Leadership Scores Research Articles

Relationship Between Residents’ Physiological Stress and Faculty Leadership Skills in a Department of Surgery

Leadership skills of team leaders can impact the functioning of their teams. It is unknown whether attending surgeons' leadership skills impact residents' physiological stress. This study sought to (1) assess the relationship between attending surgeons' leadership skills and residents' physiological stress and (2) to characterize lifestyle behaviors associated with resident physiological stress. We hypothesized that strong attending leadership skills would be associated with low resident physiological stress. This prospective observational cohort study was conducted at a single urban, academic medical center in the US, over 12 months. Residents were enrolled during their rotation of 1 to 2 months on the Trauma and ICU services. The primary predictor was the attending surgeons' leadership skills that were measured using a weekly survey filled out by residents, using the Surgeons' Leadership Inventory (SLI). The SLI uses a 4-point Likert scale to measure surgeons' leadership skills across eight domains. The primary outcome was residents' physiological stress, which was measured by their Heart Rate Variability (HRV). We recorded the residents' HRV with a WHOOP strap that was continuously worn on the wrist or the bicep. We used multivariate repeated measures gamma regression to assess the relationship between attending leadership skills and residents' physiological stress, adjusting for hours of sleep, age, and service. Sixteen residents were enrolled over 12 months. The median attending surgeons' leadership score was 3.8 (IQR: 3.2-4.0). The median residents' percent of maximal HRV was 70.8% (IQR: 56.7-83.7). Repeated measure gamma regression model demonstrated a minimal nonsignificant increase of 1.6 % (95% CI: -5.6, 8.9; p-value = 0.65) in the percent of maximal HRV (less resident physiological stress) for every unit increase in leadership score. There was an increase of 2.9% (95% CI= 1.6, 4.2; p-value < 0.001) in the percent of maximal HRV per hour increase in sleep and a significant decrease of 10.9% (95% CI= -16.8, -5.2; < 0.001) in the percent of HRV when working in the ICU compared to the Trauma service. This study revealed that more residents' sleep was associated with lower physiological stress. Attending surgeons' leadership skills were not associated with residents' physiological stress.

Who is the real team leader? Comparing leadership performance of the team leader and CPR Coach during simulated cardiac arrest

PurposeTo describe the leadership performance of team leaders and CPR Coaches, and to determine if there is a correlation between leadership scores and CPR performance during management of simulated pediatric cardiac arrest events. MethodsThis is a secondary analysis of data from a prior randomized controlled trial. We observed the performance of both team leaders and CPR coaches during the management of an 18-minute simulated cardiac arrest scenario which was run for 20 resuscitation teams comprised of CPR-certified professionals from four pediatric tertiary care centers. CPR Coaches were responsible for providing real-time verbal feedback of CPR performance to compressors. Two raters were trained to use the Behavioral Assessment Tool (BAT) to assess leadership performance of the team leader and CPR Coach. BAT scores of team leaders and CPR coaches were compared and linked with objective CPR performance. ResultsThere was no significant difference between the BAT scores of team leaders and CPR coaches (median score 27/40 vs 28.8/40, p = 0.16). Higher BAT scores of team leaders were significantly associated with higher percentage of excellent CPR (r = 0.52, p = 0.02), while higher BAT scores of CPR coaches were significantly associated with higher chest compression fraction (r = 0.48, p = 0.03). ConclusionsBoth team leaders and CPR coaches have similarly high leadership performance during the management of simulated cardiac arrest. Leadership behaviors were associated with quality of CPR performance.Clinical Trial Registration: Registration ID: NCT02539238; https://www.clinicaltrials.gov.

The relationship between ethical leadership and nurse well-being: The mediating role of workplace mindfulness.

