Exploring Leadership Pedagogy Among Louisiana Baccalaureate Nursing Programs

This qualitative study explores how nursing educators teach leadership in Louisiana baccalaureate programs contrasted with ideal policy expectations. The study identifies 7 main themes including the purpose of the leadership course, selected teaching strategies, and faculty perspectives for future nursing leadership education.

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Exploring Leadership Pedagogy Among L
Baccalaureate Nursing Programs
Sarita James
Walden University
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Walden University
College of Health Sciences
This is to certify that the doctoral dissertation by
Sarita James
has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.
Review Committee
Dr. Eric S Anderson, Committee Chairperson, Nursing Faculty
Dr. Leslie Hussey, Committee Member, Nursing Faculty
Dr. Eileen Fowles, University Reviewer, Nursing Faculty
Chief Academic Officer
Eric Riedel, Ph.D.
Walden University
2017

Abstract
Exploring Leadership Pedagogy Among Louisiana Baccalaureate Nursing Programs
by
Sarita Vickers James
MSN, Loyola University-New Orleans, 2006
BSN, Northwestern State University, 1990
Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Nursing with Specialization in Education
Walden University
November 2017

Abstract
Nursing accreditation bodies have recommended that nursing education programs prepare
graduates who display competence in leadership. However, the reality of how nursing
leadership skillsets are acquired at the undergraduate level and transferred into practice
remains debatable. The purpose of this qualitative study was to understand how nursing
educators teach leadership in Louisiana baccalaureate programs contrasted with ideal
policy expectations. The action learning and reflective practice theories provided the
foundational theoretical influences for this study. Six face-to-face virtual interviews were
conducted with nursing faculty who were currently teaching or had taught leadership in a
baccalaureate nursing program for at least 1 year. Data collection and analysis using the
constant comparative method of the Corbin and Strauss grounded theory approach was
used. From the data analysis, 7 main themes were identified, including the purpose of the
leadership course, the selected teaching strategies to meet the purpose of the course,
teaching to support student learning styles and workplace expectations, the application of
evidence-based practice principles for leadership, the measured effectiveness of selected
teaching strategies, faculty perspectives of leadership efficacy at the undergraduate level,
and faculty perspectives for future nursing leadership education. Research findings
suggest that positive social change for undergraduate nursing education could be
influenced by the employment of active learning and reflective practice allowing the
student to experience leadership, reflect on leadership, and improve on developing
leadership competence. The generalist would become receptive to leadership before entry
into practice, impacting the changing healthcare environment.

Exploring Leadership Pedagogy among Louisiana Baccalaureate Nursing Programs
by
Sarita Vickers James
MSN, Loyola University, New Orleans, 2006
BSN, Northwestern State University, 1990
Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Nursing with Specialization in Education
Walden University
November 2017

Dedication
I dedicate this study first and foremost to God for providing me with the
opportunity to undertake a doctoral study for the benefit of nursing education. I also
dedicate this study to my husband, Michael, my three children, Barry, Andrew, Maggie,
and my new daughter-in-law, Chloe. Your compassion, dedication, and support for the
greater good is immeasurable. I love you all.

Acknowledgments
I wish to extend my most sincere gratitude to my dissertation chair and mentor,
Dr. Stoerm Anderson. Your support and commitment to nursing research and my success
is greatly appreciated. I would also like to thank Dr. Leslie Hussey, my committee
member for timely, valuable feedback and support with great commitment to student
success. Thank you to Dr. Eileen Fowles for serving as the reviewer of my dissertation as
representative of the University Research Review (URR) committee. My scholarly
success is a result of the influence and integrity of all of you.
I am especially grateful to the research participants who displayed great
commitment to nursing education by volunteering their time to assist me in the
completion of this study. A special thank you to my employer and peers who assisted in
the flexibility of my work schedule and helping in the peer review of this study.
Finally, I would like to thank my family for their love, support, encouragement,
and tolerance as we completed this journey together.

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Table of Contents
Chapter 1: Introduction to the Study ....................................................................................1
Introduction ....................................................................................................................1
Background ....................................................................................................................1
Purpose of the Study ......................................................................................................9
Research Questions ......................................................................................................10
Theoretical Foundation ................................................................................................10
Nature of the Study ......................................................................................................12
Definitions....................................................................................................................16
Assumptions .................................................................................................................18
Scope and Delimitations ..............................................................................................19
Limitations ...................................................................................................................20
Significance of the Study .............................................................................................20
Significance to Nursing Policy ....................................................................................21
Chapter Summary ........................................................................................................23
Chapter 2: Review of the Literature ...................................................................................24
Introduction ..................................................................................................................24
Literature Search Strategy............................................................................................25
Theoretical Foundations...............................................................................................26
Action Science and Action Learning: Kurt Lewin ......................................................26
Action Science and Action Learning: Chris Argyris and Donald Schon.....................27
Reflective Practice: Donald Schon ..............................................................................28

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Literature Review.........................................................................................................30
Active Learning in Education ......................................................................................30
Active Learning and Competency ...............................................................................32
Active Learning, Mentorship, and Identity Development ...........................................33
Leadership Education in Baccalaureate Nursing Programs .........................................34
Methodology ................................................................................................................37
Chapter Summary ........................................................................................................40
Chapter 3: Design, Method, and Analysis .........................................................................42
Introduction ..................................................................................................................42
Research Design, Rationale, Role of Researcher .........................................................43
Role of the Researcher .................................................................................................45
Research Design Method .............................................................................................47
Participant Selection Logic ..........................................................................................47
Procedures for Recruitment, Participation, and Data Collection .................................49
Instrumentation ............................................................................................................52
Data Analysis Plan .......................................................................................................55
Trustworthiness and Ethical Procedures ......................................................................58
Ethical Procedures .......................................................................................................60
Chapter Summary ........................................................................................................62
Chapter 4: Data Collection and Analysis ...........................................................................64
Introduction ..................................................................................................................64
Study Setting and Participant Demographics ..............................................................65

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Data Collection ............................................................................................................66
Data Analysis ...............................................................................................................69
Research Findings ........................................................................................................72
Chapter Summary ......................................................................................................109
Chapter 5: Interpretation of Findings, Recommendations, and Implications ..................111
Introduction ................................................................................................................111
Interpretation of Findings ..........................................................................................111
Study Limitations .......................................................................................................124
Recommendations ......................................................................................................126
Implications and Positive Social Change ...................................................................127
Conclusion .................................................................................................................130
References ........................................................................................................................134
Appendix A: Research Questions ....................................................................................144
Appendix B: Research Interview Protocol ......................................................................145
Appendix C: Matrix of Relationship of Research Questions and Interview
Questions..............................................................................................................147
Appendix D: Email Letter of Introduction to Study and Request for Participation ........148
Appendix E: Letter of Cooperation..................................................................................149
Appendix F: Recruitment Email for Interest in Study .....................................................151
Appendix G: Interest to Participate in Study Survey ......................................................152
Appendix H: Email Letter of Invitation for Participation ................................................153
Appendix I: Content Topics for Interview ......................................................................154

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Appendix J: Content Topics Ranking Matrix .................................................................156

1
Chapter 1: Introduction to the Study
Introduction
Traditionally, nursing pedagogy in leadership courses includes primarily didactic lectures
with a clinical component and occurs in most baccalaureate programs during the last semester
before graduation. There is an assumed expectation that baccalaureate nursing programs should
prepare nursing students for leadership practice (ANA, 2008; AACN, 2008; IOM, 2011, 2016,
Louisiana Campaign for Action, 2017). However, this reality of how disciplinary leadership
skillsets are acquired and transferred into practice is different from the literature that speaks to a
progression from a novice after graduation to a practicing professional over time (Benner 1981;
Forsythe & Snook, 2002; Ganz & Lin, 2012; Winkler & Marshall, 2017).
Healthcare organizations and accreditation bodies have recommended that nursing
education programs prepare graduates with a leadership principles and skill-sets who
demonstrate competence in leadership. This chapter includes a discussion supporting the need
for current research relevant to nursing leadership pedagogy in undergraduate nursing programs.
Background research revealed the significance, purpose, and theoretical influences of this study,
demonstrating alignment with the research questions. Chapter 2 includes further information on
previous research.
Background
Nursing leadership courses in baccalaureate curricula are usually offered during the last
semester before graduation. I reviewed the primary research to identify literature that speaks to
leadership education, the transfer and application of leadership knowledge, and leadership
teaching strategies for effective leadership practice in baccalaureate nursing programs.

2
The traditional lecture/clinical structure of leadership pedagogy does not prepare the
nursing graduate for leadership practice in the workplace, as the clinical component of leadership
courses often involves the student observing a charge nurse or other leader instead of applying
the knowledge learned through practice (Kling, 2009: Lekan, Corazzini, Gilliss, & Bailey, 2011;
Shin, Sok, Huyn, & Kim, 2014). The American Association of Colleges in Nursing (The
American Association of Colleges in Nursing [AACN], 2008), the Institute of Medicine
(Institute of Medicine [IOM] 2011, 2016), the Louisiana Campaign for Action (2016; 2017), and
the National League of Nursing (National League of Nursing [NLN], 2010) place expectations
for the preparation of leadership practice on nurse educators at the baccalaureate level. A
common theme identified within the primary research was that nursing faculty are the facilitators
for the knowledge transfer and development of leadership skills within a variety of settings
(Allen, Ploeg, Kaasalainen, 2012: Kirkman, 2013; Kram, 1983; Lekan, Corazzini, Gilliss, &
Bailey, 2011). Leadership in terms of performance begins after acquiring a basic professional
skill-set, reinforced with a mentored residency assisting the novice in the transition from new
graduate into an expert practitioner over a period of time (Benner, 1981; Forsythe, Snook, Lewis,
& Bartone, 2002; Winkler & Marshall, 2017). Conversely, after reading the IOM report and
follow-up report, one may assume that the novice has developed the professional skill-set for
leadership during the undergraduate nursing program and will enter a period of mentored
practice through mentored residencies for leadership when nursing practice begins (IOM, 2011,
2016).
There is a lack of evidence concerning nursing faculty perspectives on how to maximize
pedagogy in leadership at the baccalaureate level through the employment of teaching strategies
that best prepare nursing students for future leadership practice. A more recent study within

3
business and management literature concluded that undergraduate faculty use lecture and
discussion teaching strategies more than student-centered methods (Jenkins, 2015). Jenkins
(2015) also concluded that teaching strategies using role play, simulation, and games, which
assist in the development and practice of leadership, ranked number 20 out of the 24 methods
included in the study. These teaching strategies were least used when surveyed among 303
leadership educators (Jenkins, 2013). Jenkins’ research agreed with the nursing study by Haber-
Curran and Tillapaugh (2015), which indicated few studies address how to approach leadership
education effectively to prepare students in the area of leadership. Success in the development of
leadership through coaching, role play, and simulation creates experiences necessary in the
preparation of how to practice leadership (Ganz & Lin, 2012).
The development and application of leadership is evaluated by the demonstration of
leadership competencies. Employers of new nursing graduates acknowledge that they lack
leadership competencies that include delegation, supervision, and communication (Lekan,
Corazzini, Gilliss, & Bailey, 2011: Theisen and Sandau, 2013). Nurse leaders; professional
organizations, including the IOM, AACN, ANA, NLN; and others have their own lists of
suggested competencies they consider essential to practice leadership. However, most of the
listed competencies are actually skills related to performance that must be cultivated and
developed over time for leadership practice (Broome & Marshall, 2017).
Alternative teaching practices utilizing mentorship, preceptorship, and reinforcement
through simulation methods integrating the academic and clinical settings may have a positive
influence on nursing curricula for leadership preparatory courses (Kirkman, 2013; Kram, 1983;
Laurent, 2000; Lekan, Corazzini, Gilliss, & Bailey, 2011: Middleton, 2013;Orlando, 1961;
Pollard, 2009; Shin, Sok, Hyun, & Kim, 2014; Smithburger, Knae-Gill, Ruby, & Seybert, 2012;

4
Thomas, Hodson-Carlton, Ryan, 2011). However, I found a deficit in the literature providing
evidence providing evidence of the effect that alternative teaching strategies has on the success
of leadership pedagogy thereby improving learning outcomes for practice (Schlairet & Pollock,
2010; Schlairet, 2011: Scott & Miles, 2013; Shin, Sok, Hyun, & Kim, 2014).
Kling (2009), Laschinger, Wong, and Grau (2012) suggested that leadership practice
exhibiting the transfer of leadership knowledge is imperative for the new graduate to assist in
coping with the stressors of the workplace. However, consistent evidence for an informed
evaluation of measurable learning outcomes for leadership development is lacking (Haber-
Curran & Tillapaugh, 2015; Shin, Sok, Hyun, & Kim, 2014). This study is relevant because
there is a deficit in the literature on how to address the basic skill set consistent with a knowledge
base about nursing leadership and professional identity. This deficit needs to be improved upon
so that the novice nursing graduate will become better prepared to develop into a leader through
mentored residencies and mentored practice once entering nursing practice (Benner, 1981;
Forsythe, Snook, Lewis, & Bartone, 2002; Ganz & Lin, 2012; IOM 2016; Kets de Vries &
Korotov, 2012).
Problem Statement
The expert committee issuing the IOM report, The Future of Nursing: Leading Change,
Advancing Health, recommended that leadership development should be provided within nursing
education curricula, preparing the undergraduate nurse for leadership roles (IOM,
Recommendations 2 and 7, 2011). The AACN recommended in their document, Essentials of
Baccalaureate Education for Professional Nursing Practice (AACN, 2008), that the profession
of nursing can have the greatest impact on the safety and quality of the healthcare delivery
system. Therefore, greater attention by professional nursing organizations and healthcare

5
governing bodies has been placed on the education of nurses and the use of alternative teaching
strategies to provide student nurses with the knowledge, attitudes, and skills to practice
effectively at the minimum level of the baccalaureate degree (AACN, 2008, IOM, 2011; 2016).
According to the AACN (2008), the role of the baccalaureate nurse is to deliver quality care,
understand how to evaluate healthcare outcomes, and develop the ability to provide leadership in
the improvement of patient care in a variety of healthcare settings.
Leadership development is imperative for the nursing student to recognize the value in
leading patient care teams while responding to a changing healthcare environment (Middleton,
2013). Healthcare organizations are not pleased with nursing graduates, stating that they are not
prepared for the transition to the practice of leadership whether at the bedside or in leadership
roles (Lekan, Corazzini, Gilliss, and Bailey, 2011). However, there appears to be a failure of
healthcare organizations to embrace mentored residencies to continue leadership development
instead of only orientations for clinical performance (Winkler & Marshall, 2017). Furthermore,
the IOM follow-up report, Assessing Progress on the Institute of Medicine Report The Future of
Nursing (IOM, 2016), maintained the recommendation that nursing curricula include courses in
leadership skill and entrepreneurship and that healthcare organizations enlist some form of
mentored nursing residencies to continue leadership development after new graduates are
employed. However, while the original report recommended these changes be made at the
baccalaureate level, the only programs listed within the IOM report at this time are master degree
programs or dual degree programs (IOM, 2016). The report concluded that there is no clear
indicator that provides accurate information on the progress of leadership education before entry
into practice (IOM, 2016).

6
The Louisiana initiative, Future of Nursing Campaign for Action in Louisiana (2016) was
the state’s attempt to address the recommendations from the IOM (2011) report. The areas of
focus within this document are relative to the IOM and AACN recommendations for nursing
education to expand leadership opportunities within healthcare environments for the delivery of
quality, safe, patient-centered care. This initiative also challenged nursing education to prepare
the baccalaureate nursing graduate in the areas of leadership, enabling them to assume leadership
roles (Louisiana Campaign for Action, Recommendations 2 and 7, 2016). While the IOM
Report (2010) and the IOM follow-up report (2016) addressed the development and
implementation of nurse residency programs to assist with the transition into professional
practice after completion of a nursing program, there was no mention of mentored residency
programs within the Louisiana Campaign for Action initiative (2016).
The majority of the members of the expert committee involved in crafting the
IOM report did not hold a degree in nursing, and were not involved in nursing academia,
practice, research, or nursing regulatory agencies. Embedded throughout the IOM report
and the AACN position is the assumption that nurses should be ready to practice to the full
extent of their education when they enter the work force. According to both the IOM and
AACN, once a nurse has received a baccalaureate degree, they should be able to practice
leadership and participate in the restructure of the healthcare system (IOM, 2011; AACN, 2008).
However, as I previously stated, the IOM (2011; 2016) established the expectation the new
graduate would be practicing with a mentor or in a mentored residency. Benner (1981)
expressed a different position in her work, From Novice to Expert, stating that the nurse is unable
to practice effectively until gaining the experience within the workplace after the educational and
training process. Benner (1981) further explained that the nurse does not reach the level of

7
competence until after 2 years of practice and experience with the assistance of a preceptor or
mentor. During this stage of nursing practice, the preceptor or mentor is assisting the new nurse
to develop their professional identity while incorporating the basic professionally specific skills,
concepts, knowledge and theory into what will later demonstrate expertly explicated practice
(Benner, 1981; Dreyfus & Dreyfus, 2005). Furthermore, the IOM report recommended the need
for healthcare organizations to implement mentored residencies to assist the novice in the
successful transition into practice (IOM, 2010; 2016).
The nursing student may learn about professionalism and leadership while gaining
some exposure from the clinical setting. However, within the documents from the IOM and
AACN there appears to be an inherent assumption that nursing educational programs should
prepare the student on how to be a nurse while at the same time how to demonstrate leadership
practice before entry into the workplace. Conversely, Benner (1981) established that when a
nurse completes the educational process no matter the degree, they are practicing at the novice
level, learning what it means to practice nursing while following examples of other
professionals. Expert ability develops over time once professional identity and maturity
have been achieved. The expert or leader no longer needs to validate their level of knowledge or
skill before making decisions that require actions to a situation (Benner, 1981: Brown, 2002;
Dreyfus & Dreyfus, 2005; Forsythe, Snook, Lewis, & Bartone, 2002).
The United States Army, Navy, and Air Force support leadership development through
experiential learning. New officers learn what their actual role will be while following another
leader who serves as their mentor. They learn how to develop an understanding of themselves
while developing the character and professional identity required of the role. The new officers
learn how to conduct themselves within a leadership role, before assuming the role of a leader

8
(Brown, 2002; Lagace, 2003). The development of knowledge and skill is a small element in the
educational process of becoming a competent leader. In Making Sense of Officership:
Developing a Professional Identity for 21st Century Officers, Snook stated that individuals
develop their professional identity over time through the experience they acquire from active
participation and interactions with educators and other leaders through their progression from a
beginner to the maturity of a competent leader (Forsythe, Snook, Lewis, & Bartone, 2002).
Traditional classroom instruction is no longer sufficient for preparing the undergraduate
for the nursing practice of leadership (Lekan, Corazzini, Gilliss & Bailey, 2011; Shin, Sok,
Hyun, & Kim, 2014). Through a review of the literature, I have determined that there is little
current contemporary research related to effective teaching strategies used for leadership
education that adequately prepares the undergraduate student for the continued development of
leadership practice. The literature fails to reveal, from a nursing faculty perspective, how
leadership pedagogy is conducted to prepare the nursing graduate to be receptive to leadership
practice. Furthermore, there is a deficit in the literature regarding the effectiveness of current
operationalized teaching methods or strategies used by faculty who teach leadership. Given this
context, I focused on an exploration of deficits that exists in the contemporary understanding of
how nursing educators in Louisiana teach leadership in baccalaureate programs contrasted with
ideal policy expectations.

9
Purpose of the Study
The purpose of this qualitative study was to explore the pedagogy employed by nursing
faculty to maximize leadership preparation in Louisiana baccalaureate nursing programs within
the context of the content recommendations guided by the AACN Essentials of Baccalaureate
Education (AACN, 2008) or other professional nursing organization’s guidelines for leadership.
I used an exploratory approach, using a semistructured interview protocol to answer the
research questions regarding how leadership education is conducted. Using the qualitative
tradition, research questions are best answered through the interpretation of the research
participants (Patton, 2002). Faculty who teach or have taught leadership for at least one year in
Louisiana baccalaureate nursing programs provided the answers to the research questions.

10
Research Questions
The five primary research questions for this study were as follows:
Central Question: What teaching strategies are deployed for leadership education among
Louisiana baccalaureate nursing programs?
Sub-Questions
1. Using the 17 content topics included within in the document, the AACN Essentials
of Baccalaureate Education as a guide, or another professional nursing
organization’s content areas for leadership, what are the top 10 content topics of
the leadership course? (The content topics were presented to the participants prior
to the interview and follow in Appendix I).
2. How do nursing faculty select the teaching strategies deployed for leadership
education?
3. How do nursing faculty evaluate the effectiveness of the deployed teaching
strategies compared to the development of leadership knowledge and professional
skill-set?
4. What is the nursing faculty’s perception of the efficacy of leadership education
and the student’s preparation for leadership at the baccalaureate level before entry
into practice?
Theoretical Foundation
I did not identify a specific theoretical foundation for leadership education that addresses
the research questions for the purpose of this study. I conducted this qualitative inquiry through
the lenses of action learning and reflective practice. According to Patton (2002), information
revealed through qualitative study using action theory may influence the understanding and

11
explanation of what is happening in programs, in this case, possibly informing the needs for
nursing program improvement. The theoretical influences of action learning (Argyris & Schon,
1974), and reflective practice (Schon, 1983, 1987) guide qualitative methods of inquiry in
understanding how individuals learn, how they reflect on what is learned, and how to improve
programs or practice using new methods from what was learned or revealed from the inquiry
(Kets de Vries & Korotov, 2012; Patton, 2002).
Through a review of the literature, I found that action learning is more effective when the
learner is allowed to participate in a safe environment, actively participating in the project or
activity with the instructor or coach (Argyris and Schon, 1974; Kets de Vries & Korotov, 2012;
Patton, 2002). Schon (1983, 1987) and Ganz and Lin (2012) discussed that the professional
practitioner learns through active practice with mentorship from the instructor or coach. This
interaction promotes the development of alternative methods of problem solving through
reflection and debriefing on what was learned from the encounter or circumstance. These
theoretical influences were the framework for this study, aligning the primary research questions,
research methodology, and purpose of this study.
Middleton recommended the work of Dewing (2008) for the application of the active
learning theory with learning examples from individuals with practice experience in the
workplace. The instructor integrates these experiences into the educational process using
alternative methods of teaching. However, after a review of the works cited by Middleton
(2013) and Dewing (2008; 2009), I found that neither gave credit to the original writers of the
theory of action learning. Dewing’s (2008) works that I read are syntheses of primary works with
no theoretical foundation (Fink, 2013; Revans, 2011). I chose not to reference the works of the
aforementioned authors without citations to original theoretical influences. The lack of original

12
context was problematic for my exploration of true action learning and reflective practice for
leadership education. For the purpose of my research, these references are not included within
the primary research influences. Chapter 2 will provide further discussion on the primary
literature, theoretical foundations, and emerging theoretical concepts guiding this study.
Nature of the Study
Basic Qualitative Exploratory Design using Grounded Theory Analytical Approach
The basic exploratory qualitative research paradigm using the inductive approach for data
collection and analysis was informed by the grounded theory design of Corbin and Strauss
(2015). The grounded theory approach guided this qualitative inquiry through the perspective of
interpretivism. However, the generation of theory was not my intent for the purpose of this
study. My primary intent for this study was to learn from nursing faculty how leadership
education is being taught to nursing students in baccalaureate programs. New information and
understanding was gathered using practical questions in a realistic setting about what is
happening in baccalaureate programs offering leadership education. Meanings, descriptions,
concepts, explanations, and interpretations emerged from the application of the analytical
procedures involved with coding and the characteristic constant comparative method of Corbin
and Strauss’s (Corbin & Strauss, 2015) grounded theory approach, which I tailored to the
context of this study without the generation of new theory.
The qualitative paradigm is best suited for the development of understanding,
explanation, or description of processes or programs (Grove, Burns, & Gray, 2013: Patton,
2002). I sought to obtain new information to understand, describe, and explain a collection of
social and educational processes among the faculty of baccalaureate nursing programs who teach
leadership education since little was revealed in the literature about pedagogy in leadership

13
among Louisiana nursing programs. Video conferenced interviews using a semistructured
protocol were conducted among nursing faculty who taught leadership courses in Louisiana
baccalaureate nursing programs.
The basic qualitative research design using the tenets of the Corbin and Strauss (2015)
grounded theory approach was best suited to help me answer the research questions. I tailored
the approach according to the context of this study using the classic constant comparative
method for data collection and analysis. Because my intent was to seek new information instead
of the generation of theory, I utilized data analysis that included open coding of emerging
concepts and axial coding of emerging relationships among those concepts (Corbin & Strauss,
2015).The practical research questions related to the basic social and educational processes of
how leadership is taught in nursing education programs. The practical research questions
provided direction for the identification of concepts, variations, and how concepts or constructs
related to each other (Corbin & Strauss, 2015).
Qualitative research is best conducted in comfortable surroundings through the interview process
among individuals who have experienced the phenomenon under study, in this case the faculty
who teach leadership in each nursing program (Patton, 2002). Even when leadership content
topics are well delineated, the research I read failed to reveal a general understanding of the
social and educational processes involved with teaching leadership. I was unable to identify
educational processes such as the program design, teaching strategies, or the integration of active
learning from a nursing faculty’s perspective. It was unclear from my review of the literature,
the nursing faculty’s perception of the advancement of leadership at the baccalaureate level
(Curran & Tillapaugh, 2015; Jenkins, 2015; Scott & Miles, 2013). The problem I identified was
the deficit that exists within the literature of nursing faculty perspectives on how to maximize

14
pedagogy in leadership at the baccalaureate level, preparing the novice to be receptive to
leadership practice after graduation from Louisiana baccalaureate nursing programs.
My study addressed the research problem, noting future research implications for
mentored residencies and practice addressed by Benner (1981), Forsythe, Snook, Lewis, &
Bartoe (2002), and Broome & Marshall (2017). The purpose of this qualitative study was to
explore the pedagogy employed by nursing faculty to maximize leadership preparation in
Louisiana baccalaureate nursing programs within the context of the content recommendations by
the AACN Essentials of Baccalaureate Education or other professional nursing organization’s
guidelines for leadership. The qualitative approach revealed emerging similarities, differences,
and uniqueness of how leadership is taught in Louisiana baccalaureate nursing programs. The
constant comparative method of data collection and analysis assisted me in answering the
research questions without the generation of theory. I sought to understand how leadership
education was approached in nursing programs in Louisiana before addressing the generation of
nursing leadership theory.
The data analysis method of thematic analysis was considered. However, the systematic
process of data collection and analysis after each interview for the emergence of themes and
categories has not been clearly defined for basic exploratory study using thematic analysis
(Aronson, 1995; Fereday & Muir-Cochran, 2006). I considered using an open-ended survey
approach. However, the ability to collect quality data is limited using the survey compared to the
semistructured interview protocol (Grove, Burns, & Gray, 2013).
Therefore, to answer the research questions in a systematic and progressive manner,
grounded in the data, the application of the basic elements of the constant comparative method of
the Corbin and Strauss (2015) grounded theory approach was best suited for my research. I

15
tailored this approach to the context of a study without the generation of new theory. Benner
(1981) also chose this approach without the generation of theory in her work, From Novice to
Expert. My utilization of the analytical procedures of the Corbin and Strauss grounded theory
approach without the generation of theory, allowed me to discover new information and
understanding of how leadership is taught in each nursing program (Benner, 1981; Corbin &
Strauss, 2015). The sampling strategy I chose to use was the combination of a purposive,
maximum variability and chain sampling strategy. I discovered diverse perspectives among
faculty who teach or have taught leadership in Louisiana baccalaureate nursing programs by
using this method for sampling.
The interaction between the researcher and the participants who know the most about a
phenomenon allows concepts, meanings, and feelings to emerge. Emerging patterns and themes
are discovered best from comprehensive transcripts, tapes, memos and journals using a
systematic, structured process for addressing the data (Corbin & Strauss, 2015). The shared
feedback from participants helps to validate emerging content and themes identified by the
researcher within the transcripts. This adds to the rigor of the inductive procedures of the Corbin
and Strauss (2015) grounded theory approach using the qualitative paradigm. I have mentioned
previously, I tailored the constant comparative data collection and analysis process for the
context of this study without the generation of theory.
This study, informed by new information I gathered from the suggested approach for
inductive data collection and analysis was framed by the principles of action learning, and
reflective practice (Argyris & Schon, 1974; Dewey, 1986; Kolb, 1984; Lewin, 1939 as cited by
Adelman, 1993; Lewin, 1946, 1999; Patton, 2002; Schon, 1983, 1987). The theories of active
learning and reflective practice relate to learning and problem-solving using qualitative inquiry.

