Leadership and teamwork in medical emergencies: Performance of nursing students and registered nurses in simulated patient scenarios

Aims and objectives: To examine nursing students' and registered nurses' teamwork skills whilst managing simulated deteriorating patients. Background: Studies continue to show the lack of timely recognition of patient deterioration. Management of deteriorating patients can be influenced by education and experience. Design: Mixed methods study conducted in two universities and a rural hospital in Victoria, and one university in Queensland, Australia. Methods: Three simulation scenarios (chest pain, hypovolaemic shock and respiratory distress) were completed in teams of three by 97 nursing students and 44 registered nurses, equating to a total of 32 student and 15 registered nurse teams. Data were obtained from (1) Objective Structured Clinical Examination rating to assess performance; (2) Team Emergency Assessment Measure scores to assess teamwork; (3) simulation video footage; (4) reflective interview during participants' review of video footage. Qualitative thematic analysis of video and interview data was undertaken. Results: Objective structured clinical examination performance was similar across registered nurses and students (mean 54% and 49%); however, Team Emergency Assessment Measure scores differed significantly between the two groups (57% vs 38%, t = 6·841, p < 0·01). In both groups, there was a correlation between technical (Objective Structured Clinical Examination) and nontechnical (Team Emergency Assessment Measure) scores for the respiratory distress scenario (student teams: r = 0·530, p = 0·004, registered nurse teams r = 0·903, p < 0·01) and hypovolaemia scenario (student teams: r = 0·534, p = 0·02, registered nurse teams: r = 0·535, p = 0·049). Themes generated from the analysis of the combined quantitative and qualitative data were as follows: (1) leadership and followership behaviours; (2) help-seeking behaviours; (3) reliance on previous experience; (4) fixation on a single detail; and (5) team support. Conclusions: There is scope to improve leadership, team work and task management skills for registered nurses and nursing students. Simulation appears to be beneficial in enabling less experienced staff to assess their teamwork skills. Relevance to clinical practice: There is a need to encourage less experienced staff to become leaders and for all staff to develop improved teamwork skills for medical emergencies.

A very short fairly interesting and reasonably cheap book about studying leadership

In teaching you how to critically appraise and work with leadership theories rather than faithfully accept them, this book will not merely make you a better student of leadership; it could make you a better leader too.

Business leadership development in China

This book argues that China's businesses, and hence China's future economic development, face a huge crisis in that there is a considerable "leadership gap" in China, with a shortage of competent business leaders, at a time when new ...

Making sense of business leadership vis-à-vis china’s reform and transition

Purpose – The purpose of this paper is to explore the contemporary paradigm of business leadership vis-à-vis China’s reform and transitional context. Design/methodology/approach – The paper employs an evidence-based approach to explore the business leadership issues influenced by economic reform and within the context of societal transition in China. A qualitative research method was adopted based on in-depth interviews with a number of middle managers from a variety of Chinese enterprises, including state-owned, domestic-private and foreigninvested enterprises. Content analysis of several rounds of interviews added depth to the data analysis. Findings – The findings complement existing thoughts and illustrate concepts, issues, and characteristics not yet emphasized in mainstream literature. General patterns and associated characteristics of business leadership in China, as well as specific patterns associated with different forms of enterprise ownerships, are identified. Research limitations/implications – The study makes a timely and necessary contribution that enriches context-specific understandings of business leadership against the backdrop of surrounding economic, social, and cultural changes. Practical implications – The study enriches understandings of commonalities and differences in leadership across the globe, facilitating working collaboratively to achieve common goals in a global community. Originality/value – The study offers new insights into business leadership by linking contextual, personal, and cognitional factors together and demonstrates some unique characteristics of leadership styles in transitional economies like China.

