The Effect of Leadership and Management Training on Team Leaders’ Managerial Competence and Job Satisfaction of Staff Nurses in the Inpatient Units
Keywords:
job satisfaction, managerial competence, team leader, trainingAbstract
The managerial competence of team leaders as first-line managers plays a crucial role in determining service quality, hospital performance, and staff nurses’ job satisfaction; however, available data indicate that this competence remains at a moderate level, highlighting an urgent need for improvement. This study aimed to examine the effect of leadership and management training on team leaders’ managerial competence and staff nurses’ job satisfaction. A quasi-experimental study with a pretes–postes control group design was conducted involving 106 respondents (53 in each group) which were selected using a purposive sampling technique. The data were analyzed using univariate and bivariate analysis. Team leaders in the intervention group received leadership training focused on the roles and competencies of first-line managers, while the control group did not receive any training. The study employed the Indonesian First-Line Nurse Managers’ Managerial Competence Scale (I-FLNMMCS) and the Job Satisfaction Survey (JSS). The results showed that leadership training significantly improved team leaders’ managerial competence in the intervention group from 47.2% in the good category to 100% (p < 0.001), as well as staff nurses’ job satisfaction from 41.5% to 98.1% (p < 0.001). In conclusion, leadership and management training is effective in enhancing team leaders’ managerial competence and staff nurses’ job satisfaction.
References
Afifah, L. (2022). Pengaruh Masa Kerja Terhadap Kinerja Perawat di Rumah Sakit X. Jurnal Ilmu Keperawatan Indonesia, 10(2), 55–62.
Al-Mugheed, K., Bayraktar, N., Al-Bsheish, M., AlSyouf, A., Jarrar, M., AlBaker, W., & Aldhmadi, B. K. (2022). Patient Safety Attitudes among Doctors and Nurses: Associations with Workload, Adverse Events, Experience. Healthcare (Basel, Switzerland), 10(4). https://doi.org/10.3390/healthcare10040631
Alligood, M. R. (2018). Nursing Theorists and Their Work. Elsevier.
Bui, T. T., Nguyen, A. T. B., Nguyen, N. T. T., Cao, T. V, Truong, A. T., & Tran, D. M. (2024). Leadership and Management Competencies of Nurse Managers: A Cross-sectional Study in Northern and Central Vietnam. South Eastern European Journal of Public Health, 35–44. https://doi.org/10.70135/seejph.vi.1218
Cherie, A., & Gebrekidan, A. B. (2005). Nursing Leadership and Management: Lecture Notes for Nursing Students. Addis Ababa University; The Carter Center; Ethiopia Public Health Training Initiative. (file available in conversation)
Chin, M., Balang, R. V., Wider, W., Tanucan, J. C. M., Sim, H. Y., & Janjuy, C. (2024). Leadership competencies and managerial competencies of nurse managers in Kuala Lumpur Hospital, Malaysia. Jurnal Ners, 19(3), 292–301. https://doi.org/10.20473/jn.v19i3.49986
Choi, P.-P., Lee, W.-M., Wong, S.-S., & Tiu, M.-H. (2022). Competencies of Nurse Managers as Predictors of Staff Nurses’ Job Satisfaction and Turnover Intention. International Journal of Environmental Research and Public Health, 19, 11461. https://doi.org/10.3390/ijerph191811461
Dahlkvist, E., Wallhagen, M., Bergsten, E. L., Larsson, J., & Enmarker, I. (2023). First-Line Managers’ Leadership Behavior Profiles and Use of Gardens in Residential Care Facilities: An Interview Study. Journal of Aging and Environment, 37(1), 65–84. https://doi.org/10.1080/26892618.2021.2001707
Dalky, A., Oweidat, I. A., Abuzaid, S. R., Khalifeh, A. H., & AlBashtawy, M. (2024). Exploring the influence of nurses’ demographics and hospital work environment on medical error reporting practices in Jordan: a cross-sectional study. BMJ Open, 14(11), e087057. https://doi.org/10.1136/bmjopen-2024-087057
Dedi, B. (2023). Kepemimpinan dan manajemen pelayanan keperawatan: Teori, konsep dan implementasi (L. Dwiantoro & Editor (eds.)). Trans Info Media.
