A Systematic Review of the Antecedents, Mediators and Outcomes of Authentic Leadership in Healthcare

Authentic leadership is a relational leadership style derived from the field of positive organizational behavior and is purported to promote healthy work environments that influence staff performance and positive organizational outcomes. The aim of this thesis was to conduct a systematic review to describe the state of the evidence on the relationship between authentic leadership, staff, and patient outcomes in healthcare. Published English-only research articles that examined the antecedents, mediators and outcomes of authentic leadership practices of leaders/managers in healthcare settings were selected from eleven online bibliographic databases. Quality assessments, data extraction and analysis were completed on all included studies. A total of 44 articles (n=38 quantitative and n=6 qualitative) representing 27 studies satisfied our inclusion criteria, were retained and included both published research and dissertations and theses. Results were reported as descriptive and narrative syntheses using authentic leadership theory as a guide. Findings provided support for positive relationships between authentic leadership and trust, job satisfaction, structural empowerment, work engagement and work group relationships. Also there were negative associations between authentic leadership and bullying, incivility and burnout. Findings from qualitative studies supported a positive connection between authentic leadership and healthy work environments and leadership characteristics were consistent with authentic leadership theory. Future studies using longitudinal and interventional designs and conducted in a variety of healthcare settings with more diverse and interprofessional samples are warranted. Healthcare leaders and practitioners can use findings of this review as a guide to increase awareness of the processes by which authentic leadership promotes positive outcomes in the workplace