Development of Leadership Behaviors in Undergraduate Nursing Students:
A Service Learning Approach
Karen J. Foli, PhD, RN
Melanie Braswell, DNP, RN, CNS, CNOR
Jane Kirkpatrick, PhD, RNC
Eunjung Lim, MS
Abstract
Purpose: The purpose of this study was to describe leadership behaviors in generic
baccalaureate nursing students at the beginning and conclusion of their senior-level course in
nursing leadership; embedded in the course was a semester-long service learning project.
Methods: A pre-/post-test design was used. Instruments designed by Kouzes and Posner were
utilized in the study. Students were given the Student Leadership Practices Inventory-Self (LPISelf/Student Version) at the beginning of the semester (Time 1) and the same scale at the end of
the semester (Time 2). In addition to the self-assessment at Time 2, the students were also
administered the Leadership Practices Inventory-Observer (LPI-Observer) and were instructed to
rate their peers whom they had worked with during the semester. These two scales (LPI-Self and
LPI-Observer) list the same behaviors along five dimensions: Model the Way; Inspire a Shared
Vision; Challenge the Process; Enable Others to Act; and Encourage the Heart. During Time 2,
students also completed six Likert type questions related to their service learning experiences.
Subjects: Sixty-five students completed the assessments. Almost three fourths of the sample
were admitted directly from high school (71%), were between the ages of 22 and 24 years old
(97%), were female (97%), Caucasian (89%), and from the State of Indiana (82%).
Analyses: The analyses were performed in SAS 9.2. Cronbach’s alphas for the subscales ranged
from 0.58 to 0.95. Paired t-tests of the pre- and post-test of the LPI-Self revealed that perceptions
of leadership behaviors improved along all five dimensions (p<0.0001). Two of the subscales,
Inspire a Shared Vision (p=0.05) and Encourage the Heart (p=0.0002), revealed significant
correlations between the post-test LPI-Self and the LPI-Observer ratings. Almost 75% (n=44)
strongly agreed that the skills learned in the service learning project are directly applicable to
their careers. Fifty-five percent (n=33) strongly agreed that their ability to delegate has improved
as a result of the class. Pearson correlation revealed a significant association between the
perceived improvement in delegation and being a leader either inside or outside the school of
nursing (Pearson’s r = 0.38 p = .0027; n = 59).
Interpretation of Findings: Service learning appears to be an effective approach to the
attainment of leadership behaviors; however, educators should be aware that the link with course
concepts and principles should be continually reinforced and student self-evaluations may not be
associated with those of peers.
KEY WORDS: nursing, leadership, service learning
Introduction
The need for effective nurse leaders has reached a renewed sense of urgency. The
Baccalaureate Essentials for Nursing (American Association of Colleges of Nursing [AACN],
2008), the Institute of Medicine report on The Future of Nursing (2010), and the formation of the
Clinical Nurse Leader (AACN, 2007; Stanley, Gannon, Gabuat, Hartranft, Adams, Mayes,
Shouse, Edwards, & Burch, 2008) have introduced a new paradigm that calls for nurses to lead
healthcare in competent and innovative ways. Preparation for this leadership role creates a new
imperative for baccalaureate-level nursing educators.
Leadership skill attainment at the baccalaureate level has been described in the nursing
literature with instruction delivery through student participation in community partnerships and
change projects, including health fairs, (Cox & Miranda, 2003; Mansfield & Meyer, 2007), peer
leaders or partnerships with lower-level classmen (Bensfield, Solari-Twadell, & Sommer, 2008;
Daley, Menke, Kirkpatrick, Sheets, 2008; Kling, 2010) and service learning (Schaffer &
Peterson, 2001; Harrison, 2010). While these studies add to the profession’s understanding of
innovation in curricula, empirical evidence that supports effectiveness in leadership skills is
lacking.
Service Learning
One potentially effective and efficient mechanism that may combine peer leadership,
community involvement, health fairs, and change projects is service learning. Nursing education
teaches both the art and science of nursing practice (Kirkpatrick & Braswell, 2010) and has
found service learning opportunities to fit especially well in nursing curricula (for example,
Laplante, 2009; Gosline & Schank, 2003; Reising, Shea, Allen, Laux, Hensel, & Watts, 2008).
