How challenge demands affect employee innovative behavior? The dual role of team leaders’ Dark Triad personality traits

The NASA Task Load Index in simulated cardiopulmonary resuscitation.

Healthcare providers frequently spend excessive time identifying a pulse and have difficulties in precisely verifying its existence. Point-of-care carotid artery ultrasound has been suggested as a potential substitute technique for pulse checks. This study aimed to evaluate the effectiveness of manual pulse checks, 2D carotid ultrasonography (USG), and rapid increases in endtidal carbon dioxide (EtCO2) levels in determining the return of spontaneous circulation (ROSC) in patients who experienced a cardiac arrest in an emergency department (ED). The study was designed as a single-center, prospective, observational study. Non-traumatic adult patients in cardiopulmonary arrest who were brought to the ED were included. Upon identifying cardiac arrest, the following data were recorded: the initial arrest rhythm, ultrasonographic and manual pulse evaluations, EtCO2 levels, resuscitation period, and vital signs post-ROSC. Team leaders' judgement used for adjudication of ROSC used as the reference standart. The investigation included 88 patients with a total of 642 CPR cycles administered to who suffered cardiopulmonary arrest. AUC values of the USG, EtCO2 and manual pulse checks were 0.974, 0.802 and 0.862 (p<0.001, p<0.001, p<0.001, respectively). AUC comparisons of USG vs manual pulse check and EtCO2 were significantly different, while manual pulse checks vs EtCO2 had no significant difference (p=0.001, p<0.001, p=0.167, respectively). The sensitivity of bedside USG for detecting carotid pulse was found to be 93.8%, with a specificity of 100%. This study suggests that 2D carotid ultrasonography can be effectively utilized for detecting pulses in patients suffering cardiopulmonary arrest.

Objective: The aim of this study was to evaluate whether verbal pressure from the team leader distracted students during a critical care simulation scenario. Particularly, examining the influence of unethical leadership on CPR quality was the objective of this work. Methods: Eighty students were randomized into study (n=40) and control group (n=40). They participated in a short cardiac arrest simulation scenario, each one separately. The scenario consisted of two tasks. Firstly, they were asked to bring to the team leader one ampule of a particular drug. A variety of drugs in their original packaging were placed on a shelf, but the handicap of this task was that the ampullae were mixed up between boxes. The second task was to perform 30 good-quality chest compressions. Study group participants were experiencing verbal pressure during the first part. Results: Study group participants fulfil the first task faster (require less time to bring the ampulla), but fewer of them find out that medications are mistaken (in comparison with the control group). Moreover, the study group reports higher stress levels (as assessed in 1 - 10 scores), and more participants perform too fast chest compressions (faster than 120 times per minute) in this group. Conclusion: Verbal pressure from a team leader increases participants' stress levels and decreases their effectiveness (chest compression quality and the ability to identify that ampullae are mistaken).

The scientific research group is an important capability base to propel a country like China to the forefront of innovative countries. Given its importance, increasing the number of scientific research groups in China is an important strategy for enhancing the country’s scientific research capacity and promoting scientific development in the world. Our study employs grounded theory and in-depth interviews to explore the construction of scientific capabilities of Chinese scientific research groups. We adopt the actor-activity-position-linkage (AAPL) model of innovation ecosystems to explore the contributing factors to the innovation output of research groups. From an actor’s perspective, research group members’ scientific competence, technological compartmentalises, and personal characteristics are important influences on scientific research capacity. Meanwhile, the academic competence of the team leader is the most central element of the team’s innovation capability. The internal structure of first-class scientific research group (FSRG) members, the management system, and the FSRG climate have a significant impact on innovation within the FSRG organisation. This study challenges the structural view of innovative talent, responds to the debate about the impact of administrative positions on scientific research, and provides insights into how to develop a tradition of innovation and maintain continuous innovation.