16
This enables the researcher to explore and understand the social interactive environment,
reflecting and learning from those social interactions or processes for the purpose of
improvement or the development of a new and different understanding of the social environment
being researched (Patton, 2002). The selected research method I used to answer the research
questions for the purpose of this research is discussed further in Chapters 2 and 3.
Possible Types and Sources of Data
1. Interviews with individual faculty who teach leadership courses in selected
Louisiana baccalaureate nursing programs
2. Review of interview transcripts and findings with the participants for member
checks to deepen and expand understandings and identify mistakes and
misconceptions
Definitions
For the purpose of this study, the following terms are discussed according to these
operational definitions:
Active Learning Method: An approach to learning through active participation,
interaction, and reflection between the faculty and student through simulation, role play, games,
scenarios, or other learning approaches that may be substitute or in addition to the traditional
lecture and clinical (Lewin, 1939 as cited by Adelman, 1993; 1999: Argyris & Schon, 1974;
Dewing, 2008; Schon, 1983, 1987; Middleton, 2013).
Traditional Learning Method: Delivery of nursing course content through lecture, the
clinical hospital experience, and summative assessment.
Experiential Learning: learning by doing, involving the reflection on previous learning
(Dewey, 1938; Kolb, 1980; Lewin, 1951; Schon, 1983, 1987).

17
Reflective Practice: “Reflection in action” in the construction of a new problem-solving
technique or reflecting on what he/she has been taught, integrating this “knowledge in practice”
to “reflection in action.” (Schon, 1983).
Leadership: the process by which an individual engages another for the achievement of
mutual objectives, goals, or achievements (Burns, 1978; Gardner, 1990).
Leadership Performance: The activity of conducting leadership strategy, decision making
based upon data, communication, change management, change theory, and systems thinking
practiced at the bedside in patient care delivery or serving in a role in healthcare systems and
organizational relationships with training (Middleton, 2013, Lacasse, 2013, Ulrich, Lavandero,
and Early, 2014).
Leadership Competence: The concept “competence” originates from the Latin language
as “the ability of a person to do a particular thing” (Stan, 2014). Although there are variable
definitions for competence across disciplines, based upon the review of the literature,
competence involves behaviors and actions specific to one’s role (Stan, 2014). Therefore, for the
purpose of this study, leadership competence is defined as “behaviors and actions” that are
specific to nursing practice in the ability to lead patients toward improved health outcomes or the
ability to lead individuals or teams toward meeting unit and organizational goals.
Nursing Leadership: The practice or performance of leadership activities as a student,
faculty, or practitioner, within a nursing environment whether the activity is practiced within the
educational institution or the clinical environment (Lacasse, 2013; Middleton, 2012; Ulrich,
Lavandero, and Early, 2014).
Mentorship: Providing a facilitated relationship with role modeling, counseling,
confirming to enhance a “sense of competence, clarity of identity, and effectiveness in one’s

18
role.” The mentor provides psychological and sometimes professional support that leads to
success during the nursing student’s educational process (Kram, 1980, 1983, Levinson, et al.,
1978).
Professional Identity: The emerging development of the individual “self” drawn from
personal experience and practice through social contact with others, including faculty in school
and leaders in the workplace. This is a development of concepts, values, morals, and personal
worldview reflecting the individual’s understanding of social interactions creating the need to
demonstrate leadership (Perry, 2012; Snook, Nohria, Khurana, 2012; Waters, Altus, &
Wilkinson, 2013).
The operational definitions discussed may be modified from the emerging data and
concepts during the data collection and analysis process.
Assumptions
The assumptions for this study were that nursing faculty participants would provide
honest responses to the interview questions. It was also assumed that the participants who
agreed to participate in the sample were actual nursing faculty who had been involved in
Louisiana nursing education programs for at least one year. It was assumed that the participants
who agreed to participate currently taught or have taught leadership education, having the
knowledge and preparation to conduct a leadership course within a Louisiana baccalaureate
nursing program. Finally, it was assumed that the interview process may be conducted during a
semester when leadership courses are being offered. These assumptions are necessary in the
context of this study to best answer the research questions from the participants who have the
experience, knowledge, and diverse interpretations of the social processes involved in leadership
pedagogy (Glaser & Strauss, 1967, 1995, 1999, 2008; Corbin & Strauss, 2015, Patton, 2002).

19
Scope and Delimitations
The exploratory qualitative research design using the suggested systematic data collection
and analysis procedures of Corbin and Strauss (2015) grounded theory without the generation of
theory, validates a pragmatic epistemology because there was no clear understanding of how
leadership education in Louisiana is being addressed to meet the recommendations of the IOM,
The Future of Nursing (IOM, 2011; IOM, 2016), the AACN (2008) recommendations, and the
Louisiana Campaign for Action (2016; 2017). Patton (2002) suggested that the pragmatic
approach to qualitative inquiry using the interview process provides answers to questions that
may add to the support, development, and improvement of programs. According to Patton
(2002), this method of inquiry contributes to action science, which aligned with the theoretical
foundation of this study through the perspective of interpretivsm.
The population for this study was selected from baccalaureate nursing programs that were
supported by the state of Louisiana, accredited by the Louisiana State Board of Nursing (LSBN),
with a status of full approval. Programs with a probationary status were the excluded
populations from this study. The nursing faculty included in the study population were actively
teaching or had taught leadership for at least one year in a Louisiana baccalaureate nursing
program. Nursing faculty who do not meet the inclusion criteria were excluded.
The delimitations to this inductive qualitative inquiry were that had no preconceived
knowledge of the participating institution’s curricular design or leadership course structure and I
was not a faculty member of a Louisiana state-supported institutions included in the sample.
Nursing faculty who do not teach leadership courses were excluded.

20
Limitations
A limitation is that I am a faculty member of a state-supported institution and a member
of the Louisiana Campaign for Action, Region 6. However, I teach in an RN-BSN program
which is excluded from this study. The Region 6 committee for the Louisiana Campaign for
Action was collecting data from practicing nurses who are already leaders in healthcare facilities
and organizations in Central Louisiana. I have a personal interest in this research topic. While I
agree that leadership should be taught in baccalaureate curricula, I believe the teaching strategy
should differ from traditional methods, providing students with realistic, safe, opportunities for
learning about nursing leadership. I believe nursing students should have an understanding of
the science, profession, and practice of nursing before attempting to lead patient care teams.
There is uncertainty on how one may develop leadership knowledge and skill while learning
what the profession and practice of nursing is about. However, despite my beliefs, a
semistructured interview protocol was followed for each interview for consistency among
participants (Patton, 2002). Findings from this study could be extrapolated for application into
future research (Patton, 2002).
Significance of the Study
Significance to Nursing Education
According to Scott and Miles (2013), there is a gap in the literature addressing the
development of leadership through education. Through my continued review of primary
literature, a deficit was discovered. There was a lack of primary current contemporary research
informing the development of leadership using best practices in nursing education. The literature
suggested that while there was evidence related to simulation, role play, role modeling, and
reflective activities for skill performance and competency development, there were few studies

21
on how these teaching strategies may be effective for leadership education and competency
development. Throughout these studies, the effectiveness of the teaching strategies are evaluated
through perceptive survey, questionnaires, and interviews among students participating in the
courses (Haber-Curran & Tillapaugh, 2015; Katz, Piefer, & Armstrong, 2010; Shin, Sok, Hyun,
& Kim, 2014). I was unable to locate studies that speak to how nursing faculty evaluate the
effectiveness of teaching strategies used for leadership education. The purpose of this qualitative
study was to explore the pedagogy employed by nursing faculty to maximize leadership
preparation in Louisiana baccalaureate nursing programs within the context of the content
recommendations guided by the AACN Essentials of Baccalaureate Education or other
professional nursing organization’s guidelines for leadership. This study may be influenced by
existing theory that may support alternative teaching strategies using best practices for the
application and assessment of leadership knowledge and competence through active participation
and reflection in baccalaureate nursing programs (Horton-Deutsch, 2016; Middleton, 2013;
Haber-Curran & Tillapaugh, 2015; Shin, Sok, Hyun, & Kim, 2014).
Significance to Nursing Policy
Nursing educators at the baccalaureate level require evidence-based methods that are
considered best practices for the preparation of graduates to meet healthcare organization
expectations as well as leadership development expectations (Haber-Curran & Tillapaugh, 2015).
The adoption of alternative teaching strategies could make a positive contribution to nursing
science and nursing policy prefacing the speculation of a faculty shortage in the midst of the
expectation to increase the percentage of baccalaureate graduates in the workplace from 50-80%
by the year2020 (IOM 2011; 2016, AACN, 2008). The application of alternative teaching
strategies influenced by action science and the action learning theory could support student

22
engagement in the practice of leadership, providing a formative evaluation for leadership
competence and program improvement meeting the expectations of the Louisiana Action
Coalition (2016; 2017), the IOM (2011; 2016) and the AACN (2008) recommendations for
leadership preparation of the baccalaureate student (Argyris & Schon, 1974; Dewey, 1986;
Dewing, 2008; Dewing, 2009: Lewin, 1946, as cited by Adelman, 1993; Lewin, 1999; Patton,
2002; Shin, Sok, Hyun, & Kim, 2014; Schon, 1987).
Significance to Nursing Practice
Action learning may be demonstrated through simulation using collaborative activities,
active participation, role modeling, reflection, role play, or peer mentorship (Argyris & Schon,
1974; Broome & Marshall, 2017; Dewey, 1986; Dewing, 2008; Dewing, 2009; Kolb, 1984;
Lewin, 1946 as cited by Adelman, 1993; Lewin, 1999; Patton, 2002; Shin, Sok, Hyun, & Kim,
2014; Schon, 1984). Therefore, the theoretical influences of the processes of action science,
action learning, and reflective practice could enhance nursing practice through nursing program
improvement and alternative teaching strategies that engage learning with purpose through
practice (Argyris & Schon, 1974; Dewey, 1986; Dewing, 2008, 2009; Horton-Deutsch, 2016;
Kolb, 1984; Lewin, 1946 as cited by Adelman, Lewin, 1999; Patton, 2002; Schon, 1984).
Significance to Nursing Research and Social Change
Finally, this study may offer potential benefit to nursing research and theory, thus
promoting social change for nursing academia by preparing the undergraduate nursing student
for leadership challenges within healthcare environments promoting patient safety, quality
patient care outcomes, patient satisfaction, and interprofessional satisfaction (Middleton, 2013;
Esparza & Rubino, 2013). There is the potential for future research that reveals the effect of
alternative teaching strategies, mentored residencies, and mentored practice for the development

23
of leadership practice over time after entering nursing practice. The commonalities and
uniqueness among nursing programs gathered from this study may influence future research to
maximize pedagogy for other undergraduate courses for the improvement of nursing program
outcomes.
Chapter Summary
The IOM (2011, 2016), the AACN (2008), and the American Nurses Association (ANA,
2010) recommended that by the year 2020, the minimum educational preparation for at least
80% of employed nursing graduates should be at the baccalaureate level. Additionally, these
organizations, along with the Louisiana Campaign for Action (2016; 2017) and the National
League of Nursing (NLN, 2010) recommended that the undergraduate nurse be prepared to
display competence in leadership upon entering the healthcare workforce (ANA, 2010; AACN,
2008; IOM, 2011, 2016). The research I have discussed and explained within this chapter has
been an attempt to inform the purpose, significance, and relevance of this study with potential
research implications using qualitative inquiry.
Chapter 2 details the extensive literature I reviewed of the primary research supporting
the background, significance, selected methodology, and theoretical foundations of this research
study. The detail from the review of the literature offers validation that a gap within current
contemporary literature exists. The lack of current primary literature revealing a nursing faculty
perspective on effective teaching strategies to maximize pedagogy in leadership for the
baccalaureate nursing students contributed to the need for this study.

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Chapter 2: Review of the Literature
Introduction
This chapter includes a description of my search of the primary literature for information
regarding effective teaching strategies for leadership within baccalaureate nursing programs.
The purpose of this search was to find evidence of various teaching strategies and their
effectiveness for preparatory leadership education. My search focused on teaching strategies
responsible for the transfer and application of leadership knowledge and leadership competence
in the development of nursing leadership before entry into practice as recommended by the
Institute of Medicine (IOM), the American Association of Colleges of Nursing (AACN), the
National League of Nursing (NLN), and the American Nurses Association (ANA). My inability
to find contemporary literature revealing effective teaching strategies for leadership pedagogy
from a nursing faculty perspective established the need for this study.
The purpose of this qualitative study was to explore the pedagogy employed by nursing
faculty to maximize leadership in Louisiana baccalaureate nursing programs within the context
of the content recommendations by the AACN Essentials of Baccalaureate Education or other
professional nursing organization’s guidelines for leadership. I tailored this exploratory
qualitative design with the application of the Corbin and Strauss (2015) grounded theory
approach according to the context of this study. I chose the constant comparative method for data
collection and analysis without the generation of theory. This systematic analytical procedures
for a qualitative study are used when little is known about the phenomenon, allowing the
research findings to emerge through the chosen data collection process (Corbin & Strauss, 2015).
This chapter reflected my initial review of the literature without introducing information that
could affect the understanding of new findings regarding the perspectives from nursing faculty

25
who teach leadership. Chapter 5 provides further detail of the research findings and supporting
literature of findings that emerged from the data analysis I conducted for this study.
In the first section of this chapter, I discuss the strategy utilized to identify primary
research related to teaching strategies and leadership education before entry into nursing
practice. I will address within the second section the theoretical foundations that served as the
conceptual and contextual lenses for this study. The third and final sections of this chapter offer a
preliminary integrative review of the current literature related to the teaching strategies for
leadership education and the selected methodology for the study.
Literature Search Strategy
I conducted an iterative search of the primary literature within the multiple databases
available through Walden University library resources. My aim was to identify research
germane to the discipline of nursing, education, business, management, and military. These
databases included Business Source Complete, CINAHL, CINAHL Plus, CINAHL and
MEDLINE Simultaneous Search, Education Research Complete, Google Scholar, MEDLINE,
ProQuest, PsycINFO, and Thoreau Multi-Database Search. I used Google Scholar and retail
bookstores to locate primary works and original materials related to theoretical influences,
concepts, and contexts there were identified throughout my research.
To conduct the literature search, I searched multiple databases, search engines, and retail
bookstores. Searches among other workforce populations besides nursing were conducted. The
initial search terms include but are not limited to: active learning, action science, nursing
education, undergraduate nursing education, undergraduate nursing programs, undergraduate
nursing leadership, leadership education, baccalaureate nursing education, leadership
competency, leadership development, leadership teaching strategies, leadership theory,

26
Louisiana nursing programs, reflective practice, and simulation in nursing education. More
detailed search terms and search term combinations emerged from the initial literature search. I
was unable to identify a theory or framework for leadership education. The common themes I
identified from the literature review directed me to the primary works guiding the theoretical
influences of my research.
Theoretical Foundations
My search for primary literature identified common themes providing the conceptual and
contextual lenses, imparting theoretical guidance for the exploration of nursing leadership
pedagogy. The theoretical foundations I discuss in this section were gathered from the following
works which are discussed in detail:
1. Action science influences of Lewin (1939, 1946, 1999)
2. Action learning of Argyris and Schon (1974)
3. Reflective practice of Shon (1983, 1987)
Action Science and Action Learning: Kurt Lewin
The literature revealed that active learning methods were effective teaching strategies
when students were participating and practicing within the learning environment. Action science
originated from the works of Lewin (1939 as cited by Adelman, 1993). Adelman (1993)
provided a meaningful synthesis of Lewin’s work on action science. The influence of action
science informed action research in Lewin’s 1930s research. Lewin’s research involved the
combined, active participation of the researcher and others in the exploration of problems and
tasks, collaborating to make group decisions for action, thereby learning from the consequences
of those decisions. Continued reflection of those actions and new strategies were a result of this
interaction. Action research was not relevant for this exploratory study since the intent of its use

27
is to learn new information and solve a problem in collaboration with others. However, Lewin’s
contribution to action science and its influence on action learning is important to mention for the
context of this study (Lewin, 1939 as cited by Adelman, 1993; Lewin, 1946, 1999).
Action Science and Action Learning: Chris Argyris and Donald Schon
The theoretical influences that impact the social processes of action science,
action learning, and reflective practice could enhance program improvement and teaching
strategies that engage learning with purpose through practice (Argyris & Schon, 1974; Dewey,
1986; Dewing, 2008, 2009; Kolb, 1984; Lewin, 1946 as cited by Adelman, 1993; Lewin, 1999;
Patton, 2002; Schon, 1984). The theoretical influences of the models developed by Argyris and
Schon (1974) that are revealed through the conceptual lenses of theory in use help explain why
and how individuals choose and implement actions for the situations they are presented with
(Anderson, 1994). I identified throughout the literature review that active learning and reflective
practice had a great impact on student success. This theoretical influence also had an impact on
the student’s personal identification with their chosen profession. The conceptual lenses of these
theories assisted me in the alignment of the research questions to the emergence of new
information of how to maximize leadership pedagogy among baccalaureate nursing programs.
There are two forms of learning that were discussed by Argyris and Schon (1974). Single loop
learning is revealed by the learner taking action in such a way as to appear competent according
to others’ beliefs. However, double loop learning is revealed by the learner actively participating
with others, helping the individuals to determine the best action (Argyris, 1974; Anderson,
1994).
Argyris and Schon (1974) stated that their definition of a theory of action is the deliberate
behavior of an individual. They believed that individuals take deliberate action and that action

28
can be explained through action learning theory. However, they also believed that individuals
should develop an understanding of not only taking action but also reflecting on the positive or
negative consequences of taking the action. The theories of action that Argyris and Schon are
best known for are the Model 1 and Model II (Argyris & Schon, 1974). After review of the
works developed by Argyris and Schon, Model I of the theories of action is less conducive and
less effective to learning than Model II.
Argyris and Schon (1974) described the learning environment for each model. Model 1
was described as ineffective, no feedback from the instructor, performance conducted by others’
expectations, intimidation, and deception. Model II, on the other hand, involves a partnership
between the instructor and the student. The instructor provides feedback for positive and
negative actions to assist the student in reflecting on the actions taken to improve on future
actions. The student in Model II is engaged in the process of learning along with the instructor,
thereby developing new behaviors. Conversely, when there is no positive relationship to promote
learning, as in Model I, the student may develop a sense of failure and either stop learning, or
become less engaged in the social process which may cause the student to be unsuccessful
(Agyris & Schon, 1974).
Reflective Practice: Donald Schon
Reflection and reflective practice are theoretical influences referenced in much of the
literature found on nursing education that incorporates active learning. Schon (1983, 1987), in
his work on reflective practice, stated that the professional practitioner learns through active
practice with the guidance, facilitation, or mentorship from the instructor. The learner practices
learn through reflection, learning from the consequences of actions, thus developing alternative
methods of solving problems when faced with them in the future. Benner, Sutphen, Leonard, and

29
Day (2010) referenced Schon in their work, Educating Nurses: A Call for Radical
Transformation, and discussed using reflection. However, they failed to provide a full
understanding of how the student learns by doing through reflection (Schon, 1983, 1987). They
only referred to Schon’s work by using reflection through journaling of the student’s experiences
(Benner, Sutphen, Leonard, & Day, 2010).
Schon described using reflection in action with education as a process to assist students to
learn by doing. This process takes time, allowing the student to reflect on actions taken, with the
help of the instructor on what was learned, what worked, and what did not work. The student
gains experience over time, preventing the student from tackling problems without knowing the
important aspects of designing a solution (Schon, 1987).
The creation of a practicum, conducive to learning in a safe environment was suggested
for the instructor or learning coach to place the student in situations they will experience in their
profession (Schon, 1983, 1987). Role play, simulation, or case studies where the student
participates in the experience with no outside assistance has been recommended for nursing,
business, or military education programs. When the learning experience is over, the student
reflects through a debriefing exercise (Dyer & Taylor, 2012; Kirkman, 2013; Sax, 2006;
Schlairet, 2011; Schon 1983, 1987; Snook, Nohira, & Khurana, 2012). The student who does
not have a positive experience in learning by doing in the active partnership with the coach or
instructor may become defensive when they are unable to design the appropriate action. These
students may feel incompetent, lose confidence, and do not accept responsibility for their
learning (Schon, 1987, pp. 166-167).

30
Literature Review
I conducted the literature review to locate useful evidence in multiple research
methodologies to inform this qualitative study. Nursing is an evidence-based interdisciplinary
practice (Winkler & Marshall, 2017; Horton-Deutsch, 2016). I approached this literature review
from a diverse selection of research that addressed the purpose of this qualitative study. The
purpose of this study was to explore the pedagogy employed by nursing faculty to maximize
leadership in Louisiana baccalaureate nursing programs within the context of the content
recommendations by the AACN Essentials of Baccalaureate Education or other professional
nursing organization’s guidelines for leadership. Whittemore and Knafl (2005) suggested to
conduct a complete review of research identified through the different research paradigms to
help control the introduction of bias from primary sources and to ensure comparative accuracy of
information. I found that a broad review of the literature added to the relevance of this study.
Garard (2014) suggested that the primary literature review should be cataloged using the
literature matrix method. Whittemore and Knafl (2005) suggested the integrative approach to
identify common categories and themes assisting in the synthesis of the literature. I identified
primary sources using various research methods related to empirical evidence and theoretical
influences guiding this study. The review for primary resources was limited, therefore some
references to secondary literature were included to add support for the deficit of primary
literature.
Active Learning in Education
The initial literature review and subsequent narrowly focused reviews that I conducted
revealed common themes. The themes I identified were related to active learning methods and
active learning teaching strategies for the improvement of nursing education and nurse

31
competency development for the potential benefit of nursing programs and organizations. These
studies were descriptive qualitative, mixed methods, and quantitative by research designs. The
integration of active learning strategies in the classroom is important to knowledge processing,
problem-solving, and effective evaluation of the transfer of knowledge. The integration of active
learning enables the student to process knowledge through active social interaction and reflection
upon those knowledge processes, producing new knowledge. The social processes that impact
educational processes include problem solving, shared reflection or debriefing, collaborative
activities, and group decision making (Argyris & Shon, 1974; Middleton, 2013; Niemi, 2002;
Shin, Sok, Hyuan, & Kim, 2014; Pfaff, Baxter, Ploeg, & Jack, 2014; Shon, 1983, 1987).
Common themes identified in the literature addressing active learning in education
suggested the integration of simulation with role play, scenarios, collaborative activities, or case
studies (Wu, Wang, Wu, & Guo, 2014; Jenkins, 2015). Experiential learning is a common
theoretical influence discussed by the authors when using active learning and the engagement of
students in competency practice (Dewey, 1986; Kolb, 1984). Active learning applied to nursing
education, using these strategies engaged students in communication, collaboration, reflection,
and other activities that encourage active participation (Argyris & Schon, 1974; Middleton,
2013; Dewing, 2008). While Jenkins (2015) stated that students learn best with innovation and
nontraditional methods, there is a lack of evidence that the effectiveness of active learning has
been evaluated except through instruments that measure student perceptions of learning (Curran-
Haber & Tillapaugh, 2015; Shin, Sok, Hyuan, & Kim, 2014; Wu, Wang, Wu, & Guo, 2014;
Middleton, 2013).

32
Active Learning and Competency
The literature consistently revealed that student leadership competency is enhanced by
the application of active learning teaching strategies in the classroom. Throughout the literature
a common theme was discussed by the researchers that traditional education is no longer
efficient for knowledge transfer and competency development (Kum & Fletcher, 2012; Lekan,
Corazzini, Gilliss, & Bailey, 2011; Shin, Sok, Hyuan, & Kim, 2014; Theisen & Sandau, 2013).
Students are accustomed to learning in fragments, receiving only what the instructor provides.
When an educator has taught in a fragmented way and does not understand how to apply an
active learning strategy, the student receives a fragmented education (Niemi, 2002). The studies I
have referenced here advocated for the integration of active learning for effective knowledge
transfer and assessment. Furthermore, the authors suggested that competencies should be
evaluated as often as clinical skill for the validation of knowledge transfer and teaching
effectiveness to prepare the student for practice (Niemi, 2002; Russ, McKinney, & Patel, 2012;
Shin, Sok, Hyun, & Kim, 2014).
The research I read related to competency development with the integration of active
learning measured student perception instead of obtaining the faculty’s perspective or
interpretation of the teaching or learning effectiveness. The comparison of competency among
the traditional methods compared to active learning methods revealed only measures of student’s
perception of competence and no faculty perspective of effective learning with measurable
outcomes (Haber-Curran & Tillapaugh, 2015; Middleton, 2013;Shin, Sok, Hyuan, & Kim, 2014:
Smithburger, Kane-Gill, Ruby, & Seyburt, 2012; Wu, Wang, Wu, & Guo, 2014).