Service learning goes beyond experiential learning found in clinical and theory courses,
however, and lends itself to the recent call for more applied learning through case studies,
reflection, and student discussion (Benner, Sutphen, Leonard, & Day, 2009).
Again, evidence is scarce that validates service learning as an effective strategy in the
development of leadership skills. Therefore, the purpose of the study was to determine the
change in leadership behaviors as perceived by students and their peers before and after a service
learning experience.
Context and Purpose
During the senior year of a generic baccalaureate nursing program, students are required
to enroll in a course specific to learning theories and attaining skills related to leadership and
management. The spring semester in which the study was conducted and as a significant
component of this course in leadership, students were required to plan and implement a large
public health fair that was embedded in a university-wide spring festival. After being divided
into groups of 5 to 6 students, students wrote memorandums of understanding that outlined what
their health fair booths would contain and the audience they would be targeting with educational
and service materials. Working with a student-led steering committee and faculty preceptors, the
students also wrote and were awarded service learning grants and communicated with a
community partner (the coordinator of the university spring festival). The health fair lasted two
weekend days, and approximately 1,800 visitors came to the tent that housed the booths. Student
informal feedback and formal reflection papers to the event were positive.
Methods
Instruments
Posner and Kouzes (1988, 1990, 1992, 1993a, 1993b, 1994, 1995, 2009) developed, the
Leadership Practices Inventory (LPI) tools, which have been widely used in organizations and
educational settings; these tools have accepted validity and reliability, ranging from 0.80 to 0.85.
Two scales (LPI-Self and LPI-Observer) list the same behaviors along five dimensions: Model
the Way; Inspire a Shared Vision; Challenge the Process; Enable Others to Act; and Encourage
the Heart. The LPI-Observer contains a wider range of responses (1-10) versus the LPI-Self (15). Thus the total score possible on the LPI-Self is 150 (range 30 to 150) and the LPI-Observer is
500 (30 to 300). A student version (Posner & Kouzes, 1992, 1994, 2009) of the LPI was
specifically chosen to measure attainment of leadership behaviors in this sample. Students were
asked to respond to how frequently they demonstrate leadership behaviors (rarely to almost
always).
Procedure and Study Design
A pre-post test design was used. Sixty-five students enrolled in a senior-level course as
baccalaureate students were given the Student LPI-Self at the beginning of the semester (Time 1)
and the same scale at the end of the semester (Time 2) (Kouzes & Posner, 2006). In addition to
the self-assessment at Time 2, the students were also administered the LPI-Observer (Kouzes &
Posner, 2006) and were instructed to rate their peers whom they had worked with during the
semester in implementing a service learning project. During Time 2, they also completed basic
demographic items, and six Likert type questions related to their service learning experiences.
The institutional review board deemed the study to be exempt status.
Analysis
The analyses were performed in SAS 9.2 (SAS Institute, Inc., Cary, NC) on the sample of
65 students. Descriptive statistics were computed and included frequency counts, means,
standard deviations, one-sample and two-sample t-tests (Z values), Cronbach’s alphas, and
Pearson correlation coefficients (r values). There were between four and five observer scores for
each self rating and therefore, mean values for each student observer scores were used in the
analysis.
Results
Sample Characteristics
As shown in Table 1, almost three fourths of the sample were admitted directly from high
school (71%), were between the ages of 22 and 24 years old (97%), were female (97%),
Caucasian (89%), and from the State of Indiana (82%). Over one third (36%) considered
themselves to be very conservative or conservative in political orientation. Half of the sample
identified with either the Protestant or Roman Catholic religion.