The COVID-19 pandemic exposed critical vulnerabilities in healthcare supply chains, revealing the limitations of efficiency-driven logistics models under conditions of extreme uncertainty, demand volatility, and ethical strain. This qualitative study examines how leadership practices, organizational culture, and team dynamics shape the implementation and sustained use of artificial intelligence (AI) technologies in healthcare logistics during pandemics and large-scale healthcare emergencies. Drawing on semi-structured interviews with 15 participants, including healthcare logistics officers, AI application experts, and organizational development professionals, the study conceptualizes AI implementation as a socio-technical transformation rather than a purely technological intervention. Findings indicate that AI-enhanced logistics systems significantly improved situational awareness, accelerated decision cycles, reduced waste, and enabled scenario-based planning. However, these benefits were realized only when AI tools were embedded within leadership practices characterized by transparency, ethical accountability, and collaborative sensemaking. Participants emphasized that trust, explainability, and perceived fairness were critical conditions for adoption, particularly when AI supported allocation of scarce, life-saving resources. Conversely, inadequate leadership readiness, role ambiguity, poor user experience, and change fatigue undermined AI effectiveness and eroded workforce trust. The study further demonstrates that AI amplified existing cultural patterns: learning-oriented cultures leveraged AI to strengthen resilience and organizational learning, while blame-oriented cultures experienced resistance and fragmentation. Overall, the findings underscore that successful AI deployment in healthcare logistics during crises depends less on algorithmic sophistication than on leadership behavior, cultural alignment, and ethical governance. The study contributes to both theory and practice by offering a human-centered framework for integrating AI into healthcare supply chains to enhance resilience, legitimacy, and preparedness for future emergencies.

IntroductionThis study examines how leader relationship-oriented behavior influences employee voice-silence conversion in cross-cultural virtual teams through digital contexts.MethodsUsing structural equation modeling with data from 342 team members across 68 virtual teams spanning 23 countries, we test a moderated mediation model that positions psychological safety as a key mediating mechanism.ResultsResults demonstrate that relationship-oriented behavior significantly promotes voice-silence conversion toward increased voice behaviors (β = 0.34, p < 0.001), with psychological safety serving as a critical mediator (indirect effect β = 0.24, p < 0.001). Cultural value differences negatively moderate this relationship (β = −0.18, p < 0.05), while digital tool usage frequency enhances the effectiveness of relationship-oriented behaviors (β = 0.15, p < 0.05).DiscussionThe findings extend leadership theory by demonstrating how traditional relationship-oriented approaches can effectively operate in digitally-mediated cross-cultural contexts, while advancing understanding of voice-silence as dynamic conversion processes rather than static behavioral states. Practical implications suggest that organizations should prioritize relationship-building competencies among virtual team leaders while recognizing that cultural diversity requires adaptive leadership approaches and that digital technologies can amplify rather than constrain interpersonal leadership effectiveness.

Background Although school-based mental health initiatives are gaining attention, research remains limited on effective and sustainable implementation, especially for autistic students. School leadership play a pivotal role in shaping mental health initiatives. However, their roles and perspectives, particularly regarding autistic students, are under-researched. Methods We applied Reflexive Thematic Analysis to 22 semi-structured interviews with senior leadership teams’ (SLTs) members from state-funded mainstream secondary schools across six regions in England. Interviews were co-produced with an advisory team and adopted a curious stance to explore SLT members’ perspectives on promoting and supporting autistic students’ mental health. Results Using inductive coding and iterative discussions, we identified four key themes: (1) SLTs’ views and beliefs about autism and autistic students, (2) The use of one-size-fits-all approaches in mental health policy and provision, (3) The difficulty of overcoming and deepening systemic barriers in organizing mental health provision, and (4) The need to deepen participation with stakeholders and services. Findings revealed existing gaps and barriers in autism-informed provision and highlighted the changes and resources needed to facilitate mental health provision for autistic students from SLTs’ perspectives. Conclusion Results offer actionable insights for practice and policy, especially in light of the systemic and cultural challenges SLTs face.