33
Active Learning, Mentorship, and Identity Development
The positive relationship between the nursing faculty and the student in the form of
facilitation or mentorship is important in an active learning environment. Throughout the
literature review, including the original works, the researchers revealed that student success in
learning, including leadership education, is dependent on the faculty, teacher, instructor, clinical
preceptor, or learning coach. These individuals assume a key role as facilitator or mentor within
the learning relationship. The interaction between the experienced faculty, instructor, or assigned
mentor and the inexperienced student can have either a positive or negative impact on how the
student learns and proceeds into a career path. This relationship and its impact on student success
and professional identity was also evident in other workforce populations besides nursing, such
as the United States Army, Navy, Air Force, business, and management (Bender, Yaffe, &
Sechrest, 2012; Forsythe, Snook, Lewis & Bartone, 2002; Hallier & Summers, 2011; Palmer,
Hunt, Neal, & Wuetherick, 2012).
The National League of Nursing (NLN, 2010) in its publication, NLN Competencies for
Nursing Graduates, includes professional identity as a core competency for the undergraduate
student. The student who receives guidance from an individual employing knowledge, skill, and
support specific to the chosen career or profession, develops an identity influencing the social
processes and professional aspects of their future (Bender, Yaffe, & Sechrest, 2012; Palmer,
Hunt, Neal, & Wuetherick, 2012). Knowledge alone does not enable the student to identify with
the profession. However, the student must develop an understanding of the professional
characteristics, social processes, and the competencies that identify the individual as a
professional (Benner, 1981; Dreyfus & Dreyfus, 2005; Forsythe, Snook, Lewis, & Bartone,
2002; Russ, McKenney, & Patel, 2013). This understanding of the profession, social processes,

34
and competencies develops over time, sometimes taking years of following other professionals
before the individual has learned and developed an identity through experiences within the
profession (Benner, 1981; Dreyfus & Dreyfus, 2005; Forsythe, Snook, Lewis, & Bartone, 2002).
Historically, nursing education began in the classroom with didactic lecture on the
theoretical aspects of nursing. The technical training occurred in the clinical setting, enabling the
student to experience the profession. The professional reference within the workplace assisted
the student to begin the development of a professional identity, although this exposure was
limited based on the constraints of the nursing course. The limited literature that I identified,
primarily for nursing professional identify, revealed that students perceive theory and clinical
placement as important aspects toward professional identity. However, the engaged clinical
mentor within a successful clinical placement appeared to have the strongest influence for the
student’s future professional identify (Maranon & Pera, 2015).
Leadership Education in Baccalaureate Nursing Programs
I found little primary research on the structure and effectiveness of leadership education
in undergraduate nursing programs. However, there were many studies that referenced active
learning and leadership education. The research studies that I read for this review, related to
student perceptions of the leadership education received. I was unable to locate references to any
follow-up research conducted on the perceptive findings. No primary research was found on
leadership education in nursing programs in Louisiana.
The teaching strategy for leadership courses in nursing education has traditionally been
didactic lecture with a clinical component. Nursing leadership courses in baccalaureate
programs are usually offered during the last semester before graduation and entry into a
healthcare workplace (Middleton, 2013: Curtis, 2011: Gore, Johnson & Wang, 2015; Scott &

35
Miles, 2013). From the business and management discipline, a study by Jenkins (2013)
discussed the lack of innovation used in leadership education using simulation, role play and
games. Jenkins’ (2013) research offered further evidence related to the deficit of available
research on the faculty perspective of useful teaching strategies for leadership education. Most
of the respondents agreed that the use of discussion as a teaching strategy was used more than
any other teaching strategy. Simulation, skill building, role play, and games were used the least
(Jenkins, 2013).
Leadership competencies including delegation, supervision, and communication are
deficits acknowledged by employers of new nursing graduates (Lekan, Corazzini, Gilliss, &
Bailey, 2011; Theisen & Sandau, 2013). Innovative strategies utilizing mentorship,
preceptorship, and reinforcement through simulation methods integrating the academic and
clinical settings should be put into nursing curricula for the practice and evaluation of leadership
competency (Orlando, 1961; Laurent, 2000; Kirkman, 2013; Kram, 1983; Lekan, Corazzini,
Gilliss, & Bailey, 2011: Pollard, 2009; Smithburger, Knae-Gill, Ruby, & Seybert, 2012;
Middleton, 2013; Shin, Sok, Hyun, & Kim, 2014, Thomas, Hodson-Carlton, & Ryan, 2011).
While these studies offered support of using alternative teaching strategies, there was little
consistent research found that provided evidence of the effect of using alternative teaching
strategies to enhance leadership education thereby improving learning outcomes for practice
(Schlairet & Pollock, 2010; Schlairet, 2011: Scott & Miles, 2013; Shin Sok, Hyun, & Kim,
2014).
The only reference to a specific leadership education theory that I found within the
review was by Laurent (2000). The Dynamic Nurse-Patient Relationship theory (Orlando, 1961)
suggested the theoretical influence by Laurent (2000), the dynamic leader-follower relationship,

36
for a possible leadership education theory. This model supported leading by validation of the
interaction between the nurse and those being led. This theory could be applied to the classroom
experience where leading by validation of the interaction is between the faculty and the student
(Laurent, 2000). I was unable to locate validation of this theory in the literature.
The search for leadership evidence and leadership education theory consistently revealed
the application of Transformational Leadership Theory for the creation and adoption of
alternative teaching strategies. Transformational Leadership Theory (Burns, 1978) provided
theoretical guidance that could enhance the undergraduate student’s development of leadership
through alternative learning methods before entry into nursing practice. This was accomplished
through the engagement of the student when faculty taught using alternative teaching strategies
(Middleton, 2013; Thomas, Hodson-Carlton, & Ryan, 2011). However, the literature search
failed to reveal current primary research on successful alternative teaching strategies that were
validated as best practices to implement from a nursing faculty perspective in baccalaureate
nursing programs.
The lack of current evidence of how leadership education is taught, preparing the new
graduate to be receptive in the development of leadership practice, leaves one to question
regarding how nursing organizations that either govern or impact nursing practice such as the
IOM, AACN, ANA, and the NLN can assume the undergraduate is prepared to conduct
themselves as a practicing professional. The deficit I identified in current, contemporary
research of how to maximize leadership pedagogy preparing the novice for transition into
practice in undergraduate leadership programs provides the relevance for conducting this study.
The progressive development of the novice through mentored practice as recommended by

37
Benner (1981), Broome & Marshall (2017), and Ganz & Lin (2012), provides additional support
for the relevance and the need for conducting this study.
Methodology
The deficit I discovered in the literature was a failure to reveal the nursing faculty’s
perspective on effective teaching strategies that maximize leadership pedagogy. This deficit
supports the relevance for conducting this study. The purpose of this qualitative study is to
explore the pedagogy employed by nursing faculty to maximize leadership in Louisiana
baccalaureate nursing programs within the context of the content recommendations by the
AACN Essentials of Baccalaureate Education or other professional nursing organization’s
guidelines for leadership.
The narrative, case study, and phenomenology qualitative designs were considered,
however it was determined that an eclectic approach to this inquiry would best serve to answer
the research questions. The narrative and case study designs reveal stories from a broad selection
of notes, artifacts, conversations, and often used in more descriptive research from a specific
time, experience, or location (Creswell, 2013; Patton, 2002). A phenomenology research design
is both a philosophy and research design. This design is not a collective sense of social
processes, but it is an individual’s interpretation of their experience with a particular situation
which is reflective to one’s own perception of the experience (Creswell, 2013; Patton, 2002).
Therefore, for the purposes of this study, to explore a collection of the teaching strategies
employed by various nursing faculty who teach leadership in Louisiana, the basic qualitative
exploratory study, using the structured Corbin and Strauss (2015) grounded theory approach was
selected. I tailored the Corbin and Strauss (2015) grounded theory approach to the context of this

38
study to analyze the data collected with semistructured interviews for the discovery of new
knowledge as interpreted by nursing faculty participants without the generation of theory.
A qualitative research design was best suited for the purpose of this qualitative study to
explore the pedagogy employed by nursing faculty to maximize leadership in Louisiana
baccalaureate nursing programs within the context of the content recommendations by the
AACN Essentials of Baccalaureate Education or other professional nursing organization’s
guidelines for leadership. The intent of this study was to learn new information without the
generation of theory. Therefore, I tailored the Corbin and Strauss (2015) grounded theory
approach for data collection and analysis, without the generation of new theory to answer the
research questions. The practical research questions addressed the basic social and educational
processes of nursing faculty who teach students in baccalaureate nursing programs. These
questions, using a semistructured interview protocol allowed for the collection of new meanings,
concepts, variations, and relationships enabling research findings to emerge (Corbin & Strauss,
2015).
These systematic analytical procedures first suggested by Glaser and Strauss (1967, 1995,
1999, 2008) and later by Corbin and Strauss (2015) for qualitative study are used when little is
known about the phenomenon, allowing the data to emerge through the selected data collection
processes (Corbin & Strauss, 2015). The research methodology for this exploratory qualitative
design was the Corbin and Strauss (2015) grounded theory approach to coding and the constant
comparative method for data analysis that I tailored to the context of this study. This approach
was used to learn new information and meaning of teaching strategies used by nursing faculty
without the generation of theory. The method of grounded theory is systematic, yet flexible

39
enough to allow the researcher to identify common categories, themes, and relationships between
the categories and themes from the data collection process (Willig, 2008).
Benner (1981) chose to use the grounded theory approach in her work From Novice to
Expert to identify the emerging progression in the development of a novice professional nurse to
an expert professional nurse. Benner used the systematic coding approach with the constant
comparative data collection and analysis method to explore how the novice nurse learns from
others, progressing in competency and nursing identity. After consideration of other qualitative
methods, I chose to employ the Corbin and Strauss (2015) systematic approach, without the
generation of theory. I found it best suited the exploration of teaching strategies used to prepare
student nurses in the development leadership since there is little known about this phenomenon.
The process by Corbin and Strauss (2015) allowed me to explore new data as it emerged from
the social interaction between me and the participants.
The primary aim of this study was to develop an understanding of how pedagogy in
leadership is maximized in Louisiana baccalaureate nursing programs. The most appropriate
approach in gathering data from actual experiences and social processes is from the individuals
who are actually involved in the experience or social interaction (Creswell, 2014; Corbin &
Strauss, 2015; Patton, 2002; Willig, 2008). Therefore, the interview process was suggested as the
initial data collection method using a semistructured protocol to allow information to emerge that
may lead to further investigation and research (Corbin & Strauss, 2015; Glaser & Strauss, 1988;
Patton, 2002).
My research followed an interpretive paradigm supported by the philosophy of social
interactionism. I used Corbin and Strauss’ (2015) suggested constant comparative data analysis
method for the identification and interpretation of analytical categories as they were identified

40
from the interview notes, audio recordings, and interview transcripts that have been reviewed
and authenticated through member checks (Corbin & Strauss, 2015; Patton, 2002; Willig, 2008).
The Corbin and Strauss (2015) systematic coding approach provided a method for me to code
each interview into meaningful units, reflecting a meaningful, interpretive analysis grounded in
the data. Through the constant comparative method during the data collection and analysis
process, the emerging themes and new data guided the study instead of strictly following a
process or method (Corbin & Strauss, 2015; Willig, 2008). Corbin and Strauss (2015) suggested
to apply the method according to the needs of the study guided by the data. I discuss in further
detail, the selected research methodology in Chapter 3.
Chapter Summary
The existing literature revealed the recommendation that programs offering
undergraduate nursing education at the baccalaureate level should incorporate alternative
teaching strategies preparing the novice student for leadership readiness before entry into nursing
practice. I identified the common themes the influences that active learning and reflective
practice may have on nursing education. The theoretical influences of active learning and
reflective practice have an impact on teaching strategies, allowing the student to display
confidence, competence, and develop professional identity (Argyris & Schon, 1974; Schon,
1983, 1987; Walker, et al., 2014; Williams & Burke, 2015). I conducted this study because of the
deficit in the current, contemporary literature related to the nursing faculty perspective on
effective teaching strategies used for leadership education in baccalaureate programs. My
review of the literature revealed that although the nursing student may learn about
professionalism and leadership while gaining some exposure to professionals within the clinical
setting, they are not ready for leadership practice as a novice (Benner, 1981; Forsythe, Snook,

41
Lewis, & Bartone, 2002; Willis & Marshall, 2017). However, the professional identity of the
nurse is developed over time after more exposure to professionals in practice, mentored practice,
or mentored residencies (Benner, 1981: Brown, 2002; Dreyfus & Dreyfus, 2005; Forsythe,
Snook, Lewis, & Bartone, 2002; IOM, 2016; Schon, 1984, 1987).
This chapter, supports my exploratory qualitative study using the Corbin and Strauss
(2015) grounded theory approach that I tailored to the context of this study. My intent for
conducting this study was to learn new information about how leadership education is taught,
maximizing leadership pedagogy in Louisiana undergraduate nursing programs without the
generation of theory. Nursing faculty who teach or had taught leadership at the undergraduate
level were the best research participants revealing information on teaching strategies used for
leadership education. The Corbin and Strauss (2015) grounded theory approach that I tailored to
the context of this qualitative study, connected the gap existing in the literature. I will explain my
selection of the research method further in Chapter 3, according to the purpose of this qualitative
study, to explore the pedagogy employed by nursing faculty to maximize leadership in Louisiana
baccalaureate nursing programs within the context of the content recommendations by the
AACN Essentials of Baccalaureate Education or other professional nursing organization’s
guidelines for leadership.

42
Chapter 3: Design, Method, and Analysis
Introduction
The purpose of this qualitative study was to explore the pedagogy employed by nursing
faculty to maximize leadership in Louisiana baccalaureate nursing programs within the context
of the content recommendations by the AACN Essentials of Baccalaureate Education or other
professional nursing organization’s guidelines for leadership. The effectiveness of an
educational program cannot be evaluated until there is an understanding of the current
operationalized teaching methods or strategies used by faculty who teach leadership. I used a
semistructured interview design for data collection to explore how leadership education is
conducted through the interpretation of the faculty who teach.
In this chapter, I address the selected research design and rationale, the role that I
assumed as the researcher, and further detail on the selected methodology as it reflects the scope
of this study. The chapter concludes with the ethical procedures and measures to that I used to
ensure the trustworthiness of the research. These measures were taken to demonstrate data
integrity and credibility. Supporting detail continues in Chapter 5.

43
Research Design, Rationale, Role of Researcher
This dissertation was a qualitative study to explore the teaching strategies used by nurse
faculty to teach leadership in Louisiana baccalaureate nursing programs. I selected the structured
grounded theory approach developed by Corbin and Strauss (2015) as a systematic process for
the collection and analysis of data to best answer the research questions without the generation of
theory. The research questions I discussed in Chapter 1 were:
Central Question: What teaching strategies are deployed for leadership education among
Louisiana baccalaureate nursing programs?
Sub-Questions
1. Using the 17 content topics included within the document, the AACN
Baccalaureate Essentials as a guide, or another professional nursing
organization’s content areas for leadership, what are the top 10 content topics of
the leadership course? (The content topics were presented to the
participants prior to the interview and follow in Appendix I)
2. How do nursing faculty select the teaching strategies deployed for leadership
education?
3. How do nursing faculty evaluate the effectiveness of the deployed teaching
strategies compared to the development of leadership knowledge and professional
skill-set?
4. What is the nursing faculty’s perception of the efficacy of leadership education
and the student’s preparation for leadership at the baccalaureate level before entry
into practice?

44
The expectations for baccalaureate education, found in the documents by the IOM,
AACN, ANA, Louisiana Campaign for Action, and the NLN, are that nursing educators should
prepare the student nurse to develop a nursing identity that demonstrates competency to practice
the tenets of leadership in the improvement of patient care (ANA, 2008; AACN, 2008; IOM,
2011, 2016; Louisiana Campaign for Action, 2016; NLN, 2010). The central concepts of this
study reflect how leadership education is taught in Louisiana and address these expectations and
core competencies.
I selected a qualitative design for this study. The qualitative design was selected over
quantitative because there is no clear understanding of what teaching strategy is being used to
teach leadership in baccalaureate nursing programs that meets the core competencies for
baccalaureate graduates defined by the accrediting agencies of the AACN and the NLN (AACN,
2008; NLN, 2010; Patton, 2002). I did not identify a quantitative study that revealed nursing
faculty perspectives comparing teaching strategies with learning outcomes. Additionally, I was
unable to identify literature revealing teaching strategies used by faculty of baccalaureate nursing
programs in Louisiana
Corbin and Strauss (2015) advocate for flexibility with the application of the constant
comparative data collection and analysis method, allowing the research findings to guide the data
collection. I tailored this approach according to the context of this study without the generation
of theory. I collected data related to the social and educational processes from the nursing
faculty who teach leadership in baccalaureate nursing programs in Louisiana. The original works
of classic grounded theory by Glaser & Strauss (1967, 1995, 1999, 2008), recommended the
quantitative design for data collection and interpretation. However, the interpretations from my
data collection revealed new information related to teaching strategies which cannot be captured

45
through the quantitative design. The identification of categories and themes from the constant
comparative method revealed what is happening in baccalaureate programs offering leadership
education as it is interpreted by the faculty who teach (Corbin & Strauss, 2015, Patton, 2002).
Role of the Researcher
The advantage of conducting a qualitative research study is that the researcher has an
active role as a participant. For this study, I participated as the interviewer, collecting data using
a semistructured interview protocol that I developed. I assumed an active role in the
transcription of the interviews. To ensure interview transcription, interpretations, and
understandings were reflecting what the participants intended, I conducted member checks as
suggested by Corbin and Strauss (2015), Lincoln and Guba (1985), Patton (2002), and Rudestam
and Newton (2014).
I had no previous personal or professional relationship with the respondents prior to
recruitment of the sample. I am a colleague of the deans, chairs, and directors of the departments
of nursing within the universities I contacted for access to the sample. Therefore, I had no
personal nor authoritative power over the participants in the study. Participation in this study
was voluntary with the incentive of a book and gift card for participation. There were no
participants in the study from my workplace nor from my former workplace. I have no
knowledge of the curricula structure or how leadership is taught in the participating institutions.
Professionally, I continue to practice as an assistant professor of nursing with 30 years of
experience as a registered nurse. My professional responsibilities include teaching Maternal
Newborn Nursing for the Associate of Science in Nursing (ASN) degree program and Nursing
Informatics for the RN-BSN degree program. While I had former experience in conducting a
clinical experience for a leadership course, I had no experience with teaching the course content.

46
My experiences as a registered nurse span across 30 years, 12 of which involved multiple
leadership roles at the regional and corporate levels. These experiences as a staff nurse, nurse
manager, nurse leader, and educator provided me with the ability to understand the language
used by the participants that relates to the field of nursing, nursing leadership, and nursing
education.
When conducting a qualitative study, researchers must remain cognizant of the influence
personal beliefs and opinions may have on the interpretations and conclusions of the study
findings. Patton (2002) stated that researchers are unable to reveal a developing understanding
of social interactions and processes without becoming directly involved with what the
participants are saying, conveying meanings and interpretations while research findings emerge.
Patton (2002) suggested that the research should maintain a position of neutrality during the data
collection and analysis procedures by using member checks to allow for the discovery of
meanings and interpretations with no preconceived ideas or personal thoughts to impact the
validity, credibility and fairness of the study.
My philosophy of teaching is the belief that educators should refrain from using
traditional methods, providing students with an experience that is learner-centered, including
realistic and safe opportunities for practice. I believe the nursing student should have an
understanding of the science, profession, and practice of nursing before attempting to lead
patient care teams. The literature I searched does not clearly reveal how the undergraduate
nursing student may develop leadership knowledge and skill while learning what the profession
of nursing is about. To maintain my neutral role, despite my personal nursing education
philosophy, I developed a semistructured interview protocol. Corbin and Strauss (2015),
Creswell (2013), Galletta (2013), and Patton (2002) suggested a face-to-face interview. For my

47
research purposes, a virtual face-to-face interview was conducted by recording the audio of each
interview.
Research Design Method
Participant Selection Logic
The research population included nursing programs in the state of Louisiana that offer a
4-year baccalaureate degree following a curricula that includes leadership education. These
universities were state-supported schools, with full approval status of the Louisiana State Board
of Nursing (LSBN). No schools on probationary status were included within this study. The
nursing programs selected are representative of each geographical location of the state: north,
central, and south Louisiana. No further identifying information was provided within the study to
protect the confidentiality of the participants.
For the selection of participants, I used a combination of purposive, maximum variability,
and chain sampling. Patton (2002) suggested to select participants who exhibit the best
knowledge for your research. In this case, those who exhibited the best knowledge were the
nursing faculty who taught leadership. The combination of mixed purposive sampling strategies
provides for triangulation and diversity among individuals and processes (Creswell, 2013;
Patton, 2002). The sample was drawn from a broad population of faculty who teach or have
taught leadership courses for the participating institutions, identified by the deans, chairs, or
directors from the partnering sites. The strength of a qualitative sample is in the purposeful
selection of participants who can provide the best information about the teaching strategies used
for leadership education. Thematic sampling, according to Corbin and Strauss (2015) and Patton
(2002) is used when the research theme has been identified prior to the data collection. This

48
method of sampling was not appropriate for my study as the research themes were not identified
prior to the initial data collection.
No recruitment or data collection was begun until all approvals were received from the
Walden University and partnering site Institutional Review Boards (IRB). The deans, chairs, or
directors from six universities in Louisiana are referred to as the nursing administrators of
partnering sites within this study from this point forward. Using my Walden University email
address, he nursing administrators of the partnering sites were contacted. The introductory email
offered an introduction to the study, recruitment request for assistance to access faculty who
meet inclusion criteria, and a cooperation agreement. A sample of the introductory email and
cooperation agreement follows in Appendices D and E.
Once all IRB approvals had been obtained as stated within the letter of cooperation, the
nursing administrators of the partnering sites were sent a recruitment email to forward to nursing
faculty who met the inclusion criteria. The recruitment email included my explanation of the
study and included a link to a survey request for expressed interest in participation and contact
information. This link protected the confidentiality of the participant from the nursing
administrators of the partnering sites. Through the survey, I requested contact information
including personal phone number and personal email address so that the individual was not
linked to his/her employer. The survey included my Walden email address and contact
information. The survey collection notifications came to my Walden University email address.
A sample of the recruitment email and survey content follows in Appendices F and G. Once
participation interest was established, a formal invitation to participate email was sent to discuss
the study, how consent would be obtained, and interview schedule availability was established.
A sample of the formal invitation to participate follows in Appendix H. I followed the Walden

49
IRB guidelines to recruit other participants who met the criteria for the study should there be a
lack of response.
According to Lincoln and Guba (1985) and Patton (2002), the sample size should remain
open until data saturation is reached. The aforementioned researchers also suggested that a
smaller sample may assist the researcher in the management of the data collection and analysis
process. However, keeping the sampling process open, allows for maximum information,
redundancy of themes, categories, and concepts (Lincoln & Guba, 1985; Patton, 2002). Corbin
and Strauss (2015) stated that the constant comparative analytic strategy dictates how long the
process would take depending on the emergence of new information. Newly discovered
information and interpretations are validated through member checks, follow-up telephone calls
or emails (Corbin & Strauss, 2015; Patton, 2002; Rudestam & Newton, 2014). For this study, I
followed the suggestions of Corbin and Strauss (2015), Lincoln and Guba (1985) and Patton
(2002). I did not meet data saturation until no new categories or themes were emerging,
redundancy was revealed in the data, and all research questions were answered.
Procedures for Recruitment, Participation, and Data Collection
The nursing administrators at each partnering site received a letter of cooperation
including a request for access to nursing faculty who meet the inclusion criteria for the study.
The letter of cooperation included a request for access to nursing faculty. I requested the
administrator’s agreement to send a recruitment email to the faculty who met inclusion criteria.
If it was the administrator’s preference, they could send names to me with contact information
based on public information of their experience. I also requested that the administrators send an
email announcing to nursing faculty the opportunity to participate in my research study. As
suggested previously, the selection criteria included the faculty who had taught in nursing

50
leadership education for at least 1 year, were either currently teaching, or had previously taught a
leadership course, and had taught leadership at the baccalaureate level in Louisiana. The
recruitment email included a survey link for the interested participant to complete. I collected
these responses through my Walden email account. A sample of the recruitment interest to
participate survey follows in Appendix H.
Once the nursing administrators shared the recruitment invitation, they had no knowledge
of who answered the research invitation. I collected survey and/or email responses from faculty
who met the criteria. I sent a formal invitation to participate email to the participants. Through
the interest to participate survey, I requested contact information and a unique identifier in the
form of a pseudonym that would be used throughout the data analysis process in place of the
participant’s name. Both the pseudonym and contact information request was an effort to
maintain participant confidentiality from their employer or colleagues.
The formal invitation to participate email followed once contact information was
achieved. This email included an introduction to the purpose of the study, how confidentiality
would be maintained, how the interviews would be conducted, the request of informed consent to
participate, and to answer any questions about voluntary participation. Schedules for potential
interview appointments were discussed and confirmed by email. The selected pseudonym was
used throughout the study instead of their name. The pseudonym had no relationship to the
individual’s last name, or any other identifiable information. The information included in the
email invitation to participate follows in Appendix H.
The formal invitation to participate email sent to each individual included the informed
consent. The freedom to exit the volunteer agreement to participate was discussed within the
informed consent, repeating again what was discussed within the introductory email.