I can see clearly now the moderating effects of role clarity on subordinate responses to ethical leadership

© Emerald Group Publishing Limited. Purpose – Although there is growing research on the relationship between ethical leadership and subordinate work behaviors, limited research has examined the boundary conditions under which ethical leadership is more or less effective. The purpose of this paper is to investigate whether subordinate perceptions of role clarity in their job role influence the relationship between ethical leadership and subordinate work behaviors. Drawing on both social exchange and social learning theories, the authors predict that in contexts where subordinates perceive low levels of role clarity, the relationship between ethical leadership behavior and subordinate helping and deviant behaviors will be weaker. Design/methodology/approach – In total, 239 employees in the Chinese public sector completed surveys across three separate time points. Confirmatory factor analysis and hierarchical regression analysis were used to analyze the data. Findings – Analyses provided support for the hypothesized relationships. When subordinates perceived higher levels of role clarity the positive relationship between ethical leadership and helping behavior was stronger, and the negative relationship between ethical leadership and deviant behavior was stronger. Research limitations/implications – As with all research the findings of this study need to be viewed in light of its limitations. First, the use of data from a single set of respondents opens up the possibility of common method bias. Second, given the study used of a sample of public sector employees from one part of China, there would be value in future research examining whether the findings from the present study are generalizable to other industrial and cultural contexts. Practical implications – This research has a number of practical implications. Given that the authors found a significant positive relationship between ethical leadership and helping behavior, and a significant negative relationship between ethical leadership and deviant behavior, it is crucial for organizations to include ethical training as an essential part of leadership development programs. However, the findings also suggest at the same time as facilitating the development of ethical leadership behaviors amongst supervisory employees, it is important for organizations to also provide employees with clarity over what is expected of them in their jobs, and the means they should employ to facilitate goal achievement. Originality/value – This study responds to recent calls for more research to identify factors which may strengthen or mitigate the influence of ethical leadership in the workplace.

How servant leadership influences organizational citizenship behavior: the roles of LMX, empowerment, and proactive personality

© 2015 Springer Science+Business Media Dordrecht While the link between servant leadership and organizational citizenship behavior (OCB) has been established, the individual-level mechanisms underlying this relationship and its boundary conditions remain poorly understood. In this study, we investigate the salience of the mediating mechanisms of leader–member exchange (LMX) and psychological empowerment in explaining the process by which servant leaders elicit discretionary OCB among followers. We also examine the role of followers’ proactive personality in moderating the indirect effects of servant leadership on OCB through LMX and psychological empowerment. Analysis of survey data collected from 446 supervisor–subordinate dyads in a large Chinese state-owned enterprise suggests that while servant leadership is positively related to subordinate OCB through LMX, psychological empowerment does not explain any additional variance in OCB above that accounted for by LMX. Moderated mediation tests confirm the moderating effect of proactive personality through LMX. By providing a nuanced understanding of how and when servant leadership leads followers to go above and beyond their job role, our study assists organizations in deciding how to develop and utilize servant leaders in their organizations.

Examining the cognitive and affective trust-based mechanisms underlying the relationship between ethical leadership and organisational citizenship: A case of the head leading the heart?

In this paper, we investigate the trust-based mechanisms underlying the relationship between ethical leadership and followers' organisational citizenship behaviours (OCBs). Based on three-wave survey data obtained from 184 employees and their supervisors, we find that ethical leadership leads to higher levels of both affective and cognitive trust. In addition, we find support for a three-path mediational model, where cognitive trust and affective trust, in turn, mediate the relationship between ethical leadership and follower OCBs. That is to say, we found that ethical leadership leads to the development of cognitive trust, which subsequently influences the development of affective trust. Affective trust, in turn, induces followers to exhibit OCBs as a means of reciprocating the leader's favourable behaviour. Our findings suggest that both affective and cognitive trust plays an important role in the social exchange processes that underlie the relationship between ethical leadership and the discretionary behaviour of followers. © 2013 Springer Science+Business Media Dordrecht.

