Antecedents of Clinical Leadership and Pre-Registration Nursing Education

Leadership has become a significant issue worldwide in the latter half of the twentieth century. More specifically there is an abundance of literature on leadership and the registered nursing workforce. In recent years there has been a growth in leadership development frameworks specifically for registered nurses. This is an area of my experience and expertise with over fifteen years’ experience of facilitating leadership development with clinicians. More recently there is a growing support for the inclusion of clinical leadership preparation in pre-registration nursing programmes, as an academic with a responsibility to influence how nurses are prepared for the profession I considered that clinical leadership and pre-registration nursing was an appropriate and needed topic of enquiry, As a consequence has become a focus of my research. This research study has focused on the identification and verification of the antecedents (knowledge, skills and behaviours) of clinical leadership (management and leadership) and the development of a curriculum model for pre-registration nursing programmes. The research design was essentially exploratory and uses survey research methodology to verify the antecedents of clinical leadership. An international scoping review between 1990 and 2011 informed the development of an on-line survey. The survey was designed using multiple methods to identify the views of nurses in Australia and included clinicians, managers and academics on proposed indicative curriculum content (the antecedents) suggested for clinical 13 leadership development in a pre-registration nursing degree. A total of 418 nurses completed the survey. The international literature review identified twenty-seven publications. The results indicated there is a paucity of literature specifically relating to clinical leadership and pre-registration nursing programmes and what is available is inconclusive and unconvincing. One of the innovative outcomes of the literature review and therefore the research study as a whole has been the elaboration of an existing definition of clinical leadership. The survey results identified there was consensus amongst the profession on what could be considered indicative and pre-requisite antecedents to include in a preregistration nursing programme. The lack of empirical evidence on curricula approaches or designs available in published literature posed a significant challenge. It was not feasible to seek the views of the profession of nurses on effective pedagogical approaches and educational strategies. Core principles of critical social theory have been explored to conceptualise an integral curriculum thread for pre-registration nursing programmes. This has resulted in the creation of an overarching model for clinical leadership – the infinity loop of clinical leadership and a conceptual model: a curriculum - pedagogy nexus for clinical leadership. For completeness a prospective multi method programme of research to include a curriculum evaluative inquiry and longitudinal cohort research study has been developed to test the usability and effectiveness of the conceptual model. Importantly, for nursing students and the profession as a whole there is a clearer expectation of what clinical leadership might look like in the novice registered nurse. For nurse academics a model is offered for 14 consideration in curriculum design and implementation with an evaluation strategy that could be replicated