51
Instructions were included within the informed consent that an actual signature is not required if
it is the preference of the participant. A link was included within the informed consent that could
be clicked on, transferring the participant to an electronic, I consent, asking for the individual’s
unique identifier instead of a name. There was a two-week period allowed between the
agreement to participate and the informed consent to provide time for all questions and concerns
to be addressed. I collected the informed consent along with the agreement to participate with
unique identifiers and placed in a locked file box for 5 years. No one except me knows the name
of the individual for each unique pseudonym. This information will not be shared as official
research records.
Data was collected from each semistructured interview that was video-conferenced and
audio recorded using Zoom (2016). I conducted the data collection by a schedule plan of at least
2 interviews per week. These events lasted 45 minutes – 1 hour, however, the schedule allowed
for flexibility when meaningful discussion occurred and the participant agreed to continue. I
saved the audio recording saved directly to my personal computer as an mp4 file and to two
separate external hard drives specifically identified for my study. The participant was informed
when the recording began and when it ended. I did not record the video. There was no personal
identifiable information included on the recording. There was no need to include demographic
information within the recording. I ensured the individual met inclusion criteria for the study
without recording information that would be identifiable.
I took notes and jotted memos down related to emerging thoughts or branching
possibilities for further reference at the end of the interview. I planned to avoid any distraction
from the richness of the interview process, allowing for the comfort of the participant. I
addressed needs for clarity once I began the interview transcriptions and data emerged into

52
themes. I had established this expectation and confirmed the participant’s agreement for follow-
up contact before ending the interview. These follow-up communications were not be required
as participation was voluntary. However, it was important that I involved the participants in this
process to keep them interested in the study and the possibility of future communication for
clarity of interpretations. I reminded the respondents that their participation remained voluntary
should they wish to exit the study. My plan included a debriefing phone call to determine the
participant’s reasons for exiting the study. This debriefing call was voluntary and the
conversation would remain confidential.
Instrumentation
The interview process in qualitative inquiry provides an environment for exploration
when it is conducted in an open-ended format (Corbin & Strauss, 2015; Galletta, 2013; Glaser &
Strauss, 1967, 1995, 1999, 2008; Patton, 2002). The interview questions should be framed to
allow the participant to reflect on the social and educational processes to be explored, allowing
meanings, themes, and concepts to be discussed (Corbin & Strauss, 2015; Patton, 2002). The
unstructured interview design is not recommended for the novice researcher according to Corbin
and Strauss (2015).
I developed a semistructured interview protocol to serve as the primary data collection
instrument. The semistructured interview was sufficient for data collection to answer the
primary research questions for this study to explore the teaching strategies used by faculty who
teach leadership. The semistructured format, using open-ended questions, allowed me to
maintain consistency among the topics to be covered with the study participants. I was able to
maintain flexibility in how I asked the questions and when I asked them which is the interview
method suggested by Corbin and Strauss (2015). According to Corbin and Strauss (2015) and

53
Patton (2002), the interview questions must be related to the participant’s experiences and social
interactions. For this study, the questions I asked were related to the nursing faculty’s experience
with teaching leadership to baccalaureate nursing students. Corbin and Strauss (2015) suggested
that new information may emerge during interview that may warrant further investigation.
Therefore, the semistructured format enabled me to ask more questions which added clarity to
my study and additional data that could lead to future research. The participants were invited to
add any additional information they felt was relevant to the discussion before ending the
interview as suggested by Corbin and Strauss (2015) and Galletta (2013). A list of the primary
research questions are included in this chapter and follow in Appendix A.
For this research topic, questionnaires nor instruments related to my study. A researcher-
developed instrument is sufficient as a data collection tool for a qualitative study where little is
found in the literature (Patton, 2002). Therefore, I created the interview protocol. The interview
protocol can be found in Appendix B.I analyzed the answers from the open-ended questions at
the end of each semistructured interview with selected nursing faculty. I separated the data into
themes according to units of meaning following the constant comparative method of the Corbin
and Strauss (2015) grounded theory approach. Emerging categories and themes are expected to
follow after each interview is conducted, transcribed, and interpreted (Corbin & Strauss, 2015;
Patton, 2002). I consistently followed the semistructured interview protocol for each interview so
that the same primary interview questions were asked of each participant. A matrix revealing the
relationship between the research questions and the interview questions follows in Appendix C.
I established content validity was established by following the procedures of Lincoln and
Guba (1985) which are referenced in Corbin and Strauss (2015) and Patton (2002). I shared the
transcriptions and interpretations from the interviews with each participant for member checks to

54
establish the content validity of the data analyses, interpretations, and my conclusions. Other
measures I took to ensure content validity included providing rich, thick descriptions of the
participants, the research settings, the interview experience, the prolonged engagement between
me with the participants and the data, and the utilization of peer review with my research
committee and two colleagues who were not directly related to the research topic or the
participants. My colleagues were comfortable with asking me the hard questions related to my
methods and choices. Finally, to ensure credibility as suggested by Lincoln and Guba (1985), I
identified my personal teaching philosophy and interest in this study from the beginning,
enabling the reader to understand any interpretation or conclusion that may be impacted or
influenced by my nursing experience, nursing educator experience, or my research interests.
(Lincoln & Guba, 1985).
The semistructured interviews were delivered over a face-to-face videoconference. The
videoconference was selected to accommodate time schedules since the participants were
actively teaching, my personal travel time to-and-from the institutions, and my ability to
transcribe the interview immediately following the encounter. The videoconference interviews
were audio-recorded. I did not archive archival of video recordings. I chose to avoid typing
notes during the interview to prevent distraction and allow me the opportunity to keenly listen
for emerging information. The face-to-face encounters added strength to the interview process as
suggested by Corbin and Strauss (2015) and Patton (2002).
I selected Zoom (2016) virtual meeting software for the interview encounters. Zoom
(2016) provided me with a secure audio conferencing method to save the audio immediately
following each interview. I was able to save the audio recordings to my local computer drive
and a back-up external hard drive as an Mp4 recording. I did not archive the video. I used a

55
digital audio recorder during the interview as a back-up should something happen to the Mp4
recording. My plan if there were technical difficulties with Zoom (2016), was to use a
speakerphone with a digital audio recorder. I had my own personal account through Zoom
(2016) that was not shared with any institution. This account was utilized for the purpose of this
study, protecting the participant’s confidentiality and authenticity.
The video conference allowed for the development of my relationship with the
participant. However, I did not archive the video to maintain participant confidentiality. With
Zoom (2016) I was able to have a separate file for audio only, allowing for the ability to delete
the video file. I repeated the confidentiality measures included within the informed consent at
the beginning of each interview. I sent a call-in number with a unique password to the
participants in an invitation email once the interview schedule was established. I assigned each
interview with a unique password for authentication purposes and for the prevention of other
individuals accidentally dialing into the interview. I controlled the interview recording which
was conducted on my personal computer. The participant was notified by me before the
recording began and when it ended. The interviews were conducted in my private office, with the
door closed to any outside distractions.
Data Analysis Plan
A qualitative research study enables the researcher to be an active participant, involved
with the data collection and analysis. I selected the Corbin and Strauss (2015) grounded theory
approach to perform coding and data analysis that I tailored to the context of this study without
the generation of theory. I analyzed the collected data using the constant comparative method
that included open coding of emerging concepts and axial coding for the emerging relationships.
The constant comparative method is a structured process to progressively identify concepts from

56
each individual interview without preconception or planning ahead, comparing different data
against each other to uncover similarities and differences (Corbin & Strauss, 2015; Glaser &
Strauss, 1967, 1995, 1999, 2008).
According to Corbin and Strauss (2015), the coding process is a means to categorize the
data into meaningful concepts. Open coding is a data analysis process to label the concepts
identified from an interview transcript into defining and developing categories. The data I
collected from the initial interview were broken apart into concepts to offer a summary and
possible meaning that emerged from the raw data. The data I collected from each subsequent
interview were broken apart into manageable datum and compared to the previous data
collection. Should I recognize similarity, I coded the data using the same conceptual name. If
the concepts were different, I coded them using different names as meaning continued to emerge
Axial coding takes the process of open coding a step further, searching for emerging meaning
and interpretation through the identification of relationships among the concepts and categories
from the interviews into core themes. Corbin and Strauss (2015) suggested that this process
requires the researcher to identify what more may be learned or what meaning emerges from the
data elaborating on the properties, contexts, or dimensions of the coded concepts as well as the
interpretations intended by the participants. (Corbin & Strauss, 2015).
I took notes and jotted memos during the interviews that related to emerging thoughts or
branching possibilities to discuss at the end of the interview or during member checks. I planned
to avoid any distraction from the richness of the interview process, allowing for the comfort of
the participant and quality data collection. I transcribed the audio-interviews as the first level of
data analysis, interpretation, and member checking. I chose to write memos with bolded labels
within the body of the memo instead of labels in the margins to help me identify and explain all

57
of the possible meanings from the conversation with the participant. I manually wrote extra
memos and thoughts within the margins of the transcriptions to assist in the constant comparative
analysis of the data collection. This method was suggested by Corbin and Strauss (2015) and
Saldaña (2016) to assist in the rigor and richness of a qualitative study. According to Saldaña
(2016) no computer software will reflect the researcher’s shared interpretation of the data with
the participant. Therefore, the coding of the data should remain the responsibility of the
researcher (Saldaña, 2016). For the purpose of this study, I used a manual method to conduct
data organization, and management of the data using index cards and an excel spreadsheet.
I transcribed each interview and reviewed my memos. I then coded all data into
meaningful themes into an excel spreadsheet, cataloged by the participant’s unique identifier.
Corbin and Strauss (2015) suggested that discrepant data may be constructed into divergent cases
for further exploration or for future qualitative study. I determined that the divergent data of my
study should be documented because they provided alternative explanations to the meanings and
interpretations.
I planned to use pseudonyms that were selected by the participant as confidential
identifiers. The pseudonyms had no relation to the participant’s name or location. I maintained
a demographic key for the purpose of follow-up for member checks. A corresponding number
beside each participant’s pseudonym signified if it was the first or subsequent communication.
The identifying information file will remain confidential and stored on hard copy and two
external hard drives for the duration of this study. These records will be maintained according to
Walden University IRB guidelines for five years (Walden University IRB, 2016). After five
years have passed, hard copy documents will be shredded, electronic files will be deleted from

58
the computer, and files from external hard drives will be deleted and disposed of according to
safe disposal guidelines.
Trustworthiness and Ethical Procedures
The reader of a qualitative study must be able to understand what is being read and make
sense of it. They must be able to trust that the researcher has applied the appropriate strategies to
ensure that rigor and credibility are demonstrated from the research findings (Corbin & Strauss,
2015; Glaser & Strauss, 1967, 1995, 1999, 2008; Lincoln & Guba, 1985; Patton, 2002). The
evaluation of qualitative research should reflect the selected method. The establishment of
evaluation criteria for grounded theory that is supported by Corbin & Strauss (2015) was
developed by Charmaz (2006). These criteria reveal how to establish thereby demonstrate the
credibility, originality, resonance, and usefulness of the study. Adherence to these criteria,
enhances the validity of the study, encouraging the reader to believe that what is written is true
(Charmaz, 2006; Corbin & Strauss, 2015; Glaser & Strauss, 1967, 1995, 1999, 2008). However,
peer review and member checking are necessary for the evaluation of trustworthiness since
evaluation criteria often involve a self-reflection that is conducted by the researcher (Corbin &
Strauss, 2015; Patton, 2002).
I conducted this study as an exploration of social and educational processes from an
interpretivist perspective through the collection of data from actual nursing faculty who teach
leadership education in nursing programs. I established credibility by using triangulation, my
prolonged engagement with the data, member checks, reflexivity, peer review, and by ensuring
data saturation had been met. Lincoln and Guba (1985) and Patton (2002) stated that trust from
the reader is directly related to the ability to trust the researcher.

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I compared what each participant said in each interview, checking for consistency on
certain perspectives over time to establish data triangulation. I shared each transcript with the
interviewed participant to further establish credibility and dependability of the data analysis and
interpretation, ensuring that I conveyed what the participants intended and that I was truthful
with that reflection. I asked the participants to review my interpretation of the common themes
drawn from their interview to obtain their perceptions of the study’s validity. Corbin & Strauss
(2015), Lincoln & Guba (1985), and Patton (2002) recommended a peer review of the study
findings to establish credibility of the data. Therefore, I asked fellow colleagues and my
dissertation committee to provide a peer review to help ensure the data appeared to be truthful,
reflecting the intentions of my research study.
The thick description of participant actions and interactions with me were described to
define the transferability of research findings for future study in other nursing education courses
or contexts. Transferability was achieved by my selection of participants from different schools
with differing levels of teaching experience instead of conducting interviews with faculty from
only one school with similar or the same teaching experience. The sampling strategy I chose,
established a more detailed thick description that may enable future researchers to transfer the
information learned into future replication of the study according to the recommendations by
Lincoln and Guba (1985) and Patton (2002). To maintain data integrity and reflexivity, the
researcher should maintain a neutral role, avoiding any personal influence that could impact the
findings drawn from the study ((Corbin & Strauss, 2015; Lincoln & Guba, 1985; Glaser &
Strauss, 1967, 1995, 1999, 2008; Patton, 2002; Willig, 2008). Therefore, I maintained a neutral
role by using the semistructured interview. The integrity and reflexivity of the study was
demonstrated by my neutral role which revealed that I had made a reasonably honest attempt to

60
remain cognizant of the influence and impact that my opinions, perspectives, personal
experiences, and knowledge had on the research process
Ethical Procedures
Research studies involving human subjects must follow the ethical guidelines established
by the Institutional Review Board (IRB) that is partnering with the researcher. For this study, I
followed the IRB guidelines established by Walden University Center for Research Quality
(2016). Before any recruitment for participation or data collection was conducted, IRB approval
from Walden University was obtained. Ethical concerns were addressed before completing the
IRB application to assist me in planning ahead for any concerns that could arise. The document
Walden University IRB Pre-Application for Ethical Concerns (Walden University, 2016) is
designed to assist in addressing ethical concerns the researcher may encounter before the actual
IRB application is submitted (Walden University Center for Research Quality, 2016). This
document was not included in the Appendices to maintain the confidentiality of the partnering
institutions selected.
The Walden IRB requires that the researcher complete a training course in protecting
human research participants. Recommendations for training modules are included in the IRB
application. I completed this course within the requirements of Walden IRB. I followed the
Walden IRB Research Ethics Planning Worksheet to ensure protection of the confidentiality of
participants, (Walden University IRB, 2016). This document includes the ethical standards that
were used to evaluate a proposal under review. The student researcher who builds a proposal
using this document as designed, addressing ethical concerns before the approval process takes
place, will be better prepared when approaching the IRB application for approval.

61
I did not conduct communication for recruitment until IRB approval from both Walden
and the partnering institutions was obtained. Participation and recruitment agreements were
conducted through email to the nursing administrators of each partnering site. A copy of the
invitation email and cooperation agreement follows in Appendices D and E. The inclusion
criteria to participate in the study was included in the email. Two IRBs of the partnering
institutions, including my employer, stated that after IRB approval from Walden University was
obtained, I must apply and follow the IRB approval process of the participating institutions.
Two institutions stated that after IRB approval from Walden University was obtained, no further
action by them was necessary. One institution stated that I must obtain IRB approval from
Walden University and that I must obtain a Site of Data Collection letter from the Dean of
Nursing. One institution required a separate review from their IRB despite any approval from
Walden University IRB.
Once all IRB approvals were received, participation agreements were achieved from the
nursing administrators of the partnering sites, and expressed interests with contact information
was collected, I sent confidential individual invitations to participate using the individual’s
personal email address from my Walden University email address. The formal email included a
formal invitation to participate and the Walden approved and numbered informed consent. The
informed consent could be electronically signed using the link included within the informed
consent. The electronic signature could be the individual’s unique identifier which included the
words, I consent. I maintained a copy of the date/time stamped email attached to the consent
form. This process was approved by the Walden IRB application and included in the ethical
worksheet (Walden University Center for Research Quality, 2016).

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I will archive all documents, including IRB permissions and approvals as well as the
audit trail of electronic and hard copy documentation or other relevant documents on my
personal computer in a specific file, two specific hard drives for the sole purpose of this research
project, and a hard copy binder, for 5 years as established by Walden University Center for
Research Quality (2016). After 5 years, I will destroy all personal identifiable information
related to this study by shredding hard copy documents, deleting all electronic files from my
computer, deleting all files from external hard drives, and disposing of the hard drives in a safe
manner that meets environmental guidelines.
Chapter Summary
This chapter has addressed the selected research design and rationale, my role as the
researcher, and further detail on the selected methodology as it reveals the scope of this study. I
have discussed the ethical procedures that I observed throughout the proposal approval process.
The sample was drawn from six baccalaureate nursing programs in Louisiana who met the
inclusion criterion for the combination purposive, maximum variability and chain sample.
Recruitment and data collection was not conducted until all IRB procedures and criteria for
approvals were met. Once I defended the research proposal, and received all formal approvals, I
sent recruitment communications for voluntary participation in this qualitative study. The
purpose of this qualitative study was to explore the pedagogy employed by nursing faculty to
maximize leadership preparation in Louisiana baccalaureate nursing programs within the context
of the content recommendations guided by the AACN Essentials of Baccalaureate Education or
other professional nursing organization’s guidelines for leadership. The effectiveness of an
educational program cannot be evaluated without a clear understanding from the faculty who
actually teach. I used a semistructured virtual video-conferenced interview for data collection.

63
This method was best suited for my exploration. The research findings, the data collection, and
data analysis will follow in greater detail in Chapters 4 and 5.

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Chapter 4: Data Collection and Analysis
Introduction
The purpose of this qualitative study was to explore the pedagogy employed by nursing
faculty to maximize leadership preparation in Louisiana baccalaureate nursing programs within
the context of the content recommendations guided by the AACN Essentials of Baccalaureate
Education or other professional nursing organization’s guidelines for leadership. The
effectiveness of an educational program cannot be evaluated without a clear understanding from
the faculty who actually teach. My exploration was conducted using a virtual video-conferenced
semistructured interview for data collection. The research questions discussed in Chapter 1 and
answered from the data collection and analysis of this study were:
Central Question: What teaching strategies are deployed for leadership education among
Louisiana baccalaureate nursing programs?
Sub-Questions
1. Using the 17 content topics included in the document, the AACN Baccalaureate
Essentials as a guide, or another professional nursing organization’s content areas
for leadership, what are the top 10 content topics of the leadership course? (The
content topics were presented to the participants prior to the interview and follow
in Appendix I)
2. How do nursing faculty select the teaching strategies deployed for leadership
education?
3. How do nursing faculty evaluate the effectiveness of the deployed teaching
strategies compared to the development of leadership knowledge and professional
skill-set?

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4. What is the nursing faculty’s perception of the efficacy of leadership education
and the student’s preparation for leadership at the baccalaureate level before entry
into practice?
The primary themes that emerged from the data collection and analysis were:
 The purpose of the leadership course
 The selected teaching strategies to address the course purpose
 The support for student learning styles and needs of the workforce
 The application of evidence-based practice principles for leadership
 Measured effectiveness of selected teaching strategies for program purpose
 Nursing faculty perspectives of leadership efficacy at undergraduate level
 Nursing faculty perspectives on implications for future nursing leadership
education
This chapter includes information regarding data collection and analysis to answer the
primary research questions. It also includes my organization of the data into primary themes and
subthemes for this study to explore how leadership pedagogy is maximized among baccalaureate
nursing programs in Louisiana.
Study Setting and Participant Demographics
The participants responding to the recruitment invitation were representative of six
different nursing institutions in the state of Louisiana. All nursing faculty respondents met the
inclusion criteria of the study with experience in teaching leadership education in a Louisiana
baccalaureate nursing program for at least the period of 1 year. The participants taught in state-
supported institutions on full approval from the Louisiana State Board of Nursing (LSBN). These

66
individuals offered a diverse representation of nursing programs that could be impacted by size,
student population, and demographic location.
I did not collect personal information from participants for the purposes of this study. To
maintain a confidential record for contact information and follow-up, I archived a demographic
matrix for the duration of the study. The individual characteristics relevant to the study were that
the participant was a nursing faculty of a partnering institution, was currently teaching, or had
taught nursing leadership in an undergraduate program for at least 1 year prior to the interview.
There were no other specific inclusion criteria or demographic criteria to participate in the study.
To protect the confidentiality of the participants, no demographic information regarding the
locations of the institutions or size was collected for this study.
Data Collection
The data collection instrument I developed was a semistructured interview protocol using
open-ended questions. New information emerged from the data I collected from the six
participants. I used the same semistructured interview for each participant. I had the flexibility
to ask the questions in any order to explore new information. Participants were given the
opportunity to add additional information they found relevant to the topic and to the study.
The interviews were conducted virtually in the privacy of my office using face-to-face
videoconference software through Zoom virtual meeting (Zoom, 2016). I created the interview
schedule according to the participant’s convenience. If the participant had to reschedule, I made
my schedule flexible to accommodate the needs of the participant. The video allowed for
personal, face-to-face interaction between myself and the participant. However, no video was
recorded. Only the voice audio was recorded and archived for transcription. The participant was

67
reminded of this before the interview began. The interviews were between 45 minutes to 1 hour
in duration.
I recorded data directly by audio in the mp4 format to the hard drive of my computer. In
the case of technical difficulties, I used an external voice recorder as a back-up for an mp3
recording. I informed the individual participants when the recording would begin and when it
would end. At the beginning of each interview, I reminded the participants that the video would
not be recorded and no identifiable information would be included in the audio recording. I
transferred the mp4 and mp3 recordings from my computer to two external hard drives once each
interview was over. Three participants connected by phone through Zoom as two of them did not
have access to a webcam at the time and one was in a location away from a computer. I had
prepared for a back-up in case of technical issues, therefore, the interview process remained
successful.
During the interview process, I only jotted memos down to remind me to go back to
topics I wanted to explore or to capture a certain word or phrase used by the participant, enabling
me to be engaged in the interview process. Once the interview was completed, I transcribed the
audio into individual transcripts to share with the participants, ensuring the transcript of our
conversation conveyed what the participant intended. I transcribed each interview. This data
collection process allowed me to transcribe additional memos and notes assisting me with the
interpretations of the data analysis.
I changed the data collection plan from the original plan in Chapter 3 because of the slow
response in participant recruitment, resulting in a smaller sample size than originally planned. I
selected to recruit from six individual institutions in Louisiana. Along with compliance with
Walden University IRB, each IRB from the six institutions had their own set of guidelines. One

68
institution required a separate IRB review. This institution failed to respond timely after I
complied with all IRB requests. Another institution required a review of my proposal by their
governing body, although a separate review was not a requirement of the institution’s IRB. I
waited for 3 months before receiving approval from this institution. After complying with all
IRB requirements, with the addition of my employer, there was a period of almost 2 months
before the first respondent was received.
I found that communicating with the administrators of the nursing departments for
recruitment was not the best choice. While these individuals were a great contact, requesting
their partnership in recruitment added a burden to their already busy schedules. I had asked that
the administrators sign a letter of cooperation and then forward the email for participation to
participants who met inclusion criteria. I believe this request was often misinterpreted. Receipt
of the letters of cooperation often required at least three reminders. The email requests to recruit
participants often required at least three reminders. In some cases, these emails were not shared
with participants. Therefore, in order to gain a larger sample, I completed the Walden University
IRB process for change and received approval to change the recruitment strategy to include
network sampling and updating the participant email to a simple flyer. The incentive of a book
and the choice of a gift card were added to the flyer to assist in recruitment. This change in
procedure had a positive impact on recruitment, resulting in 1 participant from six different
nursing programs in the state of Louisiana.
I encountered some unusual circumstances that required flexibility because I was
managing human subject requirements with so many different institutions. There was a perceived
lack of knowledge regarding the IRB processes among five of the partnering sites. The
cooperation process of one institution was brief because the administrator was knowledgeable of

69
the IRB procedures. This perceived lack of knowledge regarding the IRB process was often the
cause of more delays in sending emails back and forth explaining IRB requirements from
Walden and the partnering institution. The administrators of larger institutions preferred to
provide direct contact to the directors of the undergraduate programs who in turn preferred to
provide me with the contact information of participants meeting inclusion criteria. The
responding participants were directed to select a unique identifier in the form of a pseudonym.
Some of the participants selected an identifier that was too easy for readers within the
participating institutions to recognize. Therefore, I submitted and received approval of another
change in procedure to identify participants by using Interview #1, #2, etc. This naming
convention had no relation to the demographics of the participant in reference to the data
analysis and interpretations.
Data Analysis
I selected the Corbin and Strauss (2015) grounded theory approach to perform coding and
data analysis that I tailored to the context of this study without the generation of theory. The
data I collected were analyzed using the constant comparative method of data collection and
analysis for the identification of emerging concepts and relationships. The constant comparative
method is a structured process to progressively identify concepts from each individual interview
without preconception or planning ahead, comparing different data against each other to uncover
similarities and differences (Corbin & Strauss, 2015; Glaser & Strauss, 1967, 1995, 1999, 2008).
The coding process is a means to categorize the data into meaningful concepts. Open
coding is a data analysis process to label the concepts identified from an interview transcript into
defining and developing categories (Corbin and Strauss, 2015). The data I collected from the
initial interviews were broken apart into concepts to offer a summary and possible meaning that

70
was emerging from the raw data. The data from each subsequent interview were broken apart
into manageable datum and compared to the previous data collection. Similar concepts were
coded using the same conceptual name. If the concepts were different, they were coded using
different names as meanings continued to emerge (Corbin & Strauss, 2015).
My transcription of the audio interviews was the first level of data analysis and
interpretation. I chose to write memos with color-coded, bolded underlined labels within the
body of the memo instead of labels in the margins to help me identify and explain all of the
possible meanings from the conversation with the participant. Although I was using Microsoft
Word, I manually wrote extra memos and thoughts in the margins to assist in the constant
comparative analysis of data and findings collected from the participants as suggested by Corbin
and Strauss (2015) and Saldaña (2016). It was suggested by Corbin and Strauss (2015) and
Saldaña (2016) that the manual coding of data influences the rigor and the richness of a
qualitative study. No computer software will reflect the researcher’s shared interpretation of the
data with the participant and coding remains the responsibility of the researcher (Saldaña, 2016).
I conducted the data collection and analysis manually using journaling, memos, index cards,
color codes, and excel for the purpose of this research study.
Once I completed the transcriptions and reviewed the memos, the interview transcription
of each participant was shared as the first level of member checking to ensure the transcription
conveyed what the participant intended. After I received agreement for the first member check,
the data were coded into meaningful categories and themes on index cards and then into a
Microsoft Excel spreadsheet, cataloged by the participant’s confidential identifier. I identified
discrepant data and cataloged them into divergent cases for further exploration or for future
qualitative study. However, I determined that this data provided alternative explanations to the

71
meanings and interpretations. I chose to document this data as suggested by Corbin & Strauss
(2015). I used the demographic matrix that I archived for follow-up clarity and member checks
as a means to document my communications with the participants.
Axial coding takes the process of open coding a step further, searching for emerging
meaning and interpretation through the identification of relationships among the concepts and
categories from the interviews into core themes. This process requires the researcher to identify
what more may be learned or what meaning emerges from the data elaborating on the properties,
contexts, or dimensions of the coded concepts as well as the interpretations intended by the
participants (Corbin & Strauss, 2015). I shared my interpretations of the themes and
relationships among the themes to the individual participants as the second level of member
checking. I conducted the constant comparative method to identify meaningful themes and
subthemes that answered the research questions. I shared each interpretation with the participants
to ensure the interpretation of findings conveyed what the participant intended. Once I received
agreement of each participant, the themes and subthemes were further coded using the same
process previously explained, identifying relationships, redundancy in the data, and divergent
data until no new concepts or themes were emerging from the data I collected.

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Research Findings
Participant recordings were transcribed at the conclusion of each interview. I read each
interview transcription at least three times to identify emerging codes and themes. I transcribed
codes onto index cards. These codes were identified by specific colors to assist with coding of
future transcriptions. I interpreted the findings from the common themes I identified from the
data collection that the selection of specific teaching strategies were guided by evidence-based
practice and AACN recommendations for undergraduate education. The teaching strategies were
selected by the faculty to achieve the purpose and learning outcomes of the leadership course
while supporting the student’s learning styles and needs. The nursing faculty conveyed that they
adjust teaching strategy and content to support area workforce expectations of a nursing
graduate. The effectiveness of the selected strategies is supported by the measured feedback and
evaluations gathered from nursing faculty, students, and area stakeholders. The research
findings, organized into the following coded themes and subthemes, were the collective
interpretations each participant agreed upon after the completion of the second round of member
checking.
Leadership Course Purpose
The theme, leadership course purpose, was defined by subthemes. The following
subthemes were then further defined by the common codes within the interview transcriptions:
Basic leadership. There appeared to be agreement among all participants that the
undergraduate student required a leadership course that addressed the basics of leadership,
delivering the basic definitions of what leadership means. According to the participants,
although leadership is discussed throughout the curriculum, the student does not understand what
leadership is until entering this course which in most cases is during their senior semester.

73
According to Interview #4, stated that, :The entry level leadership course for basic leadership is
offered the junior semester followed by a second level, more advanced course during the senior
semester.” Interview #2 stated, “The baccalaureate student doesn’t have leadership or work
experience.” Interview #3 stated, “Leadership content is integrated, but this is the first
“leadership course.” Before they get to me, they have heard content about communication,
delegation, but much of the content they have never heard before until entering the leadership
class.”
Leadership style. For the same reasons as previously discussed, there was agreement
among the participants that the undergraduate student develop an understanding of the various
leadership styles such as authoritarian, democratic, and laissez-faire styles to begin to identify
the leadership style they purposed to become through practice activities. This practice assisted
the student to identify different leadership styles displayed among faculty, clinical partners, and
themselves.
Interview #3 stated, “As part of the clinical evaluation, the students complete a graded in
class, clinical summation. They discuss their different reflections of their management style,
leadership style, communication, conflict management, and decision making styles. We have
already discussed it all in class, so now they are bringing it to themselves and what we expect
from them, and it’s all in the assignment instructions: what is your style (management,
leadership, communication, decision-making, and conflict management styles), what are some
strengths and weaknesses of that style, what improvements could be made.”
Leader role and role transition. The nursing faculty noted that most students did not
know the difference between a leader and manager. Therefore, the leadership course was
intended to prepare the undergraduate for the role transition from a student to a registered nurse

74
while at the same time, providing an introduction of the leadership role. According to Interview
#4, the undergraduate lacks a “leadership compass.” The development of this leadership
compass enables the nurse to not only be a leader among unlicensed personnel and peers, but
also at the patient’s bedside. Becoming a leader is not only about the leader role. The transition
to the role of the nurse also includes helping the students understand ethical dilemmas that could
be encountered. The participants expressed the importance of helping the student to identify and
reflect on how they might react to certain ethical decision whether a leader of a patient care team
or in a leadership role.
Interview #4 stated, “Most of this content, this is the first time these students have ever
heard this, they really don’t have a leadership compass yet. They’ve been taught teamwork,
communication skills, therapeutic communication, and basic terminology in healthcare. But they
haven’t really had in depth instruction in leadership content end and of itself. Interview #2 stated.
They would have a practicum and a project with the theory course; they would have to identify a
quality improvement initiative in the clinical site they were assigned, applying a rubric criteria,
developing a paper and power point presentation. It helped them to focus on leadership theory,
resource management, staffing, supplies, and other resources. Developing an understanding of
the role of nurse leader/manager that it isn’t just about patient care, but other things a leader or
manager would have to be aware of.”
Leader principles and performance. There was agreement among the participants that
until entering the leadership course, the undergraduate has a lack of knowledge regarding actual
leadership performance, practicing the principles of leadership. These principles were exampled
by performing simple delegation, prioritization, and making safe patient assignments whether in

75
interactive activities or in clinical. Five of the six participants provided examples of charge
nurse experiences among the students and attendance of leadership meetings
Interview #5 stated, “Even in our clinical component, if there are 8 students in the clinical
setting, one student is assigned as a charge nurse. I am there, but the charge nurse comes in
early, makes the assignments, and this charge nurse does not take patients. This occurs each
week. The student gets this experience each week. If there is another student who is having time
management issues, or a patient that is declining, the student charge nurse catches this and
approaches the student about these issues.”
Employeeship. The six participants spoke of several important concepts that were
interpreted as employeeship. Among these codes that could be collapsed into the subtheme were
resume writing, how to obtain a nursing job, how to be a good employee, participating in a job
interview, and participating in a performance evaluation.
Interview #1 stated, “One of the other things we would conduct mock peer interviews. I
had a panel of interviewers set up and an interviewee. I would give them a script. The peer
review panel nor the others would know the questions I would ask. The participants were
evaluated based on their ability to identify the illegal questions I asked, the behavioral questions,
or the other leadership aspects that were inserted. This way the participants were evaluated on
real life situations within a real life scenario.”