The purpose of this study was to explore the relationship between nurses' well-being and their ethical leadership, and the mediating role of workplace mindfulness in this relationship. This was a quantitative cross-sectional study. This cross-sectional study was conducted in three tertiary hospitals in central China from May 2022 to July 2022, and the Nurses' Workplace Mindfulness, Ethical Leadership and Well-Being Scale were distributed and collected via the Internet. A total of 1579 nurses volunteered to participate in this study. SPSS 26.0 statistical software was used to analyse the data by Z-test and Spearman's rank correlation; the internal mechanism of workplace mindfulness and ethical leadership on nurses' well-being was completed by AMOS 23.0 statistical software. The scores of nurses' well-being, workplace mindfulness and ethical leadership were 93.00 (81.00, 108.00), 96.00 (80.00, 112.00) and 73.00 (67.00, 81.00) respectively. The professional title, age and department atmosphere affect their well-being. Spearman's analysis showed that nurses' well-being was positively correlated with ethical leadership (r = .507, p < .01) and workplace mindfulness (r = .600, p < .01); workplace mindfulness partially mediated the relationship between ethical leadership and nurses' well-being accounting for 38.5% of the total effect ratio [p < .001, 95% CI = (0.215, 0.316)]. Nurses' well-being was at a medium level, and had a higher score in ethical leadership and workplace mindfulness, and workplace mindfulness played a partial mediating role between ethical leadership and nurses' well-being. This suggests that nursing managers need to pay attention to clinical nurses' well-being experience, actively focus on the relationship among ethical leadership, workplace mindfulness and well-being and integrate core values such as positivity and morality into nurses' daily routines, so as to improve the work enthusiasm and well-being experience of clinical nurses, enhancing the nursing quality and stabilizing the nursing team.

Leveling Entrepreneurial Skills of Vocational Secondary School Students in Indonesia: Impact of Demographic Characteristics

Context: This article aims to determine the entrepreneurial skills of Vocational Secondary School students after the implementation of a new curriculum that promotes entrepreneurship courses in Indonesia. The authors believe that after taking such courses, students will be able to generate entrepreneurial skills. This study also explores the effect of demographic characteristics on students' entrepreneurship skills level, especially with respect to gender, school, and family. Approach: This study used a quantitative approach, with data collected through a questionnaire with five variables, that is, leadership, reflective communication, risk-taking, creatively innovative, and future orientation. Data were collected from 463 students who had taken entrepreneurship subjects that were chosen randomly. Data were analyzed using linear regression. Findings: 52.22% of our respondents had a moderate score for entrepreneurial skills, this is not in accordance with the expected learning outcomes, there are students who have entrepreneurial skills at a high level. With respect to creative innovation, in particular, a majority (53.15%) had a low score and 4.1% had a very low score. Moreover, family had a significant and positive effect on all dependent variables (leadership scores, reflective communication scores, risk-taking scores, creatively innovative scores, future orientation scores, and overall entrepreneurial skills scores). School demographic characteristics had a significant positive effect on the value of future orientation. These results indicate that private schools tend to strengthen the level of reflective communicative scores. Conclusion: The entrepreneurial skills of most vocational students are middling. This indicates that entrepreneurship subjects at Vocational Secondary schools have not been able to achieve their expected learning outcomes or help students develop entrepreneurial skills at a high level. Thus, further research is needed to determine the causes behind the problem. Schools are expected to be able to establish harmonious relationships by involving families to support the improvement of an informal learning environment that supports the mastery of entrepreneurial skills of vocational students.

Analysis of Civil Servant Discipline Control at the Education and Culture Office of Central Sulawesi Province

This study aims to determine and analyze the effectiveness of employee discipline supervision at the Education and Culture Office of Central Sulawesi Province. The sample for this research was 66 civil servants spread across every field in the Education and Culture Office of Central Sulawesi Province. The results showed that supervision at the Education and Culture Office of Central Sulawesi Province had been running effectively because the average total score of the variable leadership and employee discipline questionnaire was 4.2. Therefore the reports collected detail all program activities that will be carried out, those that are realized, and the budget that is used on time so that employees at the Education and Culture Office of Central Sulawesi Province have implemented Government Regulation no. 53 of 2010 concerning employee discipline. This can also be seen in entering and leaving work, honesty, thoroughness, and employees being responsible for their work.

Relationships between leadership behaviour of nurse managers and nurses' levels of job satisfaction and compassion fatigue during the COVID-19 pandemic.