Table 1
Sample Characteristics
Characteristics
Type of Student
Admission From High School
Internal Transfer Student
RN Completion Student
Other
Age (Years)
22 – 24
30
40
Gender
Male
Female
Ethnic Group
Caucasian or White American
N (%) or Mean ± SD
45 (71)
13 (21)
1 (2)
4 (6%)
23.00 ± 2.44
61 (97)
1 (2)
1 (2)
2 (3)
61 (97)
56 (89)
Hispanic American
Asian American/Pacific islander
Bi-racial or multi-racial
Other
Religion
Protestant
Roman Catholic
Non-denominational Christian
Other
None
Don’t know/Declined
Political Perspective
Very conservative/conservative
Somewhat conservative
Neither conservative nor liberal
Liberal/Somewhat liberal
Don’t know/Declined
Geographic Region
Indiana
Outside of Indiana
Outside of USA
1 (2)
4 (6)
1 (2)
1 (2)
13 (21)
18 (29)
19 (30)
4 (6)
7 (11)
2 (4)
23(36)
11 (17)
8 (13)
15 (18)
5 (8)
51 (82)
10 (16)
1 (2)
Service Learning Items
Six Likert style questions were posed to the students and computed means and standard
deviations are shown in Table 2. While 73% (n=44) strongly agreed that the skills learned in the
service learning project are directly applicable to their careers, only 55% (n=33) strongly agreed
that their ability to delegate has improved as a result of the class. While 65% (n=39) strongly
agreed that the service learning project had increased their understanding of the course concepts,
33% (n=20) disagreed with the statement.
Table 2
Service Learning Item Responses
Itema
N (%)
Mean ± SD
I felt my contributions were appreciated by the
school of nursing.
59 (91)
4.37 ± 1.20
I am a leader in a student organization (either
inside or outside the school of nursing).
59 (91)
4.36 ± 1.21
The skills I used in the process of the service
learning project are directly applicable to my
career.
60 (92)
4.27 ± 1.27
In this class, I felt I made a worthwhile
contribution to the community.
59 (91)
4.02 ± 1.40
The service learning project increased my
understanding of course concepts and
principles.
60 (92)
3.97 ± 1.43
My ability to delegate has improved as a result 60 (92)
3.77 ± 1.42
of this class.
a
Likert style questions: strongly agree=5; agree=4; neutral=3; disagree=2; strongly
disagree=1.
As outlined in Table 3, Pearson correlation revealed a significant association between the
perceived improvement in delegation and being a leader either inside or outside the school of
nursing (Pearson’s r = 0.38 p = .0027; n = 59). Students’ perception of the service learning
project in increasing understanding of course concepts and principles was significantly correlated
with the all of the service learning items with the exception of being in a leadership position
either inside or outside the school of nursing.
Table 3
Pearson Correlation Coefficients for Service Learning Items
Pearson Correlation
Coefficients
Item 1a Item 2a Item 3a Item 4a Item 5a Item 6a
Item 1
The Service Learning project
increased my understanding of the
course concepts and principles.
1.00000
0.59006
<.0001
60
0.45867
0.0003
59
0.55682
<.0001
59
0.40642
0.0013
60
0.11078
0.4036
59
Item 2
The skills I used in the process of the
Service Learning project are directly
applicable to my career.
0.59006
<.0001
60
1.00000
0.50985
<.0001
59
0.45954
0.0003
59
0.29371
0.0227
60
0.10890
0.4116
59
Item 3
In this class, I felt I made a
worthwhile contribution to the
community.
0.45867
0.0003
59
0.50985
<.0001
59
1.00000
0.65932
<.0001
58
0.47275
0.0002
59
0.15236
0.2536
58
Item 4
I felt my contributions were
appreciated by the school of nursing.
0.55682
<.0001
59
0.45954
0.0003
59
0.65932
<.0001
58
1.00000
0.42470
0.0008
59
0.19011
0.1529
58
Item 5
My ability to delegate has improved
as a result of this class.
0.40642
0.0013
60
0.29371
0.0227
60
0.47275
0.0002
59
0.42470
0.0008
59
1.00000
0.38380
0.0027
59
Item 6
I am a leader in a student organization
(either in or outside the school of
nursing).
0.11078
0.4036
59
0.10890
0.4116
59
0.15236
0.2536
58
0.19011
0.1529
58
0.38380
0.0027
59
a
60
60
59
59
60
1.00000
59
Pearson R, p value, N
Leadership Behaviors: LPI-Self (Pre- and Post-Test) and LPI-Observer Scores
As shown in Table 4, paired t-tests of the pre- and post-test LPI-Self reveal that the
students’ perceptions of themselves as leaders improved along all five dimensions (p<0.0001).