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Engaged and receptive. There was agreement among the six participants that the goal of
a leadership course is to engage the student with real world application to see the value in
nursing leadership, interpreted as becoming leadership receptive.
Interview #6 stated, “They have 180 clinical hours for this course. The lecture each week
is actually the theory part, and the rest of the time they are in clinical; so it’s really trying to
apply situations in a baccalaureate program; probably within a year they might be a charge nurse.
So they experience all the principals of management –real life situations with budgeting, staffing,
leadership, conflict, change- so these we cover in the case studies.” Interview #3 stated, “. This
is why we’ve done away with a lot of lecture, bringing it back to more of a seminar style. The
students have been more receptive and have been coming to class more. That thought drives our
leadership strategies because we have to be more creative and bring to more real world
application to make it more welcoming to the students if you will.”
Evidence-based practice and historical context of leadership. Five of the six
participants spoke of the importance of the historical context of nursing leadership with threads
of evidence-based practice and recommendations from AACN and QSEN. These participants
also referenced theoretical influences of Kolb (1984) for experiential learning and Benner (1981)
for the progression of the preparation of a generalist. Interview # 3 spoke of the influence of
Kramer (1974) to introduce the nursing student to realistic social experiences including conflict
in nursing practice. Interview #1 noted that while the AACN Essentials were significant, for a
basic leadership course, using those specific content areas were too high-level. Each participant
spoke to the value of remaining current within the contemporary evidence for best practices in
nursing and leadership pedagogy.

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Interview #2 stated, “Looking at the historical context of leadership theory- it is an
important starting point for students. The baccalaureate student doesn’t have leadership or work
experience. They need to develop an understanding of the autocratic, democratic, and laissez
faire leadership styles and having examples of those gives them a context to think back and
reflect on previous experiences in clinical, or with faculty in how the course was lead. Having a
historical context helps the student to have a framework in order to understand what they are
seeing or what they want to develop in as a nurse leader.”
Value of team. The value of working together as a team was a subtheme of expressed
importance among all participants. Threaded throughout the interview transcripts were teaching
strategies employed to engage students to work together as a team followed by reflective
journaling or peer review on how the group worked together and the importance of the team for
safe patient care.
Interview #2 stated, “You know it’s important to instill the value of the team, that we
aren’t doing this by ourselves, we function as a team in the care of the client whether it’s with the
health care provider, occupational therapist, the nutritionist, we aren’t by ourselves. We all have
to play nice together in the sandbox, we all share information as well as sharing our time with the
patient especially if it’s time for the patient to have a bath, but Oh no, physical therapy is here
and they need to get the patient up. So, it’s working as a team, and carving out those periods of
time that we absolutely need to have time with that patient.”

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Selected Teaching Strategies for Leadership Course Purpose.
The theme, the selected teaching strategies for the leadership course purpose, was defined
by subthemes. The following subthemes were then further defined by the common codes within
the interview transcriptions:
Lecture with power point and supplemental material. Didactic lecture with the aid of
power point continued to be a common teaching strategy used by the nursing faculty participants.
Although all participants spoke to using more alternative methods with interaction, lecture with
power point was still used as a means to introduce leadership content in support of the interactive
component. Supplemental modules were used by institutions that used standardized methods of
evaluation to aid the reinforcement of course content.
Interview # 5 stated, “Of course we use a lot of lecture and power points.” Interview #4
stated, “I teach an entry level, very basic leadership course. The way we have structured our
curriculum is a two-part series. The students in the baccalaureate program receive the first
leadership course, which is mine, then a year later, they receive a second leadership course
taught by a different instructor-who has the same knowledge and skills, etc. In my course, they
are introduced to the basic content areas that we just mentioned. The main teaching strategy I
use is a lot lecture.”
Role play. A common teaching strategy utilized for the student to gain real life
experiences in a safe environment was the application of role play. The students were presented
with real life leadership experiences with the expectations of conducting themselves as a leader
would, demonstrating real life leadership behaviors. A consistent description of using role play
was a means for the students to have a safe experience. Other examples of how role play was
used were in mock interview experiences, performance evaluations, assuming the role of charge

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nurse in making patient assignments in class, addressing problematic staff behaviors, and crucial
conversations using evidence-based communication methods such as “Team Strategies and Tools
to Enhance Performance and Patient Safety (TEAMSTEPPS)” (AHRQ, 2017) or the “I am
Concerned, I am Uncomfortable, I believe Safety (CUS) tool” (AHRQ, 2017).
Interview #1 stated, “We did a lot of role playing, a lot of scenarios, involving each of the
3 levels I defined earlier. How they would handle a particular situation.” Interview #3 stated,
“Problematic staff behaviors case studies: like nurses who are chemically or psychologically
impaired, marginal employees and how to deal with them from a charge nurse perspective;
people who aren’t getting their jobs done. We do case studies on those in class and we have
them role play some of those crucial conversations.”
Case Studies, scenarios, activities. The common description for the application of case
studies, leadership situational scenarios, and interactive activities was to provide students with
actual experiences to work through as a team with the application of course content. These
strategies used by the study participants were focused on problem-solving, decision-making,
prioritization, delegation, and ethical dilemmas. Interview #2 included the use of debates to
engage interactive discussion regarding ethical decisions as a leader.
Interview #6 stated, “Lecture Case studies: Each group has a different case study and
each reporter comes to the front of class to present the case study and that group’s answers to the
case student. This is the format we use for lecture. The lecture each week is actually the theory
part, and the rest of the time they are in clinical; so it’s really trying to apply situations in a
baccalaureate program; probably within a year they might be a charge nurse. So they experience
all the principals of management –real life situations with budgeting, staffing, leadership,
conflict, change- so these we cover in the case studies.” “The students still like to have some

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power point lecture as a brief outline since that is what their exams come from. They love case
studies the most. They can actively problem-solve an actual situation in the hospital and
whatever the lecture is for the day, they can apply the leadership principle discussed in lecture to
solving the questions and then they present to the class. They love working in groups and
interacting with each other. We try not to have just straight lecture but interactive lecture.”
Self-reflection. Self-reflection is described throughout the data collection as a method
for students to reflect on what they learned, on their performance in a leadership role, on their
performance as a team member, conflict management, and on their progression in leadership
development from the beginning of the course to the end. Self-reflection is used to assist the
student to identify for themselves what they have experienced and how they may improve in the
future. These self-reflections are conducted in various ways from journaling in the clinical
setting or throughout the course, as a method of debriefing after interactive activities, or in the
form of a self-evaluation.
Interview #2 stated, “It is very important to self-reflect; we in practice conduct our self-
evaluation. Students are also asked to self-reflect, they don’t like it- I guess it’s uncomfortable,
but in order to improve yourself, self-reflection is an important quality to have.” Interview #3
stated, “Discussion Questions: I mentioned the one about new graduates, with transition, and
reality shock. We also use another one specific to conflict management and having the students
conduct self-reflection on their own conflict management styles and their comfort with conflict.
Then we discuss it openly in class. ”Interview #1 stated, “We then used the strategy to determine
and identify the leadership styles -laissez faire, authoritarian, or democratic and the
responsibilities for each. We then took these descriptors to the next level by allowing students to

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design situations they encountered the different leadership styles-which one they chose to work
for and which style they would assume as a leader.”
Simulation; Low-fidelity simulation. Simulation was described as simulation in an
actual lab by three of the nursing faculty. The simulation activities were conducted for students
to experience the role of a manager, practice in making staff assignments, delegation,
prioritization, time management, and assertive communication. Interview # 3, #4, and #6
described other simulation activities designed to work as a team, apply different management
styles, and work through a change process. Interview #4 noted that simulation is under-utilized
and could be deployed more for leadership practice.
Interview #3 stated, “Management simulation: In-class sim based upon Friday night
in the ER. We partnered with a local ER to get that. We are able to bring it to senior students.
We were not able to do the full, but a small version of that. They each take on the role of a
manager of a unit, whether step down, ER, or ICU or surgery. They have to learn hospital
through-put, hospital communication among departments, and it is a very good learning strategy.
We spend the whole day on that, for 2 hours, including debriefing.” Interview #4 stated, “I use
low fidelity simulations with them. I will put the students through different types of scenarios
that require teamwork, leadership, different management styles, some type of change process and
they have to work through that leadership scenario as a team. So, those are a couple of the major
teaching strategies I use. I think there is still much opportunity out there that we haven’t explored
all of the realms of how simulation works, and how we can bring that to the table. We think of
simulation in the clinical sense, but what we don’t realize at the crux of it, we are trying to teach
them how to interact with another human being and have that high level communication skill,
which is found in leadership, it’s the basis for it.”

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On-line discussion forum. According to Interview #3, #4, and #6, the online discussion
forum was described by three of the nursing faculty as a means of collaboration among the
students to discuss a leadership scenario presented, focusing on content discussed in class. The
goal of this strategy was for the students to reflect and discuss on the leadership roles and
decisions involved in the scenario presented.
Interview #4 stated, “One of the things we do now is weekly online blogs or discussions
on whatever content has been covered that week, we go back and give them a scenario- so they
are getting double the interaction-live with scenarios in class and they also have to do some
research to come up with solutions to a minor dilemma I give them online.”
Clinical with leadership faculty. The clinical experience was different among the
participants. Interview #2 and #5 described the clinical component as part of the leadership
course where the actual leadership faculty teaching the course were also the clinical faculty with
the student for six weeks. During this time, each student had the opportunity to assume the role
of charge nurse over their peers, reflecting on the experience at the end of the clinical day. This
experience is facilitated by the nursing faculty, but the student is allowed to act as the charge
nurse with little interference by the faculty. The student’s resources were the team members on
the unit. In this environment, the students learn to communicate with actual patient care teams
and other disciplines. Students also gain leadership exposure by attending leadership meetings
with the leaders and managers of the assigned areas. Interview #5 described activities that were
included during these clinical experiences that related to resource management, budgeting, and
staffing.

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Interview #2 stated, “I really feel that for leadership education to be effective, there has to
be an application component, a clinical/practicum project component to really cement what they
are learning in theory. I believe also from the feedback that I have gotten over the years from
the facilities and nurse managers, about when students are on the units doing their leadership
clinical, they see a difference in these students, and having that theoretical background, prepares
them for when they are out after graduation, and they tend to be a stronger student.” Interview #5
stated, “Although I am there, the student charge assumes this role. This is part of our clinical.
This has been helpful with our students based on the data we have obtained. Once these student
graduate, they are comfortable because they have experienced this before they graduate.
Clinical with preceptor. Interview #3 and Interview # 6 described clinical experiences
with a trained preceptor over a period of time. These nursing faculty trained the preceptors and
provided them with the course expectations for the students. Instead of fragmented time from a
faculty member who is stretched among 10 students, the student receives one-on-onetime with
the preceptor. According to Interview #6, the student is also given the opportunity to act as
charge, in some cases over their peers in a junior clinical experience. The nursing faculty at both
institutions maintain the responsibility to facilitate the experience to ensure outcomes are met.
Interview #6 stated, “As leaders, from the beginning of the semester to the end of the
semester, we see the students grow. We visit them in clinical and talk with their preceptors. The
students comment that they learned the most about being a nurse in this semester. I think it is
from the one on one experience with a preceptor as opposed to being with one faculty who has
12 students. These students have the undivided attention of the preceptor, so they learn more
from this than the other clinicals.” “Well, another faculty member and I have found that many of
the hospitals did not have a preceptor course for the staff nurses. We obtained a grant and

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developed a 4 hour program for how staff nurses can become good preceptors. We went to all of
the hospitals in the city and taught it. We had many nurses take the course.” Interview#3 stated,
“Yes, they have the 6-week preceptorship which is individually paired with a qualified preceptor
in the acute care environment. They have assignments associated with that clinical as well.
They have clinical reflections every day- they do their self-evaluation with their clinical
objectives as well as the faculty and the preceptor.”
Leadership performance with core clinical courses. It is important to note that
although discrepant, this concept was found to be relevant to this study. Interview #4 described
that leadership performance is expected within the clinical experiences of the required core
courses once students have entered into the leveled leadership courses. This institution offers an
entry level leadership course at the junior level followed by a more advanced course at the senior
level. Students are expected to demonstrate leadership attributes learned within the course.
However, these clinical experiences are not taught nor evaluated by the leadership faculty. These
clinical experiences are evaluated by the core clinical faculty responsible for that particular
course.
Interprofessional clinical. The interprofessional clinical experience was described as a
component of the preceptorship that is part of the leadership course at one institution. Although
this is also discrepant and not shared among the other participants, the interprofessional
experience allows the student to value the other professions involved with caring for a patient in
other settings that are not acute care. For this experience, students spend time at a dental or
oncology clinic with a preceptor, completing the expectations for a nursing role.

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Interview #6 stated, “All of them experience a 4 hour interprofessional clinical. They
may go to a dental clinic or an oncology outpatient chemotherapy clinic. They are assigned to a
nurse or nurse practitioner completing a checklist of the things they can do.”
Support for Student Learning Styles and Needs of Workforce
The theme, the support for student learning styles and needs of the workforce, was
defined by subthemes. The following subthemes were further defined by the common codes
included within the interview transcriptions:
Faculty feedback and faculty evaluation. Consistently, the participants referenced the
necessity of faculty feedback regarding student learning styles and cognitive needs before
entering the leadership course. This feedback was presented in faculty meetings and at the end
of the semesters. This feedback assisted the faculty who taught leadership in determining the
best structure for student engagement and support to achieve the leadership course purpose and
learning outcomes. The faculty feedback confirmed that the students learned best through
interaction, experiences, self-reflection, and support from lecture content.
Interview #6 stated, “Yes, we meet at the beginning of the semester. But due to the size
of the class, we meet each week to discuss clinical and the class. And at the end of the course,
we go over the evaluations and determine if any changes need to be made. With this large group
and 7 clinical sections, it is important to meet each week.” Interview #3 stated, “. It’s myself and
one other faculty who teach in the classroom and clinical as well as the preceptors in the clinical
setting. We base upon what’s worked in the past, what feedback from the students, as well as
our course objectives, map out what we are going to do.” Interview #5 stated, “Yes, we have met
and looked as a faculty how we have assigned charge nurses. Other semesters we have thought
about taking on that charge nurse role in those courses. These assignments have to be based on

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acuity and skill of the nurse. We are teaching this now, but at senior level. We are discussing as
a faculty to possibly implement this maybe in semester 3 in the first Med Surg.”
Student feedback. Consistently, the participants spoke of the importance of student
feedback regarding their perceptions of the course structure and how they learned best.
According to the participants, student feedback was positive for the application of teaching
strategies that require interaction, team work, and experiences. At one institution, the nursing
faculty described that one student reflected they were finally able to experience what a real nurse
is. The participants acknowledged that students continued to prefer at least some didactic lecture
with power point support.
Interview #3 stated, “Course Evaluations: we do these on Moodle, our learning
management platform. We ask about our teaching strategies in class and whether they felt it was
helping them meet the course objectives. We ask about the class environment itself. We ask
about whether they thought their evaluation was done based upon course objectives.” Interview
#2 stated, “Their responses were positive, and they felt that while it was a labor-intensive course,
they truly learned and were glad for the experience.” Interview #6 stated, “One thing we learned
is that some of these meetings are the graduates are often reticent to delegate. So we try to focus
on delegation in their interactions, and make sure in clinical, each week they look to see how
they have delegated. As leaders, from the beginning of the semester to the end of the semester,
we see the students grow. We visit them in clinical and talk with their preceptors. The students
comment that they learned the most about being a nurse in this semester. I think it is from the
one on one experience with a preceptor as opposed to being with one faculty who has 12
students.”

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Student self-evaluation. The student’s self-evaluation was described as a reflective tool
for the student to evaluate their progress usually within the clinical setting in the areas of
leadership. The data collected from the student’s self-evaluation assists the nursing faculty in
choosing the appropriate teaching strategies that supports the student’s learning, thus meeting
course outcomes.
Interview #6 stated, “At the end of each semester, the students evaluate the course. Also
through going to National Conferences, the new evidence is flipped lecture. Also, this last
semester should be a bridge between school and real life as a nurse. You want it as interactive as
it can be. The students still like to have some power point lecture as a brief outline since that is
what their exams come from. They love case studies the most. They can actively problem-solve
an actual situation in the hospital and whatever the lecture is for the day, they can apply the
leadership principle discussed in lecture to solving the questions and then they present to the
class. They love working in groups and interacting with each other. We try not to have just
straight lecture but interactive lecture.” Interview #4 stated, “On our student evaluation surveys,
incessant comments from students how important the course was and when they first started they
didn’t see the importance of the course, but after completing it in their junior year, they are better
prepared for the next, and they realize what they didn’t know to begin with. They are better
prepared for their senior year; I’ve had senior instructors comment the students are more
prepared and better able to handle dilemmas and problems and ethical concerns; I would like to
think it is attributed to the beginning leadership course and they’ve had some exposure.”
Preceptor evaluation. The preceptor evaluation is conducted for those institutions that
incorporate preceptors for leadership clinical. According to Interview #3 and #6, the feedback
from the preceptor assisted the nursing faculty to determine if the student had deficiencies, the

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student’s level of leadership performance, and the student’s growth from the beginning of the
experience to the end.
Interview #3 stated, “Clinical evaluations are important: students conduct a self-
evaluation, I complete one, and the preceptors complete one. It is important to note that the 4
main evaluation components (Overarching themes) are:
-professionalism
-nursing roles (all nursing roles, not just health care provider)
-communication
-clinical judgement.”
Interview #6 stated. “Clinical is evaluated by a clinical evaluation tool, graded by the
clinical preceptor and assigned clinical faculty.”
Stakeholder and alumni feedback. The undergraduate nursing programs are charged
with educating students to become a generalist for the healthcare workforce. Each participant
spoke to the importance of having feedback from the external stakeholders. According to
Interview #4 . . . “from those who actually experience what the nurse does.” Interview #5
discussed what they learned from the feedback received from the stakeholders. The healthcare
stakeholders want the student ready to take charge when they graduate because they no longer
want to hire a novice until they have passed the NCLEX. Teaching strategies and content are
often updated to reflect the needs of the stakeholders. Interview #6 discussed that the healthcare
administrators commented at an advisory meeting that the new graduates were having problems
with delegation. Therefore, more activities with delegation were added to the leadership course.
Another example from Interview #3 was an observed knowledge deficit in how to be a good
employee. Therefore, additional activities were added on the importance of knowing how to

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nursing job and the character of a professional According to Interview #3, #5, and #6, the ability
to obtain data from alumni has a great impact on how and what is taught to prepare the
undergraduate for leadership. An example was that some graduates inform their previous
instructors that often as soon as orientation is over, they are expected to be in charge. Thus, more
experiences of assuming the role of charge nurse is often added to the curriculum, preparing the
student for this role transition.
Interview #6 stated, “The end of each semester we meet as a school with the CNOs of the
hospitals in the city and ask them how they feel our students are prepared to be leaders. One
thing we learned is that some of these meetings are the graduates are often reticent to delegate.
So we try to focus on delegation in their interactions, and make sure in clinical, each week they
look to see how they have delegated.” Interview #3 stated, “The manager of that extern program
came and talked to our administrator about this. At this point, however, these students haven’t
taken the leadership course. They need to hear about how to be a good employee before they get
to me. We had a meeting in our shared governance council and had this conversation-not that we
need to police their jobs, but make the student aware of the ramifications, if you sign this
contract, this is what it means. Each year, our dean and administrators meets with the
administrators of area hospitals to discuss leadership issues they see and leadership concepts that
are deficient- I would like to think it isn’t just us; they are seeing graduates performing at the
bare minimum, not showing up to work on time; and we talk about these things, about being a
good employee, having integrity, that is frustrating to hear. As far as leadership aspects, the role
of charge nurses, and it’s so much more than making patient assignments, it’s customer service,
etc. - I tell the students they will be charge nurses sooner than they think, and the students don’t
believe it. But then I get emails 4 months after graduation, and they say, “Yes you were right.””

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Student exit interview. The student exit interview was discrepant, however, it is
relevant to the description of supporting selected teaching strategies for leadership. Interview #5
spoke to the positive impact the student exit interview has on improving the leadership course.
At this institution, the students discussed the importance of the undergraduate program and their
leadership course.
Interview #5 stated, “Yes, we have an end of course evaluation, but our Associate Dean
conducts an exit interview with the students before they graduate. This exit interview covers the
beginning to the end of the program. The students say some positive things about our program
and what they have learned in leadership. They feel ready to be able to become leaders of a unit,
and be charge nurses of a unit.”
Application of Evidence-Based Practice Principles for Leadership
The theme, the application of evidence-based practice principles for leadership, was
defined by subthemes. The following subthemes were then further defined by the common
codes within the interview transcriptions:
American Association of Colleges of Nursing (AACN). Each institution included
within this study was accredited by the AACN. The participants stated they adhere to the AACN
Essentials of Baccalaureate Education recommendations. The interviews with #2, #3, #4, #5,
and #6 revealed a common thread of how the AACN guidelines and suggested content for
leadership are referenced in their leadership courses. However, Interview #1 described the
AACN Essentials as too high level for an entry level leadership student, thereby developing the
leadership course content from student feedback and personal leadership experience. The
participants were asked to rank in order of importance the 17 content areas within the AACN
Essentials document. This ranking matrix follows in Appendix J.

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Interview # 1 stated, “I’m not sure I can rank the top 10 most important. I think
those points are at a higher level sometimes than what we need to start off in teaching
leadership.”
Quality and Safety Education for Nurses (QSEN). QSEN competencies were
referenced by five of the six participants as important for nursing leadership including quality
improvement, communication, collaboration, conflict management, and problem-solving.
Interview #2 stated, “What I used in the class were course quizzes and exams, a problem
solving rubric applied to a case study. It wasn’t just asking the questions at the bottom of the
case study but required the student to:
Define a problem
Facts and assumptions drawn from the case study
What were some possible extraneous variables that were not listed
This causes them to creatively think what else could have been out there; was it the shift,
time of day, was it the staffing that caused the situation. Then they have to apply two courses of
action to fix or remedy the situation based on leadership theories and QSEN principles; they
choose 2 of those. Then explain what were the risks and benefits of the chosen courses of action.
It causes them to think and to think about what next; almost a root cause analysis of the case
studies if you will.”
Kolb. While all participants spoke to the importance of experiential learning and gaining
real life experiences through clinical and interactive components of the classroom, only three
referenced Kolb’s influence for experiential learning.

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Interview #4 stated, “Weekly role plays where we conduct in class, just an impromptu
role play on how they would interact with a certain scenario; I have a rubric I follow, very
simple-did they follow instructions, did they communicate well, how was their communication
style, did they involve everyone in the team, things of that nature; did they address the leadership
concern at the time in a full capacity based on the knowledge they had at the time. Later in the
semester, they complete a presentation that involves a role play, taking a leadership dilemma of
their choosing and they complete a role play. I have a rubric that is associated with that
presentation; they complete a power point that gives education to the class, but they also develop
a role play from that.”
Kramer. All participants spoke of the importance of real life experiences and scenarios
that involved conflict management. Interview #3 referenced Kramer’s influence from her work,
Reality Shock (1974). The nursing student is introduced to real social processes involved in
conflict in nursing, allowing the student to determine the best social behavior to display while in
school and after practice. According to Interview #3, allowing the student to experience conflict
and reflect upon it prepares them for the different conflicts after practice.
Interview # 3 stated, “As part of that teaching strategy, we use a discussion question,
where the student goes out and speaks to a new graduate of their choice and ask them about their
transition process and experiences, including the reality shock we talk about in class, we talk
about Kramer’s and Benner’s theory and those types of things to get them ready. And that is
what they are introduced to right at the beginning.”
Benner. The influence of Benner’s theory, From Novice to Expert (2008) was described
by Interview #2, #3, and #4. They described the progression of learning and leadership at the
undergraduate level before the novice is entering into practice. The remaining three described the

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continuum and progressiveness of learning after entry into practice, however, they did not
reference the theoretical influence of Benner (2008).
Active learning. The theoretical influences of the models developed by Argyris and
Schon (1974) that are revealed through the conceptual lenses of theory in use help explain why
and how individuals choose and implement actions for the situations they are presented with
(Anderson, 1994). However, six participants did not reference to the theoretical influences of
active learning by Argyris and Schon (1974). The participants described interactive components
of role play, simulation, group work with peers in case studies, and the clinical experiences.
Nursing is an interdisciplinary science, impacted by multiple theoretical influences. Therefore, it
is important to note that the description of teaching strategies by the nursing faculty was an
explanation of how the various components of leadership were actually taught. There was no
description by the participants of the actual strategy of active learning, influenced by the work of
Argyris and Schon (1974). I would question if this failure to discuss the active learning theorist
or theoretical influence might be related to the failure of Benner (2008) to acknowledge the
works of Argyris and Schon (1974).
Reflective practice. Reflection and reflective practice are theoretical influences
referenced in much of the literature found on nursing education that incorporates active learning.
Schon (1983, 1987) in his work on reflective practice, discussed that the professional practitioner
learns through active practice with the guidance, facilitation, or mentorship from the instructor,
to learn through reflection on the consequences of actions, thus developing alternative methods
of solving problems when faced with them in the future. While reflection in the form of self-
reflection, debriefing, and weekly reflective journaling were referenced among the six
participants, again there was no reference to the theoretical influence of Schon (1983, 1987).

