education, educational services (such as information counseling and automated grading), health-care education and medical training. Diversifying application contexts demonstrate specific purposes for using chatbots in education but are confronted with some common challenges. Multi-faceted factors can influence the effectiveness and acceptance of chatbots in education. This study provides an extended framework to facilitate extending artificial intelligence chatbot applications in education.

Research limitations/implications

The authors have to acknowledge that this study is subjected to some limitations. First, the literature search was based on the core collection on Web of Science, which did not include some existing studies. Second, this bibliometric analysis only included studies published in English. Third, due to the limitation in technological expertise, the authors could not comprehensively interpret the implications of some studies reporting technological advancements. However, this study intended to establish its research significance by summarizing and evaluating the effectiveness of artificial intelligence chatbots from an educational perspective.

Originality/value

This study identifies the publication trends of artificial intelligence chatbots in educational contexts. It bridges the research gap caused by previous neglection of treating educational contexts as an interconnected whole which can demonstrate its characteristics. It identifies the major application contexts of artificial intelligence chatbots in education and encouraged further extending of applications. It also proposes an extended framework to consider that covers three critical components of technological integration in education when future researchers and instructors apply artificial intelligence chatbots to new educational contexts.

Article
Publication date: 11 October 2023

Xiao Xu

Utilizing datasets of Ecuador, Hungary, Kazakhstan, Mexico and Peru from the Programme for the International Assessment of Adult Competencies survey from 2017 to 2018, this study…

Abstract

Purpose

Utilizing datasets of Ecuador, Hungary, Kazakhstan, Mexico and Peru from the Programme for the International Assessment of Adult Competencies survey from 2017 to 2018, this study aimed to develop and validate a profile indicating core workplace skills in developing countries.

Design/methodology/approach

DeVellis' guide of scale development navigated the development of the profile. Multiple techniques including item analysis, exploratory factor analysis, confirmatory factor analysis and multigroup confirmatory factor analysis were used on a sample of 7,166 participants to validate the profile of core workplace skills in developing countries.

Findings

A resultant five-dimensional profile with 18 items was developed: oral communication skills, reading skills, math skills, information and communication technology skills and learning skills. The estimates of composite reliability showed the profile was reliable. The validity estimates of the profile were obtained from several sources including content, convergent, discriminative and construct validity. The measurement invariance was also held for the profile.

Originality/value

Based on the researcher's knowledge, the study is the first attempt to develop a profile to indicate core workplace skills in developing countries. The profile theoretically framed the core workplace skills in developing countries and provides a new measure for identifying, evaluating and thus improving core workplace skills in developing countries for different stakeholders in the era of Education 4.0.

Details

Higher Education, Skills and Work-Based Learning, vol. 14 no. 2
Type: Research Article
ISSN: 2042-3896

Keywords

Open Access
Article
Publication date: 9 January 2024

Rania Ahmed Aly El Garem, Amira Fouad and Hassan Mohamed

This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating…

Abstract

Purpose

This paper explores the effect of perceived service quality, trust, perceived value and perceived cost on patient satisfaction and loyalty as well as exploring the moderating role of the sociodemographic factors.

Design/methodology/approach

The data were gathered from 462 patients via a structured questionnaire, while structural equation modeling was utilized for the analysis.

Findings

Results indicated that trust, perceived value and patient satisfaction have important roles in shaping the patient loyalty, while patient satisfaction was found to fully mediate the patient’s perceived service quality. Loyalty relationship was also found to partially mediate the trust–loyalty relationship. Nonetheless, the patient’s satisfaction–loyalty relationship was found to be only moderated by the age factor.

Practical implications

Implications are provided to the Egyptian private hospitals in order for them to formulate improvement plans as well as set higher standards of conduct.

Originality/value

This original research is the first one, up to the researcher knowledge, that explores the drivers of patient satisfaction in the private hospitals in Egypt.

Details

Journal of Humanities and Applied Social Sciences, vol. 6 no. 2
Type: Research Article
ISSN: 2632-279X

Keywords

Open Access
Article
Publication date: 28 September 2023

Eeva Vuorivirta-Vuoti, Suvi Kuha and Outi Kanste

Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study…

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Abstract

Purpose

Coronavirus disease (COVID-19) has challenged leadership in hospitals worldwide. The experiences of leadership during the pandemic changed leadership significantly. This study aims to describe nurse leaders’ perceptions of what future leadership in hospital settings in the post-pandemic era needs to be like.

Design/methodology/approach

A qualitative descriptive study was used. A total of 20 nurse leaders from the Finnish central hospital were interviewed from June to October 2021. The data were analysed using inductive content analysis.

Findings

The analysis revealed five main categories describing nurse leaders’ perceptions of future leadership in hospital settings in the post-pandemic era: digitalisation and hybrid working culture, development of sustainable working conditions, moving smoothly to the post-pandemic era, dissolution of traditional regimes of organisation and flexibility in leadership.

Practical implications

In the post-pandemic era, the constantly changing demands and challenges currently facing healthcare systems have significantly increased the complexity of hospital organisations. This requires critical evaluation and change to traditional leadership. Enhancing flexibility and authenticity in leadership, strengthening competencies, implementing a wide range of digital resources and increasing the appeal of the nursing profession to build the next generation of nurses – all of these are needed to provide sustainability in future healthcare.

Originality/value

The results identify the critical points of leadership that need to be developed for future challenges and for maintaining a sufficient supply of qualified professionals. Acting on this information will enhance flexibility in organisations and lead to acceleration of changes and the development of new kinds of leadership in the future

Details

Leadership in Health Services, vol. 37 no. 5
Type: Research Article
ISSN: 1751-1879

Keywords

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