Deng, J., Wang, P., Tian, X., Li, K., Yang, L., & Ding, S. (2024). Turnover intention and its influencing factors among male nurses in China: a national-scale descriptive study. BMC Nursing, 23(1).
Dg Majannang, E. A., Kadir, A., & Hamsinah, S. (2021). Hubungan Motivasi dan Masa Kerja terhadap Kinerja Perawat di Ruang Rawat Inap RSUD Haji Makassar. Jurnal Ilmiah Mahasiswa & Penelitian Keperawatan, 1(2), 196–202.
Dharma. (2017). Metodologi Penelitian Keperawatan (Pedoman Melaksanakan dan Menerapkan Hasil Penelitian). Trans Info Media.
Dharma, K. K. (2021). Metodologi Penelitian Keperawatan : Panduan Melaksanakan dan Menerapkan Hasil Penelitian. Trans Info Media.
El-sayed, A., Ahmed, M., & Zakaria, A. (2024). The Relationship between the Head Nurses’ Managerial Competency and the Staff Nurses’ Job Satisfaction. Mansoura Nursing Journal, 11(2), 15–29. https://doi.org/10.21608/mnj.2024.379218
Ellis, P., & Bach, S. (2022). Leadership, management and team working in nursing (3rd ed.). Learning Matters.
Emamgholi, S., Khanjari, S., & Haghani, H. (2020). Impact of an Educational Program on Nurses’ Performance in Providing Peripherally Inserted Central Catheter Care for Neonates. Journal of Infusion Nursing : The Official Publication of the Infusion Nurses Society, 43(5), 275–282. https://doi.org/10.1097/NAN.0000000000000387
Ernstmeyer, K., & Christman, E. (2022). Nursing Management and Professional Concepts. Chippewa Valley Technical College.
Fairbrother, G., Jones, A., & Rivas, K. (2009). Development and validation of the Nursing Workplace Satisfaction Questionnaire (NWSQ). Contemporary Nurse, 34(1), 10–18. https://doi.org/10.5172/conu.2009.34.1.010
Fekry Ahmed, M., & Moustafa Abd-ElGhani, A. (2021). First Line Nurse Managers’ Managerial Competency and its Relationship with their Staff Nurses’ Work Engagement at Main Mansoura University Hospital. Egyptian Journal of Health Care, 12(1), 471–485. https://doi.org/10.21608/ejhc.2021.142700
Fjordkvist, E., Hälleberg Nyman, M., Winberg, M., Joelsson-Alm, E., & Eldh, A. C. (2024). First-line managers’ experience of guideline implementation in orthopaedic nursing and rehabilitation: a qualitative study. BMC Health Services Research, 24(1), 871. https://doi.org/10.1186/s12913-024-11353-w
Flatekval, A. M. (2023). Performance improvement clinical nursing experience. Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing, 46, 52–58. https://doi.org/10.1016/j.profnurs.2023.01.011
Geese, F., Zwakhalen, S., Lucien, B., & Hahn, S. (2022). Job satisfaction of advanced practice nurses in cancer care: A systematic review. European Journal of Oncology Nursing, 56. https://doi.org/10.1016/j.ejon.2021.102089
Gillies, D. (2000). Nursing Management A system Approach. WB. Sauders Company.