To reveal the relationships between the leadership behaviour of nurse managers and nurses' levels of job satisfaction and compassion fatigue during the COVID-19 pandemic. This descriptive and cross-sectional study was performed with 353 nurse professionals participating from 32 cities across Turkey. The data were collected online between August and November 2020 by using the introductory information form, Minnesota Satisfaction Questionnaire, Leadership Behaviour Questionnaire and Compassion Fatigue subdimension of the Professional Quality of Life Scale. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed in the study. Nurses mostly stated their managers as employee-oriented and change-oriented leaders. Nurses' intrinsic and overall satisfaction was high, extrinsic satisfaction was low and their compassion fatigue was at a critical level during the pandemic. According to nurses' personal and professional characteristics, there were significant differences in job satisfaction, compassion fatigue and change-oriented leadership scores. When nurse managers exhibit employee-oriented leadership behaviour, nurses' compassion fatigue decreases and job satisfaction increases.

Differences in humble leadership and team performance in nursing: an online cross-sectional study

ObjectivesThe current study measures the differences in humble leadership and team performance in nursing based on the sample’s characteristics.DesignA cross-sectional study.SettingIn 2022, the current study sample was recruited from governmental...

Leadership Behavior Associations with Domains of Safety Culture, Engagement, and Health Care Worker Well-Being.

Leadership is a key driver of health care worker well-being and engagement, and feedback is an essential leadership behavior. Methods for evaluating interaction norms of local leaders are not well developed. Moreover, associations between local leadership and related domains are poorly understood. This study sought to evaluate health care worker leadership behaviors in relation to burnout, safety culture, and engagement using the Local Leadership scale of the Safety, Communication, Operational Reliability, and Engagement (SCORE) survey. The SCORE survey was administered to 31 Midwestern hospitals as part of a broad effort to measure care context, with domains including Local Leadership, Emotional Exhaustion/Burnout, Safety Climate, and Engagement. Mixed-effects hierarchical logistic regression was used to evaluate the relationships between local leadership scores and related domains, adjusted for role and work-setting characteristics. Of the 23,853 distributed surveys, 16,797 (70.4%) were returned. Local leadership scores averaged 68.8 ± 29.1, with 7,338 (44.2%) reporting emotional exhaustion, 9,147 (55.9%) reporting concerning safety climate, 10,974 (68.4%) reporting concerning teamwork climate, 7,857 (47.5%) reporting high workload, and 3,436 (20.7%) reporting intentions to leave. Each 10-point increase in local leadership score was associated with odds ratios of 0.72 (95% confidence interval [CI] 0.71-0.73) for burnout, 0.48 (95% CI 0.47-0.49) for concerning safety climate, 0.64 (95% CI 0.63-0.66) for concerning teamwork climate, 0.90 (95% CI 0.89-0.92) for high workload, and 0.80 (95% CI 0.78-0.81) for intentions to leave, after adjustment for unit and provider characteristics. Local leadership behaviors are readily measurable using a five-item scale and strongly associate with established domains of health care worker well-being, safety culture, and engagement.

Transformational leadership and predictors of resilience among registered nurses: a cross-sectional survey in an underserved area

BackgroundHigh resilience increases nurses' ability to cope with job-related stressors and enhances job satisfaction and, consequently, their retention. The study aims to identify resilience predictors and perceptions of transformational leadership in a convenience sample of registered nurses in Lebanon.MethodsAn anonymous cross-sectional survey of a convenience sample of 240 registered nurses working for more than a year at three private hospitals in an underserved area in South Lebanon was used. The survey instrument included demographic questions, the True Resilience Scale ©, and the Global Transformational Leadership Scale. Multiple linear regression was used to assess the predictors of resilience after a descriptive analysis of the study variables.ResultsThe survey response rate was 85%. The nurses' mean resilience score was 119.4 (SD 15.3), and their perception of transformational leadership score was M = 25.0, SD = 6.8. Compared to bedside nurses, nurse managers, nurses with more than five years of experience, and nurses in critical nursing units had statistically significant higher resilience scores (p < 0.05). Resilience scores and perception of global transformational leadership were moderately correlated (r = 0.53, p < 0.05). In the final multiple linear regression model, 30% of the variation in resilience scores was explained by designation (p < 0.05) and perception of Global Transformational Leadership (p < 0.01). Perception of global transformational leadership scores explained 29% of the variance in resilience scores. Designation and perception of global transformational leadership predicted resilience in this sample.ConclusionsA national survey of the Lebanese nursing workforce is needed to achieve an improved predictive model and support policy developments to increase resilience among bedside nurses and retain them in the nursing workforce. Nurse administrators can help by strengthening their transformational leadership behaviors. Consistent use of transformational leadership styles will strengthen bedside nurses' resilience, increase nurse retention, and help sustain the Lebanese nursing workforce.