However, t-test analysis revealed that three of the thirty items did not show significant
differences pre- and post-LPI-Self scores: these items were related to cooperation versus
competition (Z = 0.0; p=1.00); following through on commitments (Z=1.84; p=0.07); and setting
goals and specific plans (Z=0.71; p=0.48).
<<<<<< Table 4 About Here >>>>>>>
As shown in Table 5, Pearson correlation coefficients were also computed between the
six service learning items and the self and observer LPI items for Time 2. Two of the subscales,
Inspire a Shared Vision (p=0.05) and Encourage the Heart (p=0.0002), revealed significant
correlations between the post-test LPI-Self and the LPI-Observer ratings. Although there was not
a significant correlation between the LPI-Self (post-test) and LPI-Observer for the subscale,
Challenge the Process (CTP), four of the six service learning items (Items 3, 4, 5, & 6) did show
a significant correlation between the individual student’s responses and their peer observations
on CTP.
Nine specific questions were significantly correlated between the post-test LPI-Self and
the LPI-Observer mean scores; five of these items were from Encourage the Heart and related to
concepts such as praise given to others (Pearson’s r= 0.36; p=0.005), encouragement (Pearson’s
r= 0.48; p<0.0001), support and appreciation (Pearson’s r= 0.31; p=0.013), celebrating
accomplishments (Pearson’s r= 0.34; p=0.0078), and recognition (Pearson’s r= 0.27; p=0.03).
Three items with significant correlations were from the Inspire a Shared Vision and related to
working toward a common goal (Pearson’s r= 0.27; p=0.03), positive behaviors toward
organizational goals (Pearson’s r= 0.39; p=0.0017), and communication with conviction about
organizational purpose (Pearson’s r= 0.31; p=0.02). The last behavior was from the Challenge
the Process subscale and measured setting goals and planning (Pearson’s r= 0.36; p=0.004).
Table 5
Pearson Correlation Coefficients for Five Subscales and Service Learning Items
S-MTW
LPI-Self (Post-test)
O-MV
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
0.19446
0.1299
62
-0.19973
0.1260
60
-0.17173
0.1895
60
-0.21611
0.1002
59
-0.22667
0.0843
59
-0.35436
0.0055
60
-0.19637
0.1361
59
0.19446
0.1299
62
1.00000
0.00141
0.9915
60
-0.12578
0.3382
60
-0.22489
0.0868
59
-0.24468
0.0618
59
-0.25018
0.0539
60
-0.32364
0.0124
59
S-ISV
O-ISV
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
1.00000
0.25150
0.0486
62
-0.23710
0.0681
60
-0.10411
0.4286
60
-0.19629
0.1362
59
-0.22283
0.0898
59
-0.24975
0.0543
60
-0.20124
0.1264
59
1.00000
-0.01599
0.9035
60
-0.19384
0.1378
60
-0.25410
0.0521
59
-0.25016
0.0560
59
-0.20258
0.1206
60
-0.26077
0.0461
59
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
0.17324
0.1781
62
-0.24704
0.0571
60
-0.21251
0.1031
60
-0.08473
0.5234
59
-0.18499
0.1607
59
-0.29916
0.0202
60
-0.18769
0.1546
59
1.00000
-0.07689
0.5593
60
-0.16213
0.2158
60
-0.30115
0.0205
59
-0.30037
0.0208
59
-0.28833
0.0255
60
-0.31367
0.0156
59
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
0.07954
0.5389
62
-0.08879
0.4999
60
-0.33227
0.0095
60
-0.00421
0.9747
59
-0.06787
0.6095
59
-0.01753
0.8942
60
-0.04308
0.7460
59
1.00000
-0.03793
0.7736
60
-0.22544
0.0833
60
-0.22292
0.0897
59
-0.24627
0.0601
59
-0.10457
0.4265
60
-0.25259
0.0536
59
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
0.45606
0.0002
62
-0.09453
0.4725
60
-0.15328
0.2423
60
-0.22596
0.0853
59
-0.26848
0.0398
59
-0.33758
0.0083
60
-0.45389
0.0003
59
