Leadership competences in undergraduate nurse education: Scale development and model testing

Aim
To develop and psychometrically evaluate a scale based on the Healthcare Leadership Model among undergraduate nursing students.

Background
Effective leadership by nurses at the point of care delivery is essential for high quality, safe and effective care. At the same time, leadership at all levels is important to ensure appropriate staffing workforce planning and service improvement. Despite the importance of leadership, undergraduate nursing students often feel under-prepared for their leadership role as newly qualified nurses. While a variety of leadership tools have been developed to enable students to self-assess none of these tools relate to multi-level leadership.

Design
A scale development and validation study employing a cross-sectional design.

Methods
Preliminary analysis ensured multivariate normality. Psychometric analyses tested the scale’s reliability (Cronbach’s Alpha) and validity by performing an Exploratory Factor Analysis with a direct oblimin rotation. A Confirmatory Factor Analysis compared the empirical model developed in this study and the theoretical one.

Results
289 final-year undergraduate nursing students were included in the final sample. The results suggest that the scale is appropriate to assess nursing students’ leadership competences. Exploratory factor analysis indicates the model has 6 factors rather than the 9 dimensions outlined in the theoretical model.

Conclusion
The notion of leadership at all levels to ensure safe, high quality and effective care is now well embedded globally. This study demonstrates that the Healthcare Leadership Model can be adapted and effectively adopted as a framework for leadership development amongst undergraduate nursing students.