Ginting, L., Susilaningsih, F. S., Suryati, Y., & Dedi, B. (2022). Komparasi Kompetensi Kepemimpinan Klinis Perawat Primer Berdasarkan Perspektif Evaluasi Diri dan Evaluasi Kepala Ruangan. Jurnal Keperawatan Silampari, 5(2), 1259–1267. https://doi.org/10.31539/jks.v5i2.3483
González García, A., Pinto-Carral, A., Pérez-González, S., & Marqués-Sánchez, P. (2021). Nurse managers’ competencies: A scoping review. Journal of Nursing Management, 29. https://doi.org/10.1111/jonm.13380
Gunawan, J., Aungsuroch, Y., Fisher, M. L., & McDaniel, A. M. (2019). Development and Psychometric Properties of Managerial Competence Scale for First-Line Nurse Managers in Indonesia. SAGE Open Nursing, 5, 2377960819831468. https://doi.org/10.1177/2377960819831468
Gunawan, J., Aungsuroch, Y., Fisher, M. L., McDaniel, A. M., & Marzilli, C. (2020). Managerial Competence of First-Line Nurse Managers in Public Hospitals in Indonesia. Journal of Multidisciplinary Healthcare, 13, 1017–1025. https://doi.org/10.2147/JMDH.S269150
Hastono, S. P. (2018). Analisis Data Pada Bidang Kesehatan (3rd ed., Vol. 3). Rajawali Pers.
Healthcare, A. M. N. (2023). 2023 Survey of Registered Nurses: The Pandemic’s Consequences. AMN Healthcare. https://www.amnhealthcare.com/siteassets/amn-insights/surveys/amn-healthcare-rnsurvey-2023.pdf
Hu, S., Chen, W., Satamo, M., Löyttyniemi, E., Yang, M., Liu, G., Chen, J., Tang, Y., Varpula, J., Li, X., & Välimäki, M. (2024). Online training to improve evidence-based leadership competencies among nurse leaders in China: a feasibility randomised controlled trial. BMJ Open, 14(11), e088386. https://doi.org/10.1136/bmjopen-2024-088386
Huang, L.-H., Chen, C.-W., Ko, N.-Y., Chang, S.-H., & Wang, H.-H. (2022). [Effectiveness of Nursing Leadership Training Programs: Mixed-Methods Research]. Hu li za zhi The journal of nursing, 69(2), 55–66. https://doi.org/10.6224/JN.202204_69(2).08
Joseph, M. L., & Huber, D. (2021). Leadership and Nursing Care Management (7th Edition (ed.)). Saunders; Elsevier. https://evolve.elsevier.com/cs/product/9780323697118?role=student
Jung, J., & Kim, J.-S. (2020). Comparison of Nursing Performance Competencies and Practical Education Needs Based on Clinical Careers of Operating Room Nurses: A Cross-Sectional Study. Healthcare, 8, 136. https://doi.org/10.3390/healthcare8020136
Kakyo, T. A., & Xiao, L. D. (2017). Nurse managers’ experiences in continuous quality improvement in resource-poor healthcare settings. Nursing & Health Sciences, 19(2), 244–249. https://doi.org/10.1111/nhs.12338
Karota, E., & Anwar, L. (2020). Buku Ajar: Aplikasi King’s Theory of Goal Attainment: Perilaku Perawatan Diri Pasien Diabetes.
Kemenkes. (2024). Pelatihan Sebagai Suatu Sistem. Kementerian Kesehatan Republik Indonesia.
Kuraoka, Y. (2022). Effects of a learning programme for nurse managers to connect their experience: A quasi-experimental study. Journal of Nursing Management, 30(5), 1188–1195. https://doi.org/10.1111/jonm.13604
Lacerenza, C., Reyes, D., Marlow, S., Joseph, D., & Salas, E. (2017). Leadership Training Design, Delivery, and Implementation: A Meta-Analysis. Journal of Applied Psychology, 102, 1686–1718. https://doi.org/10.1037/apl0000241
Laschinger, H., McGillis Hall, L., Pedersen, C., & Almost, J. (2005). A Psychometric Analysis of the Patient Satisfaction With Nursing Care Quality Questionnaire. Journal of Nursing Care Quality, 20, 220–230. https://doi.org/10.1097/00001786-200507000-00006
Lee, S.-M., Ahn, B.-W., & Yu, M. (2024). Educational needs for nursing manager competency in Korean hospitals: multi-center cross-sectional study. BMC Nursing, 23(1), 918. https://doi.org/10.1186/s12912-024-02585-6
Li, X., Zhang, Y., Yan, D., Wen, F., & Zhang, Y. (2020). Nurses’ intention to stay: The impact of perceived organizational support, job control and job satisfaction. Journal of Advanced Nursing, 76(5), 1141–1150. https://doi.org/10.1111/jan.14305
Linda Roussel, Richard J. Swansburg, R. C. S. (2021). Management and Leadership for Nurse Administrators (fourth edi). Jones & Bartlett Publisher.