Implementation readiness for evidence-based autism practices in school systems.

The increase in the number of autistic children being identified has led to increased demand on public schools to provide high-quality services. Effectively scaling up evidence-based practice (EBP) use for autistic students is challenging, given the complicated organization of special education. Teachers have significant challenges implementing autism EBP with fidelity. Factors such as implementation leadership and climate and attitudes toward EBP are linked to successful EBP use and may vary at different levels of the education system. Examining mechanisms of successful implementation is a critical step to support scale-up. In this observational study, conducted from September 2018 to March 2020, California school personnel (n = 2273) at multiple levels of the system completed surveys related to implementation climate, leadership, and attitudes toward EBP. Data were collected throughout California at the Special Education Local Plan Areas, County Office of Education, and district and school levels from educators and administrators working in public schools supporting autistic students. Multi-level modeling was conducted to characterize implementation readiness. Overall, implementation climate and leadership scores are low across levels with regional levels rated more positively than districts or schools. Attitudes toward EBP were moderate, with those working in schools having the poorest ratings and specialists/trainers and related service providers (e.g., speech-language pathologists) having the highest ratings. Outcomes provide a unique opportunity to compare implementation factors across organizational levels with a large, statewide sample. These data provide guidance for developing implementation interventions at multiple levels of the education system to increase readiness for effective scale-up of autism EBP in schools. Personnel and leaders at different organizational levels may need differentiated training targeting improved implementation climate and leadership. Personnel within districts and schools may experience a particular benefit from leadership support for EBP implementation.

Individual and organizational factors as predictors of early evidence-based practice adoption in Michigan high schools: Baseline data from an implementation trial.

Adolescents increasingly access mental health services in schools. School mental health professionals (SPs; school counselors, social workers, etc.) can offer evidence-based mental health practices (EBPs) in schools, which may address access gaps and improve clinical outcomes. Although some studies have assessed factors associated with EBP adoption in schools, additional research focusing on SP- and school-level factors is warranted to support EBP implementation as SPs' mental health delivery grows. Baseline data were collected from SPs at Michigan high schools participating in a statewide trial to implement SP-delivered cognitive behavioral therapy (CBT) to students. Models examined factors associated with attitudes about EBPs, implementation climate, and implementation leadership, and their associations with CBT knowledge, training attendance, and pre-training CBT delivery. One hundred ninety-eight SPs at 107 schools (87%) completed a baseline survey. The mean Evidence-Based Practice Attitude Scale (EBPAS) total score was 2.9, and school-aggregated mean scores of the Implementation Climate Scale (ICS) and Implementation Leadership Scale (ILS) were 1.83 and 1.77, respectively, all on a scale ranging from 0 (low) to 4 (high). ICS and ILS scores were lower than typically reported in clinical settings, while EBPAS scores were higher. School characteristics were not significantly associated with EBPAS, ICS, or ILS scores, but scores did differ by SP role. Higher EBPAS scores were associated with more CBT knowledge (average marginal effect for 1 SD change [AME] = 0.15 points) and a higher probability of training completion (AME = 8 percentage points). Higher ICS scores were associated with a higher probability of pre-training CBT delivery (AME = 6 percentage points), and higher ILS scores were associated with higher probability of training completion (AME = 10 percentage points). Our findings suggest that SPs' attitudes toward EBPs and organizational support were positively associated with early signs of implementation success. As schools increasingly fill the adolescent mental healthcare access gap, efforts to strengthen both provider attitudes toward EBP and strategic organizational factors supporting EBP delivery will be key to encouraging EBP uptake in schools. Schools are an important setting in which adolescents receive mental healthcare. We need to better understand how to implement evidence-based practices (EBPs) in this setting to improve student mental health. This study examined the attitudes and perceptions of school professionals (SPs) as key contributors to the implementation of a particular EBP, the delivery of cognitive behavioral therapy (CBT) in schools. The study found that implementation climate and leadership scores in participating schools were lower than scores typically reported in clinical settings, while scores for SP attitudes about EBP adoption were higher than typical scores in clinical settings. Results further suggest that SPs with more positive attitudes toward EBPs are more knowledgeable of CBT and more likely to complete a 1-day CBT training. We also found that higher implementation climate scores were associated with SPs reporting pre-training CBT delivery (although this association was not statistically significant), and more implementation leadership was associated with SPs completing the CBT training. These findings suggest that SP attitudes toward EBPs and organizational support in schools are positively associated with early signs of implementation success. Early, low-intensity efforts to (1) improve SP attitudes about mental health EBPs, and (2) increase schools' support for implementation may scaffold more intensive implementation efforts in schools down the road.

