Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter July 6, 2021

Understanding clinical leadership behaviors in practice to inform baccalaureate nursing curriculum: a comparative study between the United States and Australia novice nurses

  • Sherylyn M. Watson EMAIL logo , Heather Ferrillo , Susan A. Goncalves and Karen Clark-Burg



While the nursing profession recognizes the importance of leadership behaviors, limited evidence exists on essential clinical leadership behaviors that nursing students should exhibit upon graduation. The purpose of this study was to determine if there were common leadership behaviors exhibited by recently graduated baccalaureate clinical staff nurses in the United States and Australia.


A quantitative descriptive study with a comparative design was conducted using The Clinical Leadership Survey.


Similar clinical leadership behaviors were reported by nurses from the two countries though there was a statistically significant difference in the overall frequency of behaviors between the two groups. Behaviors in the ‘challenging the process’ domain were less commonly practiced in both countries, identifying a clinical gap and opportunity for student development.


This study identifies the central behaviors that should be included in baccalaureate nursing education curriculum in order to prepare students for successful transition into practice.

Corresponding author: Sherylyn M. Watson, PhD, MSN, RN, CNE, Davis & Henley College of Nursing, Sacred Heart University, 5151 Park Avenue, Fairfield, CT, 06825, USA, Phone: +1 203 416 3792, Fax: +1 203 365 7662, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The research related to human use has complied with all the relevant national regulations, institutional policies, and in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ Institutional Review Board of equivalent committee: Sacred Heart University, CT, USA # 181219A and University of Notre Dame, Australia, Freemantle, W.A. # 019019F.


American Association of College of Nursing. (2021). The essentials: Core competencies for professional nursing education. Retrieved from in Google Scholar

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Washington, D.C.: ANA.Search in Google Scholar

American Nurses Association. (2018). ANA leadership competency model. Retrieved from∼4a0a2e/globalassets/docs/ce/177626-ana-leadership-booklet-new-final.pdf.Search in Google Scholar

Atwater, L. E., & Yammarino, F. J. (1992). Does self-other agreement on leadership perceptions moderate the validity of leadership and performance predictions? Personal Psychology, 45(1), 141–164. in Google Scholar

Australian College of Nursing. (2020). Emerging nurse leadership program. Retrieved from in Google Scholar

Birks, M., Davis, J., Smithson, J., & Cant, R. (2016). Registered nurse scope of practice in Australia: An integrative review of the literature. Contemporary Nurse: A Journal for the Australian Nursing Profession, 52(5), 522–543. in Google Scholar PubMed

Boamah, S. A. (2019). Emergence of informal clinical leadership as a catalyst for improving patient care quality and job satisfaction. Journal of Advanced Nursing, 75(5), 1000–1009. in Google Scholar PubMed

Brown, A., Dewing, J., & Crookes, P. (2016). Clinical leadership as an integral curriculum thread in pre-registration nursing programmes. Nurse Education Today, 38, 9–14. in Google Scholar PubMed

Carragher, J., & Gormley, K. (2017). Leadership and emotional intelligence in nursing and midwifery education and practice: A discussion paper. Journal of Advanced Nursing, 73(1), 85–96. in Google Scholar PubMed

Chappell, K. B., Richards, K. C., & Barnett, S. D. (2014). New graduate nurse transition programs and clinical leadership skills in novice RNs. The Journal of Nursing Administration, 44(12), 659–668. https://doi:10.1097/NNA.0000000000000144.10.1097/NNA.0000000000000144Search in Google Scholar PubMed

Chavez, E. C., & Yoder, L. H. (2015). Staff nurse clinical leadership: A concept analysis. Nursing Forum, 50, 90–100. in Google Scholar PubMed

Cummings, G. G., Lee, S., Tate, K., Penconek, T., Micaroni, S. P. M., Paananen, T., & Chatterjee, G. E. (2021). The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership. International Journal of Nursing Studies, 115. in Google Scholar PubMed

Cummings, G., MacGregor, T., Davey, M., Lee, H., Wong, C. A., Muise, M., & Stafford, E. (2010). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 47, 363–385. https://doi:10.1016/j.ijnurstu.2009. in Google Scholar PubMed

Fardellone, C., Musil, C. M., Smith, E., & Click, E. R. (2014). Leadership behaviors of frontline staff nurses. The Journal of Continuing Education in Nursing, 45(11), 506–513. in Google Scholar PubMed

Francis-Shama, J. (2016). Perceptions of leadership among final-year undergraduate nursing students. Nursing Management, 23(7), 35–39. https://doi:10.7748/nm.2016.e1535.10.7748/nm.2016.e1535Search in Google Scholar PubMed

Grindel, C. G. (2016). Clinical leadership: A call to action. Medsurg Nursing, 25(1), 9–16.Search in Google Scholar

HealthWorkforce Australia. (2013). Health LEADS Australia: The Australian health leadership framework. Retrieved from in Google Scholar

Institute of Medicine. (2010a). The future of nursing: Leading the change, advancing health. Washington, D.C.: National Academies Press.Search in Google Scholar

Institute of Medicine. (2010b). Report brief. The future of nursing: Focus on education. Washington, D.C.: National Academies Press.Search in Google Scholar

Jones, T. L. (2020). Self-reported leadership practices among frontline medical-surgical nurses: An exploratory descriptive study of prevalence, patterns and associated factors. Medsurg Nursing, 29(3), 159–167.Search in Google Scholar

Kouzes, J. M., & Posner, B. Z. (1988). Development and validation of the leadership practice inventory. Educational and Psychological Measurement, 48, 483–496.10.1177/0013164488482024Search in Google Scholar

Kouzes, J. M., & Posner, B. Z. (1995). The leadership challenge: How to keep getting extraordinary things done in organizations. Vol. 2. San Francisco, CA: Jossey-Bass.Search in Google Scholar

Larsson, I. E., & Sahlsten, M. J. M. (2016). The staff nurse clinical leader at the bedside: Swedish registered nurses’ perceptions. Nursing Research and Practice, 2016. in Google Scholar PubMed PubMed Central

Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: An integrative review. Contemporary Nurse, 45(1), 10–21. in Google Scholar PubMed

Nursing and Midwifery Board of Australia. (2016). Retrieved from in Google Scholar

Patrick, A., Laschinger, H. K. S., Wong, C., & Finegan, J. (2011). Developing and testing a new measure of staff nurse clinical leadership: The clinical leadership survey. Journal of Nursing Management, 19(4), 449–460. in Google Scholar PubMed

Stanley, D. (2014). Clinical leadership characteristics confirmed. Journal of Research in Nursing, 19(2), 118–128. in Google Scholar

Stanley, D., & Sherratt, A. (2010). Lamp light on leadership: Clinical leadership and Florence Nightingale. Journal of Nursing Management, 18, 115–121. in Google Scholar PubMed

Stanley, D., & Stanley, K. (2017). Clinical leadership and nursing explored: A literature search. Journal of Clinical Nursing, 27, 1730–1743. http://doi:10.1111/jocn.14155.10.1111/jocn.14145Search in Google Scholar PubMed

Willman, A., Bjuresater, K., & Nilsson, J. (2020). Newly graduated registered nurses’ self-assessed competence and need for further training. Nursing Open, 7, 720–723. in Google Scholar PubMed PubMed Central

van de Mortel, T. F. (2008). Faking it: Social desirability response bias in self-report research. Australian Journal of Advanced Nursing, 25(4), 40–48.Search in Google Scholar

Received: 2021-02-12
Accepted: 2021-06-25
Published Online: 2021-07-06

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 28.5.2023 from
Scroll to top button