Lu, H., Zhao, Y., & While, A. (2020). Job satisfaction among hospital nurses: A literature review. International Journal of Nursing Studies, 94, 21–31. https://doi.org/10.1016/j.ijnurstu.2019.01.011
Lucas, P., Jesus, É., Almeida, S., & Araújo, B. (2023). Relationship of the nursing practice environment with the quality of care and patients’ safety in primary health care. BMC Nursing, 22(1), 413. https://doi.org/10.1186/s12912-023-01571-8
Lumbanraja, S., & Yuliana, N. (2021). The relationship between years of service and job satisfaction among nurses in a private hospital. Jurnal Keperawatan Dan Kebidanan, 12(2), 105–112.
Marquis, B. L., & Huston, C. J. (2011). Leadership Roles and Management Functions in Nursing: Theory and Application (9th ed.). Lippincott Williams & Wilkins.
Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: Theory and application (10th ed.). Wolters Kluwer Health.
McGonigle, D., & Mastrian, K. G. (2025). Nursing Informatics and the Foundation of Knowledge (Sixth edition). Jones & Bartlett Learning.
Mirzaei, A., Imashi, R., Yaghoobi Saghezchi, R., Jafari, M. J., & Nemati-Vakilabad, R. (2024). The relationship of perceived nurse manager competence with job satisfaction and turnover intention among clinical nurses: an analytical cross-sectional study. BMC Nursing, 23, 528. https://doi.org/10.1186/s12912-024-02203-5
Mulyani, S., & Sitorus, R. (2020). Pengaruh jenjang karir terhadap kinerja perawat pelaksana. Jurnal Keperawatan Indonesia, 23(1), 45–53. https://doi.org/10.7454/jki.v23i1.880
Murray, E. (2022). Nursing Leadership and Management for Patient Safety and Quality Care. Davis Company,.
Noor, S. (2022). Peningkatan Kinerja Perawat dan Kepuasan Klien: Model Komitmen Organisasi Berbasis Keyakinan Kesehatan. Salemba Medika.
Notoadmodjo. (2019). Pengantar ilmu perilaku kesehatan. Jakarta: PT. Rineka Cipta.
Notoatmodjo, S. (2014). Ilmu Perilaku Kesehatan. Rineka Cipta.
Noviyani, Warouw, H., & Palendeng, H. (2013). Hubungan Kepuasan Kerja dengan Prestasi Kerja Perawat PNS di Instalasi Rawat Inap Rumah Sakit Umum Daerah Kota Tidore Kepulauan. E-Jurnal Keperawatan (e-Kp), 1(1). https://ejournal.unsrat.ac.id/v2/index.php/jkp/article/view/2221
Nurmeksela, A., Kvist, T., Turunen, H., Mikkonen, K., & Partanen, P. (2024). Relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study. Journal of Nursing Management, [ISI]([ISI]), [ISI]-[ISI]. https://doi.org/10.1111/jonm.13963
Nursalam. (2020). Manajemen Keperawatan: Aplikasi dalam Praktik Keperawatan Profesional. Salemba Medika.
Nursalam. (2022). Manajemen Keperawatan: Aplikasi dalam Praktik Keperawatan Profesional (5th ed.). Salemba Medika.
Oducado, R. M., & Montaño, H. (2021). Workplace Assertiveness of Filipino Hospital Staff Nurses: A Cross-sectional Study. Nurse Media Journal of Nursing, 11, 294–304. https://doi.org/10.14710/nmjn.v11i3.39314
Paarima, Y., Kwashie, A., Asamani, J., & ansah ofei, adelaide maria. (2022). Leadership competencies of first-line nurse managers: a quantitative study. Leadership in Health Services, ahead-of-p. https://doi.org/10.1108/LHS-05-2021-0047
Peraturan Mentri Kesehatan RI. (2017). PERATURAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR 40 TAHUN 2017 TENTANG PENGEMBANGAN JENJANG KARIR PROFESIONAL PERAWAT KLINIS.