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The different methods to employ reflective practice were discussed and described within each
interview. However, these descriptions of journaling and self-reflection left me to interpret the
influence of reflective practice referenced in the works of Schon (1983, 1987).
Evidence. There were consistent descriptions of the application of the evidence in the
review of peer reviewed journals, quality initiatives, and ethical dilemmas. The nursing faculty
encouraged research on best practices to apply to quality initiative projects and presentations as
well as ethical decision making case studies.
As Interview #6 stated, “At the end of each semester, the students evaluate the course.
Also through going to National Conferences, the new evidence is flipped lecture.”
Interview #2 also stated, “And then we did discussion forums among the groups. The
responses had to be based upon the evidence; having them get into the research to support their
response. “Probably because of the evidence. Students had to get into research, but I also got into
the research to find what would cause the students to think more critically and creatively, and
having them speak about it and articulate what they researched, helped them learn at another
level.”
Interview #4 stated, “One of the things we do now is weekly online blogs or discussions
on whatever content has been covered that week, we go back and give them a scenario- so they
are getting double the interaction-live with scenarios in class and they also have to do some
research to come up with solutions to a minor dilemma I give them online.”

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Interview # 3 also stated, “What we did, instead of talking about it and testing on a test, we
implemented a group project, the Quality Safety Group project. The students in groups of 4 or 5,
we the faculty have created quality or safety case studies modified on QSEN or different available
case studies. The student walks through the case study through the quality improvement process,
they have to incorporate.”
Measured Effectiveness of Selected Teaching Strategies for Program Purposes
The theme, the measured effectiveness of teaching strategies for the course purpose, was
defined by subthemes. The following subthemes were then further defined by the common
codes within the interview transcriptions:
Written exams. As a whole, summative written exams remained the main evaluation
tool used to evaluate mastery of content covered in the leadership theory course.
Interview #4 stated, “Yes, I do. The first exam is a fair amount of comprehension and
understanding because they are just getting started with the basics and concepts. Then as the
semester progresses, the following exams become more analytical in nature and also include
scenarios.
Interview #1 stated, “Unfortunately, all too often we have to rely on written exams or
written work to evaluate. Most of my evaluations were on written exams.”
Interview #3 stated, “We have 2 tests. One at mid-term and one final. They are very
short. For several reasons; our course objectives are evaluated using the methods I’ve told you
about. But we still wanted to have some NCLEX style testing in place. We do that as well. We
only have 15 items on the mid-term and final. It’s not a big portion of our class because students
are taking major exams in the med surg class and we don’t want to burn them out.

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Clinical scenario-based exam. Interview #5 described a clinical scenario-based exam
that included resource management, budgeting, and productivity to determine patient care hours
and full-time equivalent hours. While the clinical experience is a pass/fail, the external
stakeholders express that the graduate nurse should have some knowledge of resource
management and productivity.
Interview #5 stated, “Yes and we also have a clinical exam that relates to resource
management, budgets, and spending. We give them a scenario about nursing leadership to
determine the total patient care hours and full-time equivalent hours. These skills are given in a
scenario-based format.”
Evaluations. The utilization of evaluations for data collection was discussed among all
participants. This form of data collection was used to determine the effectiveness of the teaching
methods, student preparation, and areas of course improvement for the future. The codes that are
subsumed under the subtheme of evaluations are:
 self-evaluation: a data collection tool for the student to self-reflect and provide
their perception of their leadership knowledge development progression from
course beginning to end
 end-of-course: completed by the student, serving as a data collection tool
reflecting the student’s perception of the effectiveness of both the theory and
clinical components of the course.
 faculty clinical evaluation: a clinical evaluation tool reflecting the student’s
performance of leadership expectations in the clinical setting that was either
facilitated by the actual leadership theory faculty or in addition to the preceptor
evaluation

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 preceptor evaluation: a clinical evaluation tool revealing data that reflects the
student’s performance of leadership expectations in the clinical setting. The data
serves as a measure of the effectiveness of the clinical experience by a trained
preceptor who had no relationship to the leadership theory content.
 stakeholder evaluation: a data collection tool reflecting the leadership
preparedness of the graduate upon entry into practice. The data reveal a measure
of the effectiveness of the teaching strategies used to prepare the undergraduate
student before entry into practice
As Interview #1 stated, “I had them write out a performance evaluation based on a job
description I gave them and a narrative example of the employee’s job performance on
timeliness, tardiness, attendance, medication errors, etc. I would sit down with the student and
have them write a performance evaluation based on that information. Depending on how well
they did with that, it was part of their course evaluation.”
Interview #2 also stated, “Another thing was the end of course survey, this was usually on
the learning platform so that we could measure student’s perceptions of the course outcomes, and
of course standardized evaluations. For the most part, students did well because this was the last
course of the end semester.”
Additionally, Interview #6 stated, “And at the end of the course, we go over the
evaluations and determine if any changes need to be made. With this large group and 7 clinical
sections, it is important to meet each week.” “It has been difficult to obtain data because once
they start working, they move around and it is difficult to track them. We have evaluations after
one year working there, after two years; we would like to collect that data, but we find it
difficult.”

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Finally, Interview #5 stated, “We meet with some of the health care facilities. They want
to try to orient less and for us to have them more prepared.”
Faculty meetings. The participants made references to pre-semester and end of course
faculty to discuss learning styles, student needs, student progression, performance, and teaching
strategies. The faculty would determine which strategies did or did not work well. The
frequency of faculty meetings were determined by the size of the classes and the number of
faculty or preceptor availability.
As Interview #6 stated, “Yes, we meet at the beginning of the semester. But due to the
size of the class, we meet each week to discuss clinical and the class. And at the end of the
course, we go over the evaluations and determine if any changes need to be made. With this
large group and 7 clinical sections, it is important to meet each week.”
Interview #5 also stated, “Yes, we have met and looked as a faculty how we have
assigned charge nurses. Other semesters we have thought about taking on that charge nurse role
in those courses. These assignments have to be based on acuity and skill of the nurse. We are
teaching this now, but at senior level. We are discussing as a faculty to possibly implement this
maybe in semester 3 in the first Med Surg.”
Stakeholder meetings. As mentioned previously, each participant discussed the
importance of meetings with the external stakeholders to gain understanding the preparation of
the new graduate compared to the stakeholder’s expectations. These meetings helped the faculty
gain understanding of improvements that were necessary for the leadership course to better
prepare the graduate to meet the healthcare workplace expectations.
As Interview #2 stated, “I believe also from the feedback that I have gotten over the years
from the facilities and nurse managers, about when students are on the units doing their leadership

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clinical, they see a difference in these students, and having that theoretical background, prepares
them for when they are out after graduation, and they tend to be a stronger student.
Evaluation rubrics. The codes subsumed under the subtheme of evaluation rubrics,
described as a tool to measure teaching strategy effectiveness, are references as marking rubrics
used for role play, problem-solving activities, simulation, performance evaluation exercises, peer
interview activity, quality improvement project with presentation, clinical summation, and case
study interactions. These rubrics listed the expectations of the student to meet the learning
outcomes of the assignment. The rubrics were a measurable tool illustrating whether or not the
student met the desired goal of the assignment.
As Interview #2 stated, “They would have a practicum and a project with the theory
course, they would have to identify a quality improvement initiative in the clinical site they were
assigned, applying a rubric criteria, developing a paper and power point presentation. “
Interview #4 also stated, “From the role play standpoint, I use a rubric that I have
developed over the years. Weekly role plays where we conduct in class, just an impromptu role
play on how they would interact with a certain scenario; I have a rubric I follow, very simple-did
they follow instructions, did they communicate well, how was their communication style, did
they involve everyone in the team, things of that nature; did they address the leadership concern
at the time in a full capacity based on the knowledge they had at the time.”
Exit interview. Interview #5 described the exit interview as a valuable tool used
between the administrator of the nursing program and the graduating student. The tool offered
data revealing the effectiveness of the nursing structure and teaching strategies employed for the
leadership course. This data was discrepant, but maintains relevance to the study as a means of
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HESI, ATI standardized exam. Three participants referenced the data collection from
leadership-specific standardized exams to identify strengths, deficiencies, and areas of needed
improvement for the leadership course. These exams were not a part of high-stakes testing but a
data collection tool for faculty and a performance feedback tool for the students
As Interview #5 stated, “Our primary method is exams. The students are also given a
standardized test through HESI that we give them as well.
Interview #3 also stated, “We do 2 ATI test- The RN competence predictor is the big
umbrella because we are at the end. Our classroom specific ATI, is the Leadership test with ATI.
We administer it about 3 weeks before the end of the semester and have our students remediate
on that. I track and trend that data to see where there may be some short-comings. We have
noticed over the last 2 semesters, our quality improvement data was not doing so well. We made
some changes this past semester. We are looking forward to seeing how that does.”
Leadership practicum. A leadership practicum was mentioned by Interview #2 as a
valuable evaluation exercise to determine leadership proficiency and effectiveness of the
leadership theory course and clinical experience. Although discrepant, this data is relevant to the
study as a real life safe demonstration of the effectiveness of how the course was taught and/or
need for improvement based upon student performance.
According to Interview #2, “I really feel that for leadership education to be effective,
there has to be an application component, a clinical/practicum project component to really
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Faculty Perspectives of Leadership Efficacy at the Undergraduate Level
The theme, faculty perspectives of leadership efficacy at the undergraduate level, was
defined by subthemes. The following subthemes were then further defined by the common
codes within the interview transcriptions:
Application component with theory. The six participants expressed equally the value
of the application of leadership principles with the theory course. Interview #2 stated that the
application component of leadership education is important to “cement” what they are learning.
The other participants agreed that providing a safe experience whether in the clinical area or the
classroom supports the theory course.
According to Interview #4, “without underlying theory and how leadership is developed,
leadership style, you have no basis to go on.”
Interview #6 also stated, “So they experience all the principals of management –real life
situations with budgeting, staffing, leadership, conflict, change- so these we cover in the case
studies.”
Interview #3 stated, “As part of that teaching strategy, we use a discussion question,
where the student goes out and speaks to a new graduate of their choice and ask them about their
transition process and experiences, including the reality shock we talk about in class, we talk
about Kramer’s and Benner’s theory and those types of things to get them ready. And that is
what they are introduced to right at the beginning.”
Experience in learning. The feedback the participants received from students who
received experience in the classroom and clinical settings was positive, reflecting the importance
of experiential learning. The impact of a positive leadership experience was described by the
participants as revealed from the feedback received from the stakeholders. According to

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Interview #4, the healthcare stakeholders are those who directly experience the student’s
competency not only in the clinical setting as a student, but when they enter the healthcare
workforce as a novice.
Partnership with stakeholders. The six participants discussed how the healthcare
organizations do a good job of preparing the clinician for a clinical role during orientation, but
they are not focused on leadership development. The participants referenced that partnerships
with stakeholders would help in the preparation of good nurses into good leaders. However, the
profession of nursing and healthcare according to Interview #4 stated, have been in “silos”.
Interview #4 also stated, “A successful worker requires a successful student, therefore the
student becomes more leader receptive.”
Preceptorship/mentorship after graduation. Five participants discussed the value of a
preceptorship or mentorship after graduation as valuable toward leadership development of the
generalist after graduation. The design of this preceptorship or mentorship should establish
further development as a leader instead of specific for the clinician.
According to Interview #6, “As leaders, from the beginning of the semester to the end of
the semester, we see the students grow. We visit them in clinical and talk with their preceptors.
The students comment that they learned the most about being a nurse in this semester. I think it
is from the one on one experience with a preceptor as opposed to being with one faculty who has
12 students. These students have the undivided attention of the preceptor, so they learn more
from this than the other clinicals. Our past grads go on to be charge nurses, unit directors, middle
management. We feel as though they have received good preparation to be a generalist; certainly
graduated as a generalist in nursing.”

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Additionally, Interview #5 stated, “We meet with some of the health care facilities. They
want to try to orient less and for us to have them more prepared.”
Finally, Interview #2 stated, “The hospital does a good job helping them to orient them
clinically, so we have very good clinicians. But there is a gap in helping develop good nurses
become good leaders. If the mentorship was there, that would be terrific, but too often we
promote good nurses to become leaders, and they are not prepared. And it can really sour a good
nurse in that position.”
Academic clinician. Aside from preparing nursing generalists, nursing academia is
focused on preparing good clinicians, not necessarily good leaders after completing a leadership
theory course. Academia has an opportunity to introduce more contemporary practice and
explore the utilization of simulation in the leadership areas, as stated by Interview #4, “for a
“higher level of interaction with a human being.”
Preceptorship with theory. The application of a preceptorship with theory is valuable
in providing more real life experiences in a safe setting. Interview # 3 and #6 stated that the
students who experienced the preceptorships with theory expressed that they “have learned the
most about being a nurse.”
Stakeholder expectations. According to Interview #1, “There is a misconception among
the healthcare workforce that within 6 months of graduation, a good clinician will perform as a
good leader.” This was a consistent discussion topic among all of the interview participants and
I have summarized their discussion here. Most stakeholders are expecting the new graduate to
perform in a leadership role, such as a charge nurse within 6 months. The healthcare
organizations are expecting more from academia, so leadership education should begin sooner in
the curriculum before the last semester. The stakeholders are expecting a leader ready novice

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Perceived value in leadership. The leadership course is in competition with other core
curriculum courses that are more valued by the student. According to Interview #3, “It is
important to note that this is one of two courses the students take in their final semester. This
leadership course and their final med surg, critical care based, highly acute course. Students tend
to place more value on the med surg course because it is harder.”
Safe nursing. According to Interview #3, “the undergraduate must understand what safe
nursing is.” Interview #3 explained, “I tell them on our first day of class, “This class is going to
be different from any other class that you have taken. We’re not necessarily teaching you
anything new about hands-on patient care; you have already learned that. We’re teaching you
how to be a safe nurse, which you may not have learned how to do already.” The students say,
“Yea, we already know how to be a safe nurse.” “Except there’s a difference between safe
bedside nursing and safe nursing overall.”
Leadership across curriculum. Interview #4 expressed that their institution introduces
leadership at the junior level and then a more advanced leadership course at the senior level. The
remaining five participants consistently expressed that the last semester is too late to introduce
leadership principles. Leadership development should be introduced earlier and reinforced
throughout the curriculum and clinical practice.
As Interview #3 stated, “It is integrated, but this is the first leadership course. Before
they get to me, they have heard content about communication, delegation, but a lot of the content
they have never heard before until entering the leadership class.”
According to Interview #1, “I think as we look more and more at the expectancy of the
employers with our production of baccalaureate prepared nurses, I think the employers are
looking to us to have done a better job in preparing nurses to assume leadership roles. One of the

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short-comings that we have a profession, we do a good job in preparing students clinically, they
graduate, they pass the NCLEX, then they start to work. After about 6 months-1 year, the
workplace says “oh this person is an excellent clinician, they manage their time and patient care
well, and they are organized.” We need to make this person a charge nurse, a manager, or a
house supervisor.” But other than a 3 hour course in their baccalaureate program, we haven’t
done anything else to prepare them for a leadership role and I think that if we even correlate
some type of clinical experience-internship, or a preceptor experience, not even for a semester
long program, but something to help the baccalaureate student have some decision-making
experience while still in the academic setting.”
Systems thinking. One participant mentioned the deficiencies among students with
systems thinking and the growing need to add this topic to the curriculum. Systems thinking
refers to the healthcare infrastructure, linkages, and dependencies. According to Interview #3,
this component should be introduced before the senior year, but currently this is not discussed
until the last semester. While these were discrepant data, they added value to the relevance of
this study, noting that leadership education for the undergraduate has implications for
improvement.
Faculty Perspectives of Implications for Future Nursing Leadership Education
The theme, faculty perspectives of implications for future nursing leadership education,
was defined by subthemes. The following subthemes were then further defined by the common
codes within the interview transcriptions:
Preceptor training. Interview #3 and #6 discussed a preceptored clinical as a best
practice for undergraduate students noting that the success was attributed to assigning students to
trained preceptors. The trained preceptors were more effective in addressing the expectations of

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the nursing programs to meet student learning outcomes. According to Interview #6, “Well,
another faculty member and I have found that many of the hospitals did not have a preceptor
course for the staff nurses. We obtained a grant and developed a 4 hour program for how staff
nurses can become good preceptors. We went to all of the hospitals in the city and taught it. We
had many nurses take the course.”
Preceptored undergraduate practice. I have interpreted the description of this code
from previous discussion as an undergraduate nursing program offering the student a
preceptorship in the last semester supporting leadership development for the generalist entering
practice.
Mentorship after graduation. This code is not the focus of this study, however, this
code was interpreted from the data that a common faculty perspective is that that learning does
not end at graduation from a nursing program. The nursing programs and the introduction to
leadership should engage the student to become leader receptive. According to Interview #1 and
#2, a program should be in place after graduation to not only foster a clinician, but also to
enhance leadership development
Academic partnerships. Interview #6 stated, “A lot of the upper and middle
management are our past graduates, so they are interested in further developing our graduates for
leadership.” According to Interview #4, “That’s in the academic world and private sector-we
haven’t partnered enough to the detriment of the student. I think that on both sides of the fence,
we’ve started to take a look and understand that we’ve got to have partnership for the success of
the student. If you want a successful healthcare worker, you have to have a successful student.
There’s no way shape or form to do that without strong partnerships.”

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Curriculum development. According to Interview #4, “The involvement of those who
experience what nursing does, could have a great impact on future curriculum development.”
The nursing curriculum could be impacted through the eyes of nursing education, the
community, the student, private sector, and the healthcare organizations.
Interprofessionalism. Interview #4 and #6 discussed the incorporation of
interprofessionalism to provide a collaborative experience for the leadership student as well as
other professions to achieve the common goal of quality care.
Driving force of healthcare. According to Interview #5, the nursing profession is and
will continue to have a strong impact on the healthcare industry.
Health reimbursement changes. The changes to healthcare, especially changes to
reimbursement, will impact nursing. Interview #5 stated, “The development of nursing
leadership is the key to success in managing resources and changes in a changing healthcare
environment.”
Nursing professionalism. Interview # 3 discussed that there is great value in the
practice world sharing in the professional development of a student along with academia.
Experienced faculty. Interview #1 and Interview #2 expressed there is value added to a
leadership education program when the nursing faculty who teach leadership have leadership
experience, providing both the clinician and leader perspective.
Trustworthiness
This study was my exploration of social and educational processes from an interpretivist
perspective through the collection of data from actual nursing faculty who teach leadership
education in baccalaureate nursing programs. I achieved content validity by performing 2 formal
rounds of member checks, the thick rich descriptions of participants, the face-to-face encounters,

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and my prolonged engagement with the participants and the data. The peer review performed by
my research committee as well as two colleagues who were not involved with my study further
established content validity. Credibility was established by addressing my teaching philosophy
and nursing education beliefs in the beginning of my study so that the reader may understand any
personal influences my beliefs or opinions may have on the data interpretations or conclusions.
Lincoln and Guba (1985) and Patton (2002) stated that trust from the reader is directly related to
the ability to trust the researcher.
Triangulation and data dependability was achieved by including six different participant
perspectives, comparing what each participant said in each interview, checking for consistency in
what they said on certain perspectives over time. I asked the participants to review my
interpretation of the common themes drawn from their interview to obtain their perceptions of
the study’s validity. Corbin & Strauss (2015), Lincoln & Guba (1985), and Patton (2002)
recommended a peer review of the study findings to establish credibility of the data. I asked
fellow colleagues and my dissertation committee to provide a peer review to help ensure the data
appeared to be truthful, reflecting the intentions of my research study.
I shared each transcript with the interviewed participant to further establish credibility
and dependability of the data analysis and interpretation, ensuring that I conveyed what the
participants intended and that I was truthful with that reflection. This review and agreement of
the data interpretation was the first round of member checks. After I completed open coding and
interpretations of the data, I shared each interpretation with the interviewed participant to ensure
the interpretation still conveyed what the participant intended and reflected a truthful
interpretation. This review was the second formal round of member checking to establish
credibility and dependability of the data.

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The participants for this study were committed to the future of nursing education.
Additionally, they were committed to the success of leadership preparation of the undergraduate.
This commitment was reflected in their explanations of their courses and their descriptions of
plans for improvement through frequent data collection at the end of each semester followed by
meetings to ensure student success. The thick description of participant actions and interactions
with me established the transferability of research findings for future study in other nursing
education courses or contexts. Transferability was achieved by the selection of participants from
different schools with differing levels of teaching experience instead of conducting interviews
with faculty from only one school with similar or the same teaching experience. The sampling
strategy established a more detailed thick description that may enable future researchers to
transfer the information learned into future replication of the study according to the suggestions
of Lincoln and Guba (1985) and Patton (2002). The integrity and reflexivity of the study should
be demonstrated by the researcher’s neutral role (Corbin & Strauss, 2015; Lincoln & Guba,
1985; Glaser & Strauss, 1967, 1995, 1999, 2008; Patton, 2002; Willig, 2008). My neutral role
exhibited during the research process demonstrated that a reasonably honest attempt had been
taken to remain cognizant of the influence and impact that my opinions, perspectives, personal
experiences, and knowledge could have on the research process.
Chapter Summary
The purpose of this qualitative study was to explore the pedagogy employed by nursing
faculty to maximize leadership preparation in Louisiana baccalaureate nursing programs within
the context of the content recommendations guided by the AACN Essentials of Baccalaureate
Education or other professional nursing organization’s guidelines for leadership. I discussed in
this chapter, the research findings designated by specific themes and subthemes to maintain

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alignment with the purpose of my study. The interpretations of the data were reviewed and
agreed upon by 2 rounds of member checking among the six nursing faculty participants.
The research findings revealed that the selection of specific teaching strategies were
guided by evidence-based practice and AACN recommendations for undergraduate education.
The specific teaching strategies were selected to achieve the purpose and learning outcomes of
the leadership course while supporting the student learning styles and needs. The selection of the
leadership teaching strategies were impacted by the area workforce expectations of a nursing
graduate. The effectiveness of the selected strategies was supported by the measured feedback
and evaluations gathered from nursing faculty, students, and area stakeholders. I will discuss
further in Chapter 5, the research interpretations that answer the research questions for my
research study. I will discuss implications for future research and implications for positive social
change that may advance nursing education, nursing policy, nursing science, and nursing
research.

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Chapter 5: Interpretation of Findings, Recommendations, and Implications
Introduction
The purpose of this qualitative study was to explore the pedagogy employed by nursing
faculty to maximize leadership preparation in Louisiana baccalaureate nursing programs within
the context of the content recommendations guided by the AACN Essentials of Baccalaureate
Education or other professional nursing organization’s guidelines for leadership. When there is
no clear understanding of what is being taught, the effectiveness of the educational program is
difficult to evaluate. The problem I addressed in this study was the deficit that existed in the
contemporary understanding of how nursing educators teach leadership in Louisiana
baccalaureate programs contrasted with ideal policy expectations. I conducted this exploration
using a semistructured virtual video-conferenced interview for data collection. The key findings
that emerged from my data collection included teaching strategies that met the purpose of
leadership education at the baccalaureate level. While achieving the course purpose, these
strategies were also selected to meet requirements for accreditation, workforce expectations,
student retention, student learning styles, and best practices for student learning outcomes. The
selection of specific teaching strategies were guided by evidence based practice and AACN
recommendations for undergraduate nursing leadership education among most of the
participants. The effectiveness of the selected strategies was supported by the measured feedback
and evaluations gathered from nursing faculty, students, and healthcare stakeholders.
Interpretation of Findings
The conclusions drawn from the research findings revealed that teaching strategies using
role play, simulation, case studies, clinical experiences, and preceptored practice, influenced by
the application of active learning (Argyris & Schon, 1974), reflective practice (Schon, 1983,

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1987), and experiential learning (Dewey, 1986; Kolb, 1984), were more effective than traditional
methods to prepare the undergraduate student to be leader receptive, establishing what Interview
#4 described as, a leadership compass, before entering into professional nursing practice.
The nursing faculty’s perspective revealed that leadership education in Louisiana at the
baccalaureate level could have greater influence on future leadership development of the
generalist when there is a partnership between the nursing education program and the nursing
workforce. This partnership helps the nursing faculty to select teaching strategies that are
learner-centered, focused on real life nursing experiences involving prioritization, delegation,
conflict, and decision-making skill sets with the application of evidence based practice. These
teaching strategies could assist in the cultivation of the professional identity of the developing
generalist. Furthermore, the application of a progressive preceptorship over a period of time
could further enhance leader receptive behaviors of the undergraduate student.
I applied the constant comparative data collection and analysis method of the Corbin and
Strauss (2015) grounded theory approach. I tailored the method according to the context of my
study, coding the data into themes and subthemes to answer the research questions, ensuring
alignment with the purpose of this exploratory study. My synthesis of the research findings and
interpretations according to each research question follow below.
Central Question: What teaching strategies are deployed for leadership education among
Louisiana baccalaureate nursing programs?
The teaching strategies selected by the nursing programs focused on interactions with
real life leadership situations in a safe environment within the classroom, or in a clinical setting
facilitated by the leadership instructor or a trained preceptor. These activities were consistently
described as the utilization of case studies, problem-solving activities, role play, decision-making

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activities, online collaboration, conflict management, participation in a change management
initiative, and participation in quality improvement initiatives within the clinical setting.
Experiential learning methods requiring real life social behaviors enhanced the development of
leadership knowledge and skill of the undergraduate student. Experiential learning was
demonstrated through group or individual assignments or in the clinical environment. These
activities, however, were often combined with lecture content supported with power point
presentations. The opportunity for the nursing student to perform in different leadership
situations enabled the students to learn about the profession of nursing and leadership. The role
of acting charge nurse, performing the roles of delegation, prioritization, staffing, time
management, and communication added value to the leadership course, helping the student to
identify with the character of a leader.
As Interview #1 stated, “We did a lot of role playing, a lot of scenarios, involving
each of the 3 levels I defined earlier. How they would handle a particular situation.” According
to Interview #3, “Problematic staff behaviors case studies: like nurses who are chemically or
psychologically impaired, marginal employees and how to deal with them from a charge nurse
perspective; people who aren’t getting their jobs done. We do case studies on those in class and
we have them role play some of those crucial conversations.” Interview #6 stated, “Lecture Case
studies: Each group has a different case study and each reporter comes to the front of class to
present the case study and that group’s answers to the case student. This is the format we use for
lecture. The lecture each week is actually the theory part, and the rest of the time they are in
clinical; so it’s really trying to apply situations in a baccalaureate program; probably within a
year they might be a charge nurse. So they experience all the principals of management –real life
situations with budgeting, staffing, leadership, conflict, change- so these we cover in the case

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studies.” “The students still like to have some power point lecture as a brief outline since that is
what their exams come from. They love case studies the most. They can actively problem-solve
an actual situation in the hospital and whatever the lecture is for the day, they can apply the
leadership principle discussed in lecture to solving the questions and then they present to the
class. They love working in groups and interacting with each other. We try not to have just
straight lecture but interactive lecture.”
These findings were similar to those discussed in Chapter 2. The development and
application of leadership is evaluated by the demonstration of leadership competencies.
Leadership competencies that include delegation, supervision, and communication are deficits
acknowledged by employers of new nursing graduates (Lekan, Corazzini, Gilliss, & Bailey,
2011: Theisen & Sandau, 2013). Nurse leaders, professional organizations, including the IOM,
AACN, ANA, NLN, and others have their own lists of suggested competencies that are
considered essential to practice leadership. However, most of the listed competencies are skills
related to performance that must be cultivated and developed over time for leadership practice
(Broome & Marshall, 2017).
The theoretical influence of active learning by Agyris and Schon (1974), although not
addressed specifically by the participants, was interpreted from the descriptions of the various
teaching strategies. The described teaching strategies utilized by the nursing faculty required
actions and consequences for the student to experience and learn from those actions. The
participants described interactive components of role play, simulation, group work with peers in
case studies, and the clinical experiences. Nursing is an interdisciplinary science, impacted by
multiple theoretical influences. Therefore, it is interesting and important to note that the nursing
faculty provided actual descriptions of how components and/or tasks of the leadership role were

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taught. However, there was no mention of the actual strategy of active learning as influenced by
the work of Argyris and Schon (1974).
According to Interview #3, “Management simulation: In-class sim based upon Friday
night in the ER. We partnered with a local ER to get that. We are able to bring it to senior
students. We were not able to do the full, but a small version of that. They each take on the role
of a manager of a unit, whether step down, ER, or ICU or surgery. They have to learn hospital
through-put, hospital communication among departments, and it is a very good learning
strategy. We spend the whole day on that, for 2 hours, including debriefing.” Additionally,
Interview #4 stated, “I use low fidelity simulations with them. I will put the students through
different types of scenarios that require teamwork, leadership, different management styles, some
type of change process and they have to work through that leadership scenario as a team. So,
those are a couple of the major teaching strategies I use. I think there is still much opportunity
out there that we haven’t explored all of the realms of how simulation works, and how we can
bring that to the table. We think of simulation in the clinical sense, but what we don’t realize at
the crux of it, we are trying to teach them how to interact with another human being and have
that high level communication skill, which is found in leadership, it’s the basis for it.”
The findings from this research are similar to those discussed in Chapter 2. These
findings, however, from a nursing faculty perspective, support that the employment of teaching
strategies incorporating the active participation of the student add value to leadership pedagogy.
The safe nursing experiences in a safe classroom environment or the clinical environment
facilitated by a nursing faculty or preceptor alone do not benefit the student without the
application of reflection. Reflection and reflective practice are theoretical influences referenced
in much of the literature found on nursing education that incorporates active learning. In his

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work on reflective practice, Shon (1983, 1987) stated that the professional practitioner learns
through active practice with the guidance, facilitation, or mentorship from the instructor, to learn
through reflection on the consequences of actions, thus developing alternative methods of
solving problems when faced with them in the future. While reflection in the form of self-
reflection, debriefing, and weekly reflective journaling are referenced among the six participants,
there was no mention of the theoretical influence of Schon (1983, 1987). Benner (1981) also
failed to mention the work of Schon (1983, 1987) and the application of reflection for nursing
knowledge and skill progression in her work, From Novice to Expert. These findings support the
identified deficit in the literature of how leadership education is being taught to meet the
expectations of the AACN or other professional nursing organizations.
Sub-Questions
1. Using the 17 content topics included in the document, the AACN Essentials of
Baccalaureate Education as a guide, or another professional nursing
organization’s content areas for leadership, what are the top 10 content topics of
the leadership course? (The content topics were presented to the participants prior
to the interview and follow in Appendix I, the matrix of the ranking follows in
Appendix J)
The interpretation of the ranked order matrix found in Appendix J is an interesting
reflection that five of the six participants agreed that leadership theory and principles are the
most significant of the 17 suggested content areas suggested by the AACN (2008). The other
ranking had the most consistency among four of the six participants was leadership skills and
strategies. This supports the interpretation of the purpose of the undergraduate leadership course
to provide a basic entry level course delivered in the final semester of an undergraduate program.