The Role of Madrasah Working Groups in Improving the Performance of Private Madrasah Teachers in Serang District

The madrasah head has the right to mobilize the teachers to participate in the madrasah working group program. On the other hand, teachers must be able to formulate lesson plans, implement learning procedures, and establish interpersonal relationships with students, fellow teachers, education personnel, parents, and stakeholders. Therefore, it is necessary to conduct research on the empowerment of madrasah working groups to encourage improved teacher performance. The approach used in this research is quantitative, which is research that describes each variable. The purpose of using a quantitative approach is to explain the facts. Based on the results of descriptive analysis, it can be seen that there is a tendency for high teacher performance to be followed by a high score of madrasah leadership. This means that there is a tendency for good leadership to support high teacher performance. The conclusions obtained from the results of this study are: First, the better the madrasah principal's leadership, the higher the teacher's performance; on the other hand, poor madrasah leadership has the potential to reduce teacher performance. Second, the higher the work motivation of teachers, the higher the performance of teachers, otherwise teachers with low work motivation tend to have low performance.&#x0D; &#x0D; &#x0D;

Performance evaluation of health houses in Iraq 2021-2022: A descriptive study.

A health house (HH) is a basic health facility in rural Iraq. The function of a HH is to provide simple health services and treatments such as giving injections, dressing simple wounds, and monitoring mother and child health. The duties also include dispensing medications, measuring blood pressure, and the daily monitoring of chlorine levels in water. These HHs also provide awareness on different subjects. The main objectives of this study are to assess the availability of the basic features of the HHs and core components of the framework of the World Health Organization (WHO) building blocks. A multistage sampling technique was used to select 50 HHs out of 497 in Iraq. A questionnaire comprising closed-ended questions was developed to be completed using the researcher's observations and interviews with the healthcare workers in the HHs. The questionnaire covered the basic features of HHs as recommended by the Iraq Ministry of Health (MOH) and the six WHO health system building blocks. Fifty HHs were enrolled in the study. The availability score of basic features was 43.6% and the general service score was 55.1%. The service-specific score was 23.3%, the health workforce score was 29.6%, and the health information system score was 79.5%. The availability of essential medicines score was 21.2%, the health financing system score was 0.0%, and the leadership and governance score was 66.7%. The HHs need to follow the standard criteria determined by the Iraq MOH to ensure the proper functioning of the health outlets.

IMPORTANCE OF SUSTAINABLE LEADERSHIP AND SUSTAINABLE LEADERSHIP PRACTICES AMONG MIDDLE-LEVEL HUNGARIAN MANAGERS

Corporations, managers, and employees are still having difficulties comprehending the idea of sustainable leadership and identifying this concept itself is a challenge for modern businesses. A new and expanded definition of leadership that is founded on sustainability principles, sustainable leadership practices, and developing an inclusive, collaborative, and responsive leadership approach is known as sustainable leadership. A better understanding of the idea of sustainable leadership and sustainable leadership practices we conducted research among Hungarian middle level managers. Main purpose of this study is to examine the level of sustainable leadership skills of middle-level Hungarian managers in a variety of industrial sectors and which sustainable leadership practices with its subcomponents can be preferred to implement in organizations by Hungarian managers. Questionnaire method was used among 201 middle-level Hungarian managers. Findings show that there is a slight difference between non sustainable leadership skills and sustainable leadership skills among managers, general results showed that sustainable leadership scores of the Hungarian managers (3.20) stayed below non- sustainable leadership scores (3.75) that indicates Hungarian managers need to improve themselves relate to sustainable leadership skills based on applying sustainable leadership practices in organizations. Among sustainable leadership practices key performance drivers (3.69) are the most applicable sustainable leadership practices among the middle level Hungarian managers comparing to foundation practices (3.35) and higher-level practices (3.56) based on scores. Among subcomponents of the sustainable leadership practices score of managers centered leadership (3.4), employee centered leadership is the highest score (3.9), organizational profit (3.2), employee’s engagement (3.4) and lowest score is the knowledge sharing culture (2.7) among the middle level Hungarian managers.

