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Advances in Pharma Business Management and Research pp 45–61 Cite as

Leadership Models and Work Behavior: An Empirical Analysis of Consequences of Authentic and Transformational Leadership

  • Martin A. Lange 5 &
  • Alina Hernandez-Bark 6  
  • Open Access
  • First Online: 20 February 2020

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With increasing importance of organizational effectivity and efficiency measures like Balanced Scorecard and optimization of employee work behavior to achieve higher organizational efficiency, Human Resource activities concerning leadership development and academic leadership research are growing. Throughout the course of the twentieth century, a multitude of empirical studies show primarily positive relationships between different constructs of leadership models and desirable variables of organizational behavior. It becomes apparent, though, that in academic research the selection of analyzed leadership models and their consequences is very heterogeneous. This Master Thesis has the objective to contribute to Leadership Research by applying a comparative empirical study in the–until today–often neglected study population of in-house and sales personnel within the pharmaceutical industry. For this purpose, an online employee survey with N = 137 participants from a leading pharmaceutical company in Germany was conducted. Based on contemporary leadership theory, a range of Hypotheses regarding consequences of modern leadership models is empirically tested. The results of the study reconfirm Identification with Manager, Trust & Loyalty and Employee Satisfaction as consequences of Authentic as well as Transformational leadership. Work context as in-house vs. sales setting shows moderating effects on some of the leadership-consequences relationships. As the research involves multiple structurally different variables as well as constructs and compares feedback of different study populations, tangible management implications to boost desirable work attitudes and behaviors can be derived and appropriately adapted to match the respective work context. Ramifications for future scientific research are also presented.

“The greatest leader is not necessarily the one who does the greatest things. He is the one that gets the people to do the greatest things.” (Comment by Ronald Reagan, former U.S. President)

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1 The Importance of Leadership for Corporate Success

Today’s organizational and business environments become heavily disrupted by challenges stemming from political, economic, social or technological currents and trends. The pharmaceutical industry, for example, faces strains like global, regional or local pressures on product pricing, new Market Access hurdles, compliance guidelines and regulations, competition from innovative, generic or biosimilar companies as well as the advent of digital business models that put corporations under pressure to be effective and efficient. Human Resource (HR) departments evaluate how to best deal with one of the companies’ most important resource: their employees. Therefore, leadership is key in organizations’ strive for long-term success and financial performance. In order to contribute to leadership research and its positive outcomes for organizations’ success, this work’s main objective is to provide an overview of relevant leadership theories, to summarize current scientific literature on consequences of leadership and to empirically test relationships between leadership and defined work attitudes and behaviors. A secondary objective is to close research gaps regarding leadership in different work contexts, esp. with regards to pharmaceutical sales and in-house personnel.

2 The Concept of Leadership

Burns ( 1978 ) stated that “Leadership is one of the most observed, yet least understood, phenomena on earth” (p. 3). This indicates that both the scientific and managerial community operates with various definitions of leadership. Vecchiotti’s ( 2018 ) chronological perspective of leadership definition development starts with a patriarchic view based on characteristics of men situated in positions of authority. Over time, the role of subordinates was recognized and leadership encourages implementers to contribute to achieve mutually agreed goals. A paradigm shift due to new aspects like collaboration, teamwork, work-life balance, continuous feedback and learning becomes apparent (Vecchiotti 2018 ). Consequently, the following definition best reflects the latest view: “Leadership is a long-term, value-based process that encourages leaders and implementers to initiate actions that contribute to achieving a common purpose, and to willingly make significant contributions in meeting mutually agreed to goals.” (Vecchiotti 2011 , p. 6). Leadership, by its processual character, is a construct that has to be considered ambiguous, polymorphic and multifaceted. Von Rostenstiel’s Leadership Model (Fig. 1 ) comprehensively describes the various components and entry points for leadership theory and research (von Rosenstiel 2001 ).

figure 1

Von Rostenstiel’s Leadership Model. Source: von Rosenstiel ( 2001 )

Von Rosenstiel’s Model is an excellent stimulus to look into four different approaches widely discussed: trait approach, behavioral approach, contingency approach, as well as two contemporary approaches of positive leadership.

Historically, leaders were described by traits (Galton and Eysenck 1869 ). In the 1930s and 1940s, leadership research focused on personal characteristics of an individual and sought to identify personality, social, physical, or intellectual attributes that differentiate leaders from non-leaders. Trait theory was aiming at discovering a built-in set of traits that leaders possess, e.g. “aggressiveness”, “self-control”, “independence”, friendliness”, or “optimism” (Owens 1973 ). A famous example is the “Big 5” Personality Model with the five fundamental dimensions “extraversion”, “agreeableness”, “conscientiousness”, “emotional stability” and “openness to experience” (Costa and McCrae 1992 ; Norman 1963 ; Tupes and Christal 1961 ). Academic research describes “Extraversion” as the most predictive trait of leadership (Bass and Bass 2008 ).

Behavioral theory tries to identify the right things effective leaders do, e.g. how they communicate, motivate, delegate, plan, or handle meetings (Owens 1973 ). The most comprehensive example is the Ohio State Studies with the objective to identify independent dimensions of leadership behavior (Schriesheim and Bird 1979 ). Two key dimensions are “Initiating Structure” and “Consideration”. The former describes task-oriented behavior, e.g. putting high emphasis on work organization, work relationships, deadlines and goal attainment. The latter refers to people-oriented behavior with a focus on mutual trust, respect for subordinates’ ideas, and regard for their feelings (Fleishman and Peters 1962 ). One of the biggest contribution of behavioral theory is the introduction of five leadership styles: (1) the autocratic leader (who permits little or no freedom, relying on his or her position, knowledge or power to reward and punish), (2) the bureaucratic leader (who gives clear orders, relying on the organization’s policies, procedures and rules), (3) the diplomatic leader (who provides limited freedom, relying on personal persuasion), (4) the participative leader (who gives a high degree of freedom and accepts group decisions and majority votes) and (5) the free-reign leader (who lets subordinates operate freely unless asked for invention) (Owens 1973 ).

Contingency approaches of leadership comprise three elements: (1) a dimension of leader behavior (“x”), (2) a criterion by which the effectiveness of the leader may be determined (“y”), (3) an environmental or situational variable (“z”) (Korman 1972 ). The focus is on the environmental or situational impact “z”, which influences the correlation between “x” and “y”. In the 1960s, Fiedler’s Contingency Model is looking for the proper match between a leader’s style (i.e. task- vs. relationship-oriented) and the degree to which the situation gives the leader control. If the right match is achieved, effective group performance follows (Fiedler 1977 ). According to Fiedler’s Model, a situation is assessed in terms of three situational dimensions: (1) leader-member relations, (2) task structure, (3) power situation. The combination of these dimensions leads to eight possible categories of leadership situations (Fiedler 1972 ). Fiedler’s fundamental conclusion is to define two ways to improve leader effectiveness: (1) Change of the leader in order to fit the situation, or (2) Change the situation to fit the leader.

Today, two so-called “positive leadership styles” attract high scholarly and managerial attention: Transformational Leadership (TL) and Authentic Leadership (AL). Transformational leaders motivate and encourage others to outperform expectations (Podsakoff et al. 1990 ). The four components of TL are referred to as the “4 I’s”: Idealized influence/charismatic leadership, Inspirational motivation, Intellectual stimulation, and Individualized consideration. As TL is associated with performance beyond expectations, this model remains at the forefront of scholarly attention (Bass and Reggio 2006 ; Gardner et al. 2010 ; Yaslioglu and Erden 2018 ). At the beginning of the twenty-first century, authentic leadership gained high scholarly attention and is now among the most prominent leadership styles studied (Banks et al. 2016 ; Berkovich 2014 ; Celik et al. 2016 ; Walumbwa et al. 2008 ). Walumbwa et al. ( 2008 ) define AL as a composite of four dimensions: (1) self-awareness (including an understanding of one’s strengths and weaknesses and being cognizant of one’s impact on other people), (2) relational transparency (which means presenting one’s authentic self to others, sharing information and expressing one’s true thoughts and feelings), (3) balanced processing (which means to objectively analyze all relevant data before decision making including challenge deeply held positions), (4) internalized moral perspective (which refers to an integrated form of self-regulation guided by internal moral standards and values versus outside pressures) (Walumbwa et al. 2008 ). In sum, AL is a construct that incorporates traits, behaviors, styles and skills to promote ethical and honest behavior (Covelli and Mason 2017 ).

3 Constructs and Generation of Hypotheses

A recent meta-analytic review by Banks et al. ( 2016 ) indicates construct redundancy of TL and AL, claiming that none of the constructs adds palpable incremental validity beyond the other. Joo and Nimon ( 2014 ) though concluded that both leadership models are complementary, not substitutable (Joo and Nimon 2014 ). Consequently, it is hypothesized that TL and AL both contribute to the relationship of leadership with various dependent variables by explaining incremental variance.

In line with Zaccaro and Klimoski’s ( 2002 ) view that different dimensions of organizations can moderate the nature of organizational leadership and its antecedents and consequences (Zaccaro and Klimoski 2002 ), scientific leadership research has been covering many of these aspects (Golden and Shriner 2017 ; Charbonnier-Voirin et al. 2010 ; Jensen 2013 ; Kulophas et al. 2015 ; Zubair and Kamal 2016 ). According to Antonakis and Atwater ( 2002 ), structural distance can be defined as physical structure (i.e., physical distance between leader and subordinate), organizational structure (e.g., hierarchical level, span of control), and supervision structure (i.e., frequency of leader-subordinate interaction). In this work, research participants’ affiliation to a specific organizational setup (in-house vs. sales staff) of the collaborating pharmaceutical company is treated as context variable. Its moderating effect on various leadership-consequences relationships is analyzed. Especially the physical distance between leader and subordinate is structurally different in both work settings. When coming to TL’s and AL’s relationship with employee attitudinal and behavioral constructs, moderation analysis will be carried out on the basis of participants’ affiliation with one of the two work contexts. Moderation hypotheses in this work have the structure presented in Fig. 2 below.

figure 2

Structure of hypothesized moderator effects. Source: Own representation

Social Identity Theory (SIT) postulates that individuals identify with social entities, e.g. individuals or organizations, to foster and maintain a positive self-concept (Tajfel and Turner 1986 ). Organizations offer employees a multitude of identification targets, so-called foci. These foci can be an organization as a whole, a team, or a manager (van Dick 2001 ). Positive leadership theories should be able to enhance subordinates’ identification with manager (IM). With respect to the IM construct, it is expected that both leadership models will contribute to employees’ Identification with Manager:

Authentic Leadership will be a positive predictor of subordinates’ Identification with Manager

Transformational Leadership will be a positive predictor of subordinates’ Identification with Manager

Moreover, it is hypothesized that the employees’ work context (i.e. organizational unit: in-house staff vs. sales) will have a moderating effect on the AL/TL-IM relationship:

The relationship between AL and IM will be moderated by employees’ work context (in-house staff vs. sales)

The relationship between TL and IM will be moderated by employees’ work context (in-house staff vs. sales)

According to West and Farr, Innovative Work Behavior (IWB) describes the intentional creation, introduction and application of new ideas within a work role, group or organization in order to benefit role performance, the group or the organization (West and Farr 1989 ). In line with previous research, it is expected that both leadership models contribute positively to employees’ IWB:

Authentic Leadership will be a positive predictor of subordinates’ Innovative Work Behavior

Transformational Leadership will be a positive predictor of subordinates’ Innovative Work Behavior

Moreover, it is postulated that employees’ work context, i.e. their affiliation to in-house vs. sales teams, will moderate the AL/TL-IWB relationship:

The relationship between AL and IWB will be moderated by employees’ work context (in-house staff vs. sales)

The relationship between TL and IWB will be moderated by employees’ work context (in-house staff vs. sales)

Rousseau et al. ( 1998 ) comprehensively describe the nature of the trust construct: “Trust is a psychological state comprising the intention to accept vulnerability based upon positive expectations of the intentions or behavior of another” (p. 394f). It comprises both exchange processes and an understanding of trust subjects and objects not limited to an individual. For the purpose of this research, focus is on the interpersonal aspect of trust between manager (trust subject) and subordinate (trust object). According to Bass’ expansion of Burns’ TL theory, loyalty is an outcome of TL, mediated by trust, honesty and further qualities of the leader. This connection is substantiated in recent studies (e.g. Monzani et al. 2016 ). Overall, both leadership models are hypothesized to positively contribute to employees’ Trust and Loyalty (T&L):

Authentic Leadership will be a positive predictor of subordinates’ Trust and Loyalty

Transformational Leadership will be a positive predictor of subordinates’ Trust and Loyalty

Again, employees’ work context (in-house staff vs. sales team) is expected to moderate the AL/TL-T&L relationship:

The relationship between AL and T&L will be moderated by employees’ work context (in-house staff vs. sales)

The relationship between TL and T&L will be moderated by employees’ work context (in-house staff vs. sales)

Employee satisfaction (ES) is a construct frequently correlated with leadership in empirical research. Wong and Laschinger ( 2013 ), for example, established a direct positive relationship between AL and ES. Yang et al. ( 2011 ) confirmed a positive relationship for TL and ES. In this work, a positive relationship between both leadership models and subordinates’ ES is postulated:

Authentic Leadership will be a positive predictor of subordinates’ Employee Satisfaction

Transformational Leadership will be a positive predictor of subordinates’ Employee Satisfaction

Employees’ work context (in-house staff vs. sales team) will have a moderating effect on the AL/TL-ES relationship:

The relationship between AL and ES will be moderated by employees’ work context (in-house staff vs. sales)

The relationship between TL and ES will be moderated by employees’ work context (in-house staff vs. sales)

4 Empirical Assessment of the Models

The statistical software IBM SPSS Statistics 21 including the macro PROCESS (Version 3.1) was used to test the hypotheses (Hayes 2013 ). In total, 5 hierarchical regression analyses were conducted, consisting out of subsequent, identical steps for each of the five dependent variables. PROCESS Matrix procedure was also chosen to define and analyze the models evaluating moderating effects. Tests of unconditional interactions between independent variables and conditional effects of focal predictors in accordance to values of the moderators are possible.

Data collection for this research project occurred through an online questionnaire activated from June 17th until/including July 15, 2018. Participating functions were employees and their first line managers from selected sales, marketing, market research, market access, medical management, patient care, human resources, communication and further business support teams. N = 247 employees, thereof N = 34 first line managers, were invited. To avoid respondents’ overload, a maximum duration of 15 min per survey is recommended (Batinic and Bosnjak 2000 ). With an average residence time of a bit longer than 11 min this threshold level was met. N = 143 employees clicked through the entire questionnaire. After initial exploratory descriptive data analysis using SPSS, N = 6 respondents were excluded due to missing data for four or more constructs. All final data analysis is therefore based on N = 137 respondents. Consequently, the ratio of evaluable cases vs. invited employees (N = 247) is 55%. Of N = 137 participants, 79 (58%) are female, 58 (42%) are male. The online cohort should quite closely reflect the workforce structure of companies of the healthcare sector. Regarding age distribution, the online cohort matches the national distribution of the German working population very well. An important variable is the affiliation of employees to in-house vs. sales personnel. In our sample, respondents are almost equally split between in-house based (N = 76; 55%) and sales employees (N = 61; 45%).

For the operationalization of AL, the ALQ (Authentic Leadership Questionnaire) as a well-established, theory-driven and validated measurement scale was chosen (Walumbwa et al. 2008 ). For the purpose of this research, a German translation of the ALQ, validated by Peus et al. ( 2012 ), was used. The version for external assessment from employees’ perspective was applied. Internal consistency alphas (Cronbach’s α) for each of the four subscales and the overall scale were originally reported to be higher than 0.7 in a cross-cultural validation study (Walumbwa et al. 2008 ). In the present project, SPSS data analysis shows a high Cronbach’s α of 0.94 for the overall ALQ construct. Responses were collected on a 5-point Likert scale with pre-determined answer options ranging from (1) “Does not apply at all” to (5) “Fully applies”; German translations were used, respectively.

TL is operationalized by the GTL (Global Transformational Leadership scale). This short measure was tested, validated and confirmed by many studies in various geographical and business contexts (Carless et al. 2000 ; van Beveren et al. 2017 ). In the present analysis, Cronbach’s α of 0.90 confirms its internal consistency. As in the original study, the response format was a 5-point Likert scale ranging from (1) “Does not apply at all” to (5) “Fully applies”.

Based on an instrument for Organizational Identification (OI) from Mael and Ashforth ( 1992 ), Ullrich et al. ( 2009 ) developed a short measure for IM consisting of three items. The original Cronbach’s α was .69 (Ullrich et al. 2009 ). Similar to organizations, teams or workgroups, managers can represent a social category with which employees identify themselves (Gautam et al. 2004 ). Therefore, the original OI instrument was amended to an IM scale. In the present research, a Cronbach’s α of 0.84 was reached. Consistent with the previous measurement constructs, a 5-point Likert scale with identical response options was used.

IWB is assessed by nine items derived from Scott and Bruce’s ( 1994 ) scale. It has also proven validity and reliability in the work of Janssen ( 2000 ). In accordance to the theoretical concept described earlier, three items each refer to the aspects of idea generation, idea promotion and idea realization. Again, a 5-point Likert scale was applied. Response options now ranged from (1) “Never” to (5) “Always”. Janssen ( 2000 ) reported a Cronbach’s α of 0.95 for this instrument. The present data set delivers a very acceptable Cronbach’s α of 0.90.

Trust in and loyalty to the leader is operationalized by use of a six item scale of Podsakoff et al. ( 1990 ). The first three items represent the trust component of the instrument. In turn, the remaining three items stand for employees’ sense of loyalty to their managers. Again, responses were collected on a 5-point Likert scale with answer options of (1) “Does not apply at all” to (5) “Fully applies”. In our data set a Cronbach’s α of 0.93 was reached, pointing to a very good internal consistency.

Additional constructs like Organizational Identification (OI) and Employee Satisfaction (ES) considered in the comprehensive work were operationalized by a validated 3-item scale from Mael and Ashforth ( 1992 ) and a five-item short instrument based on an original scale developed by Brayfield and Rothe ( 1951 ).

Hypotheses H 1a to H 8a are tested by application of regression analysis. Hierarchical Regression analysis is applied to evaluate the differential explanatory effect of both Leadership Models, AL vs. TL. Four three-step hierarchical regression analyses were run with the following dependent variables: IM, IWB, T&L and ES. At step one of each of the separate calculations, the demographic variables age and sex were entered to control for covariates. AL was entered at step two as first predictor of conceptual interest. The second predictor TL was entered at step three. The variables were introduced stepwise to see if they have an effect over and above covariates.

Table 1 shows the Means, Standard Deviations, Cronbach’s α for all constructs covered, as well as Intercorrelations.

Due to limited space, not all statistical analyses are presented in detail. Of course, all analyses and their results are available when contacting the authors. As age and gender might have effects on the dependent variables of interest, they were entered in the analyses as control variables.

TL explained additional variance above and beyond AL in Identification with the Manager, Trust and Loyalty in the leader, and Employee Satisfaction (confirmation of Hypotheses H 1a , H 2a , H 5a , H 6a, H 7a , H 8a ). However, neither AL nor TL explained significant variance in Innovative Work Behavior (rejection of Hypotheses H 3a , H 4a ,).

Nevertheless, when context was included inside the model (moderator: in-house vs. sales), there was a positive relation between AL and innovative work behavior for sales, but not for in-house staff (see Fig. 3 ). Additionally, the moderator analyses revealed that the relation for both AL and TL and trust and loyalty towards the leader was stronger in sales than in in-house staff (see Figs. 4 and 5 ). Consequently, hypotheses H 3b , H 5b , H 6b are confirmed. Hypotheses H 4b , as well as H 7b and H 8b on moderating influences of context on the relationship between AL/TL and ES are rejected, though.

figure 3

The moderating influence of work context on the AL-IWB relationship. Source: Own representation based on SPSS analysis

figure 4

The moderating influence of work context on the AL-T&L relationship. Source: Own representation based on SPSS analysis

figure 5

The moderating influence of work context on the TL-T&L relationship. Source: Own representation based on SPSS analysis

5 Summary, Implications and Outlook

Key objective of this work was to empirically test the relationship between leadership and its key consequences. By means of an online survey with 137 employees of a pharmaceutical company in Germany, the importance of positive leadership models–Authentic and Transformational leadership–for the occurrence of desirable work attitudes and behaviors like Identification with Manager, Trust and Loyalty, and Employee Satisfaction, was documented. This implies that in corporate practice a positive leadership culture is suitable to stimulate relevant employee actions that contribute significantly to corporate success.

Based on a comprehensive literature review, AL and TL were identified as the main contemporary leadership models of interest. Consequently, these approaches constituted the key independent variables entered both into multiple hierarchical regression as well as moderation analysis models. As a secondary objective, the empirical analysis shed light on the pharmaceutical industry sector and expanded scientific knowledge regarding consequences and potential moderating effects of work contexts.

Essences of the present empirical research are:

Positive Leadership Behaviors (AL and TL) are positive predictors of critical employee attitudes and business targets like Identification with Manager, subordinates’ Trust and Loyalty, and Employee Satisfaction.

The empirical research results confirm construct validity and conceptual independence of both positive leadership theories, AL and TL.

Work context, operationalized as in-house vs. sales personnel, significantly impact some leadership-consequences relationships, i.e. leadership’s relationship with Trust and Loyalty is significantly moderated by work context (with a stronger effect in the study population of sales force); for the AL-IWB relationship, a significant moderating effect for sales personnel was also confirmed.

Although an often stated need for quantification of positive leadership behavior in corporate financial success and target figures was not subject of this investigation, the confirmed relationships between positive leadership and most of the desirable work attitudes and behaviors indicate that AL and TL contribute positively to operating profit.

In addition to the above mentioned financial aspects, hints on positive aspects of employee behavior, namely Innovative Work Behavior, could be derived. As this was especially accentuated in the context of customer facing sales personnel, one could infer that high AL in sales contexts can have a halo effect on sales reps customer interactions.

In order to achieve corporate goals, a recommendation to pharmaceutical companies is to establish a corporate culture that fosters positive leadership behavior. Leader recruitment, leadership training and development should take the “4 I’s” of TL and the four aspects of AL as a reference. Specific examples for HR departments can be to provide platforms and trainings for people managers to develop capabilities as mentors, coaches and active listeners. In order to be able to act as a positive role model for employees, leaders should be clear about ethical and moral standards, also with regards to the specifics of the pharmaceutical industry. Moreover, tools to foster leaders’ and employees’ self-awareness, a culture that supports transparency and one of error tolerance would be very beneficial to establish the desirable leadership styles, hence positive employee attitudes and behaviors.

Although this research shows promising results, a few limitations need to be mentioned. First, this study has a cross-sectional design. Therefore, longitudinal investigations could be of interest in order to evaluate intrapersonal developments over time and if and how they impact job attitudes and behavior. Second, due to requirements of the collaborating company’s works council in order to ensure anonymity and maximum data protection, a dyadic approach to collect and analyze data based on team structures was not allowed. It would be advisable for future research to collect and use this information in order to enhance data quality and model reliability by reducing a potentially high amount of additional variance. Similarly, the actual duration of individual leader-subordinate relationships could actively be controlled for, as interpersonal relationships including the development of trust tend to evolve over time. Third, all outcome variables are solely based on employee self-assessment. This potential for common source bias could be reduced in future studies if additional sources of feedback and information can be taken into account, e.g. supervisors’ evaluations of employees’ behavior or secondary data from more objective performance evaluations. Fourth, the present moderation analysis is purely based on self-reported organizational allocation to in-house vs. sales departments. This was used as a surrogate for work context, primarily reflecting physical distance to the supervisor, which in turn was supposed to impact frequency and quality of communication. However, quality of leader-subordinate interaction might be perceived quite differently on a personal level. In future studies, analysis could therefore be controlled for effective communication frequency and/or perceived quality of communication channel and content of leader-subordinate exchange.

Despite these limitations and implications for future research, the study provided various important insights. It seems to be first research project to systematically analyze the two contemporary positive leadership models Authentic Leadership and Transformational Leadership in a comparative context of in-house staff and sales representatives of a single pharmaceutical company in Germany.

In order to build on the current outcomes, the following direction for future research can be proposed. First, a longitudinal study design could be chosen to be able to track the development of interpersonal leader-subordinate relationships over time. Second, recourse to potentially more objective multi-source data to substantiate the expressed employee attitudes and behaviors might be beneficial. Third, the study could be run in or across different companies and industries to detect significant differences or communalities. Similarly, the study could be replicated by inclusion of different hierarchy levels within companies to assess if team size or span of control impacts the relationship of leadership and its consequences. Fourth, the evaluation of antecedents of AL and TL could be added to the research design to potentially derive implications for people management and personnel development.

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Lange, M.A., Hernandez-Bark, A. (2020). Leadership Models and Work Behavior: An Empirical Analysis of Consequences of Authentic and Transformational Leadership. In: Schweizer, L., Dingermann, T., Russe, O., Jansen, C. (eds) Advances in Pharma Business Management and Research. Springer, Cham. https://doi.org/10.1007/978-3-030-35918-8_6

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Impact of transformational leadership on work performance, burnout and social loafing: a mediation model

  • Hira Khan 1 ,
  • Maryam Rehmat   ORCID: orcid.org/0000-0002-3377-0082 2 , 3 ,
  • Tahira Hassan Butt 3 ,
  • Saira Farooqi 2 , 3 &
  • Javaria Asim 2 , 3  

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The aim of this research was to study the effect of transformational leadership on employees’ work outcomes which include their work performances and working burnout, and their working behavior such as social loafing at workplace. Also, it studies the impact of intrinsic motivation as a mediator between transformational leadership and other stated variables. A cross-sectional survey was conducted to collect data from 308 employees working in the telecommunication sector. To test the hypotheses, Model 4 of Process Hayes was used to test direct and mediating effects among transformational leadership and employees’ work outcomes and working behavior. The results showed that transformational leadership has a significant positive relationship with mediator intrinsic motivation. The results also concluded that work performance has positive significant relationship with transformational leadership. However, there is indirect and insignificant relationship of transformational leadership with working burnout and social loafing. Therefore, it can be stated that organizational leaders must have transformational attributes by getting informed of their employees well because transformational leader can inspire employees to achieve anticipated or significant outcomes. It gives employees self-confidence over specific jobs, as well as the power to make decisions once they have been trained.

Introduction

During the last two decades, transformational leadership has gained most conspicuous place in philosophy of leadership [ 81 ]. Therefore, it is not surprising that the current evolution in leadership theory and practice has attracted the interest of both practitioners and researchers and they exhibited great deal of interest toward exploring its ascendancy for organization and individuals as well [ 72 , 87 ]. Particularly, the studies conducted during the previous decades recommends that transformational leadership is considerably related to followers’ behaviors and performance [ 20 , 65 ]. In a review on progress in the domain of leadership printed in “Annual Review of Psychology,” Avolio et al. [ 8 ] stressed the need to establish mechanisms that connect leadership to vital organizational and individual outcomes. They further stressed the need to investigate the role of mediators, so as to clarify the noteworthiness of leadership for organizations. Chan and Mak [ 20 ] in their research contended that “a variety of different influence processes may be involved in transformational leadership yet there is still room for research to further examine the process of the relationship between transformational leadership and follower attitudes and behaviors.” Transformational leadership defined as leadership approach in which a leader transforms his followers, inspires them, builds trust, encourages them, admires their innovative ideas, and develops them [ 12 ], is presently the most extensively acknowledged definition in the leadership literature.

Transformational leadership can be implicated to managerial context. Transformational leadership which is the leader’s competency to get performance of employees beyond expectations, can be more helpful and beneficial in enhancing one’s ability to intrinsically motivate them. It can improve psychological empowerment as well [ 85 ]. Transformational leadership has four components which are: (i) idealized influence, (ii) inspirational motivation to enhance confidence, (iii) intellectual stimulation, and (iv) individualized consideration [ 13 ]. Idealized influence is shown when a leader efficiently makes provision of accurate sense of mission and appropriately visualizes it. Inspirational motivation can be defined as leadership attitude which deals with emotional traits of employees, builds confidence in employees about their performances, appropriately communicates and provides actual feedback [ 68 ]. Individual consideration refers to the support of leader for each follower. It may include training and coaching, allocating tasks according to the competence of each individual and supervision of performances [ 92 ]. Intellectual stimulation describes the effort of leader to motivate and encourage his employees to be more adaptive and follow new technical approaches according to the varied situation. It may be advantageous to overcome the cues and hindrances which occur at multi stages [ 14 ]. Transformational leaders can anticipate that employees will need transformational leadership when the work is more stressful and when the work is more meaningful [ 84 ].

Extant research on the transformational leadership tried to explore its “black box” and presented empirical confirmation of its direct fruitful consequences for followers’ outcomes including work performance [ 16 , 44 , 52 , 90 ], burnout [ 40 , 82 ], and social loafing [ 5 ]. Nevertheless, there exists some room for further research, explaining the specific mechanisms by which transformational leadership influence such individuals’ behavior and psychological state particularly at organizational level [ 16 ]. Hence, this study aims at providing new comprehension of how and why and under what circumstances transformational leadership influences work performance, burnout and social loafing of employees, in Pakistani context.

Transformational leadership tends to maximize the level of professional performance of work In addition to provided literature on association of transformational leadership and work performance; researchers indicate that organizations of diverse structures highly depend upon the performance of its workers. Past studies have empirically established the positive association between work performance and transformational leadership [ 9 ]. Transformational leaders inspire their followers to have shared vision of targeted goals and standards of performance defined by the organization and also facilitate them achieve it [ 4 ]. Another factor which is highly influenced by transformational leadership is employee’s burnout which may be decreased through this particular style of leadership. Prevalence of stress is highly probable in any organizational sector [ 73 ]. Transformational leadership is most influencing factor which enhances the employee’s ability to deal with all kind of circumstances as such leader provide supportive circumstances to employees so that they can maintain the optimum level of mental health through inspirational motivation and also enhances their confidence level [ 28 , 93 ].

“Social loafing is the inclination of putting less effort while working in a team than working alone” [ 5 ]. Transformational leader, while working in a group, follows a strategy in which he can allocate various assignments and tasks according to the competencies of employee and he must evaluate performances of each individual. Social loafing is a psychological aspect of an individual which may differ from situation to situation and individual to individual [ 55 ]. Leadership literature has established that individualized consideration by the leader may deflate the degree of social loafing [ 45 ].

Building on the previous literature, this research incorporated employee intrinsic motivation as a factor that explains the linkage of transformational leadership with employee work performance, burnout and social loafing. Intrinsic motivation which is “the implementation of an action for the inherent satisfaction rather than for external reasons” [ 63 ]. Undeniably, the motivation of current workforce is not much reliant on extrinsic rewards. Rather material rewards may decline job performance in complex jobs with diverse responsibilities [ 30 ]. Further, in order to perform their duties effectively in today’s dynamic work environment, the employees need to have an elastic and highly flexible work arrangement. For that reason and for instilling good motivation among workers, organizations not only offer extrinsic rewards to them but also plan to enhance their intrinsic motivation [ 63 ]. Transformational leadership is the leadership approach which contributes to present a clear and justified organizational vision and mission by motivating workers to work toward idea through developing association with employees, consider employees’ requirements and assisting them to exert their potential positively, participates to positive outcomes for an organization [ 31 ]. Employees whose work competencies are encouraged by the leader are more likely to have higher intrinsic motivation and resultantly perform better at work. They become more focused and try to accomplish organizational goals by taking their own interests. There also exists indirect association between employees’ burnout and transformational leadership through mediating effect of intrinsic motivation [ 28 ]. Transformational leaders focus more on individual requirements and they build strong association with their employees who are supposed to perform with higher objectives, which enhances employees’ intrinsic motivation. Such motivation keeps them away from burning out [ 6 ]. We further argued that intrinsic motivation mediates the relationship between transformational leadership and social loafing. Previous studies indicate that role of intrinsic motivation discourages social loafing as it does not happen circumstantially only, but it also happens whenever an employee is low in intrinsic motivation [ 5 ].

This research makes provision of significant contribution in the literature of organizational behavior by enriching our understanding of the conditions under which transformational leadership influences employee performance, burnout and social loafing. The findings of our research allow organizations and its management to comprehend how efficiently and effectively they can follow a policy or some kind of advanced strategy in order to intrinsically motivate their employees so that they can increase the level of work performance and deflate burnout and social loafing in employees.

Literature review

Transformational leadership and intrinsic motivation.

Envisioning visions and motivating are two core jobs of effective leadership [ 24 ]. According to traditional transformational leadership literature, transformational leaders guide and encourage employee mindfulness by enunciating a vision that escalates employees’ consciousness and consideration for the significance of organizational values, goals, and performances [ 42 ]. Thusly, fundamental to the theory on transformational leadership is a strong accentuation on the part of a combined vision; that is, an idealized arrangement of objectives that the organization seeks to accomplish one day [ 18 ]. Transformational leaders, through clear enunciation, have their utmost influence on the followers’ sentiments by cultivating a feeling of success and proficiency in them. Transformational leaders are much capable to improve organizational outcomes according to the market requirements by developing human resources and creating justified modifications [ 34 ]. The reason to acquire specific knowledge is associated with the degree that what is the level of intrinsic motivation of a person and how he is keen to get knowledge by developing particular competencies and meaningful learning [ 78 ]. Transformational leadership has power to enhance the ability of psychological empowerment which is referred as intrinsic motivation [ 85 ]. According to [ 74 ], the idea of motivation is known as “the set of reasons why people behave in the ways they do”, for example, intrinsic motivation is “the motivational state in which the employees are driven by their interests in the work rather than a contract-for-rewards approach to completing a task” [ 24 ]. A study by Koh et al. [ 51 ] identified that intrinsic motivation is highly influenced by the transformational leadership, as the transformational leader guides and supports effectively, self-motivation to be an effective and beneficial part of an organization increases as well.

Transformational leadership comprises four interconnected behavioral dimensions including “idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration” [ 11 ]. All behavioral dimensions can influence employees’ intrinsic motivation. First, transformational leaders utilize idealized influence and offer inspirational motivation through communicating an alluring collective vision [ 91 ]. This collective vision provides a meaningful idea of team’s tasks by a leader which increase the intrinsic motivation of employees [ 75 ]. Transformational leadership can develop positive outcomes such as optimism and high self-interests in all members of team which ultimately increase the pleasure and job satisfaction relevant to the task [ 26 ]. Second, the intellectual stimulation of transformational leaders boosts team members’ confidence to develop more effective emotional and situational stability and resolving their problems by their own selves [ 11 ]. They are also motivated to understand and encourage the basic knowledge and skills of other coworkers to share new ideologies. Third, transformational leaders differentiate individuals’ ideas and interests, promote their ideas to describe their uniqueness, and consider them through individualized consideration [ 11 ]. When employees observe the behaviors of their leaders, all of them feel motivated and try to construct one another’s ideas and competencies to create innovative solutions of problems. Therefore, in this article, we expect that all dimensions of transformational leadership encourage employees to invest higher willingness and energy in their work and tasks which exhibit their higher intrinsic motivation. Therefore, it can be hypothesized that:

Transformational leadership relates positively to intrinsic motivation.

Transformational leadership, intrinsic motivation and work performance

Intrinsic motivation is highly associated with the work performance. Intrinsic motivation may be defined as “the doing of an activity for its inherent satisfactions rather than for some separable consequence but it is rare for employees to experience intrinsic motivation in all of their tasks” [ 76 ]. Intrinsic motivation is generated for self-developing attributes that refers to make an individual ready to be the part of learning procedure without having interests of extrinsic rewards [ 83 ]. Intrinsic motivation is basically the degree of an individual’s interest in a task completion and how he engages himself in work [ 3 ]. It describes the psychological development process with an employee’s performance [ 85 ].

According to recent operational settings, enhancing the employees’ motivation has become one of most impactful human resources strategy. Most of the organizations are tending to build up, sustain and grow their HR strategies, just to motivate their employees so that short-term and long-term goals and objectives can be achieved. In recent researches, there are numerous variables which can be influenced by employees’ intrinsic motivation like performance, creativity, and relevant outcomes. For example, it has been stated that behavior of an individual influences the work outcomes which are performance and quality as well [ 10 ]. It is strongly evidenced that motivation has a most important role between cognitive abilities and work performance. Gist [ 37 ] suggested that short term goals can be achieved through self-interest of an individual. Also, a research indicates that there is a significant and direct relationship of intrinsic motivation and job performance [ 43 ]. Furthermore, an employee’s intrinsic motivation illustrates an important contribution in organizational progress and growth [ 39 ]. The work performance indices are constructed for the degree of performance, not only for the individual level always; it also includes group and organizational performances [ 2 ]. In most employment situations, where intrinsic motivation of an employee is supposed to be high, the employee usually tries to acquire continual employment,and he/she develops interpersonal associations with his subordinates, perform better at job as they take pleasure in the process of finishing their tasks effectively [ 38 ]. Conversely, if the worker feels de-motivated, it can be resulted in low performance of work. Thus intrinsic motivation may be concluded with better performance of work while meeting organizational targets and goals [ 7 ].

As we propose the direct relationship of intrinsic motivation and performance, it may be stated that the intrinsic motivation can actively influence the performance of work as a significant workplace outcome [ 19 ]. Therefore, we hypothesize that:

Intrinsic motivation relates positively to employee work performance.

In current research, we posit that intrinsic motivation is one of the main mechanisms by which transformational leaders influence employees’ job performance. Transformational leaders may help to ensure individual’s inner motivation to perform a task efficiently which in turn increases their work performance .These leadership approaches are advantageous for both individual and organizational growth [ 36 ]. In fact, it is justified to examine how leaders motivate their employees and this motivation enhances their performance [ 12 ]. In line with the previous literature [ 22 , 23 ], we expect that transformational leadership enhances individuals’ intrinsic motivation which in turn will significantly predict employee job performance. Intrinsic motivation is known as self-directed type of motivation and represents the highest commitment and stability with the self [ 25 ]. A variety of researches indicate that higher intrinsic motivation result in better performance [ 89 ] as intrinsic motivation inspires and encourages employees to work more efficiently. Therefore, it can be hypothesized:

Intrinsic motivation mediates the relationship between transformational leadership and work performance.

Transformational leadership, intrinsic motivation and employee’s working burnout

Intrinsically motivated employees persistently focus on their tasks and jobs because they find themselves more focused, attentive and exert their best efforts while being a part of an organization and in achieving the goals of their employing organization [ 76 ]. Burnout is a psychological and mental condition which happens in response to high stress level at job; it is a multi-dimensional concept which covers the following three aspects: emotional exhaustion, depersonalization, and decreased personal focus for accomplishment of goals [ 77 ]. Burnout affects the interpersonal relationship of employees too [ 58 ].

Prior research indicates that there is contrary effect of intrinsic motivation on employee’s working burnout [ 70 ]. Intrinsically motivated employees find their jobs more interesting, are more optimistic, put more effort in their work, and have higher perseverance level because they gain contentment and fulfillment from performing a task itself [ 15 ]. Vallerand [ 88 ] in his study exhibit that “employees with high intrinsic motivation have higher level of vitality, positive effect, self-esteem, absorption, concentration, effort, and persistence” and when such employees went through the felling of burnout, they have more personal resources to surmount this situation. Such employees feel less exhausted, less stressed and more focused toward contributing in organization’s progress [ 49 ]. Intrinsically motivated employees feel less pressure and low stress level rather than the employees who are low in motivation [ 69 , 71 ]. Intrinsic motivation of employees’ can be negatively associated with their burnout [ 70 ].Therefore; the employees who are high in intrinsic motivation can decrease their burnout at workplace [ 50 ]. Thus, it can be hypothesized that:

Intrinsic motivation is negatively associated to employee’s working burnout.

In current research, we propose that intrinsic motivation plays a mediating role between transformational leadership and burnout. Burnout is the major concern for organizations as it influences the relevant outcomes. It results in low productivity and commitment. Hence, it causes the high turnover and absenteeism in employees [ 82 ]. Studies indicate that leaders highly contribute to employees’ health and welfare as well [ 80 ]. But the relationship between leadership behaviors and employee burnout is less studied yet [ 41 ]. As mentioned earlier, there exists a positive relationship between transformational leadership and intrinsic motivation which in turn make them more competent, teach them how to handle and manage stressful conditions and reduce their burnout. Therefore, we hypothesize that:

Intrinsic motivation mediates the relationship of transformational leadership and employee’s working burnout.

Transformational leadership, intrinsic motivation and social loafing

Social loafing is defined as the tendency of individuals who exert less effort and their productivity decreases when working in groups than working individually [ 21 , 33 , 57 , 79 ]. It is a negative employee behavior and is particularly shown by individuals with lower motivation [ 1 ]. These kinds of behaviors can be resulted in low productivity and poor commitment toward a task [ 62 ] and organization as well.

Social loafing is common practice and can be observed in every organizational setting, across age and gender and in different professions and various cultures [ 46 ]. This is more alarming that it can be seen at every single workplace and considered as misconduct. The variety of factors is studied in influence of social loafing, but there is still an insufficiency of individual inherent factors such as intrinsic motivation which is part of this research framework.

“Intrinsic motivation which describes an inherent tendency that individuals engage in activities due to their inner interests, pleasure and satisfaction” [ 70 ] is negatively linked to Social loafing. George [ 33 ] established in his study on 221 salespeople that intrinsic task involvement is negatively linked to social loafing. He further exerted that intrinsically motivated individuals may have self realization that their efforts are vital for the success of their team/group and for organization as well and therefore they are less likely to be engaged in social loafing. He/she would try his/her own best to exert extra effort to accomplish the goals and tasks assigned by the leader.

Therefore, we hypothesize that:

Intrinsic motivation is negatively linked to social loafing.

Intrinsic motivation may be described as the inherent process that initiates attributes, behaviors and what defines people to moves or act [ 27 ]. Self-determination theory indicates that there are different levels of motivation. Intrinsic motivation is at the most independent end of the scale because an individual opts to get engaged in any conduct according to his own choice [ 32 ]. A leader motivates his employees by incorporated strategies which results in better achievement of goals and objectives of a firm or organization. Gilbert et al. [ 35 ]. Social loafing is defined as a reduced amount of effort and motivation while being a part of group or working in a team as compared to working individually [ 46 ]. Social loafing is well-known phenomena and can be found in all of the organizations, across gender, and age and in various occupations and different cultures [ 46 ].

Social loafing is considered as a big hindrance in organizational growth as well. It causes low potential [ 61 ], low productivity [ 29 ], and low motivation of other team members too [ 67 ]. It decreases the overall efficiency, productivity and performance of the team [ 47 ]. Social loafing is widely spread term which is also known as social disease [ 54 ].

In line with this connection, social loafing is a big moral and social issue since it is an option that “involves modifying the life plan of another individual or group of individuals” [ 60 ]. On contrast, if a transformational leader motivates his employees and encourages their performance on individual basis, then through individualized considerations and inspirational motivation, social loafing can be decreased. Therefore, it can be hypothesized:

Intrinsic motivation mediates the relationship of transformational leadership and social loafing.

Mediating role of intrinsic motivation between transformational leadership and social loafing

(Fig.  1 ).

figure 1

Theoretical framework

Sample and data collection

The data was collected through survey via emails, online surveys and printed questionnaires through convenience sampling from individuals working in the telecommunication sector. The participants were informed about the objective of this study and the assurance of confidentiality and anonymity of their responses. Respondents were assured that their information will not be assessed by any individuals except those who are authorized. After removing the duplicates, outliers and responses with missing data, we obtained 308 valid responses for further data analysis Table  1 depicts the demographic characteristics of the respondents.

  • Transformational leadership

Transformational leadership was measured by McColl-Kennedy and Anderson [ 59 ] four-item scale. Six-point Likert scale (1—strongly disagree to 6 —strongly agree) was used to measure responses. This is the most widely used scale to measure transformational leadership. Cronbach’s alpha for transformational leadership scale is 0.84.

  • Intrinsic motivation

In this study, Liu et al. [ 56 ] four-item scale was adopted to measure intrinsic motivation. To record the responses five-point Likert scale was used (1 —strongly disagree to 5—strongly agree). Cronbach’s alpha for intrinsic motivation scale is 0.89.

  • Work performance

To measure work performance [ 19 ] four-item scale was adopted. Five-point Likert scale (1—much worse to 5—much better) was used to measure responses. Cronbach’s alpha of work performance scale is 0.80.

  • Working burnout

Working burnout was measured by Kristensen et al. [ 53 ]. Seven items with five-point Likert scale (1 –never to 5—always) was used. Cronbach’s alpha of burnout scale is 0.88.

  • Social loafing

Social loafing was measured by Akgunduz and Eryilmaz [ 1 ]. Four items with five-point Likert scale (1—strongly disagree to 5—strongly agree) was used. Cronbach’s alpha of social loafing scale is 0.80.

Data analysis

After data collection, the reliability, correlation was calculated by using SPSS software. Research model was tested using Hayes Process Model 4.

Descriptive statistics

Table  2 describes descriptive statistics of all the study variables including the mean, standard deviation, and correlation. Correlation coefficients are in the anticipated directions and provide preliminary support for our study hypotheses. Our results depicts that transformational leadership and intrinsic motivation ( r  = 0. 29, p  < 0.01) are positively and significantly correlated. Further intrinsic motivation is significantly associated with work performance ( r  = .30, p  < 0.01); working burnout ( r  = − 0.59, p  < 0.01); social loafing ( r  = − 0.15, p  < 0.01).

Reliability analysis

To examine the consistency of the variables, reliability analysis is calculated. The reliabilities of all the variables with number of items are summarized in Table  3 . The values between 0.84 and 0.8 indicate good reliability. The reliability of transformational leadership is 0.84 which is good, and intrinsic motivation shows another good reliability which is 0.89. Working burnout shows 0.88 reliability. The reliability of work performance is 0.8 and the reliability of social loafing is 0.8 which is also good. So this explains that the data used is reliable.

Hypothesis testing

Results of mediation for work performance.

Firstly, we investigated the impact of Transformational Leadership (X) on Work Performance (Y) through mediating factor of Intrinsic Motivation (M). Results justify that total effect of transformational leadership on work performance (path c, Fig.  2 ) is significant ( β  = 0.13, t  = 3.07, p  < 0.01) as shown in Table  4 . The relationship between transformational leadership and intrinsic motivation (path a, Fig.  4 ) is highly significant and positive which support Hypothesis 1 also ( β  = 0.31, t  = 5.20, p  < 0.01). Furthermore, the findings showed that the relationship between Intrinsic Motivation and Work Performance (path b, Fig.  2 ) is positive and significant relationship ( β  = 0.19, t  = 4.79, p  < 0.01).

figure 2

Mediation model—work performance

Our overall findings represent that there is positive and significant impact of transformational leadership on work performance (path c ′, Fig.  2 ) through the mediation of intrinsic motivation ( β  = 0.07, t  = 1.68, p  > 0.01) which accepts Hypothesis 3.

Results for mediation for working burnout

In this model we studied the relationship of Transformational Leadership(X) and Working Burnout (Y) through mediating role Intrinsic Motivation (M). Results indicated that total effect of transformational leadership on working burnout is significant ( β  = − 0.19, t  = − 3.51, p  < 0.01 We examined the relationship between the mediator, Intrinsic Motivation and the dependent variable, Working Burnout (path b , Fig.  3 ). The findings showed a significant and negative relationship ( β  = − 0.50, t  = − 11.98, p  < 0.01). This finding supports Hypothesis 4. As it is shown in Table  5 the final results determined a significant relationship between transformational leadership and working burnout with mediation of intrinsic motivation (path c ′, Fig.  3 ) ( β  = − 0.03, t  = − 0.66, p  > 0.01). Therefore Hypothesis 5 is accepted.

figure 3

Mediation model—working burnout

Results for mediation for social loafing

Our third and last finding for studied relationship between transformational leadership and social loafing through mediator intrinsic motivation, are presented in Table  6 . According to the total effect model, the relationship between transformational leadership and social loafing (path c , Fig.  4 ) is significant and negative ( β  = − 0.32, t  = − 9.57, p  < 0.01) as shown in Table  6 .

figure 4

Mediation model—social loafing

The outcomes showed that intrinsic motivation and social loafing (path b , Fig.  4 ) are insignificantly and related relationship ( β  = − 0.01, t  = − 0.31, p  > 0.01) which opposes Hypothesis 6.

Our last finding determined that transformational leadership does not have a significant negative impact on social loafing (path c ′, Fig.  3 ), while controlling intrinsic motivation ( β  = − 0.32, t  = − 9.07, p  < 0.01). Thus Hypothesis 7 is not accepted. Thus, it can be resulted that there is no mediation.

Theoretical contributions

Although, previous researches have vastly recognized the direct impact of transformational leadership on positive employee work outcomes [ 17 , 48 ], yet not all employees do not respond to transformational leadership optimistically [ 66 ]. This study overall, made an important contribution to the available literature mainly by including variables that are very essential for all work environments that are aiming toward high employee motivation and performance. The current study is a unique attempt to look at the relationship between of transformational leadership, employees’ work performance, working burnout, and social loafing and intrinsic motivation in Asian context. This study contributes to the existing literature on transformational leadership since it is among the first to investigate the indirect impact of transformational leadership on employees’ work performance, working burnout, and social loafing through intrinsic motivation. Providing empirical evidence for association between transformational leadership (independent variable), work performance, working burnout and social loafing (dependent variables) through the mediating effect of intrinsic motivation. Our empirical results provide support for our hypothesized model except for the indirect effect of transformational leadership on social loafing through intrinsic motivation. Transformational leadership consists of four elements which are idealized influence, inspirational motivation, intellectual stimulation and Individualized consideration [ 13 ]. All of these elements showed very good reliability and consistency with each other. These elements actively participate to affect the outcome of intrinsic motivation [ 85 ].

This study shows that transformational leadership has a significant and positive relationship with employees’ intrinsic motivation. Previous literature supports this finding that transformational leadership promotes motivation in employees and develops positive psychological states such as meaningfulness of work, experienced responsibility for the outcomes and knowledge of work results. It indicates that transformational leadership directly exerts its influence by helping employees or followers to think more positively about themselves and their tasks, by enhancing the quality of their relationships, and by creating environments that are fair, respectful, and supportive [ 86 ] and all of these factors contribute positively toward employee’s self motivation toward his/her work (i.e., intrinsic motivation).

The positive elements of transformational leadership bring out positive psychological states by escalating intrinsic motivation among employees. Employees with increased intrinsic motivation are more effective and efficient toward their work performances. They are supposed to be converted into responsive and perform efficiently in their work [ 64 ].

This study results showed significant positive relationship of transformational leadership on working burnout through intrinsic motivation. When a transformational leader indicates support for honest and fair matters associated with employees, the employee feels less exhausted and motivated. Intrinsically motivated employees who are driven by enjoyment and interest in their work are more likely to work hard at their jobs and feel less fatigue, less emotional exhaustion, and increased desire to participate in the organization [ 49 ].

Finally, it was examined that how transformational leadership impact social loafing through Intrinsic motivation. Findings depicts that although Social loafing has a significant and negative relationship with transformational leader, but their indirect relationship through intrinsic motivation is not significant The reason behind can be that the direct strong association between transformational leader and social loafing as “transactional leaders effectively inspire followers to identify with a mission while rallying them to work together to achieve organizational objectives.” Further, social loafing in employees is also effected significantly by other factors such as workload, organizational culture, tenure of job. etc.

Practical implications

Our study also provides several practical implications for organizations. Transformational leaders who realize the significance of intrinsic motivation for employees will adopt such behaviors that are conducive for development employees’ intrinsic motivation at the workplace. The results of current study confirmed that transformational leadership through fostering intrinsic motivation create such environment which is stress free and fruitful for employee effective performance. One way to exhibit these behaviors by managers is to aim at encouraging motivation among employees based on their inherent happiness and enjoyment. Another way to enhance employees’ intrinsic motivation and involvement toward organizational success is to value their contributions and sharing organizational goals and objectives with their workers. Further, it is very essential for organizational leaders to be transformed by being informed of their employees well because transformational leader can inspire people to achieve unexpected or remarkable results. It gives workers autonomy over specific jobs, as well as the authority to make decisions once they have been trained. In that the leader can inspire workers to find better ways of achieving a goal as leadership can mobilize people into groups that can get work done, and morale, in that transformational leaders raise the well-being and motivation level of a group through excellent connection. The findings of this study also stressed the need of designing leadership coaching and training programs in order to develop transformational leadership which may include “programs for communication, motivation, and brainstorming, to train employees with the necessary resources to be more articulate and inspirational as well as to think out of the box”.

Limitations and future directions

The first limitation of this research is that cross-sectional survey has been conducted. There may be ambiguity in establishing causal direction. Results may vary while collecting data at various times. It is suggested to conduct longitudinal study design in future research to see how impact of transformational leadership on employee outcomes varies over time. Next, it represented data from only the telecom sector of Lahore, Pakistan which may limit the study generalizability it would have been advantageous to conduct this research across the diverse sectors and n different context. Another limitation of this research is that there can be a probability of response bias as all the data was collected through same source i.e., employees. For example, a person can have deliberate falsification by quoting false responses of statements, just to attain social desirability. An employee in the organization may have high degrees of social loafing but he may not state it appropriately as well. Future researchers may collect data from different sources like work performance data can be collected from supervisors.

Existing literature and this research too is having high tendency toward constructive and significant outcomes to discover impact of transformational leadership so it is suggested that in future studies impact of transformational leadership should be examined in relation to more negative employee outcomes such as turnover intention and cyber loafing.

It is also recommended to see the impact of other mediators like emotional stability between transformational leadership and employees’ various outcomes.

Furthermore, future studies can also observe the effect of different moderators such as performance appraisal politics and contingent awards on the existing research model. It might prove valuable.

Future studies can also respond to the limitations of current research by collecting data across different business sectors (education, banking, etc.) of diverse locations.

This research contributes to the field of organizational behavior by enhancing our knowledge on how a transformational leader upgrades employees’ positive work outcomes by improving their intrinsic motivation. Furthermore, their increased intrinsic motivation will develop their positive work outcomes by increasing employees’ work performance and the same time reducing their burnout and work stress. We hope that our study will stimulate future endeavors to advance our understanding in this domain.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Khan, H., Rehmat, M., Butt, T.H. et al. Impact of transformational leadership on work performance, burnout and social loafing: a mediation model. Futur Bus J 6 , 40 (2020). https://doi.org/10.1186/s43093-020-00043-8

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Developing a model for effective leadership in healthcare: a concept mapping approach

Charles william hargett.

1 Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine

Joseph P Doty

2 Feagin Leadership Program

Jennifer N Hauck

3 Department of Anesthesiology

Allison MB Webb

4 School of Medicine

Steven H Cook

5 Department of Neurosurgery

Nicholas E Tsipis

Julie a neumann.

6 Department of Orthopaedic Surgery

Kathryn M Andolsek

7 Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, USA

Dean C Taylor

Despite increasing awareness of the importance of leadership in healthcare, our understanding of the competencies of effective leadership remains limited. We used a concept mapping approach (a blend of qualitative and quantitative analysis of group processes to produce a visual composite of the group’s ideas) to identify stakeholders’ mental model of effective healthcare leadership, clarifying the underlying structure and importance of leadership competencies.

Literature review, focus groups, and consensus meetings were used to derive a representative set of healthcare leadership competency statements. Study participants subsequently sorted and rank-ordered these statements based on their perceived importance in contributing to effective healthcare leadership in real-world settings. Hierarchical cluster analysis of individual sortings was used to develop a coherent model of effective leadership in healthcare.

A diverse group of 92 faculty and trainees individually rank-sorted 33 leadership competency statements. The highest rated statements were “Acting with Personal Integrity”, “Communicating Effectively”, “Acting with Professional Ethical Values”, “Pursuing Excellence”, “Building and Maintaining Relationships”, and “Thinking Critically”. Combining the results from hierarchical cluster analysis with our qualitative data led to a healthcare leadership model based on the core principle of Patient Centeredness and the core competencies of Integrity, Teamwork, Critical Thinking, Emotional Intelligence, and Selfless Service.

Using a mixed qualitative-quantitative approach, we developed a graphical representation of a shared leadership model derived in the healthcare setting. This model may enhance learning, teaching, and patient care in this important area, as well as guide future research.

Introduction

Physicians must become effective healthcare leaders in order to influence the care of individual patients, the performance of diverse clinical teams, and the direction of major healthcare organizations and beyond. The importance of effective healthcare leadership is difficult to overestimate as leadership not only improves major clinical outcomes in patients, but also improves provider well-being by promoting workplace engagement and reducing burnout. 1 – 5 We define the ability to influence as the foundation of our definition of healthcare leadership: Healthcare leadership is the ability to effectively and ethically influence others for the benefit of individual patients and populations.

Over the last ten years, we have created, implemented, and refined several undergraduate medical education (UME) and graduate medical education (GME) leadership development educational programs. We have found that medical students, residents (synonymous with junior registrar), and fellows (postgraduate trainees; synonymous with advanced specialist registrar) are exposed to little intentional education to prepare them for their current and future personal and professional leadership challenges. Importantly, from a developmental and educational perspective, omitting topics such as leadership in medical education “is a powerful, if unintended signal, that these issues are unimportant”. 6 Our programs are not designed to prepare individuals for specific leadership roles. Rather, they facilitate individuals’ learning and development of leadership skills that will prepare them to influence many facets of life, including healthcare.

We have found that leadership models are extremely helpful for learners to grasp new concepts, make sense of lessons learned through their experiences, afford structure that facilitates lasting comprehension through reflection, and provide a basis for learner assessment and program evaluation. 7 In the formative years of our programs, we used business leadership models as the foundation to teach leadership skills. Our review of other leadership development schools and professions (for example, the Wharton School of Business - University of Pennsylvania, the Fuqua Business School at Duke University, the United States Service Academies, and the Department of the Army) were helpful, yet they lacked emphasis on subtle aspects unique to healthcare leadership. We then looked for explicit healthcare leadership models and found that few existed. Further, none seemed to facilitate effective leadership learning in UME and GME.

Our inability to find an appropriate healthcare leadership model led us to create a leadership model specific to healthcare. This model needed to be based on competencies that were recognized as the most important attributes for effective healthcare leadership. The purpose of the paper is to present the research process that resulted in the Duke Healthcare Leadership Model, as shown in Figure 1 .

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Object name is jhl-9-069Fig1.jpg

The Duke Healthcare Leadership Model.

Note: ©2017 Dean C. Taylor, MD. All rights reserved.

The study was a mixed method study using a modified concept mapping approach to derive, prioritize, and thematically structure the fundamental competencies of healthcare leadership. Concept mapping is a mixed methods approach that combines qualitative group processes such as brainstorming and interpretive sorting with rigorous quantitative data analysis to produce a visual depiction of the composite thinking of the group. This process of structured conceptualization has been used to address complex issues in healthcare, and provides a framework that can guide action planning, program development or evaluation and measurement. 8 , 9 We used a comprehensive literature review and focus groups to develop a set of statements that described healthcare leadership competencies. Next, we implemented a card sorting task, followed by analysis and interpretation. Finally, we created and refined a graphical representation of healthcare leadership. These successive steps are illustrated in Figure 2 and will be explained in more detail in following sections. The study was approved by the Duke Health Institutional Review Board after it was determined to be exempt from full review. Participation was voluntary, and informed consent was not required.

An external file that holds a picture, illustration, etc.
Object name is jhl-9-069Fig2.jpg

Sequence of steps in the concept mapping approach to derive, prioritize, and thematically structure the fundamental competencies of leadership in medicine.

Literature review

Building upon our prior meta-analysis exploring leadership curricula used to teach medical students, we performed an updated literature search and review of existing leadership models. 10 Information gleaned was used to develop semi-structured focus group interview questions, a list of common healthcare leadership attributes, and a script to be used in focus group discussions.

Focus groups

Participants were recruited to collect expert opinion on the leadership competencies required of a healthcare leader in any environment . Each focus group lasted approximately two hours, and was led by the same team of moderators. Moderators used the script developed from the semi-structured focus group interview questions to lead the discussions. One of the moderators took notes of the comments from the group members and from subsequent debriefing sessions. The focus groups were also asked to critique the leadership attributes identified from the literature. Participants were asked to rank the top 10 attributes required of a healthcare medical leader. The focus group data were analyzed through constant comparison analysis by identifying common themes through saturation within each group and across groups. An initial set of competency statements was derived and further refined by eliminating duplication and targeting specifically for healthcare settings. The resulting competency statements formed the basis for the quantitative card sorting and cluster analysis.

Card sorting task

The sorting procedure was administered online with the open source program FlashQ. 11 Following an introduction with instructions, participants were presented with the focus group leadership competency statements in random order and asked to sort them in order of importance based on their individual point of view. More specifically, participants were asked to rate the relative importance of each leadership attribute based on its value or importance in contributing to effective leadership performance in real-world clinical situations. During the sorting process, participants placed one unique statement in each box on a grid with a fixed quasi-normal distribution. Competency statements could be allocated to a ranking position ranging from +5 (most important) to −5 (least important). Respondents could change the placement of cards until the final positioning of all statements reflected their ranking of the statements relative to each other in importance. After completing the card sorting, participants were asked to provide their rationale for placing the competency statements at the extreme ends (+5 or −5 columns) of the sorting grid. All responses were anonymous, though respondents could elect to enter demographic data, including sex, current role, and leadership experience.

Hierarchical cluster analysis

Demographic data and importance scores were calculated using descriptive statistics. All data were analyzed with JMP Pro 13.0 (SAS Institute Inc., Cary, NC, USA). Cluster analysis is a statistical technique to find similar groups of cases in a data set and is particularly useful in the development of a classification or conceptual scheme. Hierarchical cluster analysis (Ward’s method, squared Euclidean distances) was used to classify leadership competency statements based on the similarity of individual sorting responses of each participant. Guided by the dendrogram and agglomeration schedule, investigators (CWH, JPD, DCT) determined the final number of clusters by consensus and based on the criterion that the clusters should reflect meaningful, distinct domains related to effective leadership in a healthcare setting.

Mixed methods analysis

We analyzed the quantitative data in conjunction with the qualitative data obtained from the focus group discussions and the statements provided by card sorting participants. This mixed methods analysis helped us define the primary healthcare leadership competency themes. Earlier versions of the model originated within our Feagin Leadership Program and the Leadership Education And Development (LEAD) Curriculum, which are internal initiatives within our UME and GME programs. The initial models were refined based on input and feedback obtained from multiple faculty, house staff, and residents over a three-year period.

The literature review found that healthcare leadership is a skill that must be 12 – 14 and can be 15 – 17 intentionally taught. Further, the literature review provided information on healthcare leadership attributes and content 18 – 25 that we used to guide the discussion to the semi-structured focus group interview questions. Thirty-nine healthcare leadership attributes were identified and used to determine the competency statements in the focus groups.

Three focus groups were carried out with a total of 19 participants, many being clinical faculty with administrative or leadership roles . From the 39 healthcare leadership attributes identified through the literature review, the focus groups’ work led to a set of 33 competency statements that represent important aspects of healthcare leadership (Supplementary material). These statements formed the basis for the card sorting task. Each one of the statements:

  • Described some of the fundamental knowledge, skills, or attitudes related to leadership (influencing others) in a healthcare setting
  • Represented the basic competencies that may be demonstrated by successful physician leaders, regardless of their work setting
  • Described the knowledge, skills, and attitudes that combine to enable residents and fellows to demonstrate behaviors that help assure effective leadership performance in real-world clinical situations

In addition to identifying the statements for our quantitative card sorting task, the focus groups also provided important qualitative data. All three focus groups emphasized that Patient Centeredness and Selfless Service are two competencies essential to effective healthcare leadership. Further, each focus group emphasized that Patient Centeredness was essential to any healthcare leadership model as this principle differentiated healthcare leadership from leadership in other fields.

Approximately 200 faculty (attending physicians and non-physician professionals) and learners (medical students, residents, and fellows) were recruited via email to participate in the card sorting exercise. Ninety-two participants responded (46 percent) (22 medical students, 29 physicians-in-training, 25 attending physicians, and 16 non-physician professionals). Sixty percent were men, and two-thirds reported prior formal leadership training. Table 1 presents a basic summary of the participants in the card sorting task. Table 2 summarizes the mean values for importance of the top competency statements.

Characteristics of participants in card sorting

Note: Discrepancies in totals are due to incomplete responses as demographic questions were optional.

Top competency statements ranked by mean (SD) importance score

Through hierarchical cluster analysis, the competency statements fell into five domains. We labeled four of the domains based on the predominant themes of the competency statements in those domains: Integrity, Teamwork, Critical Thinking, and Emotional Intelligence. A fifth domain comprised a set of low-rated competency statements for which no unifying theme could be identified ( Figure 3 ). Fundamental leadership domains with mean importance scores for each leadership competency statement are presented in Table 3 .

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Organization of competency statements based on hierarchical cluster analysis and mixed quantitative and qualitative assessment.

Five fundamental competency themes in leadership in medicine with mean importance score for each competency statement

Mixed methods analysis of the quantitative and qualitative data resulted in two additional competency themes for the healthcare leadership model. We used the qualitative input from the focus groups and the card sorting comments to separate Patient Centeredness and Selfless Service from the Emotional Intelligence domain ( Figure 3 ). The focus group affirming that Patient Centeredness is a unique, defining component found in effective healthcare leaders was confirmed through feedback and experience we received when testing early versions of the model in leadership education settings. We concluded that Patient Centeredness is more than a competency for healthcare leadership; it is a core principle.

We also identified the highly rated statement of “Communicating Effectively” (originally clustered in the Integrity domain) as essential to each domain, and not a separate competency. Similarly, “Pursuing Excellence”, although highly rated and part of the Critical Thinking domain, is a statement that is an aspirational goal and, as such, a part of each competency.

Finally, we modified the graphic representation of the model based on its use in teaching students, residents, and fellows, along with the feedback we received from these learners and faculty. The resulting model ( Figure 1 ) features that the central core principle of Patient Centeredness is surrounded by the overlapping five core competencies. We recognize Emotional Intelligence 26 , 27 as the core competency that holds the other competencies together, and therefore it is positioned as the “keystone” in the model; if Emotional Intelligence is removed, the model will crumble. Integrity and Selfless Service are intentionally positioned at the base of the model; although they may be difficult to teach, they are extremely important to effective healthcare leadership and must be recognized and emphasized as essential “foundational” core competencies. Critical Thinking and Teamwork are positioned as the “framework core competencies”, holding the model together and overlapping with the other three competencies.

From curricular, pedagogical, and assessment perspectives, a model serves as the foundational starting point for learning and as an organizing framework for the developing leadership curricula. The model presented here addresses this need. We used a concept mapping approach to create a model specific to the needs of learning in healthcare leadership.