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There was one participant who taught in a leveled program where leadership was
introduced at the junior level and then another leadership course was offered at the senior level
with the application of higher ordered thinking. Interview #4 interpreted the AACN content
rankings according to levels of complexity. According to Interview #4, “the undergraduate lacks
a leadership compass. Therefore, the curriculum should incorporate a leadership course, one that
gives them the perspective and the basic knowledge to be able to handle higher order of
leadership thinking and problem solving.”
Interview # 1 stated “I’m not sure I can rank the top 10 most important. I think those
points are at a higher level sometimes than what we need to start off in teaching leadership.”
The absence of this ranking by Interview #1 could be further interpreted as a lack of direction in
selecting the actual content for the leadership course. The selected teaching strategies used by
Interview #1 were more focused on tasks of a leader or manager. The leadership course content
selected by Interview #1 were based upon the participant’s prior experience as a leader and
deficits encountered within the healthcare environment. These findings as a whole confirm the
deficit in the literature regarding leadership pedagogy discussed in Chapter 2. The interpretation
of the ranked order content areas helped guide my interpretation of the research findings that
illustrated how nursing faculty selected the teaching strategies employed for their leadership
courses.
2. How do nursing faculty select the teaching strategies employed for leadership
education?
Previous course performance and student progression had an impact on how the nursing
faculty structured the leadership course. This fact also guided how teaching strategies were
selected to engage the student in finding value in the leadership course. Faculty found it

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challenging to stress the importance of nursing leadership since the course was offered during the
same time as important core courses that could delay the student’s successful completion of the
nursing program. According to Interview #3, “they place more value on med surg than what
some would say soft skills of leadership.”
The end of course evaluations completed by the students, faculty, and preceptors offered
valuable data on teaching strategies that were effective in meeting course outcomes. Feedback
from stakeholders was important to update the course curriculum with necessary updates to
nursing practice and healthcare changes, thereby meeting nursing leadership expectations
through nursing education of the undergraduate. The clinical summation and graduate exit
interview provided student perceptions of how they learned best. However, the most significant
indicator of how best to approach leadership education is from the faculty who teach. Faculty
data collection from evaluations and debriefing meetings of what worked best and what needed
to be improved upon appeared to be the most prominent methods of determining the best
teaching strategy to deploy for student success. This finding was an extension of the knowledge
in the discipline of nursing education from a nursing faculty’s perspective on how to maximize
leadership pedagogy at the undergraduate level based on a deficit identified in the contemporary
literature covered in Chapter 2. My interpretation of the research findings that revealed how
faculty selected leadership education teaching strategies helped guide my exploration of how
nursing faculty determine the effectiveness of the selected strategies.

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3. How do nursing faculty evaluate the effectiveness of the deployed teaching
strategies compared to the development of leadership knowledge and professional
skill-set?
Evaluation methods to determine the effectiveness of selected teaching strategies
were previously discussed. The written exam continues to be the prominent evaluation tool used
to measure student mastery of leadership theory content. The Assessment Technologies Institute
(ATI) and Health Education Systems Incorporated (HESI) specific standardized exams for
leadership were another method to identify proficiency or deficiency in leadership knowledge.
The data from these exams were significant in course content and teaching strategy
improvement. However, the leadership course is not deemed effective without an application
component of leadership practice. Leadership courses with positive feedback employed methods
for the evaluation of teaching effectiveness using specific rubrics for each interaction or project
with clear expectations for performance and the clinical evaluation tool completed by the nursing
faculty or assigned preceptor. According to Interview #2, “What I used in the class were course
quizzes and exams, a problem solving rubric applied to a case study. It wasn’t just asking the
questions at the bottom of the case study but required the student to:
Define a problem
Facts and assumptions drawn from the case study
What were some possible extraneous variables that were not listed
This causes them to creatively think what else could have been out there; was it the shift,
time of day, was it the staffing that caused the situation. Then they have to apply two courses of
action to fix or remedy the situation based on leadership theories and QSEN principles; they
choose 2 of those. Then explain what were the risks and benefits of the chosen courses of action.

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It causes them to think and to think about what next; almost a root cause analysis of the case
studies if you will.”
The contemporary literature outlined in Chapter 2 was deficient in the effectiveness of
using different active learning teaching strategies for leadership education in Louisiana
baccalaureate nursing programs from a nursing faculty perspective. It was important for my
study, after I had explored how nursing faculty teach leadership, to explore their feelings and
perceptions about leadership education at the baccalaureate level.
4. What is the nursing faculty’s perception of the efficacy of leadership education
and the student’s preparation for leadership at the baccalaureate level before entry
into practice?
Leadership development is progressive and begins as an undergraduate with a basic
understanding of the differences between and leader and a manager. The undergraduate is
prepared to be a nursing generalist with leadership knowledge. According to Interview #6, “Our
past grads go on to be charge nurses, unit directors, middle management. We feel as though they
have received good preparation to be a generalist; certainly graduated as a generalist in nursing.”
Additionally, Interview #2 stated, “The baccalaureate student doesn’t have leadership or work
experience.” Interview #3 stated, “Leadership content is integrated, but this is the first
“leadership course.” Before they get to me, they have heard content about communication,
delegation, but much of the content they have never heard before until entering the leadership
class.” Nursing educational programs prepare the undergraduate to be a good clinician with
some leadership knowledge. The external stakeholders, the individuals who either directly or
indirectly experience the nursing competency of a student or novice within the healthcare
facilities, have high expectations of the undergraduate once they enter practice. However the

121
orientations and residencies for the novice have a focus on developing the clinician instead of
developing the clinician with leadership attributes
Experiences gained as a student before entry into practice are significant in the
development of the professional identity. However, one course with clinical in leadership is not
supported by the literature. The novice should continue in a mentored or preceptored relationship
over a period of time for expertly explicated practice (Benner, 1981; Forsythe, Snook, Lewis, &
Bartone, 2002; Kolb, 1984; Winkler & Marshall, 2017). After reading the IOM report and
follow-up report, one may assume that the novice has developed the professional skill-set for
leadership during the undergraduate nursing program, entering a period of mentored practice for
leadership development when nursing practice begins (IOM, 2011, 2016).
The best experiences gained by the undergraduate in leadership development appeared to
be among the institutions that offered a preceptorship where the faculty was not responsible for
the entire clinical group and the student was partnered with a trained preceptor. According to
Interview #3 and #6, the longer the preceptorship, the more prepared the student felt after
graduation. Interview #6 stated, “The students comment that they learned the most about being a
nurse in this semester. I think it is from the one on one experience with a preceptor as opposed
to being with one faculty who has 12 students. These students have the undivided attention of
the preceptor, so they learn more from this than the other clinicals.”
The experiences gained from a clinical with faculty facilitation were meaningful with each
student assuming the role of charge nurse of their clinical group, but this was one experience over
a 6-week timeframe. According to Interview #2, “I believe also from the feedback that I have
gotten over the years from the facilities and nurse managers, about when students are on the units
doing their leadership clinical, they see a difference in these students, and having that theoretical

122
background, prepares them for when they are out after graduation, and they tend to be a stronger
student.” I question the validity of a leadership evaluation from a clinical experience that is not
conducted by the leadership preceptor or faculty. This was the case with the program discussed
by Interview #4. The student is expected to utilize the leadership principles learned within a core
clinical course conducted by faculty who did not teach the primary leadership course. The clinical
evaluation tool encompasses those leadership expectations however, these are often subjective in
nature. I question which outcome bears more weight; the core clinical course, or the leadership
outcomes.
Annual meetings are conducted with the healthcare organizations to gain understanding
of the needs of nursing graduates. The findings that emerged from the data revealed that some
nursing curricula are adapting more to the needs of the workforce for the novice to be leadership
ready once orientation or residencies are completed instead of fostering further leadership
development, cultivating a professional identity and maturity through experience over time as
recommended by the literature (Benner, 1981; Brown, 2002; Dreyfus & Dreyfus, 2005; Forsythe,
Snook, Lewis, & Bartone, 2002; Schon, 1987).
In one area of the state, feedback received from the stakeholders was that the novice was
resistant to delegate, therefore, more delegation activities were added to an already complex
curriculum with a very large class. According to Interview #6, “One thing we learned is that
some of these meetings are the graduates are often reticent to delegate. So we try to focus on
delegation in their interactions, and make sure in clinical, each week they look to see how they
have delegated. “ All participants spoke of the expectations of the novice to assume the charge
nurse role quickly after completion of an orientation or residency which was often only eight
weeks in duration, focusing on further development of the clinician.

123
Healthcare stakeholders are beginning to avoid hiring the novice until after successful
completion of the NCLEX exam. According to Interview # 5, “In healthcare, they are trying to
wait until students have passed. Because they want to start hiring-these residency programs you
can only do so much until you pass your boards. Our goal is that they pass on the first try so
they can get employed.” Students who experienced a preceptorship are more supportive of
leadership development mentorships after graduation because they saw the value from their
experience. According to Interview #6, “We now have a BSN-DNP program. Some of the BSN
graduates within a couple of months go into the BSN-DNP. I have been teaching for a number
of years. A lot of the upper and middle management are our past graduates, so they are
interested in further developing our graduates for leadership.”
There appeared to be consistent agreement among the six participants that leadership
pedagogy is better employed across the curriculum instead of delaying until the junior or senior
semester. The course loads for the undergraduate student and availability of faculty has an
impact on the content and curricula placement. According to Interview #2, “The baccalaureate
student doesn’t have leadership or work experience.” Interview #3 stated, “Leadership content is
integrated, but this is the first leadership course. Before they get to me, they have heard content
about communication, delegation, but much of the content they have never heard before until
entering the leadership class.” Additionally, Interview #4 stated, “Most of this content, this is
the first time these students have ever heard this, they really don’t have a leadership compass yet.
They’ve been taught teamwork, communication skills, therapeutic communication, and basic
terminology in healthcare. But they haven’t really had in depth instruction in leadership content
end and of itself.”

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The leadership courses were offered in competition with other high stakes courses,
making it difficult to engage students to value the leadership concepts. Interview #3 expressed,
that it is important to engage the student, challenging them to learn the difference between safe
nursing and being a safe nurse. The faculty were committed to student success, however, there
appeared to be high expectations from the nursing institutions and stakeholders placing
responsibility on nursing educators for the preparation of a well-rounded academic clinician who
is leader-ready upon entry into practice. From the data analysis, I interpreted there was little
commitment from the stakeholders to assist in the continued development of the nurse except
through the hospital orientation at hire or a residency that is focused on the clinical aspects of a
novice. Interview #5 stated, “We meet with some of the health care facilities. They want to try to
orient less and for us to have them more prepared.” Finally, Interview #2 stated, “The hospital
does a good job helping them to orient them clinically, so we have very good clinicians. But
there is a gap in helping develop good nurses become good leaders. If the mentorship was there,
that would be terrific, but too often we promote good nurses to become leaders, and they are not
prepared. And it can really sour a good nurse in that position.”
Study Limitations
I serve as a faculty member of a state-supported institution. This could be viewed as a
study limitation. However, this program is an RN-BSN completer program and not included
within this study. I served as a member of the Louisiana Campaign for Action, Region 6. The
Region 6 committee, however, was collecting data from practicing nurses who were already
leaders in healthcare. According to Corbin and Strauss (2015) and Patton (2002) to avoid the
intrusion of personal beliefs, feelings, or opinions to impact the interpretation of study findings,
the researcher must address the potential for research limitations early in the research process.

125
I have a personal interest in this research topic. While I agree that leadership should be
taught in baccalaureate curricula, I believe the teaching strategy should differ from traditional
methods, providing students with realistic, safe, opportunities for learning about nursing
leadership. I believe nursing students should have an understanding of the science, profession,
and practice of nursing before attempting to lead patient care teams. How a nursing student may
develop leadership knowledge and skill while learning about the profession of nursing remains
debatable. I addressed my personal philosophy of nursing education early in my research study. I
employed the semistructured interview process to avoid any intrusion of my personal opinions,
beliefs or feelings on the research findings or interpretations.
The initial slow response and inherent lack of interest to participate during the initial
recruitment endeavors could be interpreted as a study limitation resulting in a smaller sample
size than originally planned. The sample included six nursing faculty participants. I was able to
obtain thick rich descriptions of how leadership education is deployed among six different
nursing institutions of varying sizes, student demographics, and populations in the state of
Louisiana. I was able to analyze the data into common themes that emerged into research
findings that answered all research questions according to the purpose of the study. The smaller
sample allowed for in depth member checking ensuring credibility and trustworthiness of the
data. The sample remained open until data saturation was met, once nothing new was being
learned through the constant comparison method using the Corbin and Strauss (2015) grounded
theory approach. Therefore the smaller sample size added strength and rigor to this exploratory
study.

126
Recommendations
The problems addressed in this study focused on an exploration of deficits that existed in
the contemporary understanding of how nursing educators in Louisiana teach leadership in
baccalaureate programs contrasted with ideal policy expectations. The purpose of this
qualitative study was to explore the pedagogy employed by nursing faculty to maximize
leadership preparation in Louisiana baccalaureate nursing programs within the context of the
content recommendations guided by the AACN Essentials of Baccalaureate Education or other
professional nursing organization’s guidelines for leadership. Findings from my research study
will be disseminated by providing an executive summary to the nursing administrators of the
partnering institutions who agreed to participate. I also plan to participate in scholarly
presentations and publish in peer reviewed journals.
A recommendation from this study, grounded in the strengths of the interpretations and
perspectives from nursing faculty participants, is that there is potential for further study on the
continued leadership development of a novice who experienced an undergraduate leadership
preceptorship. According to the participants from this study, nursing education prepares a
nursing generalist who is leader receptive. To continue the leadership development of a novice,
there should be academic partnerships between nursing academia and healthcare organizations to
develop trained preceptors or mentors who support the novice nurse after entry into practice over
a period of time. This progression in the development of a professional identity to leadership
readiness through mentored practice is supported by the literature discussed in Chapter 2
(Benner, 1981; Forsythe, Snook, Lewis, & Bartone, 2002; Winkler & Marshall, 2017) and
further strengthened by the findings that emerged from this study. These partnerships could have
a positive impact on curricula development of undergraduate nursing programs.

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Implications and Positive Social Change
Significance to Nursing Education
According to Scott and Miles (2013), there is a gap in the literature addressing the
development of leadership through education. Through continued review of primary literature, a
deficit was discovered. There was a lack of primary current contemporary research informing
the development of leadership using best practices in nursing education. The literature suggested
that while there was evidence related to simulation, role play, role modeling, and reflective
activities for skill performance and competency development, but there were few studies on how
these teaching strategies may be effective for leadership education and competency development.
Throughout these studies, the effectiveness of the teaching strategies were evaluated through
perceptive survey, questionnaires, and interviews among students participating in the courses
(Haber-Curran & Tillapaugh, 2015; Katz, Piefer, & Armstrong, 2010; Shin, Sok, Hyun, & Kim,
2014). I was unable to locate studies that spoke to how nursing faculty evaluated the
effectiveness of teaching strategies used for leadership education.
The purpose of this qualitative study was to explore the pedagogy employed by nursing
faculty to maximize leadership preparation in Louisiana baccalaureate nursing programs within
the context of the content recommendations guided by the AACN Essentials of Baccalaureate
Education or other professional nursing organization’s guidelines for leadership. This study was
influenced by existing theory that supported alternative teaching strategies using best practices
for the application and assessment of leadership knowledge and competence through experiential
learning, active participation, and reflection in baccalaureate nursing programs (Horton-Deutsch,
2016; Middleton, 2013; Haber-Curran & Tillapaugh, 2015; Shin, Sok, Hyun, & Kim, 2014).

128
My interpretation from the research findings could lead to positive social change for the
improvement of leadership education influenced by the employment of active learning and
reflective teaching strategies from a nursing faculty perspective. The students of leadership
faculty who employed preceptorships using trained preceptors experienced positive learning
outcomes. Positive social change could be experienced among faculty who teach leadership,
using self-reflective practice, for the advancement of nursing leadership pedagogy that would
allow the student to experience leadership, reflect on leadership, and improve the development of
leadership competence. The suggested teaching strategies and reflective practice could position
undergraduate programs for a restructure of nursing curricula for the employment of professional
identity and nursing socialization processes. This restructure would provide progressive
leadership competency and skill development before the junior or senior semesters, establishing
leadership readiness before entry into practice.
Significance to Nursing Policy
Nurse educators at the baccalaureate level require evidence-based methods that are
considered best practices for the preparation of graduates to meet healthcare organization
expectations as well as leadership development expectations (Haber-Curran & Tillapaugh, 2015).
While facing speculation of a faculty shortage, recommendations to increase baccalaureate
nursing graduates from 50% to 80% by 2020, the leadership recommendations from the AACN
or other professional nursing organizations, and the IOM recommendations (AACN, 2014; IOM,
2011, 2016), the adoption of alternative teaching strategies could make a positive contribution to
nursing science and nursing policy. From the data analysis and my interpretation of the research
findings, the application of alternative teaching strategies influenced by experiential learning,
action science, action learning theory, and reflective practice could support student engagement

129
in the practice of leadership, providing a formative evaluation for leadership competence and
program improvement (Argyris & Schon, 1974; Dewey, 1986; Dewing, 2008; Dewing, 2009:
Kolb, 1984; Lewin, 1946, as cited by Adelman, 1993; Lewin, 1999; Patton, 2002; Shin, Sok,
Hyun, & Kim, 2014; Schon, 1987).
Significance to Nursing Practice
Action learning and experiential learning may be demonstrated through simulation using
collaborative activities, active participation, role modeling, reflection, role play, or peer
mentorship (Argyris & Schon, 1974; Broome & Marshall, 2017; Dewey, 1986; Dewing, 2008;
Dewing, 2009; Kolb, 1984; Lewin, 1946 as cited by Adelman, 1993; Lewin, 1999; Patton, 2002;
Shin, Sok, Hyun, & Kim, 2014; Schon, 1984). Therefore, the theoretical influences of the
processes of action science, action learning, experiential learning, and reflective practice from
my interpretation of the data, could enhance nursing practice through program improvement and
alternative teaching strategies that engage learning with purpose through practice (Argyris &
Schon, 1974; Dewey, 1986; Dewing, 2008, 2009; Horton-Deutsch, 2016; Kolb, 1984; Lewin,
1946 as cited by Adelman, Lewin, 1999; Patton, 2002; Schon, 1984).
Significance to Nursing Research and Positive Social Change
Finally, my research offers potential benefit to nursing research and theory, thus
promoting positive social change for nursing academia by introducing best practices to maximize
leadership pedagogy in the preparation of the undergraduate nursing student for leadership
challenges and expectations from healthcare environments for the promotion of patient safety,
quality patient care outcomes, patient satisfaction, and interprofessional satisfaction (Middleton,
2013; Esparza & Rubino, 2013). There is the potential for a future researcher to collect data for
a study on the effect of alternative teaching strategies, mentored residencies, or mentored

130
practice for the development of leadership over time after entering nursing practice. The
commonalities and uniqueness among nursing programs gathered from this study may influence
future research to maximize pedagogy for other undergraduate courses for the improvement of
nursing program outcomes.
Conclusion
Nursing accreditation bodies have recommended that nursing education programs prepare
graduates who display competence in leadership. However, the reality of how disciplinary
leadership skillsets are acquired and transferred into practice remains debatable. The purpose of
this qualitative study was to understand how nursing educators teach leadership in Louisiana
baccalaureate programs contrasted with ideal policy expectations before entry into practice. The
action learning and reflective practice theories provided the foundational theoretical influences
for this study. Six face-to-face interviews were conducted via Zoom with nursing faculty who
were currently teaching or had taught nursing leadership in an undergraduate program for at least
one year.
The American Association of Colleges in Nursing (AACN, 2008), the Institute of
Medicine (IOM) (2011, 2016), the Louisiana Campaign for Action (2016, 2017), and the
National League of Nursing (NLN, 2010) place expectations for the preparation of leadership
practice on nursing educators at the baccalaureate level. However, there is a deficit within the
contemporary literature on how leadership education is addressed to meet these expectations.
The findings and my interpretations from the data revealed that healthcare stakeholders also
place high expectations on nursing educators to prepare the novice to demonstrate leadership and
professionalism. The problem addressed in this study focused on an exploration of deficits that
exist in contemporary understanding of how nursing educators teach leadership in Louisiana

131
baccalaureate programs. Before leadership readiness of graduates from nursing baccalaureate
programs can be evaluated, there must be an understanding of the current operationalized
teaching methods or strategies used by the faculty who teach leadership.
To accomplish this qualitative exploration, I conducted data collection and analysis using
the Corbin and Strauss (2015) constant comparative data analysis method to identify recurring
themes. From the data analysis, I identified 7 main themes, including the purpose of the
leadership course, the selected teaching strategies to meet the purpose of the course, teaching to
support student learning styles and workplace expectations, the application of evidence-based
practice principles for leadership, the measured effectiveness of selected teaching strategies,
faculty perspectives of leadership efficacy at the undergraduate level, and faculty perspectives
for future nursing leadership education.
The key findings that emerged from my research included teaching strategies that met the
purpose of leadership education at the baccalaureate level. While achieving the course purpose,
these strategies were also selected to meet requirements for accreditation, healthcare workforce
expectations, student retention, student learning styles, and best practices for student learning
outcomes. The selection of specific teaching strategies were guided by evidence-based practice
and AACN recommendations for baccalaureate nursing education in Louisiana. The
effectiveness of the selected strategies was supported by the measured feedback and evaluations
gathered from nursing faculty, students, and area stakeholders.
The conclusions drawn from the study findings revealed that the selected teaching
strategies using role play, simulation, case studies, and preceptored practice, theoretically
influenced by the application of experiential learning (Dewey, 1986; Kolb, 1984), active learning
(Argyris &Schon, 1974) and reflective practice (Schon, 1983, 1987 ), were more effective to

132
prepare the undergraduate student to be leader receptive before entering into professional nursing
practice than traditional didactic lecture without real life experiences in the clinical setting.
The purpose of this qualitative study was to explore the pedagogy employed by nursing
faculty to maximize leadership preparation in Louisiana baccalaureate nursing programs within
the context of the content recommendations guided by the AACN Essentials of Baccalaureate
Education or other professional nursing organization’s guidelines for leadership. Therefore, from
a nursing faculty’s perspective, the research findings revealed that leadership education at the
baccalaureate level has a stronger influence on future leadership development of the generalist
when there is a partnership between the nursing education program and the nursing workforce.
This partnership assists the nursing faculty to select teaching strategies that are learner-centered,
focused on real life nursing experiences that involve prioritization, delegation, conflict, and
decision-making skill sets with the application of evidence-based practices. These teaching
strategies should assist the nursing faculty to cultivate the professional identity of the developing
generalist. The application of progressive preceptorship over a period of time would further
enhance leader receptive behaviors influenced by active learning and reflective practice.
“We do not learn from experience . . . we learn from reflecting on experience (Dewey,
1938 as cited by Dewey, J., 1986).” I believe this quote is reflective of my research findings and
the nursing education experience as a whole. I believe it also reflects how we progress as nurses
through the multiple phases of a nursing professional career. Experience and reflection could be
how nursing faculty might approach the practice of nursing leadership pedagogy. Lifelong
learning begins as a nursing student, continuing throughout our profession. It is experiential, it
requires active participation, and finally reflection on the practice and what we learned from that

133
practice. Without the application of reflective practice and the progressive development of a
nursing professional identity, we would never improve in practice nor profession.
Many of us can remember when the new novice was expected to be ready for practice
soon after graduation, although prepared as a generalist. Unfortunately, the idealistic
expectations of the novice from professional organizations and the healthcare organizations
continue. The new graduate is expected to be able to manage themselves, their patients, and the
support staff. These expectations remain of the new novice after completing a 4-year generalist
nursing education program and a brief orientation or residency that is created for the clinician.
As nursing faculty, seeking to maximize leadership pedagogy, it is necessary to continue to
practice self-reflection on the practice of nursing education and ask ourselves…. What are we
doing? And how do we do it for the success of our student and the safety of those to whom we
have committed our compassion and care?