No Evidence of a Gender-Equality Paradox in Gendered Names: Comment on Vishkin, Slepian, and Galinsky (2022)

This article reexamines the results of Vishkin, Slepian, and Galinsky (2022), which found larger gender differences in voiced names with higher gender equality over time and across states. I show that the employed statistical methods and calculations led the authors to draw incorrect conclusions. Using more appropriate methods, I show that there is no evidence of a systematic decrease in the proportion of voiced female names over time nor a corresponding increase for male names in Study 1 and that the gender difference has actually decreased. In Study 2, I show that, contrary to the authors’ hypothesis, both men and women have a higher proportion of voiced names in states with higher female leadership scores and that the increased difference disappears when controlling for a cultural confound—states’ proportion of foreign-born inhabitants. I conclude by discussing some overarching issues and thoughts on best practices.

The relationship between the conflict management strategies and ethical leadership behaviours of nurse managers perceived by nurses.

The aims of this study were to determine nurse managers' level of ethical leadership perceived by nurses and to examine its relationship with conflict management strategies. Ethical leadership is about how managers use their power in their decisions and actions, and its source is based on moral and ethical authority. Therefore, it is important to understand the impact of ethical behaviours of nurse managers in the work environment on determining conflict management strategies. The data of this descriptive, correlational, and cross-sectional study were collected face-to-face from 285 nurses between April-June 2019. The data collection instruments included the introductory information form, the Ethical Leadership Scale, and The Rahim Organizational Conflict Inventory-II. Ethical leadership scores perceived by nurses in nurse managers were found 3.78, and the highest score was obtained from the behavioural ethics subscale (3.81 ± .91). In conflict management strategies perceived by nurses, it was determined that they got highest scores from collaborating style (3.76 ± .90) and lowest scores from competing style (2.90 ± .94). There was no significant relationship only between ethical leadership and its subscales and competing (r: -.038/-.041, p > .05). In other subscales, there were positive, moderate, and highly significant relationships (r: .466-.747, p < .001). The rate of explanatoriness of communicative ethics subscale in conflict management strategies ranged from 22.3% to 58.0%. The study shows that communicative ethics subscale significantly affects the conflict management strategies of nurse managers. Therefore, it is important for nurse managers to communicate bilaterally and be a role model for nurses. Ethical leaders value trust and respect in their interactions with employees and reflect what appropriate behaviour to the situation is. Nurses who perceive that their managers demonstrate ethical leadership behaviours will also evaluate their role in conflict resolution. On the other hand, the power-based, aggressive, noncompromising domination approach that the person imposes on others is not associated with the ethical leadership perception towards their managers by nurses and is a strategy that should not be preferred. Therefore, nurse managers who use appropriate conflict management strategies were seen as a role model by nurses.

Matching into Orthopedic Surgery in the U.S. Navy: A Review of Applicant Selection Criteria.

The U.S. Navy offers an attractive opportunity for residency training in orthopedic surgery. The factors that Navy orthopedic residency program leadership finds important in applicant selection for training have not been reported. Additionally, data regarding the academic competitiveness of recently matched applicants have not been previously published. This study presents the results of two surveys administered to all navy orthopedic program directors and department chairmen, as well as data for United States Medical Licensing Examination (USMLE) Steps 1 and 2, medical school class percentile, leadership responsibilities, research endeavors, and letters of recommendation of both matched and unmatched applicants. Two anonymous surveys were administered to all program directors and department chairmen at Navy orthopedic residency training programs with questions designed to gauge perceived importance of various application factors when selecting for the match. The results were compiled, and mean levels of importance were reported. Deidentified data were collected on all applicants to Navy orthopedic residency programs from 2015 to 2019. Data points specific to USMLE Step 1 and 2 board scores, medical school class percentile, research, leadership, and letters of recommendation were analyzed using single and multiple logistic regression analyses, and odds ratios for each variable were calculated. Navy leadership unanimously expressed that clerkship performance at the individual program director's institution was most important, followed by Steps 1 and 2 licensing examination scores. Single logistic regression analyses showed that Step 1 score and clinical, leadership, and recommendation scores were statistically significant. When controlled for Step 1 score, only academic performance and leadership scores maintained statistical significance. Applicants to Navy orthopedic surgery residency programs should strive to be competitive in all aspects of their application, with specific emphasis placed on outstanding performance during orthopedic clerkships, demonstration of leadership characteristics, and academic excellence. With transition to a pass/fail grading system for Step 1, there will be more emphasis on other measures of academic success, such as Step 2 scores and clinical clerkship grades.