Participative leadership and the organizational commitment of civil servants in China: The mediating effects of trust in supervisor

The present study examines whether participative leadership engenders organizational commitment amongst Chinese civil servants and analyses the mechanisms by which it transmits its effects. Confirmatory factor analysis and structural equation modelling revealed that there was a significant relationship between supervisor-level participative leadership and the affective and normative commitment of subordinates, but no relationship with continuance commitment. Affective trust was also identified as the mediator variable underlying the relationship between participative leadership and organizational commitment. We show that participative leadership of supervisors elicits higher levels of trust and leads subordinates to reciprocate through exhibiting higher levels of organizational commitment. Our study also reveals that Chinese civil servants who accept an unequal distribution of power between supervisors and subordinates typically exhibit lower levels of affective and normative commitment to the organization than those who do not. Our results provide greater support for the deepening of administrative reforms and the dissemination of participative leadership practices in China's new civil service system. © 2013 British Academy of Management.

The relationship between ethical leadership and unethical pro-organizational behavior: linear or curvilinear effects?

In this study, we examine the nature of the relationship between ethical leadership and unethical pro-organizational behavior (UPB), defined as unethical behavior conducted by employees with the aim of benefiting their organization, and whether the strength of the relationship differs between subordinates experiencing high and low identification with supervisor. Based on three-wave survey data obtained from 239 public sector employees in China, we find that ethical leadership has an inverted u-shaped (curvilinear) relationship with UPB. As the level of ethical leadership increases from low to moderate, UPB increases; as the level of ethical leadership increases from moderate to high, UPB decreases. Further, we find that the strength of this inverted u-curve relationship differs between subordinates with high and low identification with supervisor. That is to say, the inverted u-shaped relationship between ethical leadership and UPB was stronger when subordinates experienced high levels of identification with supervisor. The theoretical and managerial implications of our findings for understanding how to manage UPB in an organizational context are discussed. © 2012 Springer Science+Business Media Dordrecht.

Transformational leadership and job involvement in the Middle East: the moderating role of individually held cultural values

This study examines whether individually held cultural values moderate the relationship between transformational leadership behavior of supervisors and the job involvement of subordinates in the Middle Eastern organizational context. Hierarchical regression analysis was used to analyze survey data from 229 employees of 10 organizations in the United Arab Emirates. In line with the findings of studies in Western countries, transformational leadership was found to influence job involvement positively. In addition, the cultural value orientations of individuals were found to moderate this relationship. Collectivism positively influenced the relationship between transformational leadership and job involvement, whereas uncertainty avoidance had a negative effect. These findings provide an insight into how transformational leadership may be used to motivate culturally diverse groups of employees within the Middle East. To enhance job involvement, organizations need to realize that the attitudinal response of subordinates to transformational leadership can depend on their cultural values. This has significant implications regarding the training and effective deployment of transformational leaders within Middle Eastern organizations.

Transformational leadership and the work outcomes of Chinese migrant workers: The mediating effects of identification with leader

This study examines the mediating influence of identification with leader on the relationship between follower perceptions of transformational leadership behavior and their work outcomes, using data obtained from migrant workers and their supervisors in a large manufacturing company located in south-eastern China. Hierarchical regression analysis revealed that transformational leadership was positively related to the affective commitment and job performance of followers, and negatively related to their turnover intentions. In contrast, no significant influence was found of transformational leadership on the innovative behavior of followers. Subsequent analysis revealed that identification with leader mediated the relationship between transformational leadership and follower attitudes, but did not mediate the relationship between transformational leadership and follower job performance. These findings highlight the importance of cultural and wider contextual influences on the processes by which leadership impacts on the work outcomes of migrant workers in the Chinese manufacturing industry. The managerial implications of these findings are discussed and suggestions for future research provided.

Servant leadership, trust, and the organizational commitment of public sector employees in China

© 2014 John Wiley & Sons Ltd. So-called servant leaders strive selflessly and altruistically to assist others before themselves, work to develop their followers' greatest potential, and seek to benefit the wider community. This article examines the trust-based mechanisms by which servant leadership influences organizational commitment in the Chinese public sector, using data from a survey of civil servants. Quantitative analysis shows that servant leadership strongly influences affective and normative commitment, while having no impact on continuance commitment. Furthermore, we find that affective trust rather than cognitive trust is the mechanism by which servant leadership induces higher levels of commitment. Our findings suggest that in a time of decreasing confidence levels in public leaders, servant leadership behaviour may be used to re-establish trust and create legitimacy for the Chinese civil service.