Abstract

Background
The Magnet® accreditation journey to excellence (ANCC, 2008) has many standards and forces to achieve. One of the forces is transformational leadership and within the definition the term inspired motivation is raised. Even Hospitals not thinking about or commencing the Magnet® journey to excellence are using transformational leadership. In the work of Bass 1985 and Burns 1978 one word is never fully defined and so it can be viewed as the hidden twin within transformational leadership that word is motivation. Being involved in and working with Magnet® accreditation exposes many questions and an enquiring mind looks for answers. The heavy use of extrinsic motivation within Kingdom of Saudi Arabia rather than the drive of intrinsic motivation led to the development of the research question. The work of Bass and Avolio will be predominant along with that of Wijsman et al (2017) and many other leaders in the fields of transformational leadership and motivation. There is a void on this type of research as many just look and investigate one or other and never both together to enhance understanding and further questioning.
Methodology
To undertake a thorough examination of the research question, a mixed methods approach with a pragmatism style was implemented. Starting from the point of initial definition for Transformational Leadership right through to current trends and additions. The methods used included literature review and assimilated systematic review, questionnaire and focus group. The questionnaire was a hybrid formed from tried and tested questionnaires available for public use, Bass and Avolio’s MLQ (1992) leadership questionnaire and Kotera et al (2022) devised the ‘Shorter form of the work extrinsic and intrinsic motivation scale’ (SWEIMS). The MLQ was adjusted slightly to include some questions to replace existing question to reach the required data focus. The focus group consisted of participants who agreed to take part following submission of their completed questionnaires. The focus group was a deep
dive around the answers given to identify key themes and further elements in the discovery of a new definition. This research is an exploratory study as a far larger population will be required to substantiate a new definition or variation of definition. The participants were from 2 countries 9 from America and 5 from Saudi Arabia, they were Chief Nursing Officers or Directors of Magnet as this level of leader has not been used previously involved in any investigations.
Findings
The use of motivation was prevalent, both extrinsic and intrinsic with some organisations even having budget to support this. There was a strong feeling that this area of research needs to be carried forward. More of the participants took over during the journey than commenced it, with a wide variance of time from 2 to more than 7 years to attain the accreditation. For many they had to introduce transformational leadership which echoes Bass and Riggio (2006) who found that nurse leaders and staff had a weak awareness about the concept of transformational leadership. Within the leadership section of the questionnaire all 4 I’s (Idealized influence, Inspirational motivation, intellectual stimulation, and individualized consideration) of transformational leadership were present but only 3 questions had all 4 I’s. The motivation section highlighted the intrinsic and extrinsic motivation of the senior staff involved. The Focus group uncovered the reasons for taking over the journey, promotion, interhospital transfer and head hunted.
Discussion
3 hypotheses were proposed and all 3 had findings. The first concurred that motivation is an integral part of transformational leadership. The second was found to be less conclusive as this was a weakness in the questionnaire but was addressed in the focus group. The effect on other healthcare groups involved in Magnet® journey. A point that needs to be addressed in the next phase of this research discovery. The third hypothesis had a strong positive finding for such a small exploratory study; however, it would need additional validation in future research. A proposed model is also included which is in its infancy status. A proposed new model
has been drafted- engagement leadership.
Two biases were identified within this research, those of confirmation bias and selection bias. To negate both in the next steps, differing levels of staff to help will reduce the bias.
The participants feedback during the focus group also alluded to a further question to add to the leadership section; “All participants spoke of the use of motivation and transformational leadership” which fits well with the research question and also elicits the findings of differentials.
Conclusion
This exploratory research has opened the door to expand the work with some minor questionnaire alterations. The response rate for the pilot was well above expected levels, which demonstrates the interest in helping make a proactive updated definition for the conjoined twins of transformational leadership and motivation. It has allowed for development of a proposed new leadership model, the engagement leadership model.