Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Examining Variation in Mental Models of Influence and Leadership Among Nursing Leaders and Direct Care Nurses

Weaver, Sallie J. PhD, MHS; Mossburg, Sarah E. MS, BSN, RN; Pillari, MarieSarah BSN, RN; Kent, Paula S. MSN, MBA, RN; Daugherty Biddison, Elizabeth Lee MD, MPH

doi: 10.1097/NCQ.0000000000000298

This study explored similarities and differences in the views on team membership and leadership held by nurses in formal unit leadership positions and direct care nurses. We used a mixed-methods approach and a maximum variance sampling strategy, sampling from units with both high and low safety behaviors and safety culture scores. We identified several key differences in mental models of care team membership and leadership between formal leaders and direct care nurses that warrant further exploration.

Armstrong Institute for Patient Safety & Quality (Drs Weaver and Daugherty Biddison and Ms Kent), Johns Hopkins University School of Medicine (Drs Weaver and Daugherty Biddison), Johns Hopkins University School of Nursing (Dr Weaver and Ms Mossburg), and Johns Hopkins Hospital (Mss Pillari and Kent), Baltimore, Maryland.

Correspondence: Sallie J. Weaver, PhD, MHS, Dept. of Anesthesiology & Critical Care Medicine, and Armstrong Institute for Patient Safety & Quality, Johns Hopkins University School of Medicine, 750 East Pratt St, 15th Floor, Baltimore, MD 21202 (

This study was supported in part by a grant from the NIH NHLBI (K23HL098452 to the Johns Hopkins University) and a grant from the Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by grant no. 1KL2TR001077-01 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily reflect the official views of Johns Hopkins ICTR, NCATS, or NIH. The authors gratefully acknowledge Michelle Eakin, Myles Leslie, and Cynthia Rand for their helpful feedback in the development of this work.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: August 22, 2017

Published ahead of print: September 29, 2017

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved