Clinical leadership proficiency is uneven in different domains and therefore calls for more emphasis on strategic leadership education in nursing profession students through leadership learning and competency-based education.
Abstract
Background: Being a key competency for nurses to deliver quality care to patients, clinical leadership is important for providing safe, high-quality, and patient-centered care. Nonetheless, information on the clinical leadership competencies specific to domains for nursing profession students has been scanty, especially in Indonesia.
Purpose: The purpose of this research is to ascertain the priority domains of competencies in clinical leadership among students of the nursing profession through CLCF and explore its implications in nursing education.
Methods: In the current research, a quantitative descriptive study with a cross-sectional design was carried out on 123 students of nursing profession in Jakarta, Indonesia, employing total sampling technique. Competence of clinical leadership was measured through 40 items Clinical Leadership Competency Framework (CLCF) which is made up of five domains. These domains include; Demonstrating Personal Qualities, Working with Others, Managing Services, Improving Services, and Setting Direction.
Results: The nursing students demonstrated moderate proficiency in the aspect of clinical leadership. The mean scores for the five domains of CLCF ranged from 2.33 to 2.67; the mean score of 2.67 was achieved in the domain of Managing Services, while 2.65 in Demonstrating Personal Qualities, 2.59 in Working with Others, 2.56 in Improving Services, and 2.33 in Setting Direction. None of the subjects demonstrated high proficiency in all five domains.
Conclusion: Clinical leadership proficiency is uneven in different domains and therefore calls for more emphasis on strategic leadership education. It would be useful to develop competencies in the aspect of Setting Direction through leadership learning and competency-based education.
Contemporary nursing education must cultivate leadership competencies alongside clinical skills to meet evolving healthcare demands. A cross-sectional methodological study of 469 nursing students was conducted. Data were collected via Clinical Learning Environment, Supervision, and Nurse Teacher (CLES +T) Evaluation Scale and the Educational Leadership Scale. More than 92% of participants reported positive perceptions of their clinical learning environment, with the highest satisfaction related to supervision and ward leadership. Factor analysis validated the three-factor structure of leadership development: visionary, instructional, and scientific leadership, explaining 64% of the total variance. The overall CLES +T score was strongly and positively correlated with overall leadership development (r = 0.718, p < 0.001). Supervisor relationship (r = 0.777), pedagogical atmosphere (r = 0.764), and the role of the nurse teacher (r = 0.770) demonstrated strong positive correlations. Additionally, significant positive correlations were observed among all leadership dimensions, with the strongest association between visionary and instructional leadership (r = 0.694, p < 0.01). Supportive clinical learning environments are strongly associated with leadership development in nursing students, emphasizing the need for curriculum designs that integrate mentorship and structured leadership training.
Sheela Upendra, Jasneet Kaur, Joyce Robert Mathivanan· Nursing and Health Sciences· 0 citations
Background: Clinical leadership competency is an important aspect of nursing practice, particularly for supporting coordinated care, effective teamwork, and sound clinical decision-making. Understanding the level of clinical leadership competency among registered nurses can help identify areas for further professional development. This study aimed to determine the level of clinical leadership competency and examine its associations with selected demographic and professional characteristics among registered nurses working in neuro units of a tertiary hospital in Riyadh, Saudi Arabia.
Methods: A quantitative descriptive cross-sectional study was conducted among 81 registered nurses. Data were obtained using a structured questionnaire that included a researcher-modified version of the Leadership Practices Inventory (LPI) Self-Assessment developed by Kouzes and Posner. The modified 40-item questionnaire assessed four clinical leadership competency domains: Demonstrating Personal Attributes, Working with Others, Duty Management, and Setting Direction & Making Decisions. Participant characteristics and competency scores were summarized using descriptive statistics. Inferential statistical tests were applied to examine associations between selected demographic and professional characteristics and the clinical leadership competency domains. Statistical significance was considered at p < 0.05. The internal consistency of the modified questionnaire was evaluated using Cronbach’s alpha.
Results: Among the 81 participants, 48 (59.3%) demonstrated excellent overall clinical leadership competency, 32 (39.5%) demonstrated good competency, and 1 (1.2%) was classified as developing. The highest proportion of excellent competency was observed in Duty Management (63.0%), followed by Working with Others (60.5%) and Setting Direction & Making Decisions (53.1%). Demonstrating Personal Attributes had comparable proportions of participants with good (49.4%) and excellent (48.1%) competency. The overall mean clinical leadership competency score was 85.5 ± 6.9, while Duty Management recorded the highest domain mean (86.7 ± 7.8). Shift leadership role was significantly associated with Duty Management (p = 0.022) and Setting Direction & Making Decisions (p = 0.018). Nationality was significantly associated with Setting Direction & Making Decisions (p = 0.048). No significant associations were identified between the competency domains and age, gender, educational level, or years of nursing experience. The modified questionnaire demonstrated high internal consistency, with a Cronbach’s alpha of 0.943.
Conclusion: The participating registered nurses demonstrated a high level of clinical leadership competency overall, with Duty Management emerging as the highest-scoring domain. Shift leadership role was associated with competency in Duty Management and Setting Direction & Making Decisions. These findings support the provision of appropriate opportunities for nurses to undertake clinical leadership responsibilities and participate in structured professional development. As the study employed a cross-sectional design, the observed associations cannot be interpreted as causal relationships. Further longitudinal and interventional research is recommended to determine whether structured leadership opportunities are associated with changes in clinical leadership competency over time.
Dr. Premalatha Jayachandra, Ahmed Alrasheedi, Badryah Alrasheedi et al.· Adolescência e Saúde· 0 citations
INTRODUCTION
Specialization in nursing is essential to enhance effectiveness, quality, and accessibility of healthcare. Barriers to implementing advanced practice nurses and specialist nurses have been widely reported to limit advanced practice roles in many countries. Identifying these barriers and promoting integration of the role requires an understanding of stakeholders' perspectives. The current study aimed to explore barriers to implementing specialist and advanced specialist nursing roles in Jordan from the perspective of nursing regulators, nursing leaders, and nursing educators.
METHODS
A qualitative descriptive design was used to collect data from a purposive sample of 23 nursing stakeholders from the private and public sectors. Data were collected through in-depth semi-structured interviews using an interview guide developed specifically for this study. Sample adequacy was guided by data saturation. Inductive thematic analysis following Braun and Clarke's 6-step approach was used.
RESULTS
Based on the participants' narratives, findings were classified into four main themes and six sub-themes: (1) Policy and Regulatory Constraints, with two sub-themes: Scope of Practice limitations and Role Ambiguity, (2) Knowledge and Skill Gaps with two sub-themes: Incompetent Graduates and the Nature of Educational Programs, (3) Organizational and Administrative Obstacles with two sub-themes: Inefficient Management Structures and Burdens, and (4) the Reluctance to Implement. In addition, participants proposed recommendations and approaches such as clarifying scope of practice, defining roles, curricular reforms, and creating a supportive organization to facilitate effective role implementation.
CONCLUSION
This study demonstrates that implementation of specialist and advanced specialist roles in Jordan is constrained by educational, regulatory organizational structure gaps, and absence of coordinated policy alignment across all levels. Establishing a collaborative implementation model supported by effective policies is crucial to assist healthcare institutions in overcoming obstacles and barriers and to support the specialized roles in Jordan.
M. Gharaibeh, Rabia S. Allari, Safa A Al-Ashram et al.· Journal of Nursing Scholarsh...· 0 citations
Objective: This study aimed to identify the degree of influence of clinical educators for improving clinical nursing competencies of new graduate nurses assigned in intensive care unit (ICU) and also to suggest ways to educate new graduate nurses in the ICU. Materials and Methods: A self-administered, unmarked web-based questionnaire survey method was employed. The quality of clinical educators was measured using the Clinical Educator Quality Scale, and the clinical nursing competency of new graduate nurses was measured using the Clinical Nursing Competence Self-Assessment Scale (CNCSS). Multiple regression analysis was performed with the four CNCSS factors as dependent variables and clinical educator quality and personal and organizational background as independent variables. Results: A total of 125 participants responded to the survey; 57 (45.6%) were admitted to the ICU, while 68 (54.4%) to the surgical ward. In the ICUs, the “competence in basic nursing practice”, “competence in coordinating the care environment and team system”, and “competence in studying in nursing practice” influenced the attitude toward new graduate nurses. In the surgical wards, ‘sex and leadership’ influenced “competence in basic nursing practice”, and “competence in developing nursing care”. A supervisor who monitors their daily work and supports their job affected “competence in coordinating the care environment and team system” and “competence in studying nursing practice”. Conclusion: We identified distinct factors that affected clinical nursing competence in ICUs and surgical wards. Therefore, new graduate nurses must be educated with different emphases, particularly in the ICUs.
Toru Miyake, Masato Yoshioka, Midori T. Kaga et al.· Journal of Rural Medicine· 0 citations
Introduction Interprofessional collaboration between nurses and physicians is essential for effective patient care, safe clinical workflows, and patient-centered outcomes. Despite its importance, interprofessional knowledge is insufficiently integrated into German medical education, potentially limiting students’ readiness for collaborative practice and their understanding of professional roles in clinical settings. This study explored how medical students perceive nurses’ work, nursing-related learning experiences, and interprofessional collaboration and Role Understanding within undergraduate medical education. Methods Fourteen medical students (1st–6th year) at the University of Magdeburg participated in semi-structured interviews recruited using purposive sampling to ensure variation across study years. Transcripts were analyzed using Mayring’s qualitative content analysis to identify categories and themes. Analytical rigor was ensured through independent coding and interdisciplinary validation in a research workshop. Results Seven themes were identified: Interprofessional Collaboration and Role Understanding, First Clinical Experiences, Nursing During the Practicum, Nursing-Related Learning Experiences During Medical School, Desired Nursing-Related Learning Experiences, Importance of Nursing, and Patient Well-being. The mandatory nursing practicum emerged as a key formative experience shaping early interprofessional role understanding. Students reported variability in supervision and structure, alongside limited curricular integration of nursing content. While interprofessional collaboration was considered essential, participants expressed uncertainty regarding nursing roles and responsibilities and emphasized the need for structured opportunities for interprofessional and nursing-related learning, including clinical skills, communication, and management of complex patient situations. Conclusion Medical students’ perceptions of nursing are strongly shaped by early and variably structured clinical experiences, particularly the nursing internship. The findings suggest that current medical curricula insufficiently support the systematic development of interprofessional role understanding. The structured integration of nursing-related learning experiences and explicit teaching about nursing roles, nursing-related practical skills and clinical workflows into medical education may strengthen interprofessional collaboration and support patient-centered care.
Lukas Valerius, Jonathan Hagedorn, Christian Albert et al.· Frontiers in Medicine· 0 citations
Objective: To elaborate and present an integrated conceptual definition of clinical leadership in nurses, empowering, based on the results of a systematic literature review.
Methodology: This study used Walker and Avant’s approach, which consisted of eight systematic steps. The literature search was conducted using electronic data from PubMed, Scopus, Science Direct, Sage Journal, ClinicalKey Nursing, and Proquest published from 2021 until 2025.
Results: An integrated conceptual framework identified three key antecedents (structural empowerment, supportive leadership climate, clinical leadership capabilities) and four core attributes, including transformational influence, enabling empowerment, relational and collaborative competencies, and ethical and professional integrity. The consequences include nurse well-being and growth, clinical excellence and safety, innovation and service improvement.
Conclusion: This conceptual analysis resulted in an integrated clinical leadership framework, conceptualizing clinical leadership in nurse empowerment as a system-level construct with interdependent components. These findings provide a strong theoretical foundation for the development of valid measurement instruments and the design of targeted interventions in clinical settings.
Mazly Astuty, T. Hariyati, Tuti Nuraini et al.· Rawal Medical Journal· 0 citations