Our model was developed based on a comprehensive literature review, focus groups, concept mapping, and hierarchical clustering. Each of the 33 competency statements is an important concept of healthcare leadership. Our methods determined which statements were most important and which coalesced into themes. We began with an initial model that had been drafted within our UME and GME leadership programs (the Feagin Leadership Progam and LEAD Curriculum). Those initial drafts were further refined over a three-year period based on feedback we received from numerous people within our institution with varied levels of healthcare experience and training (faculty, fellows, residents, students, administrators, and non-physician educators). That input led to a model that has face validity, is well accepted, and can be used in pedagogical processes that help all of us learn to be better leaders.

Recent literature emphasizes the importance and need for the intentional, explicit promotion of leadership development curricula and training in medical education. 28 – 31 Clearly, leadership development education should be intentional and not informal or implicit. The model presented here provides a framework for intentionally teaching leadership skills in healthcare education.

There continue to be efforts to appropriately characterize “content” 32 and define competencies. 33 Sonnino argues for two dozen competencies, the most important of which are finances and economics, emerging issues and strategic planning, personal professional development, adaptive leadership, conflict management, time management, ethical considerations, and personal life balance. 34 Seven of those eight align well with our model; we would argue that finances and economics are more managerial skills and context dependent. Further emphasizing the significance of leadership development in postgraduate medical education, in 2015 the Canadian residency CanMeds competency framework replaced their role of “manager” with that of “leader”. 35

There are several limitations to our study. Foremost, model creation is not an exact science. Our mixed methods approach involves subjective interpretation of how to organize overlapping concepts. For example, communication could be considered a separate competency. Instead, we chose to include communication as essential for all core competencies - learning to communicate better enables one to be better at each healthcare leadership competency. Others’ subjective assessments may have led to different interpretations.

This model is also derived from research done at a single institution, and as a result may not be generalizable to other settings. We do not suggest that ours is the only or best healthcare leadership model. It is offered as a model that others can use and refine for their own environments. The methods we describe can serve as a guide if others desire to create their own institutionally specific model. Nonetheless, this model has guided our teaching of skills and concepts that lead to improved competency in areas recognized as essential for effective, ethical healthcare leadership. It has subsequently led to an assessment of learners and an evaluation of our programs.

Models are most useful when validated. Preliminary validation of our model is complete. Our group is committed to re-validate the model in more diverse and larger healthcare settings. Our next steps involve developing, refining, and validating an evaluation instrument that assesses the competencies and core principle in the model. This work is underway through the Health Evaluation Assessment of Leadership. 36

We designed a leadership model specific to healthcare using concept mapping. The research led to a model based on the core principle of Patient Centeredness and core competencies of Emotional Intelligence, Integrity, Selfless Service, Critical Thinking, and Teamwork. We have found this model useful for teaching leadership skills, and are currently designing a relevant evaluation instrument.

Supplementary materials

Competency statement definitions.

  • Acting with Personal Integrity – behaving in an open, honest, and trustworthy manner
  • Communicating Effectively – ability to communicate with patients and team; successfully navigating difficult conversations and providing feedback
  • Acting with Professional Ethical Values – applying medical ethical principles to difficult situations
  • Pursuing Excellence – striving for excellence in all areas of personal, team, and organizational life
  • Building And Maintaining Relationships – listening to and supporting others; gaining trust; and showing understanding
  • Thinking Critically – being able to think analytically and conceptually to evaluate and solve problems
  • Motivating – inspiring oneself and others to achieve goals
  • Optimizing Team Dynamics – understanding team members’ roles, strengths, and weaknesses; influencing diverse talents to achieve common goals
  • Managing People – delegating, providing direction, and promoting equality and diversity
  • Maintaining Patient Centeredness – focusing on patients’ best interests; working in partnership with patients; ensuring patient safety
  • Adapting To Change – flexibility, adapting to change readily, being the first to change when required
  • Managing Personal and Team Performance – the ability to assess successes and failures of oneself and team members and make adjustment as needed
  • Being Decisive – using values and evidence to act decisively, especially in difficult situations
  • Encouraging Improvement and Innovation – creating a climate of continuous quality improvement and identifying areas for growth
  • Encouraging Contribution – creating an environment where others have the opportunity to share their thoughts and ideas without fear of criticism
  • Planning – developing short-term and long-term plans to achieve personal, team, and organizational goals
  • Developing Self-awareness – being aware of one’s own values, principles, and assumptions
  • Fostering Vision – developing an organizational vision, communicating that vision, and embodying its principles
  • Developing and Implementing Strategy – integrating and aligning plans, resources, and people to achieve goals
  • Managing Self – organizing and self-regulating actions and emotions
  • Serving Selflessly – ability to put others’ needs before one’s own; demonstrating great concern for common good/other people
  • Continuing Personal Development – learning through continuous professional development and being open to feedback
  • Managing Resources – knowing what resources are available and using one’s influence to ensure that resources are used efficiently and safely, reflecting the diversity of needs within given populations
  • Cultivating Personal Resilience – ability to cope with demanding situations
  • Applying Knowledge and Evidence – the ability to translate research and evidence-based practice in order to optimize outcomes
  • Maintaining Personal Balance – prioritizing activities to maintain mental and physical health
  • Having A Strong Knowledge Base – being an expert in a given field and demonstrating mastery of core knowledge
  • Facilitating Transformation – actively contributing to positive change
  • Evaluating Systemic Impact – measuring and evaluating outcomes; taking corrective action where necessary
  • Understanding Situational Context – seeking broader perspectives on problems; understanding community and stakeholders perspectives
  • Developing Networks – developing professional connections with stakeholders inside and outside the institution
  • Understanding Community Impact – having awareness that decisions about patient care impact population health
  • Understanding Historical Context – being aware of the history, culture, and traditions of the institution and including these in decision-making

Acknowledgments

The authors thank members of the Feagin Leadership Program for their extensive backing of this project. The authors acknowledge all of the participants of the focus groups and other non-author members of their team including Prinny Anderson, MBA, Med; Jane Boswick-Caffery, MBA, MPH; Matthew Boyle, MD; Thomas Mullin, MD; and John Yerxa, MD. We also thank Saumil Chudgar, MD, MS, for feedback and editing work on this paper.

The authors acknowledge the assistance of Donald T Kirkendall, ELS, a contracted medical editor, for his assistance in preparing the manuscript for submission.

The views, opinions, and/or findings contained in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy, or decision. Citation of trade names in this presentation does not constitute an official DA endorsement or approval of the use of such commercial items.

Allison MB Webb is currently a resident in the National Capital Consortium’s program Combined Internal Medicine – Psychiatry Residency at Walter Reed National Military Medical Center, Bethesda, MD, USA. Nicholas E Tsipis is an Emergency Medicine Resident at Georgetown University Hospital/Washington Hospital Center, Washington DC, USA. Julie A Neumann is a sports medicine fellow at Kerlan-Jobe Orthopaedic Clinic. The authors report no conflicts of interest in this work.

  • Open access
  • Published: 17 February 2024

The complexity of leadership in coproduction practices: a guiding framework based on a systematic literature review

  • Sofia Kjellström 1 , 2 ,
  • Sophie Sarre 2 &
  • Daniel Masterson 1  

BMC Health Services Research volume  24 , Article number:  219 ( 2024 ) Cite this article

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Metrics details

As coproduction in public services increases, understanding the role of leadership in this context is essential to the tasks of establishing relational partnerships and addressing power differentials among groups. The aims of this review are to explore models of coproduction leadership and the processes involved in leading coproduction as well as, based on that exploration, to develop a guiding framework for coproduction practices.

A systematic review that synthesizes the evidence reported by 73 papers related to coproduction of health and welfare.

Despite the fact that models of coleadership and collective leadership exhibit a better fit with the relational character of coproduction, the majority of the articles included in this review employed a leader-centric underlying theory. The practice of coproduction leadership is a complex activity pertaining to interactions among people, encompassing nine essential practices: initiating, power-sharing, training, supporting, establishing trust, communicating, networking, orchestration, and implementation.

Conclusions

This paper proposes a novel framework for coproduction leadership practices based on a systematic review of the literature and a set of reflective questions. This framework aims to help coproduction leaders and participants understand the complexity, diversity, and flexibility of coproduction leadership and to challenge and enhance their capacity to collaborate effectively.

Peer Review reports

Introduction

For more than 40 years, scholars and practitioners have sought to identify and understand various aspects of coproduction with the goal of improving services as well as equalizing (or at least reorganizing) power relations in service design and delivery [ 1 ]. More recently, such discussion has focused on the roles of leaders and leadership in coproduction, seeking to describe and assess the various types of leaders and leadership that might maximize the goals of coproduction processes and outcomes. Leaders can act to make coproduction, in all its forms, happen [ 2 , 3 ]. Leaders can enhance coproduction by providing resources, establishing inviting structures, and prioritizing the involvement of various stakeholders. Conversely, they can inhibit coproduction by perpetuating conservative administrative cultures, failing to provide training, or being reluctant to share power [ 3 ]. Coproduction relies on leadership at all levels, ranging from senior managers to local “champions” and including the citizens and third-sector organizations that participate in coproduction activities and practices.

This review presents a synthesis of research on the leadership of coproduction, which has been recognized for its scarcity [ 3 , 4 , 5 , 6 ]. The review provides new knowledge regarding the fact that coproduction leadership must become more deliberately (in)formed by collective leadership models. It also illustrates the multiplicity and complexity associated with coproduction leadership activities by outlining practices in which leaders must engage to ensure success. This review can inform a framework that offers guiding insights on which commissioners, evaluators, managers and leaders of coproduction can reflect as well as suggestions and directions for future research.

  • Coproduction

Coproduction is a broad concept that is associated with different meanings across a range of contexts [ 1 ]. Many definitions and uses of the term coproduction and codesign have been identified [ 7 ]. Throughout this paper, although we acknowledge the distinctions associated with the concepts and origins of the notion of codesign, we use the broad term coproduction to refer to some form of collaboration or partnership between service providers and service users or citizens. For this review, we follow the definitions provided by Osborne and Strokosch [ 8 ], who identified ‘ consumer coproduction’ as an inevitable component of value creation in interactions among service providers; ‘participatory coproduction’, in which context participation is deliberative and occurs at the strategic level of service design and planning; and ‘enhanced coproduction’, which represents a potential mechanism for transforming organizational processes and boundaries.

Power is inevitably central to coproduction. Schlappa and Ymani claimed that the coproduction process is “inherently negotiated, emergent and reliant on a range of actors who may have both common and contrasting motivations, and are able to exercise power, which in turn is moderated by the context in which these relations occur” [ 6 ]. This sensitivity to motivation, context and power is helpful for our understanding of leadership in coproduction.

Leadership models

Most conceptualizations of leadership have been based on the claim that leadership is a kind of inherent characteristic exhibited by human beings, such that leaders are depicted as heroes with unique traits, styles or behaviours [ 9 ]. However, research on leadership in coproduction is important in relation to an emerging body of research that focuses on the notion of “leadership in the plural” [ 10 ] or “collective leadership” [ 11 , 12 ]. These phrases act as umbrella terms that refer to overlapping concepts such as shared, collaborative, distributed, pooled and relational leadership. A core feature of these models is that leadership is not (only) viewed as a property of individuals and their behaviours but rather as a collective phenomenon that is distributed or shared among different people [ 10 ]. A distinction can be made between two types of collective leadership. Leadership can be shared in interpersonal relationships; for example, it can be pooled among duos or trios at the top of an organization, or shared leadership can be exercised within teams working on a project. This notion is based upon the assumption that people have different skills that complement each other. The second kind of collective leadership is a more radical version of this notion, according to which leadership emerges as a result of direction, alignment, and commitment within a group [ 11 ] or can be observed to reside within the system, for example, in the form of distributed leadership across interorganizational and intraorganizational boundaries and networks [ 10 , 12 ]. In cross-sectoral collaboration, leadership is distributed across time and space, which requires structures to guide how leadership is shared and organized. It has been argued that collective leadership is best suited to the analysis of coproduction practices [ 4 , 6 , 13 , 14 ].

It is important to note that distinctions have been made between management (planning, monitoring and controlling) and leadership (creating a vision, inspiring and changing) based on behaviours [ 15 ]. However, many authors have not made such a distinction, and the terms have frequently been used interchangeably. We therefore adopt the practice employed in the papers included in this review and use the terms leadership and leader as catch-all terms; we only use the words management or manager when the papers refer to job titles or ‘public management’.

Leadership models can be regarded as resembling a colour palette that offers a variety of choices, and similar to colours, some models fit a situation better than others. This paper investigates the use and fit of various leadership models for coproduction.

Leadership of coproduction research

Extant research on the leadership of coproduction has been described as “sparse” [ 4 ], a “neglected area” [ 5 ] and “overlooked” [ 3 , 6 ]. Despite a recent resurgence of interest in the potential of coproduction as a means of maintaining and improving the quality of health and social care, significant questions regarding how coproduction can and should be led in this context remain unanswered. Most reviews of coproduction have not addressed this issue [ 2 , 16 , 17 , 18 ]. Clarke et al.’s (2017) review identified the lack of managerial authority and leadership as a key barrier to the implementation of coproduced interventions but did not explore the implications of this finding for future practice. The review conducted by Bussu and Galanti (2018) stands alone in its focus on leadership, although the empirical cases explored by those authors were restricted to the context of local government in the UK. Recent empirical case studies that have explored leadership [ 13 , 14 , 15 , 19 ] have focused on public managers [ 3 , 5 , 14 ] or on identifying the consequences of different models of leadership. This review contributes to the literature by providing knowledge regarding how to make deliberate choices pertaining to coproduction leadership in terms of how it is conceptualized and shared and the activities that are necessary for leading coproduction.

Coproduction leadership practices

The leadership of coproduction poses a number of challenges. A proposed aim of coproduction is to drive change within services and in traditional state-citizen relationships by establishing equal and reciprocal relationships among professionals, the people using services, and their families and neighbours. This task requires a restructuring of health and welfare services to equalize power between providers and other stakeholders with an interest in the design and provision of these services. However, it has been suggested that coproduction runs the risk of reproducing existing inequalities in power rather than mitigating them since coproduction is inevitably saturated with unequal power relations that must be acknowledged but cannot be managed away [ 20 ].

In this paper, we present the findings of a systematic review of the literature on leadership in coproduction. The purpose of this review is to explore models of coproduction leadership and the practices involved in leading coproduction in the context of health and social care sectors [ 7 ]. The results are synthesized to develop a framework for actors who seek to commission, design, lead or evaluate coproduction processes. This framework emphasizes the need to make more deliberate choices regarding the underlying conceptualization of leadership and the ways in which such a conceptualization is related to the activities necessary for leading coproduction. Based on the framework, we also propose specific guiding questions for individuals involved in coproduction in practice and make suggestions for future research.

This systematic literature review is based on a study protocol on coproduction research in the context of health and social care sectors [ 21 ], and data were obtained from a published scoping review, where the full search strategy is provided [ 7 ]. The scoping review set out to identify ‘what is out there’ and to explore the definitions of the concepts of coproduction and codesign. In brief, the following search terms for the relevant concept (co-produc* OR coproduc* OR co-design* OR codesign*) and context (health OR social OR & “public service*” OR “public sector”) were used to query the following databases: CINAHL with Full Text (EBSCOHost), Cochrane Central Register of Controlled Trials (Wiley), MEDLINE (EBSCOhost), PsycINFO (ProQuest), PubMed (legacy), and Scopus (Elsevier). This paper focused on leadership. All titles and abstracts included in the scoping review ( n  = 979) were obtained and searched for leadership concepts (leader* OR manage*) ( n  = 415). These materials were reviewed independently by SK and SS using the following inclusion criterion: conceptual, empirical and reflection papers that included references to the management and/or leadership of coproduction. Study protocols were excluded because we wanted to capture lessons drawn from implementation, and conference papers were excluded because they lacked sufficient detail. Articles focusing on the context of individual-level coproduction (i.e., cases in which an individual client or patient was the focus of coproduction) were excluded, as we were interested in the leadership processes involved in collective coproduction. Conflicts were resolved through discussion and further consideration of disputed papers. This process led to the inclusion of 73 articles (Fig.  1 – PRISMA flow chart).

figure 1

PRISMA flow chart

The method used for this research was a systematic review with qualitative synthesis. The strength of this approach lies in its ability to complement research evidence with user and practitioner considerations [ 22 ]. In the process of examining the full texts of the papers, two researchers (SK and SS) extracted background data independently. To promote coproduction, four stakeholders were strategically selected through the personal networks of one of the authors, SK. These stakeholders exhibited diverse expertise in the leadership of coproduction. One was a leadership developer and family member of an individual with 24/7 care needs. Another was a physician. The third worked in peer support and had personal experience with mental health services. The fourth was a health care leader. Four key articles were chosen due to the diversity of leadership ideas they exhibit and the depth of the explicit text on leadership they provided. During the analysis by stakeholders, no themes were changed or refined; instead, the analysis confirmed the relevance of the initially identified themes, thus emphasizing the robustness of our findings based on a process that involved reading four key articles and identifying the perceived key implications for our research aim.

A qualitative synthesis unites the findings of individual studies in a different arrangement, thereby constructing new knowledge that is not apparent from the individual studies in isolation [ 23 ]. This fact is particularly evident in this review, since leadership was seldom the main focus of the included articles. Accordingly, we employed multiple pieces of information to construct a pattern. The process of synthesis started at a very broad level with the goal of understanding which aspects of leadership were addressed in the literature. This process then separated into two strands. One such strand focused on interpreting the data from the perspective of current leadership models, while the other focused on interpreting leadership practices – i.e., the activities and relationships that are part of the process of leading coproduction. We searched for themes both within and across individual articles, and our goal was interpretative rather than purely aggregative. This process resulted in three themes pertaining to coproduction leadership models and nine coproduction leadership practices. We present these findings together in the form of a framework because consideration of both leadership models and practices prompts better and more conscious choices, which can improve the quality of coproduction. Persons one and two from the stakeholder group also provided feedback on a draft of this paper, and their insights were integrated into this research.

Sample description

We included 73 papers (Additional file 1 ) dating from 1994 to 2019 (the year in which the initial search was performed). Most of these papers were empirical ( n  = 54), and more than half of them were case studies ( n  = 30). Fifteen articles were conceptual papers, and four were literature reviews. The setting or focus of the papers was predominantly on services ( n  = 66), while the remainder of the papers were on research ( n  = 4) or policy ( n  = 3). The papers drew on evidence collected from 13 countries, and the most common national setting was the UK ( n  = 29). Nine cross-national papers were also included. Issues related to leadership were rarely the focus of the papers.

Results: A coproduction leadership framework

The synthesis consists of three parts (roles, models and practices), which are combined to develop an overarching and integrative framework for essential issues pertaining to coproduction leadership [ 4 , 24 ].

People and roles

The way in which the leadership of coproduction has been conceptualized in the literature suggests that a range of actors are involved in the coproduction of health and wellbeing and that these actors can take on different leadership roles and functions. Service users, community members and community representatives can play a vital role in the task of deliberatively coproducing or even transforming services, as can third-sector organizations, external experts, politicians, mid-level facilitators, managers, and senior leaders.

It has been argued that it is important to involve leaders from diverse backgrounds who have personal experiential knowledge of public involvement to encourage involvement from a broader population [ 25 , 26 , 27 ]. Service users and community members play leadership roles in coproduction initiatives related to health or well-being. These roles involve shared decision-making and accountability at various levels, ranging from the personal to the systemic.

Senior leaders include formal representatives of organizations (executives, politicians, or formal managers) and formal or respected leaders of communities. They play an important role throughout this process. During the initiation stage, by implementing and sustaining the outcomes of coproduction, they play a crucial role in the provision of resources such as time, money, materials, and access to networks. In the interim stages, their commitment to coproduction, sponsorship, and engagement is vital.

Champions and ambassadors use their expertise and passion to drive coproduction efforts. In particular, "insider" champions can establish trust among participants and help service providers understand the importance of coproduction. These champions advocate for coproduction and actively support initiatives [ 28 , 29 , 30 , 31 ]. Ambassadors are individuals who have expertise and volunteer their time to train others or work with clients in coproduced services. They play a crucial role in the tasks of supporting and promoting coproduction [ 28 , 32 , 33 ].

Project leaders and facilitators are individuals who are responsible for guiding and supporting coproduction projects, thereby ensuring their smooth operation and collaborative nature. Project leaders are responsible for overall project management, including the setting of goals, objectives, and timelines. They play a pivotal role in ensuring that projects remain on track, and they facilitate accessible and transparent dialogue among stakeholders and ensure equal representation [ 34 , 35 ]. Facilitators focus on supporting the group involved in coproduction, maintaining respectful interactions, empowering service users and carers, and addressing any tensions that may arise during the collaborative process [ 36 , 37 ].

In summary, senior leaders sponsor and support coproduction. Champions and ambassadors are individuals who advocate for and support coproduction initiatives, while project leaders and facilitators are responsible for managing and guiding coproduction projects themselves, thereby ensuring effective collaboration among stakeholders. All of these roles can be played by people drawn from various backgrounds, including senior staff, health care professionals, experts in coproduction, researchers, citizens, or volunteers.

Three models of leadership in coproduction

These actors play different leadership roles, and leadership can be exercised by individuals or groups. Three leadership models have been proposed: leadership as enacted by individual leaders, coleadership and collective leadership.

Leadership by individual leaders

A leader-centric view has been the dominant interpretation of leadership in the field of coproduction. Many references were made to “senior leaders”. This term was used to describe formal representatives of organizations or services (senior managers, executives), formally appointed community leaders (policy-makers, local government leaders), or respected leaders of communities. Senior support was described as an important success factor in coproduction [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. Other leadership roles included project leaders, facilitators, ambassadors, and champions – as described in the previous section.

Some papers referred to traits and characteristics exhibited by leaders that facilitate coproduction. These factors included innovativeness, personability, action orientation [ 46 ], courage [ 47 ], passion [ 32 , 46 ], and empathy [ 25 , 46 , 48 ]. “Strong leadership” was often mentioned, albeit without elaboration [ 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. By implication, “strong leadership” appeared to include providing clear direction and guidance, having a clear vision [ 53 ], holding onto a vision [ 34 ], and keeping the vision alive for the team [ 43 ].