The Five-4-Life Quality Improvement Program: Improving Frontline Nurses' Cardiopulmonary Resuscitation Leadership and Team Management Skills.

Poor leadership and teamwork in cardiopulmonary resuscitation (CPR) are associated with poor patient outcomes. Frontline nursing staff frequently identify patients in cardiac arrest but may not have the initial leadership and teamwork skills to organize their initial rescue response. The Five-4-Life Quality Improvement (QI) program was pilot tested in a pediatric unit within a 510-bed acute care hospital in 2 phases: first, an educational program focused on leadership, team dynamics, and CPR skills, followed by sustaining interventions in the unit. Video recordings of 12 mock codes (4 pre-, 4 post-, 4 follow-up) were analyzed by trained observers. Descriptive statistical tests indicated a significant improvement in leadership, teamwork, and task management scores pre- and post-program, and sustained after the program. Implementing the Five-4-Life QI program is feasible in improving leadership, teamwork, and task management of first responding frontline nurses.

Psychological coherence, inclusive leadership and implicit absenteeism in obstetrics and gynecology nurses: a multi-site survey

BackgroundImplicit absenteeism is very common among clinical nurses. We aimed to evaluate the role of psychological coherence in the inclusive leadership and implicit absenteeism among obstetrics and gynecology nurses, to provide evidence to the clinical management of nurses.MethodsThrough the convenience sampling method, a survey of gynecology nurses in tertiary hospitals in 16 cities of Anhui Province, China was conducted using the General Information Questionnaire, the Stanford Implicit Absence Scale, the Inclusive Leadership Scale and the Sense of Coherence Scale. Statistical analysis was performed by SPSS 20.ResultsA total of 1080 nurses were included with an effective response rate of 93.5%. The average score of nurses' recessive absenteeism in this study was (16.8 ± 0.15). The average of inclusive leadership score was (34.25 ± 7.23). The average score of psychological coherence score of obstetrics and gynecology nurses was (55.79 ± 8.28). Pearson correlation analysis showed that there was a relationship between implicit absenteeism behavior, inclusive leadership, and the level of psychological coherence in obstetrics and gynecology nurses (all P < 0.05). Linear regression analysis indicated that psychological coherence played a partial mediating role between inclusive leadership and obstetrics and gynecology nurses' implicit absenteeism (all P < 0.05).ConclusionsObstetrics and gynecology nurses have serious recessive absenteeism with low sense of psychological coherence and inclusive leadership. Nursing managers should improve the psychological coherence through effective interventions, thereby reducing the incidence of implicit absenteeism.

Toxic Leadership and Empowering Leadership: Relations with Work Motivation.

PurposeThe present study aims to verify the association between two opposing models of leadership, toxic and empowering, and the different dimensions of work motivation.Participants and MethodsThree questionnaires (Toxic Leadership Scale, Empowering Leadership Questionnaire, and Multidimensional Work Motivation Scale) were applied to 408 workers. Cluster analysis was performed.ResultsCluster analysis produced eight clusters based on the different configurations of leadership dimensions, namely coercive, centralizer, false paternalistic, toxic role model, coach, narcissistic-empowering, toxic, and empowering. Those clusters relate differently to work motivation dimensions.ConclusionThe profiles with higher scores in empowering leadership dimensions are more generally related to autonomous regulation (identified and intrinsic work motivation). The profiles with higher toxic leadership dimensions are more related to amotivation and controlled regulation (extrinsic work motivation). One profile stood out: the narcissistic-empowering profile that combines high scores in narcissistic leadership and empowering leadership dimensions. This profile unexpectedly relates significantly to autonomous regulation. This study contributed to the knowledge of the work motivation dimensions concerning empowerment and toxic leadership. Therefore, it contributes to deepening the nomological network of the concepts and providing inputs to human resource processes suitable to improving the organizational results and the workers’ quality of life.