Pertiwi, B., & Hariyati, R. T. S. (2019). The impacts of career ladder system for nurses in hospital. Enfermería Clínica, 29, 106–110. https://doi.org/10.1016/j.enfcli.2019.04.016
Pirino, M. V. B., Nascimento Sobrinho, C. L., & Dini, A. P. (2023). Professional satisfaction in nursing during the COVID-19 pandemic. Revista latino-americana de enfermagem, 31, e3893. https://doi.org/10.1590/1518-8345.6364.3893
Potter, P. A. (2013). Fundamentals of nursing. St. Louis, Mo. : Mosby Elsevier.
Potter, & Perry. (2010). Buku Ajar Fundamental Keperawatan: Konsep, Proses, dan Praktik. EGC.
Pradiptha, I. D. A. G. F., Putra, M. M., Wijana, I. K., & Gayatri, G. (2024). The Relationship between Nurse Career Development and Job Satisfaction. Babali Nursing Research, 5(1), 196–204. https://doi.org/10.37363/bnr.2024.51359
Putri, A. D., & Widodo, T. (2021). Pengaruh masa kerja terhadap kepuasan kerja perawat di ruang rawat inap. Jurnal Kesehatan Dan Keperawatan Medika, 9(1), 33–41.
Rahmah, N. M., Wati, N. M. N., Martyastuti, N. E., Rachmawati, D. S., Prameswari, R. D., Wahyuningsih, G. N. S., Sastamidhyani, N. P. A. J., & others. (2023). MANAJEMEN KEPERAWATAN. PT. Sonpedia Publishing Indonesia. https://books.google.co.id/books?id=SxHAEAAAQBAJ
Rembet, I. Y., Wijayanty, C. D., & Susilo, W. H. (2023). Pengaruh Pelatihan Self Leadership Terhadap Clinical Leadership Competency Perawat Pelaksana di Dua Rumah Sakit Umum Swasta Tipe C Provinsi Sulawesi Utara. Aksara: Jurnal Ilmu Pendidikan Nonformal, 9(1), 421–436. https://doi.org/10.37905/aksara.9.1.421-436.2023
Rezaei, N., Sahebzadeh, M., & Amini-Rarani, M. (2024). The Relationship Between First-Line Nursing Managers’ Communication Skills and Nurses’ Job Satisfaction: A Systematic Review protocol. https://doi.org/10.21203/rs.3.rs-4279525/v1
Robbins, S. P., Judge, T., & Judge, T. (2018). Organizational Behavior. Pearson. https://books.google.co.id/books?id=yonBswEACAAJ
Rondonuwu, J. R., Bunga, A. L., & Susilo, W. H. (2019). The Impact of Leadership Training That Serves by Nursing Managers Towards Work Motivation and Clinical Care Performance. Jurnal Pendidikan, 7(2). https://doi.org/10.47718/jpd.v7i2.810
Sari, D. P., Lestari, A. R., & Putri, M. E. (2022). Educational background and job satisfaction among hospital nurses: A cross-sectional study. Nursing Journal of Indonesia, 12(1), 33–40.
Sari, N., Yandrizal, & Rahayu, D. (2023). Faktor-faktor yang berhubungan dengan kepuasan kerja perawat pelaksana di RSU Bengkulu. Jurnal Vokasi Keperawatan, 5(2), 85–93. https://ejournal.unib.ac.id/JurnalVokasiKeperawatan/article/view/33883
Schultz, T. R., Forbes, J., & Hafen Packard, A. (2024). Emergency Medical Treatment and Labor Act: Impact on Health Care, Nursing, Quality, and Safety. Quality Management in Health Care, 33(1), 39–43. https://doi.org/10.1097/QMH.0000000000000438
Sherman, R. O. (2015). Self-management in leadership. http://www.emergingrnleader.com/selfmanagement-in-leadership/
Shirey, M. R., & Fisher, M. L. (2008). Leadership agenda for change toward healthy work environments in acute and critical care. Critical Care Nurse, 28(5), 66–78. https://doi.org/10.4037/ccn2008.28.5.66
Silaen, P., & Pardede, J. A. (2020). Analisis peran kepala ruang dalam meningkatkan mutu pelayanan keperawatan di rumah sakit. Journal of Healthcare, 3(2), 85–94. https://journal.ukmc.ac.id/index.php/joh/article/view/1126
Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review. International Journal of Environmental Research and Public Health, 18(4). https://doi.org/10.3390/ijerph18041552
Sugiyono. (2019). Metodelogi Penelitian Kuantitatif dan Kualitatif Dan R&D. Bandung: Alfabeta.