1.00000
-0.00380
0.9770
60
-0.13387
0.3079
60
-0.19490
0.1391
59
-0.21784
0.0974
59
-0.23523
0.0704
60
-0.33526
0.0094
59
1.00000
Model the Way
(S-MTW)
LPI-Observer
Model the Values
(O-MTW)
LPI-Self (Post-test)
Inspire Shared
Vision (S-ISV)
LPI-Observer
Inspire Shared
Vision (O-ISV)
62
62
0.25150
0.0486
62
S-CTP
LPI-Self (Post-test)
Challenge the
Process (S-CTP)
LPI-Observer
Challenge the
Process (O-CTP)
1.00000
62
0.17324
0.1781
62
S-EOA
LPI-Self (Post-test)
Enable Others to
Act (S-EOA)
LPI-Observer
Enable Others to
Act (O-EOA)
1.00000
62
0.07954
0.5389
62
S-ETH
LPI-Self (Post-test)
Encourage the
Heart (S-ETH)
LPI-Observer
Encourage the
Heart (O-ETH)
1.00000
62
0.45606
0.0002
62
65
65
O-CTP
65
O-EOA
65
O-ETH
65
Note: Item 1: The service learning project increased my understanding of the course concepts and principles. Item
2: The skills I used in the process of the Service Learning project are directly applicable to my career. Item 3: In this
class, I felt I made a worthwhile contribution to the community. Item 4: I felt my contributions were appreciated by
the school of nursing. Item 5: My ability to delegate has improved as a result of this class. Item 6: I am a leader in a
student organization (either in or outside the school of nursing).
Discussion
This study contributes to the body of evidence supporting service learning as a powerful
pedagogical approach, specifically the attainment of leadership behaviors in undergraduate
nursing students. Limitations of the study, however, should be discussed. While the instruments
were administered pre-and post-service learning experiences, potential confounding variables
included a concurrent capstone course during which the students were paired with preceptors in a
variety of healthcare settings (100 hours throughout the semester) and a concurrent course in
professional issues in nursing. There is also the possibility of a maturational effect; these
students graduated days after the end of the semester.
Overall, the students perceived themselves as gaining in leadership behaviors. The three
items that did not show improvement surrounded the concepts of cooperation, keeping promises
and commitments, and setting goals and plans. One explanation is that the students were already
demonstrating these leadership characteristics at the time of the pre-test LPI-Self assessment.
In contrast, only two subscales, Inspire a Shared Vision and Encourage the Heart,
revealed correlations with their peers at the time of pos-test assessment. These two subscales
contained eight of the nine significantly correlated items between LPI-Self (post-test) and LPIObserver scores.
Table 4
Mean, Standard Deviation, Internal Consistency and Paired T-Tests of Pre-Test, Post-Test and Peer Assessments
Student Leadership
Practices Inventorya
Subscales
Model the way
Inspire a shared
vision
Challenge the process
Enable other to act
Encourage the heart
a
n = 65.
Pre-Test
Mean
± SD
3.59
± 0.47
3.42
± 0.61
3.25
± 0.55
4.09
± 0.47
3.64
± 0.69
Cronbach
alpha
0.58
0.74
0.69
0.65
0.85
Post-Test
Mean
± SD
3.99
± 0.47
3.93
± 0.52
3.70
± 0.49
4.35
± 0.38
4.06
± 0.59
Pre- vs.
Post-Tests
Cronbach
alpha
Paired
t test
0.65
<0.0001
0.77
<0.0001
0.69
<0.0001
0.59
<0.0001
0.82
<0.0001
Peer
Mean
± SD
8.17
± 0.97
7.64
± 1.05
7.67
± 1.06
8.66
± 0.88
8.05
± 0.95
Peer vs. Post
Cronbach
alpha
0.92
0.95
0.95
0.94
0.94
Correlation
0.19
(p=0.13)
0.251
(p=0.05)
0.1732
(p=0.18)
0.08
(p=0.54)
0.46
(p=0.0002)
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