Other researchers noted a more collaborative and democratic leadership style that is characterized by listening, transparency, deliberation, and nurturing coproductive behaviours [ 27 , 30 , 48 ]. Senior leaders could use a “top-down” approach to promote user involvement. Alternatively, they could “learn to manage horizontally not top down; embrace ground up initiatives; [and] aim to empower partners” [ 32 , 45 , 51 ] and be “open to changes that would disturb traditional relationships and power disparities between service users and providers” [ 41 ]. Respondents to a survey of participants in a peer-led support network favoured a traditional directive model of leadership alongside a more facilitative and enabling style [ 56 ]. However, they found it challenging to transition to a more distributed and collective leadership approach.

Co-leadership

The terms “co-lead”, “co-leadership” and “dual leadership” refer to situations in which a formal leadership role is allocated to more than one person, in which context the relevant people may represent different institutions or different groups, e.g., different professional groups, researchers and service users/citizens, or teachers and students [ 28 , 31 , 40 , 41 , 57 , 58 ]. Coleads were defined as “individuals who led and made joint decisions” [ 59 ]. Some papers explored the leadership role of service users or community members in the coproduction of research related to health or wellbeing [ 35 , 60 , 61 ]. In these studies, areas of research were proposed by patients/community members, who then collaborated with academic researchers, thereby playing an equal or leading role. Coleadership was reported to result in shared learning.

Collective leadership

Few discernible differences among “ shared”, “distributed” and “collective” leadership were found in the papers included in this review. The approaches examined in this context were characterized by distributed roles and responsibilities in which different individuals’ skills and expertise were identified as best suited to the task at hand. Shared leadership depends on willingness on the part of leaders (implicitly non-community leaders) to be challenged and directed by community members rather than rigidly maintaining their previous conceptions of the issues and the appropriate means of addressing them [ 36 ].

Ward, De Brún, Beirne, Conway, Cunningham, English, Fitzsimons, Furlong, Kane and Kelly [ 62 ] referred to collective leadership as an emergent and dynamic team phenomenon. Other authors argued for a more structured approach to shared leadership [ 36 , 41 ] or distributed leadership [ 28 , 42 , 56 , 59 , 63 ]. Such an approach could involve allocating specific roles to service users, engaging them in a formal structure and/or enabling them to set an agenda [ 41 ], specifying shared roles and responsibilities [ 36 ], and/or providing dedicated support to lay “champions” in research studies [ 28 ]. Various benefits were attributed to collective leadership, such as empowering people to speak up [ 36 , 51 ] and feel engaged.

Nine practices associated with leading coproduction

We identified nine processes that encompass wide-ranging activities and interactions between individuals and groups with regard to leading the coproduction of health and wellbeing. As Farr noted, “Coproduction and codesign […] involves facilitating, managing and co-ordinating a complex set of psychological, social, cultural and institutional interactions” [ 64 ]. In some cases, these processes naturally align with certain actors—for instance, senior leaders play key roles in the tasks of initiating coproduction and implementing and sustaining its results—but other processes (championing coproduction, establishing trusting relationships, and ensuring good communication) are applicable to any and all participants in the coproduction process. Similarly, some of these practices occur at particular timepoints in a coproduction arc (namely, during the stages of initiation or implementation), while others can occur at any or all timepoints (i.e., during the assimilation stage or beyond). Deliberately considering the most suitable leadership model with regard to the aims and context of an initiative is useful at the start, but reflecting on the operation and appropriateness of the model is always salient.

Initiating coproduction

The initiation of coproduction entails recognizing the need for coproduction, dedicating resources, inviting and establishing relevant multi-stakeholder coproduction networks, and coproducing a vision and goals.

It has been argued that senior leaders act as gatekeepers for coproduction because they must recognize the need for it [ 45 ]. Senior leaders play a role in the task of determining the extent to which communities are given the opportunity to influence service design and integration [ 38 , 51 ]. Coproduction requires resources (principally time and money but also networks), which can be used to take advantage of other resources such as skills [ 29 , 31 , 34 , 40 ]. Senior leaders often control or provide access to such resources, which means that they are best positioned to initiate coproduction initiatives [ 41 , 65 ]. However, the findings of a cross-national study on the coproduction of policy showed that, in practice, senior leaders’ control over resources meant that they tended to define the means, methods and forms of participation [ 65 ].

In the task of establishing a conducive environment for coproduction, it is important to pay attention to which actors (organizations or individuals) are participating in the process [ 33 , 42 , 64 , 66 ] and to factors that may delimit those participants or their involvement [ 36 , 42 , 67 ]. Several papers emphasized the need to ensure that all stakeholders are involved from the outset [ 37 , 38 , 41 , 48 , 51 ]. In the initiation stages, a shared vision should be created [ 36 , 61 , 68 ], goals should be coproduced, and responsibilities should be clearly allocated [ 65 ]. Role clarity, ability, and motivation have been identified as determinants of coproductive behaviour, and leaders must implement arrangements to achieve these goals for coproducers [ 69 ].

Power sharing

It has been argued that coproduction leadership must attend to issues pertaining to power redistribution [ 60 , 61 , 63 , 64 ] and uphold the ideology of coproduction by promoting the values of democracy and transparency [ 30 , 32 , 70 , 71 , 72 , 73 , 74 ]. This process can occur at different levels.

At the macro system level, several cultural shifts have been implicated in the redistribution of power – a shift in current professional and stakeholder identities; more fluid, flattened and consensus-based ways of working; and a willingness to accommodate ‘messy’ issues [ 75 ]. The last of those issues was highlighted by Hopkins, Foster and Nikitin [ 29 , s 192], who suggested that coproduction requires service providers to “sit more easily with the unknown, to be comfortable in not having all the answers.” Similarly, “The challenge is that to be transformative, power must be shared with health service users. To do this entails building new relationships and fostering a new culture in health-care institutions that is supportive of participatory approaches” [ 42 , p 379].

At the meso level, several practices could be used to share power. Greenhalgh, Jackson, Shaw and Janamian [ 30 ] identified the importance of equitable decision-making practices and “evenly distributed power constellations.” This goal can be achieved, for instance, by ensuring that service users represent a majority on the project management committee or in codesign events with the goal of challenging dominant professional structures and discourses [ 37 ]. Other scholars called for clear roles and responsibilities [ 38 , 59 , 65 ]. Mulvale, Moll, Miatello, Robert, Larkin, Palmer, Powell, Gable and Girling [ 36 ] recommended the establishment of shared roles and responsibilities, the creation of a representative expert panel to resolve stalemates, and possibly the implementation of formal agreements regarding data and reporting. Importantly, however, Greenhalgh, Jackson, Shaw and Janamian [ 30 ] noted that governance structures and processes alone do not automatically overcome the subtle and inconspicuous uses of power. Farr [ 64 ] recommended the constant practice of critical reflection and dialogue and posed several questions for participants to consider: who is involved, what the interactions are like, how coproduction efforts are implemented within and across structures, and what changes are made.

Although sharing power has been described as an essential component in coproduction, the involvement of stakeholders does not necessarily entail empowerment [ 47 ], and case studies have demonstrated that service improvement initiatives that involve citizens or service users can be instrumental and effective with regard to improving services without enhancing or sharing power or political consciousness if stakeholders are invited but power is not shared [ 32 ]. Farr [ 64 ] noted that rather than coproduction being inherently emancipatory, coproduction and codesign processes can have either dominating or emancipatory effects [ 33 ], and the exclusion of vulnerable groups from coproduction has the potential to reinforce existing inequities [ 75 ].

Training and development for emerging leadership

The importance of appropriate training and mutual learning was noted in several papers [ 36 , 42 , 48 , 63 , 69 , 76 , 77 ]. Implicitly, training for professionals was framed in terms of training in the process of sharing power with service users or facilitating collaboration, whereas training for service users was framed as capacity-building in terms of collaboration and/or leadership. In one case study focusing on coproduced research, participants rejected the notion of “training” from academic researchers with the aim of avoiding suggesting that a certain level of “expertise” needed to be transferred [ 60 ].

Playing a leadership role can be empowering [ 51 , 71 ], but for some individuals, it can be overwhelming [ 71 ]. Leading coproduction requires practice and the development of skills and capacities [ 26 , 48 ]. In some initiatives, lay partners were initially involved in limited roles and gradually took on more responsible leadership tasks over time [ 28 , 42 , 78 ]. In addition, community members’ level of involvement was flexible—they could be participants or take on additional roles as volunteers, paid staff members or directors of organizations. This flexibility offered participants the opportunity to "begin sharing, as opposed to shouldering, the burden of involvement” [ 71 ].

The provision of support

Support is necessary throughout the coproduction process from its outset to the stages of implementation and sustainment [ 25 , 34 , 68 ]. Key dimensions of support include facilitating, advocating for, and championing coproduction. Project management is instrumental to the smooth operation and facilitation of coproduction [ 34 , 35 , 37 , 44 ]. Several facilitation activities are conducted by project leaders and facilitators [ 41 , 42 , 59 , 61 , 78 ]. These activities include holding onto a vision and keeping it alive for the team, ensuring that the project remains on track, and helping maintain momentum. In one codesign case study, facilitators helped people focus on quick wins with the goal of maintaining motivation and engagement; they "needed to support movement from inaction to action, by sifting through group ideas to fix a plan" [ 34 ]. Although these authors acknowledged that this approach may have limited coproduction, they argued that such initiatives would not be sustainable if they were perceived to be “unfeasible.”

Another key function entails advocating for and championing coproduction initiatives to ensure that the process remains ongoing [ 25 , 28 , 29 , 30 , 31 , 32 , 37 , 41 , 74 , 79 ]. Senior leaders play an important role in the task of championing coproduction, and their support has often been described as an important success factor [ 34 , 38 , 39 , 43 , 80 ]. However, effective champions could equally include health care professionals [ 37 ], experts in coproduction [ 51 ], researchers [ 35 , 60 , 61 ], volunteers [ 51 ] or other citizens [ 41 , 61 ]. Champions with lived experience can gain the confidence of their peers and help create understanding among service providers [ 28 , 36 ].

Establishing trusting relationships

Coproduction is essentially relational and requires concerted efforts to establish trusting relationships and a sense of commitment. The importance of trust among stakeholders in coproduction has been noted in several papers [ 28 , 30 , 36 , 37 , 38 , 46 , 48 , 64 , 74 , 81 , 82 ]. In the field of health research, it is difficult to secure funding for the process of establishing relationships and working in the context of partnerships during the early stages of development [ 25 ]. It can therefore be helpful to base recruitment for coproduction initiatives on pre-existing trusting relationships [ 36 ]. If such pre-existing trusting relationships do not exist, policy-makers and senior leaders play a role in the creation of frameworks that can facilitate the development of trust both among organizations and between organizations and citizens, such as political and bureaucratic commitment on the part of regional and local governments and the engagement of actors who play a “boundary-spanning” role in the relationships between service providers, non-government organizations and communities [ 38 ]. Trust is established based on clear responsibilities [ 38 ] and adherence to the principles of engagement in coproduction. In addition to these frameworks, individual leaders must develop trust through interactions with coproducers, using collaborative skills such as those pertaining to communication and listening [ 48 ]. In one case study, through the frank sharing of the organizational, financial, and governance challenges and opportunities faced by stakeholders, people reached a growing understanding and appreciation of each other’s positions, which engendered trust [ 30 ]. Mulvale, Moll, Miatello, Robert, Larkin, Palmer, Powell, Gable [ 36 ] highlighted the importance of understanding and responding to participants’ histories, contexts, and cultural differences.

Commitment can be viewed as more important than resources [ 59 ]. The commitment to and engagement in coproduction exhibited by an organization’s senior leaders demonstrate organizational commitment and lend credibility to coproduction initiatives [ 25 , 34 , 38 , 41 , 47 , 59 , 80 , 83 ]. On some occasions, coproduction initiatives are reported to senior leaders, while on other occasions, the senior leaders were part of the coproduction team. Senior leaders who adopt a more hands-on approach serve as role models [ 25 ], advocating for patient engagement and engendering commitment on the part of staff and patients [ 28 ]. In public health initiatives, buy-in from community leaders confers legitimacy on innovations, helps ensure community trust [ 61 , 78 ], increases the engagement of community members [ 78 ] and is key to a project’s success [ 83 ].

Communication

Communication is a key activity in coproduction, and leaders must establish an environment that is conducive to “epistemological tolerance” [ 47 ], such that different perspectives are valued and appreciated. Such environments facilitate dialogue among partners [ 28 , 30 , 35 , 51 ] and allow critical voices to be heard [ 42 ] . Open dialogue among stakeholders is a starting point for the task of identifying the sources of assumptions and stereotypes, which is itself a prerequisite for change in attitudes and practice [ 28 ]. Project leaders must also facilitate accessible and transparent dialogue and ensure the equal representation of all stakeholders, including those who are less able to communicate verbally [ 57 , 71 ]. Professional leaders are responsible for critically reviewing their professional norms, organizational/institutional processes and past and present policies and practices [ 55 , 75 ].

Dealing with multiple stakeholders, which is inevitably required in coproduction, requires addressing multiple perspectives in an attempt to bring them together. This task frequently involves a degree of conflict and peace negotiation [ 30 , 34 , 41 , 48 , 61 , 64 ]. Leaders should be alert to conflict and power dynamics [ 34 , 36 ]. It may be necessary for meeting chairs to encourage participants to move on from their familiar, entrenched positions to avoid descending into circular arguments and stalemates (Chisholm et al. 2018). This task could require the injection of a critical voice, as Greenhalgh explained:

“Meeting chairs were selected for their leadership qualities, ability to identify and rise above “groupthink” (bland consensus was explicitly discouraged), and commitment to ensuring that potential challenges to new ideas were identified and vigorously discussed. They set an important ethos of constructive criticism and creative innovation, with the patient experience as the central focus. They recognized that if properly handled, conflict was not merely healthy and constructive, but an essential process in achieving successful change in a complex adaptive system. ” [ 30 ]

Leaders must acknowledge the facts that discomfort can arise when more equitable relationships are established [ 61 ] and that challenges to professional identity [ 84 ] and the loss of control [ 72 ] are factors in this process.

Networking refers to the practice of establishing and maintaining relationships with various stakeholders both within and outside the coproduction initiative. Since coproduction involves working with different stakeholders in networks, several papers have discussed the vital mediating processes associated with this context.

“Bridging, brokering and boundary spanning roles have a key role in cross fertilization of ideas between groups, for generating new ideas and for increasing understanding and cooperation” [ 32 , 53 ].

In policy-making, it is helpful to develop coordination structures and processes such as cross-sector working groups and committees, intersector communication channels [ 65 ], and relationship and dialogue structures [ 42 ]. Community representatives can play a mediating role between individuals and public organizations and may alleviate professionals’ concerns regarding the transaction costs of coproduction in the planning and management of services [ 26 , 81 ]. However, these representatives may or may not use this power to amplify the voices of individual coproducers [ 81 ].

An important role of project leaders is that of the “broker” [ 32 , 85 ], who focuses on mediating among different stakeholders in an attempt to align their perspectives [ 26 ,  37 ,  72 , 86 ]. Another role focuses on spanning the boundaries across sites [ 50 ], between local service providers [ 68 ], or among local services, non-government organizations and the community [ 38 ]. Bovaird, drawing on a number of cases of coproduction, came to the following conclusion:

“ there is a need for a new type of public service professional: the coproduction development officer, who can help to overcome the reluctance of many professionals to share power with users and their communities and who can act internally in organizations (and partnerships) to broker new roles for coproduction between traditional service professionals, service managers, and the political decision-makers who shape the strategic direction of the service system.” [ 81 ]

Orchestration

This practice involves reflecting on and improving coproduction itself. It includes activities such as evaluating the effectiveness of coproduction efforts, assessing the impact of coproduction on outcomes, and making adjustments to improve the coproduction process. Several papers have addressed the roles of local government or public managers or health professionals in overseeing and (as we refer to this process) ‘orchestrating’ the networks involved in coproduction at the community or local government level [ 30 , 33 , 65 , 74 , 87 ]. Orchestration involves recruiting the appropriate actors as noted above as well as directing and coordinating activities, thereby ensuring that the whole is more than the sum of its parts. As part of their orchestration work, leaders play a role in the task of managing risk in service innovation [ 55 , 87 ] and must commit to self-reflexivity and a critical review of norms, policies and practices to alert themselves to any unintended negative consequences and strive to counteract them [ 55 ]. Sturmberg, Martin and O’Halloran [ 88 ] used the metaphor of ‘conducting’ to describe the function of leadership in health care – i.e., leading the orchestra through inspiration and empowerment rather than control, leading to the provision of feedback as the performance unfolds.

From a public service perspective, Powers and Thompson [ 69 ] argued that coproduction requires the leader (“usually a public official”) to mobilize the community on behalf of the public good, organize the provision of the good, create incentives, and supervise the enforcement of community norms. Sancino [ 74 ] argued that local governments play a ‘meta-coproduction role’ that requires them to maximize the coproduction and peer-production of community outcomes by taking into account community contributions and deciding which services should be commissioned or decommissioned (a point that was also made by Wilson [ 87 ]) and to promote coproduction and peer-production in such a way as to promote the coproduction of outcomes that have been decided through a democratic process. In this way, he argued,

"the local government becomes the pivot of different kinds of relationships and networks made up of different actors who collectively assume the responsibility for implementing an overall strategic plan of the community beyond their specific roles and interests." [ 74 ]

Sancino [ 74 ] attempted to draw out the leadership implications of this situation, arguing that rather than focusing on service delivery, public managers must create appropriate conditions for such meta-coproduction. This task entails a directing role based on framing shared scenarios for change in the community through sense-making; an activator role based on activating, mobilizing and consolidating the social capital of the community to promote diffused public leadership; a convenor role based on serving as a meta-manager in the process of self-organizing the knowledge, resources and competencies pertaining to the community in question; and an empowering role based on creating conditions in which peer production and coproduction can be combined to create the corresponding added value (i.e., higher levels of community outcomes) [ 74 ]. This practice essentially focuses on self-assessment and continuous improvement within the coproduction framework.

Implementation

It has been argued that coproduction in services [ 30 , 79 ] or policy-making [ 65 ] may improve implementation. The role of leadership in supporting the implementation of the outcomes of coproduction is essential [ 37 , 41 , 49 , 52 , 64 , 65 , 85 , 86 ]. Leaders can argue for the legitimacy of coproduced innovations [ 89 ] and implement mechanisms aimed at acting on the issues thus raised and continuing to promote patients’ involvement [ 28 , 41 ]. Implementing the outcomes of coproduction relies on outcome-focused leadership [ 30 ]. The results of coproduction initiatives must be transformed into strategic plans and policies [ 41 ], and patient perspectives must be translated into actionable quality improvement initiatives [ 49 ]. Conversely, implementation can be blocked by leaders who fail to respond to the results of coproduction initiatives or who implement policies or procedures that are poorly aligned with the recommendations arising from coproduction [ 30 , 41 ]. It should also be acknowledged that not all demands thus generated can always be met [ 61 ]. Failures of implementation run the risk of stakeholder disillusionment; thus, the management of expectations is important.

A framework for coproduction leadership

When coproduction is initiated, it is possible to consider the actors involved and to imagine various forms of coproduction. In the design process, it is possible to make a deliberate choice with regard to the most appropriate model of leadership, and depending on the leadership model selected (leader-centric, coleadership, or collective leadership), different leadership practices emerge. The nine leadership practices identified can be enacted by different people and in different ways. The leadership of coproduction that thus emerges is shaped by issues such as the model of coproduction, the stakeholders involved, participants’ motivations and the context of coproduction. A main concern lies in the need to design project structures and work practices that are aligned and that enable leadership to emerge. We thus created a table (Table  1 ) that illustrates potential reflective questions in this context.

This discussion highlights and problematizes the two main findings of this systematic review, namely, the need to deliberately consider underlying models of leadership and the complex character of leading coproduction.

The need for the deliberate use of leadership in the plural

A focus on leader-centric approaches and the quality of leaders has characterized public leadership research [ 90 ]. Such a focus is echoed in our findings on coproduction leadership, first with regard to the prominence of senior leaders and, to a lesser extent, facilitators. Politicians were rarely identified in the papers included in our review despite representing some of the main actors identified in a previous review [ 4 , 91 ]. Second, many papers referenced the need for “strong” leaders, and the skills and behaviours of individual leaders were noted. As other researchers have found, despite the focus of this field on relationships and interactions, its emphasis has frequently remained on the individual leader and their ability to engage and inspire followers [ 13 ]. Furthermore, even in papers that emphasized ‘coleadership’ or ‘collective leadership,’ the focus remained on public managers, service managers and facilitators. Very little evidence has been reported concerning individual service users’ or citizens’ leadership of (as distinct from involvement in ) coproduction. Although the involvement of community leaders was reported to play a role in project success, no articles explored this issue.

However, some important exceptions should be noted. For example, some studies exhibited a preference for mixed models, employing both a directive approach (particularly in the beginning) and a more facilitative and distributed leadership approach [ 56 ]. Rycroft-Malone, Burton, Wilkinson, Harvey, McCormack, Baker, Dopson, Graham, Staniszewska and Thompson [ 53 ] concluded that consideration should be given to models that combine hierarchical, directive structures with distributed facilitative forms of leadership.

One explanation for this rather narrow view of leadership is that despite the rapidly increasing number of publications in the general field of coproduction [ 7 , 18 ], empirical studies have still lacked depth with regard to investigations of the leadership of this process. Most empirical studies included in this review mentioned leadership only in passing or derived some conclusions regarding leadership from case studies focusing on other aspects of the coproduction process.

Another explanation for this situation is that although coproduction focuses on partnership, in most cases, senior leaders have control over resources and the power to define the means, methods, extent and forms of participation [ 65 ]. Even shared leadership models seem to rely on traditional leaders’ willingness to share power [ 10 ], as leaders are the actors who invite, facilitate, and support the participation of coleaders. However, some signs of change towards a broader view should be noted. Recent publications have theorized the leadership of coproduction and included case studies that have demonstrated leadership to be a social, collective and relational phenomenon that emerges as a property of interactions among individuals in given contexts [ 13 , 19 ].

The complexity of coproduction leadership practices

Our findings indicate that the leadership of coproduction practices entails challenging and complex tasks. Complexity emerges in cases in which many parts are interrelated in multiple ways. Different kinds of leadership activities may be necessary depending on the stakeholders involved [ 92 ], the context [ 13 ], and the mode, level, and phase of coproduction [ 93 ]. A complexity perspective based on systems thinking is therefore useful [ 13 , 19 ]. All actors involved in coproduction are potential leaders, but for that potential to be realized, the coproduction initiative and its leadership must be framed and comprehended in a more plural way. A recent study on systems thinking and complex adaptive thinking as means of initiating coproduction advocated a collective leadership approach [ 19 ].