Suhonen, R., Stolt, M., Habermann, M., Hjaltadóttir, I., Vryonides, S., & Tonnessen, S. (2021). Leadership and management competencies of head nurses and directors of nursing in European hospitals. Journal of Nursing Management, 29(4), 759–767. https://doi.org/10.1111/jonm.13193
Syapitri, H., Amila, & Aritonang, J. (2021). Buku Ajar Metodologi Penelitian Kesehatan. Ahlimedia Press.
Tomaszewska, K., Kowalczuk, K., Majchrowicz, B., Kłos, A., & Kalita, K. (2024). Areas of professional life and job satisfaction of nurses. Frontiers in Public Health, 12, 1370052. https://doi.org/10.3389/fpubh.2024.1370052
Tseng, P.-C. (2014). Organizational support, self-efficacy, and job satisfaction among school nurses in New Jersey. Seton Hall University.
Wang, L., Tao, H., Bowers, B. J., Brown, R., & Zhang, Y. (2019). When nurse emotional intelligence matters: How transformational leadership influences intent to stay. Journal of Nursing Management, 27(8), 1806–1814. https://doi.org/10.1111/jonm.12873
Weiss, S. A., Tappen, R. M., & Grimley, K. A. (2019). Essentials of nursing leadership & management (7th (ed.)). F. A. Davis Company. https://lccn.loc.gov/2019000397
Widodo, S., Ladyani, F., Asrianto, L. O., Dalfian, Nurcahyati, S., Devriany, A., Khairunnisa, Lestari, S. M. P., Rusdi, Wijayanti, D. R., Hidayat, A., Sjahriani, T., Armi, Widya, N., & Rogayah. (2023). Buku Ajar Metode Penelitian. CV. Science Techno Direct.
Wong, F. M. F. (2024). Job satisfaction in nursing: A qualitative inquiry into novice and experienced nurses’ perspectives. Nurse Education in Practice, 78, 104018. https://doi.org/10.1016/j.nepr.2024.104018
Yeh, T.-P., Lin, Y.-K., Lu, H.-Y., Bloomfield, J., & Chen, I.-H. (2025). Impact of Empowering Leadership Training Through Flipped Learning Approach on the Well-Being of Nursing Staff and Residents in Long-Term Care Settings. Journal of Nursing Management, 2025, 5815383. https://doi.org/10.1155/jonm/5815383
Yesilbas, H., & Kantek, F. (2024). Relationship between structural empowerment and job satisfaction among nurses: A meta-analysis. International Nursing Review, 71(3), 484–491. https://doi.org/10.1111/inr.12968
Yoder-Wise, P. S. (2019). Leading and Managing in Nursing (7th ed.). Elsevier.
Yusnaini, Y., Arif, Y., & Dorisnita, D. (2021). Kemampuan Kepemimpinan Klinis Perawat Pelaksana Berdasarkan Pendekatan Clinical Leadership Competency Framework dan Faktor-Faktor Determinannya. Jurnal Keperawatan Silampari, 4(2), 337–350. https://doi.org/10.31539/jks.v4i2.1914
Zhang, Y., Wu, J., Fang, Z., Zhang, Y., & Wong, F. K. (2021). Newly graduated nurses’ intention to leave in their first year of practice in China: a structural equation model. Journal of Nursing Management, 29(6), 1532–1542. https://doi.org/10.1111/jonm.13282