ObjectiveTo explore the effect of in-hospital follow-up on post-intensive care syndrome in families of PICU (Pediatric Intensive Care Unit) patients.MethodsA total of 88 families of children admitted to the PICU of Hunan Children’s Hospital from January 1, 2023, to September 30, 2023, were selected as research subjects. The control group received routine nursing intervention, while the experimental group, based on the control group’s care, established a PICU communication team. The team was divided into three subgroups: the department director and head nurse, Chief resident and Responsible Nurse Team Leader, Doctor in charge of the patient’s bed and Person in charge of health education. On the day of Transfer to another department and 3 days after Transfer to another department, one group of personnel communicated face-to-face with the family members regarding the patient’s condition and precautions. After the communication, the intervention effects on the parents of the children in both groups were assessed within 30 min using the Post-Intensive Care Syndrome Questionnaire (C-PICSQ), the Depression-Anxiety-Stress Scale (DASS-21), and the Critical Care Family Satisfaction Scale (CCFSS).Measurements and main resultsBefore the intervention, there were no statistically significant differences in the C-PICSQ scores, DASS-21 scores, and CCFSS scores between the family members of children in the two groups (p > 0.05). Three days after Transfer to another department, the C-PICSQ score of 16.25 ± 3.93 for the family members in the experimental group was lower than the C-PICSQ score of 33.25 ± 5.97 in the control group. The DASS-21 score of 17.91 ± 2.18 for the experimental group was lower than the DASS-21 score of 34.77 ± 5.30 for the control group, and the CCFSS score of 80.91 ± 9.64 for the experimental group was higher than the CCFSS score of 37.89 ± 14.49 for the control group, with all differences being statistically significant (p < 0.05).ConclusionIn-hospital follow-up can effectively alleviate post-intensive care unit (PICU) syndrome in family members, reduce negative emotions such as depression, anxiety, and stress among parents, improve family satisfaction.

The Chief of Staff (CoS) position, in both the public and private sectors, assists the executive team in strategizing, communicating, and making decisions for the organization the Centers for Disease Control and Prevention uses the model of a CoS within its incident management system (IMS) for public health emergency responses. During those responses, the CoS is responsible for the oversight and coordination of the operational and management functions, and that position is a primary member of the response leadership team. An effective CoS leverages their knowledge of systems and processes, resources, and subject matter expertise from across the organization to solve operational challenges. The position also facilitates connections with other federal response agencies, nongovernmental organizations, and international and domestic partners. Health departments seeking to improve how their organization addresses routine and unexpected challenges during emergency responses could consider adding a CoS role to their IMS.

ABSTRACT The hospitality industry's increasing awareness of environmental sustainability has fostered green innovative service behavior, a crucial aspect of its performance. The study aims to identify the influence of green participative leadership on employee green service innovative behavior via the mediating role of green knowledge sharing and the moderating effect of person-green value congruence. We collected data from 391 employees and 89 of their direct team leaders and employed a different time-lag approach, which was analyzed using multilevel structural equation modelling. The study findings revealed that green participative leadership positively influences employee green service innovative behavior, and is also mediated by green knowledge sharing. The results showed that green person-green value congruence moderates the relationship between green participative leadership, green knowledge sharing, and subsequent green service innovative behavior among hotel employees. The theoretical and practical implications for the hospitality industry are discussed.

ABSTRACT Purpose In the United Kingdom (U.K.), football academies are required to have an Academy Management Team (AMT); middle management is responsible for ensuring the academy functions effectively and efficiently. This study sought to explore the training and educational requirements for AMT members and suggest practical recommendations for the development of AMT members in the future. Methodology: Recruiting 45 AMT members, a mixed-methods approach was employed using a survey and semi-structured interviews. Findings: Thematic analysis developed themes reflecting large differences in the leadership and management training of AMT members. This is related to the specific concept of interpretation and translation of strategy throughout their own department and the Academy. Practical implications: Leadership and management training for middle managers (AMT) is poorly funded, with current skills primarily developed through previous experience. Those who had undertaken leadership and management training felt better equipped at interpreting and translating information to inform more effective decisions. Training needs ranged from areas such as performance management of staff and allocating resources to managing change and strategic planning within the academy. Research Contribution This study explored the training and educational needs of middle managers (AMT) within elite UK football academies.

Abstract Schools are well-placed to implement mental health interventions to large groups of children and young people. This study aimed to explore school staff perceptions of barriers and facilitators to the implementation and potential impact of five universal mental health interventions.Qualitative data collection (primarily semi-structured interviews) with 60 members of school staff (including class teachers, senior leadership team members, and pastoral support leads) was conducted across 20 primary and secondary schools in England in 2019. As part of two randomised controlled trials, schools were randomised to deliver one of five universal, classroom-based mental health interventions: The Guide, Youth Aware of Mental Health (YAM), Strategies for Safety and Wellbeing (SSW), Relaxation Techniques, and Mindfulness-Based Exercises. Data analysis drew on a reflexive thematic analysis approach.Facilitators identified by school staff across the five interventions were: seeing the benefits; fit with school context; ease of implementation; consistency and security; and taking responsive action. Barriers or challenges identified across the five interventions were: not always seeing the benefits; varying engagement; differences of opinion, knowledge, and experience; and struggles with time and space.The findings suggest that to enable the impactful implementation of school-based, universal mental health interventions, school staff need to be consulted about what would work best within their individual schools, to ensure that interventions can meet the needs and preferences of different school environments and students.