Our findings highlight the need for a complex way of making meaning of leadership throughout the coproduction process, such as the ability to be flexible due to circumstances and employ both strong leadership and more facilitative approaches when necessary. Leaders must also promote the values of democracy, transparency and the redistribution of power among stakeholders throughout the process [ 64 , 94 ]. These practices and tasks are complex, which must be matched by an inner mental complexity [ 95 , 96 ]. Several practices identified in this research, such as genuinely valuing diverse perspectives, promoting mutual transformative power sharing and welcoming conflicts, require a complex mode of meaning-making that results from psychological development. These issues warrant further exploration. Future studies featuring a thoughtful choice of leadership and complexity models as well as a broader methodological repertoire are thus necessary (see Table  2 for an overview).

Methodological strengths and limitations

A strength of this review lies in its integration of research on the sparse and overlooked issue of leadership in coproduction. Our search strategy, which involved using the key words manag* and lead*, may have excluded some relevant papers. To verify that this approach did not represent an excessively blunt exclusion criterion, we checked 10% of the articles that were excluded based on this criterion. All of these articles would also have been excluded for failing to include any exploration of the management or leadership of coproduction. We therefore determined that this exclusion criterion was justifiable. Many papers did not have an explicit focus on leadership; however, by synthesizing the data, all data were treated as reflections that jointly created a larger pattern, similar to a kaleidoscope. The exclusion of non-peer-reviewed papers is likely to have led to the exclusion of coproduced outputs, which may have offered important insights into the leadership of coproduction, particularly with regard to the experiences of service users and citizens playing leadership roles. In the reporting of this review, the PRISMA guidelines were followed (Additional file 2 ). It should be noted that the lack of reporting bias assessment and certainty assessment represents a limitation of this study.

Future research

Future research (see Table  2 ) should focus on under-represented roles, such as those of politicians and community leaders, and explore emerging collective leadership models based on real-time observational studies. It should also investigate the balance between strong and shared leadership by using qualitative and participatory research methods. Incorporating systems thinking and relevant leadership models can offer new perspectives on collective leadership practices.

Practical implications

This paper explored coproduction leadership practices and revealed that they require a deliberate and plural understanding of leadership roles and tasks. We proposed a framework for coproduction leadership that takes into account the actors involved, the models of leadership, and the leadership practices that emerge in different contexts and during different phases of coproduction. We also provided a set of reflective considerations that can help all actors involved in this process make more deliberate choices regarding the parties involved, leadership models of coproduction, and practices (Table  1 ).

Our systematic review revealed some gaps in the literature on coproduction leadership, such as the lack of attention to the mental complexity of coproduction leaders, the under-representation of service users and citizens as leaders, and the need for more empirical studies that use appropriate models and methods to capture the complexity of coproduction leadership. We suggest that future research should address these gaps, thus contributing to the advancement of coproduction theory and practice.

Our framework also has some practical implications for coproduction leaders and participants. At the start of coproduction process, all people, particularly leaders, must learn more about different models of leadership and how power is shared. Throughout this process, flexibility is necessary because leadership constellations change over time; they emerge and fade away, thus implying different underlying leadership models. A multitude of practices must be implemented throughout the coproduction process. People in leader roles must be aware of their personal strengths and limitations, not only with the goal of sharing leadership but also with the aim of establishing partnerships with others who have competence in certain practices, such as facilitation or addressing conflicts. Reflecting upon the guiding questions can also help illustrate the extent to which power and leadership are being shared. In conclusion, to create more equal power relations over time, we must challenge our current practices and work deliberately to enhance the capacity of individuals and groups to effectively engage in coproduction leadership.

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Acknowledgements

The authors wish to thank Forte, the Swedish Research Council for Health, Working Life and Welfare. In particular, we would like to thank Mary McCall for valuable help.

Open access funding provided by Jönköping University. The study of Samskapa, a coproduction research programme, received funding from Forte, the Swedish Research Council for Health, Working Life and Welfare, under grant agreement no. 2018–01431.

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Kjellström, S., Sarre, S. & Masterson, D. The complexity of leadership in coproduction practices: a guiding framework based on a systematic literature review. BMC Health Serv Res 24 , 219 (2024). https://doi.org/10.1186/s12913-024-10549-4

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California Management Review

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CMR INSIGHTS

The new leadership model: the rise of new roles for leaders in the dei world.

by Mostafa Sayyadi, Luca Collina, and Michael Provitera

The New Leadership Model: The Rise Of New Roles For Leaders In The DEI World

Image Credit | Levi Meir Clancy

Studies conducted by McKinsey in 2022 reveal that companies within the top 25% for racial and ethnic diversity are 35% more likely to experience superior performance, yet up to 24% of employees still report feeling excluded in the workplace, emphasizing why leaders must champion diversity, equity, and Inclusion (DEI) throughout their organizations.

Related CMR Articles

Myths about Diversity: What Managers Need to Know About Changes in the U.S. Labor Force , Friedman, Judith J., and Nancy DiTomas, 38/4 (Summer 1996): 54-77

The role of leadership has expanded to diversity, equity, and Inclusion, coupled with a thorough understanding of the conceptual skills of interpersonal relationships. Leaders must accept that diversity is here to stay. Finding the uniqueness of each employee and accepting them where and how they are is key to future success in any organization. Conceptual skills used to be found primarily in the upper echelon of organizations. However, they are needed from the front-line staff to the management.

Furthermore, everyone needs to use conceptual skills. In his work “Skills of an Effective Administrator”, Robert Katz (1947), a seminal author, defined conceptual skills as understanding how all parts of a business work together and driving changes that affect the whole company or critical business outcomes. 1 Thus, people can manage their own jobs and the expansive reach of the organization to its vital customers. Peter Drucker once mentioned that a business is not operative without a customer, and reaching each customer where they are is equivalent to an organization’s success. Drucker also coined knowledge management as an empowering trait of all employees as they perform their jobs.

The cognitive ability is also to be capable of leading others through strong interpersonal relationships. 2 3 4 5 Interpersonal relationships between leaders and employees create a positive work environment that promotes trust, collaboration, effective communication, empathy, and teamwork. These qualities enhance employees’ customer orientation, leading to a focus on delivering exceptional service and meeting customer needs.

Is New Training Needed?

Being promoted to leadership is like becoming a black belt in martial arts. The learning just begins at that point at an entirely new level. 6 7 8 9 Many supervisors and leaders that get promoted experience very little to no training. Some go away to a two-day supervisor training, and a colleague must trust their group members to catch them as they fall backwards. This builds camaraderie, but there is so much more to leadership. Leadership training begins with an introspective journey that requires continuous development, and in some cases, as Peter Drucker once noted, leaders need to know what not to do. However, a fundamental mediator element is the one that allows the Unlearning step.

The unlearning task is not an easy one. However, today’s dynamic environment demands leaders to be able to unlearn. As a result, older methods, beliefs, and habits must be discarded to make way for new, more effective ones. Any leadership training program must incorporate the concept of unlearning.

In addition to this critical activity, a leader’s personality must be continuously discerned to achieve a challenging personal transformation and positively influence others. Therefore, leaders must deepen their insights to be more authentic in nature, and sometimes, this requires an outside evaluation from knowledgeable, effective leaders who can add suggestions for continuous improvement. Discernment is a key leadership trait and usually develops over time. Leaders must also discern followers and develop their personalities to lead better and more introspective by grasping new management techniques and attempting to implement them.

The simplistic perception of human beings as the most complex phenomenon is why leaders stay away from deepening their insights and resort to simple management fad-type techniques to minimize the complexity of the leader-follower equation. Executives must smooth the path of leadership development to enhance their ability to solve complex leader-follower conflicts. Leader-follower conflicts show their ugly face when followers are left alone without any direction or when many demands are coming from multiple leaders, causing friction. Employees must also use their conceptual skills to let leaders know when their needs may not be realistic in the allotted timeframe.

Diversity, Equity, and Inclusion (DEI) in Leadership

We have found that the discussion of the challenges and complexities of leadership makes some senior managers reluctant to develop as leaders. This reluctance seems quite logical, as leadership development requires leaders’ personal development and deepening their insights in dealing with complex issues. These issues are sometimes too complex to solve in a short time or more significant and more prominent issues must be addressed. Two EDI experts, Robin Di Angelo, and Verna Myers, have observed authentic leadership asks to manage discomfort and difficult conversations about systemic inequities. Authentic leadership involves a deep dive into the realm of introspection to develop an authentic leadership persona. In an international financial company in Australia, after several meetings were held via chatbots with lower-level employees to include their views on the redevelopment of new knowledge management systems, employees became more aware of the possibility of cyber-attacks and how to avoid phishing, reducing the related risks. 10 11 12 In some cases, executives appear to be following predetermined recipes to resolve problems and lead others. Models of leadership are often used in universities and specific organizations. Some leadership models are only used once, while others are only used with some leaders. Once the leader moves on, they take the leadership model with them, and that leadership model is not utilized.

The key to leadership models is that they are for all people in organizations and, in some cases, reach out to suppliers, vendors, and even customers to build a solid leadership presence—leadership models that reap the most significant benefits to the stakeholders. In practice, leadership models set specific roles at all levels of the organization that not only motivate people within the organization and instill a sense of ownership into employees but also become a boundaryless model of organizations, creating an Open business system: In an open business system, team members are involved in decision-making and creativity and collaboration are encouraged. This can lead to increased innovation and greater efficiency in the organization.

Aggressive behavior from leaders is nothing new. At Salomon Brothers Inc., leaders would tell people to tell their story walking or fire someone by saying they are out of here. These aggressive behaviors are not known as micro-aggressions. Micro-aggressions are pinpointed toward a particular group. They could be passive or aggressive. The key is understanding where they are and abolishing them from the organization.

The Future of Leadership

Making the organization a think-tank for the world to view, understand, learn, and apply. Next, we define the roles of leaders for the future. We need to have a deeper dive into the roles for the future. We propose a new model of leadership that can help develop leadership in today’s global and complex business environment. A model that, along with personal development, introduces leadership as a set of roles that leaders should adopt according to diversity, equity, and Inclusion.

Leaders can play an essential role in leadership development. 13 14 First, leaders must take a deep dive into the introspective journey and personal development of authentic leadership for their personal transformation and to better influence others. 15 Some executives see nothing wrong with having a psychologist in the midst to help them and other employees cope with the day-to-day stress of leadership—both personal and professional.

This new leadership model also needs to embrace diversity, equity, and inclusive practices that can meet the needs of all employees and stakeholders. Our approach with executives is to pose leadership roles that consider leadership a responsible and continuous commitment to create motivation and a sense of shared ownership for employees, ensuring everyone feels included and valued and operating in an environment where employees feel safe to speak up and share ideas without fear of being judged or punished (Psychologically safe environment -PSE).

The New Leadership Model: New Roles for the DEI World

We now describe these new leadership roles after the deep dive and the personal assessment criteria. The first role ( Innovative Democratic Leaders ) emphasizes the democratization of the organization and away from pyramidal and bureaucratic structures. With the emergence of the complexities of digital transformation and artificial intelligence, leaders need to grasp ways of meeting the needs of employees and stakeholders without them being persuaded by leadership models that are counterproductive not only in the workplace but also in their personal lives.

In another new role ( Innovation Leader Search Steering Committee ), they appear as supporters who are full of personal qualities such as patience and humility. They are at the forefront of the future. They invite all employees to participate broadly in transformations. In this role, leaders recognize that all employees, from the lowest to the highest organizational levels, are pieces of what we call organizational genius. The other we suggest for leaders is Organizational Excellence Keeper . In this role, leaders are responsible for maintaining organizational excellence through continuous learning of human capital within the organization. Leaders should expand the infrastructure to develop the knowledge flow process throughout the organization and help their human resources on the path of excellence and growth by designing performance feedback systems. The effectiveness of this stage also requires communication of human resources with DEI experts and management consultants.

research paper on leadership model

Figure 1: The New Leadership Roles in the DEI World

How to Equip Leaders to Champion DEI?

As for the new, learning also requires upskilling in culture, communications, allyships, and creating an inclusive environment. With reference to training content about diversity, equity, and inclusion. we have asked executives to develop a positioning statement that reflects how they address DEI, why they do it, what it means to them to understand and develop leadership competency, and the importance of this introspective viewpoint as role models for followers.

The origins of managing DEI come from authentic leadership and servant leadership approaches, resulting in extensive participation. Promoting self-reflection, building skills, adopting inclusive behaviors, driving systemic change, fostering collaboration, and establishing accountability measures.

Achieving this personal transformation for leaders requires understanding the impact of assumptions of their past and present behaviors. In fact, leaders must realize that their beliefs will play an essential role in their behavior. Leaders should adopt the best assumptions according to the diversity, equity, and inclusion circumstances to provide the best behaviors to meet the followers’ needs.

We also distributed a checklist determining their stand on several managerial issues. And the best possible behaviors according to adopting the best assumptions and trying to master behaviors separately. Once this was diagnosed, we attempted to raise the bar through extensive training and development.

We demonstrated to the managers in workshops’ training that best assumptions and pursue behaviors could play an essential role in their personal development. For example, we asked them to hypothesize how humility can be essential in developing organizational leadership. Then, we asked them to write down the best behaviors in performing their duties in a checklist, according to this assumption and regardless of the position of the organization in which they are located. The results were fantastic, and the feedback received from the managers showed us that many behaviors with their employees had improved significantly compared to before these training workshops were held.

How To Transform Employee Training

There are many ways of using DEI executive training. We use DEI training to improve discussion learning quality by enhancing teaching and learning to maximize opportunities and experiences for employees and stakeholders. We do it by enhancing the tools and techniques of Diversity, Equity, and Inclusion (DEI) to explore significant ways of learning and growing with diverse life experiences, different perspectives, and a wide array of backgrounds.

Interactive Techniques:

  • We propose a life story exercise that gets executives to explore their life stories and utilize lessons to help them lead people better.
  • We shed light on motivational techniques that address inequities in leadership and follower relationships by enhancing authentic leadership to meet the needs of the people who collaborate with and communicate with them in our diverse global society.
  • We use particular movie scenes and exercises that tap into the inner core of leadership development.
  • We develop the civil leadership characteristics that enhance organizations’ ability to meet stakeholders’ needs by equipping them with what it takes to have an inclusive community, embracing a society of social justice.
  • AI and Automation play an essential part in leadership development. Here, we examine their benefits and risks while simultaneously discussing building PsyCap (Psychological Capital). PsyCap skills offer positive perspectives to tackle difficult situations.

Key Points and Insights for Executives

Some crucial points are making leadership roles where everyone can take part and feel ownership, helping leaders grow in self-understanding and open-mindedness, and doing fun training on diversity, fairness, and Inclusion using real people’s stories and motivation exercises.

We have four actionable ideas for executives.

  • First, set up deep training sessions on diversity, fairness, and Inclusion using real stories and inspiration. This helps leaders stop biases and learn to value differences.
  • Second, make leadership roles where all workers can take part in big decisions. This stops rigid top-down control. Leaders need to stop wanting to control everything and learn to share power.
  • Third, leadership roles are all about constant learning. Help people stop using outdated skills and learn skills needed today to understand the impact and how to manage DEI.
  • Fourth: Use chatbots and AI to create safe places to stop old assumptions and behaviors. Do activities like picturing an ideal diverse future and thinking backwards about how to get there. Question old assumptions by exploring worst-case situations.

The bottom line is leadership now means making DEI the top priority. Interactive training, roles where everyone participates, and constant learning allow this change. Leadership has to champion DEI, including everyone’s unique talents. Executives should lead this change to create positive, engaged cultures where all feel they belong.

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Leadership Research Paper

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This sample leadership research paper features: 7900 words (approx. 26 pages), an outline, and a bibliography with 38 sources. Browse other research paper examples for more inspiration. If you need a thorough research paper written according to all the academic standards, you can always turn to our experienced writers for help. This is how your paper can get an A! Feel free to contact our writing service for professional assistance. We offer high-quality assignments for reasonable rates.

I. Introduction

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II. Leadership Defined

III. The Trait Approach to Leadership

IV. What Do Leaders Do? The Behavioral Approach

V. Situational Approaches to Leadership

VI. Contingency Theories of Leadership

VII. Leader-Member Exchange Theory

VIII. Charismatic and Transformational Leadership

IX. Leader Emergence and Transition

X. Leadership Development

XI. Summary

XII. Bibliography

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Introduction

There are few things more important to human activity than leadership. Most people, regardless of their occupation, education, political or religious beliefs, or cultural orientation, recognize that leadership is a real and vastly consequential phenomenon. Political candidates proclaim it, pundits discuss it, companies value it, and military organizations depend on it. The French diplomat Talleyrand once said, “I am more afraid of an army of 100 sheep led by a lion than an army of 100 lions led by a sheep.” Effective leadership guides nations in times of peril, promotes effective team and group performance, makes organizations successful, and, in the form of parenting, nurtures the next generation. Winston Churchill, the Prime Minister of Great Britain during World War II, was able to galvanize the resolve of his embattled people with these words: “I have nothing to offer but blood, toil, tears, and sweat.” When leadership is missing, the effects can be equally dramatic; organizations move too slowly, stagnate, and often lose their way. The League of Nations, created after the World War I, failed to meet the challenges of the times in large part because of a failure to secure effective leadership. With regard to bad leaders, Kellerman (2004) makes an important distinction between incompetent leaders and corrupt leaders. To this we might also add leaders who are “toxic.” Bad leadership can perpetuate misery on those who are subject to its domain. Consider the case of Jim Jones, the leader of the Peoples Temple, who in 1978 ordered the mass suicide of his 900 followers in what has been called the Jonestown Massacre, or the corrupt leadership of Enron and Arthur Anderson that impoverished thousands of workers and led to the dissolution of a major organization. These examples remind us that there are many ways in which leadership can fail.

Leadership Defined

When you think of leadership, the ideas of power, authority, and influence may come to mind. You may think of the actions of effective leaders in accomplishing important goals. You may think of actual people who have been recognized for their leadership capabilities. Dwight D. Eisenhower, 34th president of the United States, defined leadership as “the ability to decide what is to be done, and then to get others to want to do it.” Leadership can be defined as the ability of an individual to influence the thoughts, attitudes, and behavior of others. It is the process by which others are motivated to contribute to the success of the groups of which they are members. Leaders set a direction for their followers and help them to focus their energies on achieving their goals. Theorists have developed many different theories about leadership, and although none of the theories completely explains everything about leadership, each has received some scientific support. Some of the theories are based on the idea that there are “born leaders” with particular traits that contribute to their ability to lead. Other theories suggest that leadership consists of specific skills and behaviors. Some theories take a contingency approach that suggests that a leader’s effectiveness depends on the situation requiring leadership. Still other theories examine the relationship between the leader and his or her followers as the key to understanding leadership. In this research paper, we examine these various theories and describe the process of leadership development.

The Trait Approach to Leadership

Aristotle suggested that “men are marked out from the moment of birth to rule or be ruled,” an idea that evolved into the Great Person Theory. Great leaders of the past do seem different from ordinary human beings. When we consider the lives of Gandhi or Martin Luther King, Jr., it is easy to think of their influence as a function of unique personal attributes. This trait approach was one of the first perspectives applied to the study of leadership and for many years dominated leadership research. The list of traits associated with effective leadership is extensive and includes personality characteristics such as being outgoing, assertive, and conscientious. Other traits that have been identified are confidence, integrity, discipline, courage, self-sufficiency, humor, and mystery. Charles de Gaulle described this last trait best when he noted that “A true leader always keeps an element of surprise up his sleeve, which others cannot grasp but which keeps his public excited and breathless.”

Another trait often attributed to effective leaders is intelligence. However, intelligence is a two-edged sword. Although highly intelligent people may be effective leaders, their followers may feel that large differences in intellectual abilities mean large differences in attitudes, values, and interests. Thus, Gibb (1969) has pointed out that many groups prefer to be “ill-governed by people [they] can understand” (p. 218). One important aspect of intelligence that does predict leader effectiveness is emotional intelligence, which includes not only social skills but strong self-monitoring skills, which provide the leader with feedback as to how followers feel about the leader’s actions.

Finally, personal characteristics such as attractiveness, height, and poise are associated with effective leadership. After decades of research, in which the list of traits grew dramatically, researchers realized that the same person could be effective in one context (Winston Churchill as war leader) but ineffective in another context (Winston Churchill, who was removed from office immediately after the war was over). The failure of this approach to recognize the importance of the situation in providing clear distinctions between leaders and followers with regard to their traits caused many scientists to turn their attention elsewhere. However, theorists using more sophisticated methodological and conceptual approaches have revived this approach. Zaccaro (2007) suggests that the revival of the trait approach reflects a shift away from the idea that traits are inherited, as suggested in Galton’s 1869 book Hereditary Genius, and focuses on personal characteristics that reflect a range of acquired individual differences. This approach has three components. First, researchers do not consider traits as separate and distinct contributors to leadership effectiveness but rather as a constellation of characteristics that, taken together, make a good leader.

The second component broadens the concept of trait to refer not only to personality characteristics but also to motives, values, social and problem-solving skills, cognitive abilities, and expertise. For example, in a series of classic studies, McClelland and his colleagues (see McClelland & Boyatzis, 1982) identified three motives that contribute to leadership. They are the need for achievement, the need for power, and the need for affiliation. In their work, leader traits are not attributes of the person but the basis for the leader’s behavior. The need for achievement is manifested in the desire to solve problems and accomplish tasks. In the words of Donald McGannon, “Leadership is action, not position.” The need for power is evident in the desire to influence others without using coercion. As Hubert H. Humphrey once said, “Leadership in today’s world requires far more than a large stock of gunboats and a hard fist at the conference table.” The final motive, need for affiliation, can be a detriment to effective leadership if the leader becomes too concerned with being liked. However, it can provide positive results from the satisfaction a leader derives in helping others succeed. Lao Tse once wrote, “A good leader is a catalyst, and though things would not get done well if he weren’t there, when they succeed he takes no credit. And because he takes no credit, credit never leaves him.”

The third component of this new approach focuses on attributes that both are enduring and occur across a variety of situations. For example, there is strong empirical support for the trait approach when traits are organized according to the five-factor model of personality. Both extraversion and conscientiousness are highly correlated with leader success and, to a lesser extent, so are openness to experience and the lack of neuroticism.