134
References
Adelman, C. (1993). Kurt Lewin and the Origins of Action Research. Educational Action
Research, 1(1), 7-21. doi:10.1080
AHRQ (2017). CUS Tool: Improving communication and teamwork. Agency for Healthcare
Research and Quality. Retrieved from https://www.ahrq.gov/teamstepps/index.html
AHRQ (2017). TEAMSTEPPS. Agency for Healthcare Research and Quality. Retrieved from
https://www.ahrq.gov/teamstepps/index.html
Allen, D., Ploeg, J., Kaasalainen, S. (2012). The relationship between emotional intelligence and
clinical teaching effectiveness in nursing faculty. Journal of Professional Nursing 28(4),
231-240. doi:10.1016
American Association of Colleges of Nursing (2008). Essentials of Baccalaureate
education for professional nursing practice. Retrieved from
http://www.aacn.nche.edu/education-resources/baccessentials08.pdf
American Association of Colleges of Nursing (2014). Nursing faculty shortage. Retrieved
from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-faculty-
shortage
American Nurses Association (2010). Scope and standards of practice: Nursing,
(2nd ed.). Silver Spring: American Nurses Association.
Anderson, L. (1997). Argyris and Schön’s theory on congruence and learning. Resource papers
in Action Research, en www. uq. net. au.
Argyris, C. & Schon, D. (1974). Theory in Practice: Increasing professional effectiveness.
San Francisco: Jossey-Bass Classics.

135
Aronson, J. (1995). A pragmatic view of thematic analysis. The Qualitative Report, 2(1),
1-5. Retrieved from http://nsuworks.nova.edu/tqr/vol2/is1/3
Bender, C., Yaffe, K., & Sechrest, L. (2012). What is a mentor? Council on
Undergraduate Research, 33(2), 34-39.
Benner, P. (1981). From Novice to expert: Excellence in power in clinical nursing
practice. Upper Saddle: Prentice Hall.
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical
transformation, (1st ed.). San Francisco: Jossey-Bass.
Brown, S. (2002). The sources of leadership doctrine in the Air Force. Retrieved from
http://www.airpower.au.af.mil/airchronicles/apj/apj02/win02/brown.html
Burns, J. (1978) Leadership. New York: Harper Perennial Political Classics.
Charmaz, K. (2006). Constructing grounded theory: A practical guide through
qualitative analysis. Los Angeles: SAGE.
Corbin, J. & Strauss, A. (2015). Basics of qualitative research: Techniques and procedures for
developing grounded theory, (4th ed.). Los Angeles: SAGE.
Creswell, J. (2013). Qualitative inquiry & research design: Choosing among five approaches,
(3rd ed.). Los Angeles: SAGE.
Curtis, E., deVries, J., & Sheerin, F. (2011). Developing leadership in nursing: Exploring
core factors. British Journal of Nursing, 20(5), 306-309. doi:10.12968
Dewey, J. (1986). The later works of John Dewey: Volume 12: 1938: Logic: The theory of
inquiry. Carbondale: Southern Illinois University Press.

136
Dewing, J. (2008). Becoming and being active learners and creating active learning
workplaces: The value of active learning in practice development. In K. Manley, B.
McCormack, & V. Wilson Editor (Eds.), International practice development in nursing
and healthcare, (pp. 273-275). Oxford: Blackwell.
Dewing, J. (2009). Moments of movement: Active learning and practice development. Nurse
Education in Practice, 10(2010), 22-26. doi:10.1016
Dreyfus, H. & Dreyfus, S. (2005). Expertise in real world contexts. Organization Studies,
26(5), 779-792. doi:10.1177
Dyer, M. & Taylor, S. (2012). Supporting professional identity in undergraduate early years
students through reflective practice. Reflective Practice: International and
multidisciplinary perspectives, 13(4), 551-563. doi:10.1080
Esparza, S. & Rubino, L. (2013). A call for new leadership in health care. In New leadership for
today’s healthcare profession (pp.1-21). Burlington: Jones & Bartlett.
Fereday, J. & Muir-Cochrane, E. (2006). Demonstrating Rigor Using Thematic Analysis:
A hybrid Approach of Inductive and Deductive Coding and Theme Development.
International Journal of Qualitative Methods, 5(1), 1-13. Retrieved from
http://www.ualberta.ca/~iiqm/backissues/5_1/pdf/fereday.pdf
Forsythe, G., Snook, S., Lewis, P., & Bartone, P. (2002). Making sense of officership:
developing a professional identity for 21st century army officers, in Lloyd J.
Matthews Editor (Ed.), The future of the army profession, (pp. 357-378). McGraw-Hill.
Fink, D. (2013). Creating significant learning experiences: An integrated approach to
designing college courses. San Francisco: Jossey-Bass.

137
Gale, N., Heath, G., Cameron, E., Rashid, S., Redwood, S. (2013). Using the framework method
for the analysis of qualitative data in multi-disciplinary health research. BioMed Central
Medical Research Methodology, 13(117), 1-8. Retrieved from
http://www.biomedcentral.com/1471-2288/13/117
Galletta, A. (2013). Mastering the semistructured interview and beyond. New York:
New York University Press.
Garard, J. (2014). Health sciences literature review made easy: The matrix method, (4th ed.).
Burlington: Jones & Bartlett.
Glaser, B. & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative
research. New Jersey: Aldine Transaction.
Glaser, B. & Strauss, A. (1995). The discovery of grounded theory: Strategies for qualitative
research. New Jersey: Aldine Transaction, Rutgers- The State University.
Glaser, B. & Strauss, A. (1999). The discovery of grounded theory: Strategies for qualitative
research. New Jersey: Aldine Transaction, Rutgers- The State University.
Glaser, B. & Strauss, A. (2008). The discovery of grounded theory: Strategies for qualitative
research. New Jersey: Aldine Transaction, Rutgers- The State University.
Gore, T., Johnson, T., & Wang, C. (2015). Teaching nursing leadership: Comparison of
simulation versus traditional inpatient clinical. International Journal of Nursing
Education Scholarship, 12(1), 1-9. doi:10.1515
Grove, S., Burns, N., & Gray, J. (2013). The practice of nursing research: Appraisal,
synthesis, and generation of evidence, (7th ed.). St. Louis: Elsevier.

138
Habor-Curran, P. & Tillapaugh, D. (2015). Student-centered transformative learning in
leadership education: An examination of the teaching and learning process.
Journal of Transformative Education, 13(1), 65-84. doi:10.1177
Hallier, J. & Summers, J. (2011). Dilemmas and outcomes of professional identity
construction among students of human resource management. Human Resource
Management Journal, 21(2), 204-219. doi:10.1111
Horton-Deutsch, S. (2016). Visionary and reflection centered: Remaining open to the
possibilities of nursing praxis, in Rosa, W. (Ed.), Nurses as leaders, (pp. 311-321). New
York: Springer Publishing.
Institute of Medicine (2011). The future of nursing: The Robert Wood Johnson Foundation
Initiative. Retrieved from http://thefutureofnursing.org/recommendations
Institute of Medicine (2016). Assessing progress on the Institute of Medicine Report The future
of nursing. Retrieved from http://www.nap.edu/21838
Jenkins, D. (2013). Exploring instructional strategies in student leadership development
Programming. Journal of Leadership Studies, 6(4), 48-62. doi:10.1002
Katz, G., Peifer, K., Armstrong, G. (2010). Assessment of patient simulation use in
selected Baccalaureate nursing programs in the United States. Simulation in
Healthcare, 5, 46-51. doi:10.1097
Kirkman, T. (2013). High fidelity simulation effectiveness in nursing students’ transfer of
learning. International Journal of Nursing Education Scholarship, 10(1), 1-6.
doi:10.1515
Kling, V. (2009). Clinical leadership project. Journal of Nursing Education, 49(11), 640- 643.
doi:10.3928

139
Kolb, D. (1984). Experiential learning: Experience as the source of learning and
Development. New Jersey: Prentice Hall.
Kram, K. (1983). Phases of the mentorship relationship. Academy of Management
Journal, 26(4), 608-625.
Kramer, M. (1974). Reality shock: Why nurses leave nursing. St. Louis: Mosby.
Lagace, M. (2003). How the U.S. Army develops leaders. Research & Ideas. Retrieved from
http://hbswk.hbs.edu/item/how-the-u-s-army-develops-leaders#1
Laschinger, H., Wong, C., & Grau, A. (2012). The influence of authentic leadership on
newly graduated nurses’ experiences of workplace bullying, burnout and retention
outcomes: A cross-sectional study. International Journal of Nursing Studies,
49, 1266-1276. doi:10.1016.
Laurent, C. (2000). A nursing theory for nursing leadership. Journal of Nursing Management,
8, 83-87. doi:10.1046
Leken, D., Corazzini, K., Gilliss, C., Bailey, D. (2011). Clinical leadership development in
accelerated baccalaureate nursing students: An education innovation. Journal
of Professional Nursing, 4(July-August), 202-214. doi:10.1016
Levinson, D., Darrow, C., Klein, E. Levinson, M., McKee, B. (1978). The seasons of
a man’s life. New York: Ballentine Books.
Lewin, K. (1946). Action research and minority problems, in G. W. Lewin (Ed.). Resolving
social conflicts. New York: Harper & Row.
Lewin, K. (1999). The complete social scientist: A Kurt Lewin reader. Washington, DC:
American Psychological Association.
Lincoln, Y. & Guba, E. (1985). Naturalistic inquiry. Beverly Hills: SAGE.

140
Louisiana Campaign for Action (2016). Future of nursing: Campaign for Action in
Louisiana. Retrieved from http://campaignforaction.org/state/louisiana/
Louisiana Campaign for Action (2017). Future of nursing: Campaign for Action in
Louisiana. Retrieved from http://campaignforaction.org/state/louisiana/
Louisiana State Board of Nursing (2016). LSBN approved nursing education programs.
Retrieved from http://www.lsbn.state.la.us/
Marañòn, A. & Pera, Ma. (2015). Theory and practice in the construction of professional
identity in nursing students: A qualitative study. Nurse Education Today, 35(2015), 859-
863. doi:10.1016
Middleton, R. (2013). Active learning and leadership in an undergraduate curriculum: How
effective is it for student learning and transition to practice? Nursing Education in
Practice, 13(2013), 83-88.doi:10.1016
National League of Nursing (2010). Outcomes and competencies for graduates of
practical/vocational, diploma, baccalaureate, masters’ practice, doctorate, and
research doctorate programs in nursing. Washington, DC: Wolters Kluwer.
Neimi, H. (2002). Active learning: A cultural change needed in teacher education and
schools. Teaching and Teacher Education, 18(2002), 763-780. doi:10.1016
Orlando, I. (1961). The Dynamic Nurse-Patient Relationship: Function, process, and
Principles. New York: G.P. Putnam’s and Sons.
Palmer, R., Hunt, An., Neal, M., Wuetherick, B. (2015). Mentoring, undergraduate
research, and identity development: A conceptual review and research agenda.
Mentoring & Tutoring: Partnership in Learning, 23(5), 411-426. doi:10.1080

141
Patton, M. (2002). Qualitative research & evaluation methods, (3rd ed.). Thousand Oaks:
SAGE.
Perry, C. (2012). Constructing professional identity in an online graduate clinical training
program: Possibilities for online supervision. Journal of Systemic Therapies, 31(3),
53-67. doi:10.1521
Pollard, K. (2009). Student engagement in interprofessional working in practice placement
settings. Journal of Clinical Nursing, 18, 2846-2856. doi:10.1111
Revans, R. (2011). ABC of Action Learning. England: Gower.
Rudestam, K, & Newton, R. (2014). Surviving your dissertation: A comprehensive
Guide to content and process, (4th ed.). Los Angeles: SAGE.
Russ, J., Mckenney, A., & Patel, A. (2013). An identity crisis: The need for core competencies
in undergraduate medical education. Med Education Online, 18(2013), 1-2. doi:10.3402
Saldaña, J. (2016). The coding manual for qualitative researchers, (3rd ed.). Los Angeles:
SAGE.
Sax, P. (2006). Developing preferred stories of identity as reflective practitioners. Journal
of Systemic Therapies, 25(4), 59-72. doi:10.1521
Schlairet, M. (2011). Simulation in an undergraduate nursing curriculum: Implementation
and impact evaluation. Journal of Nursing Education, 50(10), 561-568.
doi:10.3928
Schlairet, M. & Pollock, J. (2010). Equivalence testing of traditional and clinical experiences:
Undergraduate nursing students’ knowledge acquisition. Journal of Nursing
Education, 49(1), 43-47. doi:10.3928

142
Schon, D. (1983). The Reflective Practitioner: How professionals think in action. New York:
Basic Books.
Schon, D. (1987). Educating the reflective practitioner. San Francisco: Jossey-Bass.
Scott, E. & Miles, J. (2013). Advancing leadership capacity in nursing. Nursing
Administration Quarterly, 37(1), 77-82. doi:10.1097
Shin, H., Sok, S., Hyun, K., & Kim, M. (2014). Original research: Empirical research-
Quantitative: Competency and an active learning program in undergraduate
nursing education. Journal of Advanced Nursing, 71(3), 591-598. doi:10.1111
Smithburger, P., Kane-Gill, S., Ruby, C., & Seybert, A. (2012). Comparing effectiveness of 3
learning strategies: Simulation-based learning, problem-based learning, and
standardized patients. Society for Simulation in Healthcare, 7(3), 141-146.
doi:10.1097
Theisen, J. & Sandau, K. (2013). Competency of new graduate nurses: A review of their
weaknesses and strategies for success. The Journal of Continuing Education in
Nursing, 44(9), 406-414. doi:10.3928
Thomas, C., Hodson-Carlton, K., Ryan, M. (2011). Preparing nursing students in a
leadership/management course for the workplace through simulations. Clinical
Simulations in Nursing, 2011(7), 99-104. doi:10.1016
Walden University IRB (2016). Research ethics & compliance: Application & general materials:
IRB application. Center for Research Quality. Retrieved from
http://academicguides.waldenu.edu/researchcenter/orec/application

143
Walden University IRB (2016). Research ethics & compliance: Application & general materials:
Research ethics planning worksheet. Center for Research Quality. Retrieved from
http://academicguides.waldenu.edu/researchcenter/orec
Walker, S., Dwyer, T., Boradbent, M., Moxham, L., Sander, T., & Edwards, K. (2014).
Constructing a nursing identity within the clinical environment: The student nurse
experience. Contemporary Nurse, 49, 103-112. doi:10.5172
Waters, K., Altus, D., Wiklinson, N. (2013). Promoting student professional identity,
challenging our own: Narrative practices in internship seminars. Journal of
Systemic Therapies, 32(3), 1-12. doi:10.152
Whittemore, R. & Knafl, K. (2005). The integrative review: Updated methodology.
Journal of Advanced Nursing, 52(5), 546-553. doi:10.1111
Williams, M. & Burke, L. (2015). Doing learning knowing speaking: How beginning nursing
students develop their identity as nurses. Nursing Education Perspectives: Research
Briefs, 36(1), 50-52. doi:10.5480
Willig, C. (2013). Introducing qualitative research in psychology, (3rd ed.). City University
London: McGraw-Hill Global Education.
Winkler, M. & Marshall, E. (2017). Creating and shaping the organizational environment and
culture to support practice excellence, in Marshall, E., & Broome, M. (Eds.),
Transformational leadership in nursing: From expert clinician to influential leader, (pp.
247-267). New York: Springer Publishing.
Zoom (2016). Zoom online meetings. Retrieved from https://zoom.us/about

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Appendix A: Research Questions
Central Question: What teaching strategies are deployed for leadership education among
Louisiana baccalaureate nursing programs?
Sub-Questions
1. Using the 17 content topics included in the document, the AACN Baccalaureate
Essentials as a guide, or another professional nursing organization’s content areas
for leadership, what are the top 10 content topics of the leadership course? (The
content topics will be presented to the participants prior to the interview and
follow in Appendix I)
2. How do nursing faculty select the teaching strategies deployed for leadership
education?
3. How do nursing faculty evaluate the effectiveness of the deployed teaching
strategies compared to the development of leadership knowledge and professional
skill-set?
4. What is the nursing faculty’s perception of the efficacy of leadership education
and the student’s preparation for leadership at the baccalaureate level before entry
into practice?

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Appendix B: Research Interview Protocol
Date _________
Time_________
Interviewer ______________________________
Interview Participant/Pseudonym ____________________
Stated agreement of understanding of informed consent Yes ____ No______
Stated agreement of understanding that participation is voluntary Yes ____ No _____
Introduction of Interview
I would like to begin by thanking you for participating in this interview today by video
conference. You have been selected to take part in this interview as you are currently a faculty
who teaches or has taught leadership in a Baccalaureate nursing program for at least a year. As a
researcher, I am interested in exploring the teaching strategies you use in teaching leadership to
your students before they graduate.
All information that you provide will only be used for this specific study and your name
will remain confidential when reporting the findings. Please be advised that since the interviews
are being conducted via videoconference for this study, the interview will be recorded by audio
only. You will be notified when the recording begins and when it ends. A copy of the recording
will be securely maintained for 5 years as required by Walden University on an external drive
that is specifically used for this study locked in a file box as well as hard copy transcriptions and
memos. The hard copy documents will be shredded at the end of 5 years. The external hard
drive files will be deleted and the hard drives disposed of in a safe manner. Please let me know
if you have any concerns. It is your preference chose to answer or decline to answer the
interview questions. I will not be requesting that you provide personal information. At the

146
conclusion, you may add any information that you feel is relevant to this research that I either
failed to ask or that you would like to discuss further. This interview will not last longer than
one hour. However, I will be more than willing to continue should you have additional
information to discuss. I will be transcribing this interview. I will provide you with a copy via
email for a full review of its accuracy and member checking to ensure my interpretations of our
conversation are clear, truthful, and accurate.
Interview Questions
Central Question: What teaching strategies are deployed for leadership education among
Louisiana baccalaureate nursing programs?
Sub-Questions
1. Using the 17 content topics included in the document, the AACN Baccalaureate
Essentials as a guide, or another professional nursing organization’s content areas
for leadership, what are the top 10 content topics of the leadership course? (The
content topics will be presented to the participants prior to the interview and
follow in Appendix I)
2. How do nursing faculty select the teaching strategies deployed for leadership
education?
3. How do nursing faculty evaluate the effectiveness of the deployed teaching
strategies compared to the development of leadership knowledge and professional
skill-set?
4. What is the nursing faculty’s perception of the efficacy of leadership education
and the student’s preparation for leadership at the baccalaureate level before entry
into practice?

147
Appendix C: Matrix of Relationship of Research Questions and Interview Questions
Research
Questions
Central
Question
Sub
Question 1
Sub
Question 2
Sub
Question 3
Sub
Question 4
Interview
Question 1
X X X
Interview
Question 2
X X
Interview
Question 3
X X X
Interview
Question 4
X X X

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Appendix D: Email Letter of Introduction to Study and Request for Participation
Subject: Research Request: Leadership Education in Louisiana Baccalaureate Nursing
Programs
Hello Dr. ____________:
I am a PhD in Nursing student at Walden University with a specialization in education.
This email serves as an invitation to your nursing program to participate in my study:
Exploring Leadership Pedagogy among Louisiana Baccalaureate Nursing Programs.
The inclusion criteria are faculty who have been teaching leadership education at the
Baccalaureate level for at least one year, and who are currently teaching or have taught
leadership education in Louisiana. In this study I will qualitatively explore the teaching
strategies used to prepare student nurses for leadership before entry into practice.
I would appreciate your participation in seeking access to the faculty at your institution
who meet the inclusion criteria. This study has met preliminary IRB criteria at Walden
University. With your consent, I will seek IRB approval as an exempt study at your
institution as well. I will be using email communication, with video conferenced
interviews as my data collection approach and will ensure confidentiality of the
participants regarding the entire research process.
Attached is a Walden University Letter of Cooperation Agreement for your signature for
permission to gain access and recruit participants. Please sign and return the Letter of
Cooperation for remittance to Walden University as well as your institution’s IRB. Upon
receipt of the Letter of Cooperation and final IRB approval, letter of invitations will be
forwarded to you for distribution to those faculty who meet the inclusion criteria.
Participants as well as institution confidentiality will be strictly maintained. I remain
available to answer questions regarding my research proposal.
Thank you very much for your consideration, time, and attention.
Sincerely,

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Appendix E: Letter of Cooperation
Community Research Partner Name
Contact Information
Date
Dear…..,
Based on my review of your research proposal, I give permission for you to conduct the
study entitled Exploring Leadership Pedagogy among Louisiana Baccalaureate Nursing
Programs within the (School of Nursing). As part of this study, I authorize you to recruit
participating faculty who meet your research inclusion criteria, conduct video-
conferenced interviews for data collection, conduct member checking via email or
telephone, and disseminate results to participants once your research is complete.
Individuals’ participation will be voluntary and at their own discretion.
We understand that our organization’s responsibilities include: access to participating
faculty who meet the inclusion criteria or those who meet inclusion criteria based on
public information about their experience by sending invitation email that includes a
participation link, encouraging participation through email that includes a participation
link, allowing faculty time to participate in video-conferenced interviews, and telephone
or email for member checks of transcripts that may be conducted during or outside of
normal office hours. We reserve the right to withdraw from the study at any time if our
circumstances change.
The researcher will be responsible for complying with our site’s research policies and
requirements, including: Obtaining proposal approval by Walden University IRB,
followed by our IRB approval of your proposal if it is required.
I confirm that I am authorized to approve research in this setting and that this plan
complies with the organization’s policies.
I understand that the data collected will remain entirely confidential and may not be
provided to anyone outside of the student’s supervising faculty/staff without permission
from the Walden University IRB.
Sincerely,
Authorization Official
Contact Information
Walden University policy on electronic signatures: An electronic signature is just as valid
as a written signature as long as both parties have agreed to conduct the transaction
electronically. Electronic signatures are regulated by the Uniform Electronic Transactions

150
Act. Electronic signatures are only valid when the signer is either (a) the sender of the
email, or (b) copied on the email containing the signed document. Legally an “electronic
signature” can be the person’s typed name, their email address, or any other identifying
marker. Walden University staff verify any electronic signatures that do not originate
from a password-protected source (i.e., an email address officially on file with Walden).

151
Appendix F: Recruitment Email for Interest in Study
Invitation to Participate in a Louisiana Nursing Research Study
You are invited to take part in a research study about teaching strategies used for
leadership education in Louisiana Baccalaureate nursing programs.
The researcher has received approval from the Dean or Chair of your nursing program to
recruit you to participate. The inclusion criteria are nursing faculty who have at least one
year experience in teaching leadership, nursing faculty who currently teach leadership
courses, or nursing faculty who have previously taught leadership courses in
Baccalaureate nursing programs in Louisiana.
The purpose of this study is to explore the teaching strategies used in Louisiana
Baccalaureate programs to prepare student nurses for leadership before entry into
practice.
If you are interested, please Click on this Link (Ctrl + Click to follow link).
or copy and paste the link into your browser. No one but the researcher will receive your
contact information collected from this link which goes to.
Thank you,

152
Appendix G: Interest to Participate in Study Survey
Interest to Participate in Study
Research Study: Exploring Leadership Pedagogy among Louisiana Baccalaureate
Nursing Programs
1. I am interested in participating in the study: Exploring
Leadership Pedagogy among Louisiana Baccalaureate
Nursing Programs
Yes
No
Maybe Later
2. I understand my participation is voluntary and I may exit
the study at any time.
Yes
No
3. By entering my contact information below, I understand
I am not obligated to continue my participation. (Please
enter your name, email address, and phone number you
wish to use for communication in comment area. No one
but the researcher will have access to this information).
Please select a pseudonym as your identifier for the study
to protect your confidentiality and include in the comment
area with your contact information.
Yes
No
Contact Information
Done

153
Appendix H: Email Letter of Invitation for Participation
Subject: Research Request: Exploring Leadership Pedagogy in Louisiana Baccalaureate
Nursing Programs
Hello ____________:
I am a PhD in Nursing student at Walden University with a specialization in education. I
received your contact information from your response to a survey link sent to you by the
Dean or Chair of your nursing program as a potential interest in my research study.
This email serves as an invitation to participate in my study: Exploring Leadership
Pedagogy among Louisiana Baccalaureate Nursing Programs. The inclusion criteria are
faculty who have at least one year teaching experience in leadership education, faculty
who currently teach leadership education, or faculty who have taught leadership courses
at the Baccalaureate level in Louisiana nursing programs. The study will explore the
teaching strategies used to prepare student nurses for leadership before entry into
practice.
This study has met IRB approval at Walden University as well as your institution. I
would appreciate your voluntary participation for this study. I will be using email
communication and video conferenced interviews to protect the confidentiality of
participants.
Attached is a Walden University Informed Consent Form for your signature to
participate. To protect your confidentiality, a link is included within the informed
consent form allowing for your electronic signature. I will include your agreement email
with the consent form. However, if you wish to sign the consent and mail it back to me,
the instructions are included on the consent. Your name as well as the participating
institution’s name will remain confidential. I am open to any questions, concerns, or
feedback you may want to address. I will expect that you take at least 2 weeks to review
the consent, ask questions, and return the signed consent or electronic signature link back
to me. Once I receive your consent, I will request your availability to schedule an
interview at your best convenience.
Thank you for the opportunity to work with you in this research endeavor. I will be
happy to share a summary of the results with you when completed.
Sincerely,

154
Appendix I: Content Topics for Interview
AACN: The Essentials of Baccalaureate Education for Professional Nursing Practice
Essential II: Basic Organizational and System Leadership for Quality Care and Patient
Safety
Using the list below as a guide, please select the top 10 content categories that are
important to address in your leadership course.
1. Leadership theory, behaviors, characteristics, contemporary approaches,
leadership development, and styles of leadership
2. Leadership skills and strategies including negotiation, collaboration, coordination,
and decision making for the promotion of quality care in various healthcare
settings
3. Change theory
4. Community organizing models
5. Social change theory
6. Creative and imaginative strategies for problem solving
7. Communication, including elements, channels, levels, barriers, models,
organizational communication, skill development, workplace communication,
conflict resolution, optimizing patient care outcomes, and chain-of-command
8. Principles of interpersonal interactions/communication
9. Healthcare systems structure and finance structure, organizational structures and
relationships (relationships between finance, organizational structure, and
delivery of care, particularly at the microsystem level, including the
mission/vision/philosophy, and values)

155
10. Reliability and reliability sciences in health care
11. Operations research, queuing theory, and system designs in health care
12. Teamwork skills, including effective teams/characteristics, application to patient
care teams, team process, conflict resolution, delegation, supervision, and
collaboration
13. Microsystems and their relationship to complex systems, quality care, and patient
safety
14. Patient safety principles, including safety standards, organizational safety
processes, reporting processes, departmental responsibilities, ownership, national
initiatives, and financial implications
15. Quality improvement, including history, elements, Continuous Quality
Improvement models, concepts, principles, benchmarking, processes, tools,
departmental ownership, roles/responsibility, methodologies, regulatory
requirements, organizational structures for QI, outcomes, monitoring, Quality
Assurance vs. QI, beginning resource need assessment, and resource
identification, acquisition, and evaluation
16. Overview of QI process techniques, including benchmarks, basic statistics, root
cause analyses, and Failure Mode Effects Analysis (FMEA) in the quality
improvement process
17. Principles of nursing care delivery management and evaluation
(AACN, 2008, pp. 14-15).

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Appendix J: Content Topics Ranking Matrix
Interview
#1
Interview
#2
Interview
#3
Interview
#4
Interview
#5
Interview
#6
1 No
ranking
 (1)  (1)  (1)  (1)  (1)
2  (2)  (2)  (2)  (2)
3  (3)  (3)  (10)  (3)
4
5
6  (4)  (3)  (7)  (4)
7  (5)  (4)  (4)  (5)
8  (6)  (5)  (5)  (6)
9  (6)  (7)
10
11  (6)
12  (7)  (7)  (6)  (2)  (8)
13
14  (8)  (8)  (7)  (3)  (9)
15  (9)  (9)  (8)
16  (10)  (4)
17  (10)  (9)  (5)  (10)