As public attention to environmental issues grows, enterprises have begun implementing environment-centered business management. Achieving environmental sustainability requires the participation of all organizational members. This study was conducted in Chinese food manufacturing small and medium-sized enterprises located in Guangdong and Jiangsu provinces, China, and employed a three-wave, time-lagged survey design to collect and match data from team leaders and employees. Hierarchical linear modeling was used to test the cross-level hypotheses, and the indirect effect was assessed using Bayesian multilevel mediation analysis. Using cross-level data from both team leaders and team members, this study examines how green transformational leadership impacts employees' pro-environmental behavior. In addition, this study examines the mediating role of employee value-action barriers and the moderating role of green brand image. The results indicate that (1) green transformational leadership positively influences employee pro-environmental behavior, (2) employee value-action barriers mediate the relationship between green transformational leadership and employee pro-environmental behavior, and (3) green brand image moderates both the correlation between green transformational leadership and employee pro-environmental behavior and the relationship between employee value-action barriers and employee pro-environmental behavior. These findings provide empirical support for the application of social learning theory and offer managerial insights into how managers can more effectively enhance their employees' pro-environmental behavior. Future research may further test the robustness and applicability of these relationships in other industries and in different regional and national contexts.

Hypertensive emergency is a critical condition that requires prompt, accurate, and professionally documented nursing care through standardized nursing processes. One of the challenges in the Emergency Department of Ar Rasyid Hospital Palembang is the suboptimal implementation of 3S-based nursing documentation (SDKI, SLKI, and SIKI) for patients with hypertensive emergencies. This community service activity aimed to enhance nurses’ professionalism through the implementation of socialization on 3S nursing documentation in emergency nursing care. The methods included an initial survey, interviews, observations, and the administration of pre-test and post-test, followed by socialization sessions and simulation of 3S documentation. The participants consisted of head nurses, team leaders, and staff nurses in the emergency department. The evaluation results demonstrated a significant improvement in nurses’ knowledge and understanding after the intervention, as reflected by higher post-test scores compared to pre-test scores. Furthermore, the implementation of 3S documentation became more consistent in emergency nursing records, both manually and through electronic medical records. This activity confirms that socialization and simulation of 3S documentation are effective strategies to improve the quality and professionalism of emergency nursing care for hypertensive emergency patients in hospital emergency departments.

Artificial intelligence based resuscitation simulation: a pilot study of a novel approach to team leadership training.

Purpose This paper examines how the metaverse, a convergence of virtual reality (VR), augmented reality (AR), and persistent digital platforms, can reshape leadership development and team collaboration. It evaluates opportunities and challenges, positioning the metaverse within established theories of leadership and adult learning. Design/methodology/approach The study employs a qualitative, descriptive methodology using secondary data from scholarly research, case studies, and industry reports. Open coding and thematic analysis identified recurring patterns, which were synthesized with theories of experiential learning, emotional intelligence, and transformational leadership. Findings Immersive simulations enhance emotional intelligence, adaptive leadership, and collaborative problem-solving across distributed teams. Gamification sustains motivation and supports innovation through virtual prototyping. However, barriers such as unequal access to digital infrastructure, cognitive fatigue, and overreliance on vendor-driven narratives limit effectiveness. A hybrid model, combining immersive tools with traditional development practices, emerges as the most effective approach for balancing engagement, inclusivity, and sustainability. Research limitations/implications Relying solely on secondary data, the study calls for future longitudinal research to explore the psychological and organizational impacts of sustained metaverse use in leadership development. Practical implications Organizations can leverage metaverse platforms to deliver scalable, interactive leadership programs but must prioritize digital inclusion and adopt hybrid strategies to mitigate risks. Social implications If implemented equitably, the metaverse can broaden access to leadership development for geographically or economically disadvantaged groups, fostering greater inclusivity in organizational learning. Originality/value The paper bridges metaverse applications with established theoretical frameworks. Rather than treating the metaverse as a wholesale replacement for leadership development, it positions immersive environments as complementary tools that democratize access to training while reinforcing essential leadership competencies.