What Do Leaders Do? The Behavioral Approach

Three major schools of thought—the Ohio State Studies, Theory X/Y (McGregor, 1960), and the Managerial Grid (Blake & Mouton, 1984)—have all suggested that differences in leader effectiveness are directly related to the degree to which the leader is task oriented versus person oriented. Task-oriented leaders focus on the group’s work and its goals. They define and structure the roles of their subordinates in order to best obtain organizational goals. Task-oriented leaders set standards and objectives, define responsibilities, evaluate employees, and monitor compliance with their directives. In the Ohio State studies this was referred to as initiating structure, whereas McGregor (1960) refers to it as Theory X, and the Managerial Grid calls it task-centered. Harry S. Truman, 33rd president of the United States, once wrote, “A leader is a man who can persuade people to do what they don’t want to do, or do what they’re too lazy to do, and like it.” Task-oriented leaders often see their followers as undisciplined, lazy, extrinsically motivated, and irresponsible. For these leaders, leadership consists of giving direction, setting goals, and making unilateral decisions. When under pressure, task-oriented leaders become anxious, defensive, and domineering.

In contrast, person-oriented leaders tend to act in a warm and supportive manner, showing concern for the well-being of their followers. Person-oriented leaders boost morale, take steps to reduce conflict, establish rapport with group members, and provide encouragement for obtaining the group’s goals. The Ohio State studies referred to this as consideration, the Managerial Grid calls this country club leadership, and McGregor uses the term Theory Y. Person-oriented leaders see their followers as responsible, self-controlled, and intrinsically motivated. As a result, they are more likely to consult with others before making decisions, praise the accomplishment of their followers, and be less directive in their supervision. Under pressure, person-oriented leaders tend to withdraw socially.

Leadership effectiveness can be gauged in several ways: employee performance, turnover, and dissatisfaction. As you can see in Table 68.1, the most effective leaders are those who are both task and person oriented, whereas the least effective leaders are those who are neither task nor person oriented. A recent meta-analysis found that person-oriented leadership consistently improves group morale, motivation, and job satisfaction, whereas task-oriented leadership only sometimes improves group performance, depending on the types of groups and situations.

In thinking about what leaders do, it is important to distinguish between leadership and management. Warren Bennis (1989) stated, “To survive in the twenty-first century, we are going to need a new generation of leaders— leaders, not managers.” He points out that managers focus on “doing things right” whereas leaders focus on “doing the right things.” Table 68.2 provides a comparison of the characteristics that distinguish a leader from a manager. As you look at the list, it is clear that a person can be a leader without being a manager and be a manager without being a leader.

Situational Approaches to Leadership

The Great Person theory of leadership, represented by such theorists as Sigmund Freud, Thomas Carlyle, and Max Weber, suggests that from time to time, highly capable, talented, charismatic figures emerge, captivate a host of followers, and change history. In contrast to this, Hegel, Marx, and Durkheim suggest that there is a tide running in human affairs, defined by history or the economy, and that leaders are those who ride the tide. The idea of the tide leads us to the role of situational factors in leadership. For example, Perrow (1970) suggests that leadership effectiveness is dependent upon structural aspects of the organization. Longitudinal studies of organizational effectiveness provide support for this idea. For example, Pfeffer (1997) indicated that “If one cannot observe differences when leaders change, then what does it matter who occupies the positions or how they behave?” (p. 108). Vroom and Jago (2007) have identified three distinct roles that situational factors play in leadership effectiveness. First, organizational effectiveness is not strictly a result of good leadership practices. Situational factors beyond the control of the leader often affect the outcomes of any group effort. Whereas leaders, be they navy admirals or football coaches, receive credit or blame for the activities of their followers, success or failure is often the result of external forces: the actions of others, changing technologies, or environmental conditions. Second, situations shape how leaders act. Although much of the literature on leadership has focused on individual differences, social psychologists such as Phil Zimbardo, in his classic Stanford Prison Experiment, and Stanley Milgram, in his studies of obedience, have demonstrated how important the situation is in determining behavior. Third, situations influence the consequences of leader behavior. Although many popular books on leadership provide a checklist of activities in which the leader should engage, most of these lists disregard the impact of the situation. Vroom and Jago (2007) suggest that the importance of the situation is based on three factors: the limited power of many leaders, the fact that applicants for leadership positions go through a uniform screening process that reduces the extent to which they differ from one another, and whatever differences between them still exist will be overwhelmed by situational demands. If all of these factors are present, it is probably true that the individual differences between leaders will not significantly contribute to their effectiveness. Nevertheless, in most of the situations in which leaders find themselves, they are not that powerless and their effectiveness is mostly a result of matching their skills with the demands of the situation, which brings us to a discussion of contingency theories.

Contingency Theories of Leadership

One of the first psychologists to develop a contingency approach to leadership effectiveness was Fred Fiedler (1964, 1967), who believed that a leader’s style is a result of lifelong experiences that are not easy to change. With this in mind, he suggested that leaders need to understand what their style is and to manipulate the situation so that the two match. Like previous researchers, Fiedler’s idea of leadership style included task orientation and person orientation, although his approach for determining a leader’s orientation was unique. Fiedler developed the least-preferred coworker (LPC) scale. On this scale, individuals rate the person with whom they would least want to work on a variety of characteristics. Individuals who rate their LPC as uniformly negative are considered task oriented, whereas those who differentiate among the characteristics are person oriented. The second part of his contingency theory is the favorableness of the situation. Situational favorability is determined by three factors: the extent to which the task facing the group is structured, the legitimate power of the leader, and the relations between the leader and his subordinates. The relation between LPC scores and group performance is complex, as can be seen in Table 68.3. A meta-analysis conducted by Strube and Garcia (1981) found that task-oriented leaders function best in situations that are either favorable (clear task structure, solid position power, and good leader/member relations) or unfavorable (unclear task structure, weak position power, and poor leader/member relations). In contrast, person-oriented leaders function best in situations that are only moderately favorable, which is often based on the quality of leader-member relations.

Another theory that addresses the relation between leadership style and the situation is path-goal theory (House, 1971). In this theory, path refers to the leader’s behaviors that are most likely to help the group attain a desired outcome or goal. Thus, leaders must exhibit different behaviors to reach different goals, depending on the situation. Four different styles of behavior are described:

  • Directive leadership. The leader sets standards of performance and provides guidelines and expectations to subordinates on how to achieve those standards.
  • Supportive leadership. The leader expresses concern for the subordinates’ well-being and is supportive of them as individuals, not just as workers.
  • Participative leadership. The leader solicits ideas and suggestions from subordinates and invites them to participate in decisions that directly affect them.
  • Achievement-oriented leadership. The leader sets challenging goals and encourages subordinates to attain those goals.

According to path-goal theory, effective leaders need all four of these styles because each one produces different results. Which style to use depends on two types of situational factors: subordinate characteristics, including ability, locus of control, and authoritarianism; and environmental characteristics, including the nature of the task, work group, and authority system. According to House and Mitchell (1974), when style and situation are properly matched, there is greater job satisfaction and acceptance of the leader, as well as more effort toward obtaining desired goals. A meta-analysis by Indvik (1986) is generally supportive of the theory. Studies of seven organizations found that task-oriented approaches are effective in situations with low task structure, because they help subordinates cope with an ambiguous situation, and ineffective in situations with high task structure, because they appear to be micromanagement. Additional studies have found that supportive leadership is most effective when subordinates are working on stressful, frustrating, or dissatisfying tasks. Researchers found participative leadership to be most effective when subordinates were engaged in nonrepetitive, ego-involving tasks. Finally, achievement-oriented leadership was most effective when subordinates were engaged in ambiguous, nonrepetitive tasks. A clear implication of the theory is that leaders must diagnose the situation before adopting a particular leadership style.

A third contingency approach is the normative and descriptive model of leadership and decision making developed by Vroom and his colleagues (see Vroom & Jago, 2007). This approach examines the extent to which leaders should involve their subordinates in decision-making processes. To answer this question, the researchers developed a matrix that outlines the five decision processes that range from highly autocratic through consultative to highly participative (see Table 68.4). Which of these approaches is the best? The answer is none of them is uniformly preferred, and each process has different costs and benefits. For example, participative approaches are more likely to gain support and acceptance among subordinates for the leader’s ideas, whereas autocratic approaches are quick and efficient, but may cause resentment. The theory suggests that the best approach may be selected by answering several basic questions about the situation that relate to the quality and acceptance of a decision. Some examples of the type of questions that should be asked are “Do I have enough information to make a decision? How structured is the task? Must subordinates accept the decision to make it work?” By answering such questions and applying the specific rules shown in Table 68.5, a leader is able to eliminate approaches that are likely to fail and to choose the approach that seems most feasible from those remaining.

Leader-Member Exchange Theory

A growing number of researchers have found that subordinates may affect leaders as much as leaders affect subordinates. Yukl (1998) pointed out that when subordinates perform poorly, leaders tend to be more task oriented, but when subordinates perform well, leaders are more person oriented. Similarly, Miller, Butler, and Cosentino (2004) found that the effectiveness of followers conformed to the same rules as those Fiedler applied to leaders. It may be that the productivity of a group can have a greater impact on leadership style than leadership style does on the productivity of the group. This reciprocal relation has been formally recognized in the vertical dyad linkage approach (Dansereau, Graen, & Haga, 1975), now commonly referred to as leader-member exchange (LMX) theory (Graen & Uhl-Bien, 1995). This theory describes how leaders maintain their influence by treating individual followers differently. Over time, leaders develop a special relationship with an inner circle of trusted lieutenants, assistants and advisors—the in-group. The members of the in-group are given high levels of responsibility, influence over decision making, and access to resources. Members of the in-group typically are those who are highly committed to the organization, work harder, show loyalty to the leader, and share more administrative duties. Their reward is greater access to the leader’s resources, including information, concern, and confidence. To maintain the exchange, leaders must be careful to nurture the relationship with the in-group, giving them sufficient power to satisfy their needs but not so much power that they become independent. The leader-member relationship generally follows three stages. The first stage is role taking. During this stage the leader assesses the members’ abilities and talents and offers them opportunities to demonstrate their capabilities and commitment. In this stage, both the leader and member discover how the other wants to be respected. The second stage is role making. In this stage, the leader and member take part in unstructured and informal negotiations in order to create a role for the member with a tacit promise of benefits and power in return for dedication and loyalty. In this stage, trust building is very important, and betrayal in any form can result in the member’s being relegated to the out-group. In this stage the leader and member explore relationship factors as well as work-related factors. At this stage, it is clear that perceived similarities between the leader and follower become important. For this reason, a leader may favor a member who is similar in sex, race, or outlook with assignment to the in-group, although research by Murphy and Ensher (1999) indicated that the perception of similarity is more important than actual demographic similarities. The final stage is routinization. In this phase the pattern established by the leader and member becomes established.

The quality of the leader-member relationship is dependent on several factors. It tends to be better when the challenge of the job is either extremely high or extremely low. Other factors that affect the quality of the relationship are the size of the group, availability of resources, and overall workload.

Charismatic and Transformational Leadership

In a speech given at the University of Maryland, Warren Bennis said, “[A] leader has to be able to change an organization that is dreamless, soulless and visionless…someone’s got to make a wake-up call. The first job of a leader is to define a vision for the organization.…Leadership is the capacity to translate vision into reality.” Effective leaders are able to project a vision, explaining to their subordinates the purpose, meaning, and significance of their efforts. As Napoleon once said, “Leaders are dealers in hope.” Although the idea of charismatic leadership goes back as far as biblical times (“Where there is no vision, the people perish”—Proverbs 29:18), its modern development can be attributed to the work of Robert House. House (1977) analyzed political and religious leaders and noted that charismatic leaders are those high in self-confidence and confidence in their subordinates, with high expectations, a clear vision of what can be accomplished, and a willingness to use personal examples. Their followers often identify with the leader and his or her mission, show unswerving loyalty toward and confidence in the leader, and derive a sense of self-esteem from their association with the leader. Charismatic leaders are usually quite articulate, with superior debating and persuasive skills. They also possess the technical expertise to understand what their followers must do. Charismatic leaders usually have high self-confidence, impression-management skills, social sensitivity, and empathy. Finally, they have the skills to promote attitudinal, behavioral, and emotional change in their followers. Those who follow charismatic leaders are often surprised at how much they are able to accomplish that extends beyond their own expectations. Research on charismatic leadership indicates that the impact of such leaders is greatest when the followers engage in high self-monitoring (observing their effect on others) and exhibit high levels of self-awareness. Charismatic leadership enhances followers’ cooperation and motivation.

It is important to recognize that charismatic leadership can have a dark side. We began this research paper with the example of Jim Jones, the charismatic religious leader who led his people to commit mass suicide. Howell and Avolio (1992) describe the difference between ethical and unethical charismatic leaders. According to their analysis, ethical leaders use their power to serve others, not for personal gain. They also promote a vision that aligns with their follower’s needs and aspirations rather than with their own personal vision. Ethical leaders stimulate followers to think independently and to question the leader’s views. They engage in open, two-way communication and are sensitive to their followers’ needs. Finally, ethical leaders rely on internal moral standards to satisfy organizational and societal interests, not their own self-interests.

In helping followers achieve their aspirations, Bernard Bass (1997) has noted that charismatic leadership is a component of a broader-based concept, that of transformational leadership. Bass believed that most leaders are transactional rather than transformational in that they approach their relationships with followers as a transaction, one in which they define expectations and offer rewards that will be forthcoming when those expectations are met. Transactional leaders use a contingent reward system, manage by exception, watch followers to catch them doing something wrong, and intervene only when standards are not met. Finally, transactional leaders tend to adopt a laissez-faire approach by avoiding the need to make hard decisions.

In contrast, transformational leadership goes beyond mutually satisfactory agreements about rewards and punishments to heighten followers’ motivation, confidence, and satisfaction by uniting them in the pursuit of shared, challenging goals. In the process of doing that, they change their followers’ beliefs, values, and needs. Bass and Avolio (1994) identified four components of transformational leadership. The first component is idealized influence (charisma). Leaders provide vision, a sense of mission, and their trust in their followers. Leaders take stands on difficult issues and urge their followers to follow suit. They emphasize the importance of purpose, commitment, and ethical decision making. The second component is inspirational motivation. Leaders communicate high expectations, express important purposes in easy-to-understand ways, talk optimistically and enthusiastically about the tasks facing the organization, and provide encouragement and meaning for what has to be done. They often use symbols to focus the efforts of their followers. The third component is intellectual stimulation. Leaders promote thoughtful, rational, and careful decision making. They stimulate others to discard outmoded assumptions and beliefs and to explore new perspectives and ways of doing things. The fourth component is individualized consideration. Leaders give their followers personal attention and treat each person individually. They listen attentively and consider the individual needs, abilities, and goals of their followers in their decisions. In order to enhance the development of their followers they advise, teach, and coach, as needed. Yukl (2002) offers the following guidelines for transformational leadership:

  • Develop a clear and appealing vision.
  • Create a strategy for attaining the vision.
  • Articulate and promote the vision.
  • Act confident and optimistic.
  • Express confidence in followers.
  • Use early success in achievable tasks to build confidence.
  • Celebrate your followers’ successes.
  • Use dramatic, symbolic actions to emphasize key values.
  • Model the behaviors you want followers to adopt.
  • Create or modify cultural forms as symbols, slogans, or ceremonies.

Perhaps Walter Lippman provided the best summary of transformational leadership. He wrote, “The final test of a leader is that he leaves behind him in other men the conviction and the will to carry on…” The genius of good leaders is to leave behind them a situation that common sense, without the grace of genius, can deal with successfully.

Leader Emergence and Transition

Who becomes the leader? The process by which someone becomes formally or informally, perceptually or behaviorally, and implicitly or explicitly recognized as a leader is leadership emergence. Scholars have debated this question for centuries and in this research paper, so far, we have offered several possible answers. The Great Person Theory suggests that some people are marked for greatness and dominate the times in which they live. Tolstoy’s zeitgeist theory suggests that leaders come to prominence because of the spirit of the times. Trait theories suggest leaders are selected based on their personal characteristics, whereas interactional approaches examine the joint effects of the situation and the leader’s behavior. Research suggests that leadership emergence is an orderly process that reflects a rational group process whereby the individual with the most skill or experience or intelligence or capabilities takes charge. Implicit leadership theories (Lord & Maher, 1991) provide a cognitive explanation for leadership emergence. According to these theories, each member of a group comes to the group with a set of expectations and beliefs about leaders and leadership. These cognitive structures are called implicit leadership theories or leader prototypes. Typically these prototypes include both task and relationship skills as well as an expectation that the leader will epitomize the core values of the group. Members use their implicit theories to sort people into either leaders or followers based on the extent to which others conform to their implicit theory of what a leader should be. These implicit theories also guide members in their evaluations of the leader’s effectiveness. Because these theories are implicit, they are rarely subjected to critical scrutiny. As a result, it is not uncommon for followers to demonstrate a bias toward those who fit the mold of a traditional leader: White, male, tall, and vocal, regardless of the qualifications of that individual to be the leader.

Transition, rotation, succession, change of command; all are words used to describe a central facet of organizational leadership—that leaders follow one another. Despite the frequent occurrence of leader successions in nearly all groups, especially in large stable organizations, relatively little research has addressed this phenomenon. An early review by Gibb (1969) reported on studies of leader emergence and succession mode. In particular, Gibb noted the importance of establishing leadership/followership through early, shared, significant experiences; he also stressed that an important aspect of the organizational climate for the new leader derives from the policies of the former leader, the consequence of which shape followers’ expectations, morale, and interpersonal relations. In general, studies have demonstrated that leadership succession causes turbulence and instability resulting in performance decrements in most organizations and thus constitutes a major challenge to organizations. Thus, the process of becoming the new leader is often an arduous, albeit rewarding, journey of learning and self-development. The trials involved in this rite of passage have serious consequences for both the individual and the organization. As organizations have become leaner and more dynamic, new leaders have described a transition that gets more difficult all the time. To make the transition less difficult, leaders might attend to the following suggestions adapted from the works of Betty Price, a management consultant. Some of these suggestions are particularly important for newly appointed leaders in establishing an effective leadership style early in their tenure as leader.

  • New leaders should show passion for their group, its purpose, and its people in order to reassure followers that the new leader is there to make the group better, not to further his or her personal ambitions.
  • New leaders should think more strategically than tactically. Look for the big picture and don’t become bogged down in implementation processes.
  • New leaders should first learn to listen, and then provide leadership. Leaders should be compelling in their ability to help others embrace the values that drive the group’s success. To do this the new leader must listen intently and provide feedback that demonstrates that he or she has truly heard what others have said.
  • New leaders should operate in a learning mode. As the new person on the block, the new leader may be unsure about the reputation of the preceding leader. He or she should honor the insights and knowledge of others, believing that one can learn from everyone. The new leader should engage people purposefully at all levels, knowing that the distance between the front line and senior leadership is often so great that one small piece of information may have tremendous impact.
  • New leaders should take particular care in doing what’s right and telling the truth, even if it is painful. One of the first tasks of a new leader is building trust. In the face of uncertainties, being honest, direct, and truthful enables people to move forward with faith. It gives them hope.
  • New leaders should encourage their people to take risks in order to achieve their goals, and be prepared to pick up the pieces if they fail. The leader’s role is to cushion the risk by providing support and encouragement, and knowing and drawing from his or her people’s best capabilities.

Leadership Development

Not everyone is born with “the right stuff” or finds himself or herself in just the right situation to demonstrate his or her capacity as a leader. However, anyone can improve his or her leadership skills. The process of training people to function effectively in a leadership role is known as leadership development and it is a multimillion-dollar business. Leadership development programs tend to be of two types: internal programs within an organization, designed to strengthen the organization, and external programs that take the form of seminars, workshops, conferences, and retreats.

Typical of external leadership development programs are the seminars offered by the American Management Association. Their training seminars are held annually in cities across the country and address both general leadership skills as well as strategic leadership. Among the seminars offered in the area of general leadership are critical thinking, storytelling, and team development in a variety of areas such as instructional technology or government. Seminars on strategic leadership address such topics as communication strategies, situational leadership, innovation, emotional intelligence, and coaching.

A second approach to leadership development is a technique known as grid training. The first step in grid training is a grid seminar during which members of an organization’s management team help others in their organization identify their management style as one of four management styles: impoverished management, task management, country-club management, and team management. The second step is training, which varies depending on the leader’s management style. The goal of the training is greater productivity, better decision making, increased morale, and focused culture change in the leader’s unique organizational environment. Grid training is directed toward six key areas: leadership development, team building, conflict resolution, customer service, mergers, and selling solutions.

Internal leadership development programs tend to focus on three major areas: the development of social interaction networks both between people within a given organization and between organizations that work with one another, the development of trusting relationships between leaders and followers, and the development of common values and a shared vision among leaders and followers. There are several techniques that promote these goals. One such technique is 360-degree feedback. This is a process whereby leaders may learn what peers, subordinates, and superiors think of their performance. This kind of feedback can be useful in identifying areas in need of improvement. The strength of the technique is that it provides differing perspectives across a variety of situations that help the leader to understand the perceptions of his or her actions. This practice has become very popular and is currently used by virtually all Fortune 500 companies. Like all forms of assessment, 360-degree feedback is only useful if the leader is willing and able to change his or her behavior as a result of the feedback. To ensure that leaders don’t summarily dismiss feedback that doesn’t suit them, many companies have arranged for face-to-face meetings between the leaders and those who have provided the feedback.

Another form of internal leadership development is networking. As a leadership development tool, networking is designed to reduce the isolation of leaders and help them better understand the organization in which they work. Networking is specifically designed to connect leaders with key personnel who can help them accomplish their everyday tasks. Networking promotes peer relationships and allows individuals with similar concerns and responsibilities to learn from one another ways to better do their job. Research indicates that these peer relationships tend to be long-lasting.

Executive coaching is a method for developing leaders that involves custom-tailored, one-on-one interactions. This method generally follows four steps. It begins with an agreement between the coach and the leader as to the nature of the coaching relationship, to include what is to be done and how it will be done. The second step is an expert’s assessment of the leader’s strengths and weaknesses. The third step provides a comprehensive plan for improvement that is usually shared with the leader’s immediate supervisor. The fourth and final step is the implementation of the plan. Coaching is sometimes a onetime event aimed at addressing a particular concern or it can be an ongoing, continuous process.

