Leadership can be defined as the means of creating an environment where employers can contribute to the purpose of the organization effectively (Garman et al, 2006). Effective leadership can improve the quality and delivery of health care services at each level of care (Martin et al, 2012). Moreover, it can promote staff management and produce efficient leadership consequences (Brand et al, 2012).
Various researches were conducted to study the consequence of the several leadership styles and the leadership development programs among clinical leaders such as nursing, allied health, and medical professions due to the requirement to achieve more productivity and employee performance(Martin et al, 2012). The redesigning of health care services often involve leadership capacity and capability of allied health professionals. Various countries funded the development of leadership in allied health care services due to its growing importance.
According to the theory introduced by Burns (1978) , transformational leadership motivates and inspires individuals to accomplish extraordinary results along with transcending individuals to work towards their self-interests, moreover, aligning the goals and purpose their followers, leaders and the organization. It is a distinct model that facilities personal and organizational change, thereby contributing to engaging organizational culture. On the contrary, Transactional leadership involves rewards and punishments which motivates individuals to achieve a target achievement as pointed by Bass (1985).
There is a need for ongoing, adaptive change in health care services which makes it quite complex. Transformational leaders facilitate health care services by providing high quality, person-centered healthcare to each individual (Cumming et.al.,2010,Wilson et al., 2013). Such leaders possess a variety of characteristics and behaviors which includes guiding insight, motivation, and empowerment further impacting motivation and intellectual stimulation in followers (Wilson et al., 2013).
In contrast, evidence suggests that transactional leadership involves active and passive management by exception (where the compliance and deviations are monitored using defined criteria) and contingent reward (a reward is provided by the leader whenever an agreed task is accomplished). Technical and industrial abilities along with analytical, interpersonal and communication skills, emotional intelligence are essential health leadership competencies (Wylie et al., 2009).
Nurses have faced unprecedented challenges and opportunities in the past and yet today they face difficulties. There is an increasing concern for the importance of adaptive and flexible leadership due to the constant changes in organizations. This type of adaptive leadership was labeled as transformational leadership by Bass in 1985 in which environments focusing on shared responsibilities directly impact the new ways of knowing. Transformational leadership can promote higher ideals and values in followers.
Nurses should embody these ideals and values. This form of leadership can lead to lower rates of burnout, a better sense of leader effectiveness, and better job satisfaction. Moreover, the use of transformational leadership can improve strategies of the organization and patient outcomes (Ross, Fitzpatrick, Click, Krouse, & Clavelle, 2014).
Taylor found that the hospital was participative when the nurse executive’s transformational leadership increased. There was a significant relationship found between transformational leadership practices and organizational commitment. Wylie and Gallagher revealed that there was a positive correlation between self-reported transformational behavior profiles, seniority and prior training that focused on leadership.
Furthermore, research has shown that strong leaders can contribute to improved rates of mortality, quality of patient care and enhanced work environment. There were many studies on the outcome of transformational leadership on job satisfaction of nurses. There was a strong relationship between nurse manager transformational leadership style and job satisfaction as revealed by Faila and Stichler (Ross, Fitzpatrick, Click, Krouse, & Clavelle, 2014)
There was a cross-sectional survey conducted in the acute tertiary hospital located in Singapore among registered nurses. The study ‘s objective was to explore differences between how nurse leaders perceived their leadership styles and perception of employers regarding their styles of leadership.
The other objective was to find a correlation between perceived leadership styles and their impact on organizational outcomes including organizational commitment, job satisfaction, and turnover intention. It was found that there was a combination of both transformational and transactional behaviors present in nurse leaders. Nurse leaders overestimated their behaviors and tend to rate themselves higher compared to how others would perceive their leadership styles.
A strong correlation was revealed between transformational leadership and outcomes including efforts, effectiveness, and satisfaction. However, the study could not correlate the leadership traits with turnover retention and organization commitment strongly which can be possible due to the limitation of sample size(Goh, Ang, & Della, 2018).
Another research revealed how leadership styles of different nurse leaders can impact job satisfaction of nurses. Quantitative and descriptive methods were used to access the relationship between leadership styles of nurse managers and job satisfaction in three different private hospitals situated in Amman. Transformational leadership scores were found to be higher followed by transactional leadership scores.
The study revealed that transformational leaders who exhibited characteristics of motivational leaders led to more satisfaction in nurses. It is also evident in literature that job satisfaction can increase through a style of leadership which focused on motivation and inspiration. Casida and Parker (2011) found similar results to this study where it was revealed that transformational leadership characteristics in nurse managers can improve the level of job satisfaction in nurses.
Moreover, in transactional domain, the study also revealed that there is a positive correlation between job satisfaction of nurses and transactional leadership having contingent reward nurses and management-by -exception. The contingent reward obtained a better score in comparison to management by exception in the study. Similar results were found that the job satisfaction of nurses was lower in the case of nurses who received management-by-exception as evident by studies conducted by Mc Guire et al (2003) and Windsor ( 2009). However, the job satisfaction of nurses who received a contingent reward relationship was better (Abdelhafiz et al., 2015).
Transactional leadership among nurses should be considered concerning the capabilities and experience that an individual has. There are certain occasions which require a leader to intervene in a situation before the mistakes occur (Stordeur et al, 2000). There should be proper education of leaders to assist the change and growth of leadership in health care. However, transformational leadership is favored among nurse leaders due to the potential it holds to increase job satisfaction, patient safety, and high performance (Fischer, 2016).
Allied health practitioners work as core members of clinical teams to optimize clinical outcomes for patients. The allied health professionals include a variety of disciplines like Audiology, Psychology, Nutrition and Dietetics, Genetic Counselling, Play therapy, Physiotherapy, Pharmacy, Sexual Assault, Art therapy in the Australian public sectors. Leadership capacity and capability are primary components for all allied health professions to capture opportunities due to the redesign of health care settings.
Moreover, it allows allied health professionals to fully accomplish their objectives and potential. Transformational leadership style has been studied extensively in nursing. However, there is a little attempt made by researchers to explore the role and impact of leadership styles regarding allied health professions. There is the role of leadership development programs in various allied health development. Studies have revealed that these programs can lead to desirable outcomes of satisfaction, extra efforts, and leadership effectiveness.
Similar evidence was found in allied health professions regarding the role of leadership styles. There was a study conducted on social workers from 26 hospitals. The managers of social workers were assessed using MLQ-5 in 2001. The study revealed that transformational leadership behaviors and transactional factor of contingent reward were associated with positive outcomes such as improved satisfaction, leadership effectiveness and extra efforts in the hospital-based social workers.
There was also a study conducted in a rehabilitation setting which revealed that transformational leadership styles were perceived by various occupational therapists to be related to positive leadership outcomes. It was also found that a combination of both transactional and transformational styles can lead to positive leadership results. Leadership training presents a crucial role in impacting leadership outcomes. Leadership training can improve transactional and transformational behaviors in leaders.
There was a study administered to explore self – reported transformational leadership behavior profiles in six allied professions in Scotland. The study showed statistical differences among the six disciplines, with radiographers and podiatrist scoring the lowest as compared to other allied health professions. It was also found that occupational therapists, speech and language pathology and physiotherapists had more transformational behaviors in comparison to other allied disciplines.
Senior graded positions were found to have higher transformation behaviors. It implies that some allied disciplines needed more leadership support. This also highlights there is a need to target and evaluate multidisciplinary leadership programs concerning the allied health professions.