Purpose The purpose of this paper is to show how psychological safety and collective leadership help human resource (HR) systems turn into everyday behaviour and better team performance. Many HR initiatives look good on paper but do not change what people actually do. Drawing on recent research and field experience, the paper focuses on concrete interactions between leaders and team members, and proposes a simple framework, mini-cases and a short checklist that HR leaders and line managers can use to start small, experiment and adjust within their own organisations. Design/methodology/approach This paper is based on a review of recent research on psychological safety, collective leadership and human resource management (HRM) micro-foundations, combined with observations from leadership development and team training projects in various organisations. Rather than presenting a formal empirical study, the approach integrates evidence with practical experience to highlight the everyday interactions that shape behaviour. The paper organises these insights into a simple framework and illustrates them with short mini-cases and a quick diagnostic that HR leaders and line managers can apply immediately. Findings Across the research and practice reviewed, two patterns stood out. Firstly, psychological safety and collective leadership consistently acted as the behavioural link between HR intentions and what actually happened in teams. HR systems alone did not shift behaviour unless day-to-day interactions supported speaking up, shared influence and basic relational coordination. Secondly, these behaviours were not abstract ideals but small, repeatable actions by both leaders and team members. When these actions accumulated, teams showed clearer decision-making, faster learning after setbacks and more reliable collaboration, regardless of hierarchy. Research limitations/implications Because this paper integrates research with field observations rather than reporting a single empirical study, the conclusions should be read as indicative rather than definitive. The examples draw mainly on knowledge-intensive and team-based settings, so some elements may need adaptation in other contexts. Even so, the review highlights clear behavioural mechanisms that can inform future empirical work on HRM micro-foundations. For practitioners, the implication is that improving psychological safety and collective leadership does not require large programmes; small, observable actions can be tested and refined within existing HR and management routines. Practical implications For HR leaders and line managers, the main implication is that psychological safety and collective leadership can be reinforced through small, routine adjustments rather than major structural changes. Simple behaviours – such as clarifying the purpose of a discussion, asking for alternative views and openly acknowledging uncertainty – help teams speak up and share influence. These actions make existing HR systems more effective by improving how people coordinate, decide and learn together. Starting with a few repeatable practices, testing them in real meetings and adjusting based on team feedback can produce visible improvements within weeks. Social implications Improving psychological safety and collective leadership has broader implications beyond organisational performance. When everyday interactions become more open and respectful, people experience fewer interpersonal risks at work, which supports wellbeing and reduces avoidable conflict. Teams become more inclusive because diverse members have more opportunities to speak and influence decisions. These conditions can also strengthen trust between managers and employees, especially in settings with strong hierarchy. Although the practices described in this paper are small in scale, they can contribute to healthier and more participatory work environments, which has benefits for both individuals and communities. Originality/value The paper brings together psychological safety, collective leadership and HRM micro-foundations in a way that is easy for practitioners to use. Rather than proposing a new theory, it highlights concrete behaviours that help HR systems work as intended in everyday team settings. By combining insights from research with observations from development programmes, the paper offers a practical lens for understanding how small interactions shape collaboration and decision-making. The simple framework, mini-cases and diagnostic are designed to help HR leaders and line managers test ideas quickly and adapt them to their own context.

Managing the imbalance between job demands and available resources in the healthcare system is increasingly challenging. These growing demands include cognitive demands arising from diagnostic challenges; constant updates to guideline-directed medical therapy (GDMT); demands to satisfy patients in the face of insufficient resources, particularly time; and a lack of alignment. It’s often unclear as to how to balance job demands and resources. However, the bar will continue to rise, pushing toward better care coordination, better quality outcomes, reduced costs, and more value-based patient-centered care. We approached the challenge of managing hospitalized patients with CHF, COPD, and pneumonia as a team, using data analytics and project management approaches to design a clinical care pathway. This pathway included a sequence of critical steps; each step was assigned to an accountable stakeholder, allocated a time box, and tied to deliverables. The care pathway improved vertical alignment between our team and senior leadership’s quality and cost demands and solidified horizontal alignment among our teams’ stakeholders. This resulted in a sustained improvement in our quality outcomes, including more than 20% improvement in length of stay, increased adherence to GDMT, reduction in costs, and the creation of a better value-based care model.

Residents as Leaders: Creating a Trauma Team Leader Nontechnical Skills Simulation Workshop.