Another form of internal leadership development is mentoring. The term mentor can mean many things: a trusted counselor or guide, tutor, coach, master, experienced colleague, or role model. A mentor is usually someone older and more experienced who provides advice and support to a younger, less experienced person (protégé). In general, mentors guide, watch over, and encourage the progress of their protégés. Mentors often pave the way for their protégé’s success by providing opportunities for achievement, nominating them for promotion, and arranging for their recognition. As a form of leadership development, there are several advantages to mentoring. A meta-analysis by Allen, Eby, Poteet, Lima, and Lentz (2004) indicated that individuals who were mentored showed greater organizational commitment, lower turnover, higher career satisfaction, enhanced leadership skills, and a better understanding of their organization.

In the future, leadership is likely to become more group centered as organizations become more decentralized. Other changes will come about as a result of new and emerging technologies. Avolio and his colleagues (2003) refer to this as “e-leadership.” Leadership effectiveness will depend on the leader’s ability to integrate the new technologies into the norms and culture of their organization.

Another change is that the future will most likely see more women break through the “glass ceiling” and take leadership positions. Men are considerably more likely to enact leadership behaviors than are women in studies of leaderless groups, and as a result are more likely to emerge as leaders (Eagly, 1987). Even though women do sometimes emerge as leaders, historically they have been excluded from the highest levels of leadership in both politics and business. This exclusion has been called the glass ceiling. Studies of leadership in organizational settings have found that men and women do not differ significantly in their basic approach to leadership, with equal numbers of task- versus person-oriented leaders. However, women are much more likely to adopt a participative or transformational leadership style whereas men are more likely to be autocratic, laissez-faire, or transactional (Eagly & Johnson, 1990). Women’s leadership styles are more closely associated with group performance as well as subordinate satisfaction, and in time our implicit theories about leadership may very well favor those who adopt such approaches.

Diversity and working in a global economy will provide additional challenges to tomorrow’s leaders. Project GLOBE (Global Leadership and Organizational Behavior Effectiveness) is an extensive international project involving 170 researchers who have gathered data from 18,000 managers in 62 countries (House, Hanges, Javidan, Dorman, & Gupta, 2004). A major goal of the project was to develop societal and organizational measures of culture and leader attributes that were appropriate to use across all cultures. There have been several important findings. In some cultures, leadership is denigrated and regarded with suspicion. People in these cultures often fear that leaders will acquire and abuse power and as a result substantial restraints are placed on the exercise of leadership. Twenty-two leadership traits (e.g., foresight and decisiveness) were identified as being desirable across all cultures. Eight leadership traits (e.g., ruthlessness and irritability) were identified as being universally undesirable. Some leadership traits were dependent upon the culture, including ambition and elitism. Six leadership styles common to many cultures were identified. They are charismatic, self-protective, humane, team oriented, participative, and autonomous. Although the charismatic style is familiar to us, some of the others are not. The self-protective style involves following agreed-upon procedures, being cognizant of the status hierarchy, and saving face. The humane style includes modesty and helping others. The team-oriented style includes collaboration, team building, and diplomacy. The participative style encourages getting the opinions and help of others. The autonomous style involves being independent and making one’s own decisions. Cultures differ in their preferences for these styles. For example, leaders from northern European countries are more participative and less self-protective whereas leaders from southern Asia are more humane and less participative.

Although most of us would agree that leadership is extraordinarily important, research in this field has yet to arrive at a generally accepted definition of what leadership is, create a widely accepted paradigm for studying leadership, or find the best strategies for developing and practicing leadership. Hackman and Wageman (2007) attempted to address this problem by reframing the questions we have been asking about leadership effectiveness, with the hope that these questions will be more informative than many of those asked previously.

  • Question 1. Ask NOT “Do leaders make a difference?” but “Under what conditions does leadership matter?” The task here is to examine conceptually and empirically the circumstances under which leadership makes a difference and to distinguish those from the circumstances for which leadership is inconsequential.
  • Question 2. Ask NOT “What are the traits that define an effective leader?” but “How do leaders’ personal attributes interact with situational properties to shape outcomes?” This approach will require that we reduce our reliance on both fixed traits and complex contingencies. To do this, we should embrace the idea that there are many different ways to achieve the same outcome.
  • Question 3. Ask NOT “Are there common dimensions on which all leaders can be arrayed?” but “Are good and poor leadership qualitatively different phenomena?” Recent research has found that ineffective leaders were not ones who scored low on those dimensions for which good leaders scored high, but rather they exhibited entirely different patterns of behavior than those exhibited by good leaders.
  • Question 4. Ask NOT “How do leaders and followers differ from one another?” but “How can leadership models be reframed so they treat all members of a group as leaders and followers?” Although it is clear that to be a leader requires that you have followers, it is equally true that most leaders are at times followers and most followers are at times leaders.
  • Question 5. Ask NOT “What should be taught in leadership courses?” but “How can leaders be helped to learn?” Research is needed to understand how leaders learn from their experiences, especially when they are coping with crises (see Avolio, 2007).

In the 21st century, the study of leadership will be increasingly collaborative as researchers from multiple disciplines tackle the questions outlined above. Some of the disciplines that must contribute to the study of leadership include media and communications. In today’s world more and more of the relationships between leaders and followers are not face-to-face but mediated through electronic means.

John Kenneth Galbraith, in his book The Age of Uncertainty, wrote that “All of the great leaders have had one characteristic in common: it was the willingness to confront unequivocally the major anxiety of their people in their time. This, and not much else, is the essence of leadership.” In the special issue of the American Psychologist devoted to leadership, Warren Bennis (2007) suggests that the four most important threats facing our world today are these: (a) a nuclear or biological catastrophe; (b) a worldwide pandemic; (c) tribalism and its cruel offspring, assimilation; and (d) leadership of our human institutions. He points out that solving the first three problems will not be possible without exemplary leadership and that an understanding of how to develop such leadership will have serious consequences for the quality of our health and our lives.

Bibliography:

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Driving change: a case study of a dnp leader in residence program in a gerontological center of excellence.

View as pdf A later version of this article appeared in Nurse Leader , Volume 21, Issue 6 , December 2023 . 

The American Association of Colleges of Nursing (AACN) published the Essentials of Doctoral Education for Advanced Practice Nursing in 2004 identifying the essential curriculum needed for preparing advanced practice nurse leaders to effectively assess organizations, identify systemic issues, and facilitate organizational changes. 1 In 2021, AACN updated the curriculum by issuing The Essentials: Core Competencies for Professional Nursing Education to guide the development of competency-based education for nursing students. 1 In addition to AACN’s competency-based approach to curriculum, in 2015 the American Organization of Nurse Leaders (AONL) released Nurse Leader Core Competencies (updated in 2023) to help provide a competency based model to follow in developing nurse leaders. 2

Despite AACN and AONL competency-based curriculum and model, it is still common for nurse leaders to be promoted to management positions based solely on their work experience or exceptional clinical skills, rather than demonstration of management and leadership competencies. 3 The importance of identifying, training, and assessing executive leaders through formal leadership development programs, within supportive organizational cultures has been discussed by national leaders. As well as the need for nurturing emerging leaders through fostering interprofessional collaboration, mentorship, and continuous development of leadership skills has been identified. 4 As Doctor of Nursing Practice (DNP) nurse leaders assume executive roles within healthcare organizations, they play a vital role within complex systems. Demonstration of leadership competence and participation in formal leadership development programs has become imperative for their success. However, models of competency-based executive leadership development programs can be hard to find, particularly programs outside of health care systems.

The implementation of a DNP Leader in Residence program, such as the one designed for The Barbara and Richard Csomay Center for Gerontological Excellence, addresses many of the challenges facing new DNP leaders and ensures mastery of executive leadership competencies and readiness to practice through exposure to varied experiences and close mentoring. The Csomay Center , based at The University of Iowa, was established in 2000 as one of the five original Hartford Centers of Geriatric Nursing Excellence in the country. Later funding by the Csomay family established an endowment that supports the Center's ongoing work. The current Csomay Center strategic plan and mission aims to develop future healthcare leaders while promoting optimal aging and quality of life for older adults. The Csomay Center Director created the innovative DNP Leader in Residence program to foster the growth of future nurse leaders in non-healthcare systems. The purpose of this paper is to present a case study of the development and implementation of the Leader in Residence program, followed by suggested evaluation strategies, and discussion of future innovation of leadership opportunities in non-traditional health care settings.

Development of the DNP Leader in Residence Program

The Plan-Do-Study-Act (PDSA) cycle has garnered substantial recognition as a valuable tool for fostering development and driving improvement initiatives. 5 The PDSA cycle can function as an independent methodology and as an integral component of broader quality enhancement approaches with notable efficacy in its ability to facilitate the rapid creation, testing, and evaluation of transformative interventions within healthcare. 6 Consequently, the PDSA cycle model was deemed fitting to guide the development and implementation of the DNP Leader in Residence Program at the Csomay Center.

PDSA Cycle: Plan

Existing resources. The DNP Health Systems: Administration/Executive Leadership Program offered by the University of Iowa is comprised of comprehensive nursing administration and leadership curriculum, led by distinguished faculty composed of national leaders in the realms of innovation, health policy, leadership, clinical education, and evidence-based practice. The curriculum is designed to cultivate the next generation of nursing executive leaders, with emphasis on personalized career planning and tailored practicum placements. The DNP Health Systems: Administration/Executive Leadership curriculum includes a range of courses focused on leadership and management with diverse topics such as policy an law, infrastructure and informatics, finance and economics, marketing and communication, quality and safety, evidence-based practice, and social determinants of health. The curriculum is complemented by an extensive practicum component and culminates in a DNP project with additional hours of practicum.

New program. The DNP Leader in Residence program at the Csomay Center is designed to encompass communication and relationship building, systems thinking, change management, transformation and innovation, knowledge of clinical principles in the community, professionalism, and business skills including financial, strategic, and human resource management. The program fully immerses students in the objectives of the DNP Health Systems: Administration/Executive Leadership curriculum and enables them to progressively demonstrate competencies outlined by AONL. The Leader in Residence program also includes career development coaching, reflective practice, and personal and professional accountability. The program is integrated throughout the entire duration of the Leader in Residence’s coursework, fulfilling the required practicum hours for both the DNP coursework and DNP project.

The DNP Leader in Residence program begins with the first semester of practicum being focused on completing an onboarding process to the Center including understanding the center's strategic plan, mission, vision, and history. Onboarding for the Leader in Residence provides access to all relevant Center information and resources and integration into the leadership team, community partnerships, and other University of Iowa College of Nursing Centers associated with the Csomay Center. During this first semester, observation and identification of the Csomay Center Director's various roles including being a leader, manager, innovator, socializer, and mentor is facilitated. In collaboration with the Center Director (a faculty position) and Center Coordinator (a staff position), specific competencies to be measured and mastered along with learning opportunities desired throughout the program are established to ensure a well-planned and thorough immersion experience.

Following the initial semester of practicum, the Leader in Residence has weekly check-ins with the Center Director and Center Coordinator to continue to identify learning opportunities and progression through executive leadership competencies to enrich the experience. The Leader in Residence also undertakes an administrative project for the Center this semester, while concurrently continuing observations of the Center Director's activities in local, regional, and national executive leadership settings. The student has ongoing participation and advancement in executive leadership roles and activities throughout the practicum, creating a well-prepared future nurse executive leader.

After completing practicum hours related to the Health Systems: Administration/Executive Leadership coursework, the Leader in Residence engages in dedicated residency hours to continue to experience domains within nursing leadership competencies like communication, professionalism, and relationship building. During residency hours, time is spent with the completion of a small quality improvement project for the Csomay Center, along with any other administrative projects identified by the Center Director and Center Coordinator. The Leader in Residence is fully integrated into the Csomay Center's Leadership Team during this phase, assisting the Center Coordinator in creating agendas and leading meetings. Additional participation includes active involvement in community engagement activities and presenting at or attending a national conference as a representative of the Csomay Center. The Leader in Residence must mentor a master’s in nursing student during the final year of the DNP Residency.

Implementation of the DNP Leader in Residence Program

PDSA Cycle: Do

Immersive experience. In this case study, the DNP Leader in Residence was fully immersed in a wide range of center activities, providing valuable opportunities to engage in administrative projects and observe executive leadership roles and skills during practicum hours spent at the Csomay Center. Throughout the program, the Leader in Residence observed and learned from multidisciplinary leaders at the national, regional, and university levels who engaged with the Center. By shadowing the Csomay Center Director, the Leader in Residence had the opportunity to observe executive leadership objectives such as fostering innovation, facilitating multidisciplinary collaboration, and nurturing meaningful relationships. The immersive experience within the center’s activities also allowed the Leader in Residence to gain a deep understanding of crucial facets such as philanthropy and community engagement. Active involvement in administrative processes such as strategic planning, budgeting, human resources management, and the development of standard operating procedures provided valuable exposure to strategies that are needed to be an effective nurse leader in the future.

Active participation. The DNP Leader in Residence also played a key role in advancing specific actions outlined in the center's strategic plan during the program including: 1) the creation of a membership structure for the Csomay Center and 2) successfully completing a state Board of Regents application for official recognition as a distinguished center. The Csomay Center sponsored membership for the Leader in Residence in the Midwest Nurse Research Society (MNRS), which opened doors to attend the annual MNRS conference and engage with regional nursing leadership, while fostering socialization, promotion of the Csomay Center and Leader in Residence program, and observation of current nursing research. Furthermore, the Leader in Residence participated in the strategic planning committee and engagement subcommittee for MNRS, collaborating directly with the MNRS president. Additional active participation by the Leader in Residence included attendance in planning sessions and completion of the annual report for GeriatricPain.org , an initiative falling under the umbrella of the Csomay Center. Finally, the Leader in Residence was involved in archiving research and curriculum for distinguished nursing leader and researcher, Dr. Kitty Buckwalter, for the Benjamin Rose Institute on Aging, the University of Pennsylvania Barbara Bates Center for the Study of the History of Nursing, and the University of Iowa library archives.

Suggested Evaluation Strategies of the DNP Leader in Residence Program

PDSA Cycle: Study

Assessment and benchmarking. To effectively assess the outcomes and success of the DNP Leader in Residence Program, a comprehensive evaluation framework should be used throughout the program. Key measures should include the collection and review of executive leadership opportunities experienced, leadership roles observed, and competencies mastered. The Leader in Residence is responsible for maintaining detailed logs of their participation in center activities and initiatives on a semester basis. These logs serve to track the progression of mastery of AONL competencies by benchmarking activities and identifying areas for future growth for the Leader in Residence.

Evaluation. In addition to assessment and benchmarking, evaluations need to be completed by Csomay Center stakeholders (leadership, staff, and community partners involved) and the individual Leader in Residence both during and upon completion of the program. Feedback from stakeholders will identify the contributions made by the Leader in Residence and provide valuable insights into their growth. Self-reflection on experiences by the individual Leader in Residence throughout the program will serve as an important measure of personal successes and identify gaps in the program. Factors such as career advancement during the program, application of curriculum objectives in the workplace, and prospects for future career progression for the Leader in Residence should be considered as additional indicators of the success of the program.

The evaluation should also encompass a thorough review of the opportunities experienced during the residency, with the aim of identifying areas for potential expansion and enrichment of the DNP Leader in Residence program. By carefully examining the logs, reflecting on the acquired executive leadership competencies, and studying stakeholder evaluations, additional experiences and opportunities can be identified to further enhance the program's efficacy. The evaluation process should be utilized to identify specific executive leadership competencies that require further immersion and exploration throughout the program.

Future Innovation of DNP Leader in Residence Programs in Non-traditional Healthcare Settings

PDSA Cycle: Act

As subsequent residents complete the program and their experiences are thoroughly evaluated, it is essential to identify new opportunities for DNP Leader in Residence programs to be implemented in other non-health care system settings. When feasible, expansion into clinical healthcare settings, including long-term care and acute care environments, should be pursued. By leveraging the insights gained from previous Leaders in Residence and their respective experiences, the program can be refined to better align with desired outcomes and competencies. These expansions will broaden the scope and impact of the program and provide a wider array of experiences and challenges for future Leaders in Residency to navigate, enriching their development as dynamic nurse executive leaders within diverse healthcare landscapes.

This case study presented a comprehensive overview of the development and implementation of the DNP Leader in Residence program developed by the Barbara and Richard Csomay Center for Gerontological Excellence. The Leader in Residence program provided a transformative experience by integrating key curriculum objectives, competency-based learning, and mentorship by esteemed nursing leaders and researchers through successful integration into the Center. With ongoing innovation and application of the PDSA cycle, the DNP Leader in Residence program presented in this case study holds immense potential to help better prepare 21 st century nurse leaders capable of driving positive change within complex healthcare systems.

Acknowledgements

         The author would like to express gratitude to the Barbara and Richard Csomay Center for Gerontological Excellence for the fostering environment to provide an immersion experience and the ongoing support for development of the DNP Leader in Residence program. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  • American Association of Colleges of Nursing. The essentials: core competencies for professional nursing education. https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf . Accessed June 26, 2023.
  • American Organization for Nursing Leadership. Nurse leader core competencies. https://www.aonl.org/resources/nurse-leader-competencies . Accessed July 10, 2023.
  • Warshawsky, N, Cramer, E. Describing nurse manager role preparation and competency: findings from a national study. J Nurs Adm . 2019;49(5):249-255. DOI:  10.1097/NNA.0000000000000746
  • Van Diggel, C, Burgess, A, Roberts, C, Mellis, C. Leadership in healthcare education. BMC Med. Educ . 2020;20(465). doi: 10.1186/s12909-020-02288-x
  • Institute for Healthcare Improvement. Plan-do-study-act (PDSA) worksheet. https://www.ihi.org/resources/Pages/Tools/PlanDoStudyActWorksheet.aspx . Accessed July 4, 2023.
  • Taylor, M, McNicolas, C, Nicolay, C, Darzi, A, Bell, D, Reed, J. Systemic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ Quality & Safety. 2014:23:290-298. doi: 10.1136/bmjqs-2013-002703

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  11. Developing a model for effective leadership in healthcare: a concept

    The purpose of the paper is to present the research process that resulted in the Duke Healthcare Leadership Model, as shown in Figure 1. Open in a separate window. Figure 1. ... We designed a leadership model specific to healthcare using concept mapping. The research led to a model based on the core principle of Patient Centeredness and core ...

  12. Leadership in the Implementation of Change: Functions, Sources, and

    Introduction. The view that leadership is essential to the successful implementation of change is central in the literature on organizational change (e.g. Burke, Citation 2017; Kotter, Citation 1996; Nadler & Tushman, Citation 1990).Such a view seems warranted, given that leadership occurs in the context of change (Burke, Citation 2017) in the extensive literature on the relationship of day-to ...

  13. Leadership: A Comprehensive Review of Literature, Research and

    This paper provides a comprehensive literature review on the research and theoretical framework of leadership. The author illuminates the historical foundation of leadership theories and...

  14. (PDF) A systematic review of studies on leadership models in

    The number of papers on leadership models in education research (1980-2014). Content uploaded by Sedat Gümüş Author content Content may be subject to copyright. ... The past two decades...

  15. The many faces of leadership: Proposing research agenda through a

    Definitions and models of leadership Organizational leadership is a multidisciplinary field and has been the area of interest to the scholars from a wide variety of backgrounds, i.e. sociology, psychology, management, education, political science, and organizational studies.

  16. Journal of Leadership & The Influence of Transformational

    Transformational leadership is one of the most widely stud-ied styles of leadership (Avolio, Walumbwa, & Weber, 2009) and has been recognized as an effective style to address organizational tensions and aid in overall perfor-mance (Bass & Riggio, 2006). Specifically, the literature on transformational leadership has demonstrated its positive

  17. The complexity of leadership in coproduction practices: a guiding

    The aims of this review are to explore models of coproduction leadership and the processes involved in leading coproduction as well as, based on that exploration, to develop a guiding framework for coproduction practices. ... (n = 66), while the remainder of the papers were on research (n = 4) or policy (n = 3). The papers drew on evidence ...

  18. Ethical leadership: A review and future directions

    Finally, ethical leadership should be associated with a number of positive follower attitudes. A review of transformational leadership research found that leaders' high ratings on transformational leadership are associated with followers' satisfaction, commitment, and motivation (Lowe, Kroeck, & Sivasubramaniam, 1996).

  19. Leadership Theories and Styles: A Literature Review

    Many researchers and practitioners have developed a consensus that the progression of thinking over the years has developed a belief that leadership is a flexible developmental process, with each...

  20. The New Leadership Model: The Rise Of New Roles For Leaders In The DEI

    We propose a new model of leadership that can help develop leadership in the DEI world. ANNOUNCEMENT. 2022 Impact Factor 1-YEAR. 10.00. 5-YEAR. 13.50. About ... him the Business - Postgraduate Programme Prize and CMCE (Centre for Management Consulting Excellence-UK) for his paper in Technology and consulting Research Prize.

  21. Servant Leadership: A systematic literature review—toward a model of

    Origins of "modern" servant leadership in the 1970s: the role of Robert Greenleaf The term "servant leadership" originates from the American consultant Robert Greenleaf who published three pathbreaking essays which still influence the research field today (Parris and Peachey, 2012a, 2012b): • The Servant as a Leader (Greenleaf, 1970)

  22. Leadership Research Paper

    This sample leadership research paper features: 7900 words (approx. 26 pages), an outline, and a bibliography with 38 sources. Browse other research paper examp ... A third contingency approach is the normative and descriptive model of leadership and decision making developed by Vroom and his colleagues (see Vroom & Jago, 2007). This approach ...

  23. Crisis leadership from the perspective of employees during the COVID-19

    Purpose: The purpose of the paper is to identify traits and behaviors of organization leaders that were deemed helpful by employees during the COVID-19 pandemic. Design/methodology/approach: This is an exploratory qualitative study that utilized online surveys. Data from 155 participants were subjected to content analysis. Findings: Several interrelated traits and behaviors of effective crisis ...

  24. (PDF) Leadership Model

    ... However, the business world is changing rapidly with the advancement in information technology and many organizations as Riordan Manufacturing (RM) transformed to a global organization....

  25. Driving change: a case study of a DNP leader in residence program in a

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  26. The analysis of situational leadership models: origin, divergence and

    The purpose of this paper is to analyse the development and application of situational leadership model, to consider perspectives to reduce the gap in previous research and to elaborate...