Assessment of Knowledge on Clinical Leadership Skills Among Registered Nurses in Selected Units of a Tertiary Hospital, Riyadh, KSA: A Cross-Sectional Study

Assessment of Knowledge on Clinical Leadership Skills Among Registered Nurses in Selected Units of a Tertiary Hospital, Riyadh, KSA: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Knowledge on Clinical Leadership Skills Among Registered Nurses in Selected Units of a Tertiary Hospital, Riyadh, KSA: A Cross-Sectional Study Dr.Premalatha Jayachandra, Mr.Ahmed Alrasheedi, Mr.Yaseen Alrabae, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7784879/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The healthcare environment, particularly among nurses, increasingly faces significant challenges, including the need for strong and effective leadership. Clinical leadership is essential for improving patient outcomes, enhancing teamwork, and ensuring efficient healthcare delivery. This study aimed to assess clinical leadership skills among registered nurses working in the neuro units of a tertiary hospital in Riyadh, Saudi Arabia. Methods: A quantitative cross-sectional research design was adopted. Data were collected from 81 registered nurses using a structured leadership assessment tool that measured five core categories: demonstrating personal qualities, working with others, duty management, setting directions, and making decisions. The data were analyzed using SPSS version 25, employing descriptive statistics, reliability testing, and non-parametric tests to explore correlations between leadership skills and demographic variables. Results: The results revealed that duty management had the highest percentage of nurses rated as excellent (63.0%), indicating strong competencies in operational management and task prioritization. Similarly, 60.5% were rated excellent in working with others, reflecting strong teamwork and interpersonal skills. Over half of the participants (53.1%) scored excellent in setting directions and making decisions, demonstrating strategic thinking and sound decision-making abilities, although some nurses required further development in this area. Demonstrating personal qualities showed a near-equal distribution between good (49.4%) and excellent (48.1%), indicating overall self-awareness and resilience. The overall leadership ability averaged 59.3% at an excellent level, with only a small number of nurses requiring improvement. The leadership skills scale demonstrated high reliability (Cronbach’s alpha = 0.943). No significant correlations were found between leadership skills and demographic factors such as age, gender, education, or nationality, except for the shift leadership role, which significantly correlated with higher duty management scores (p = 0.022). Conclusion: This study highlights strong leadership capabilities among registered nurses, with decision-making and personal development identified as key areas for targeted growth. Structured leadership programs are recommended to further enhance nursing leadership performance and improve patient care outcomes. Nursing Leadership skills Registered nurses Duty management Training Shift leader Figures Figure 1 Introduction/Background Nurses collaborate with a diverse team of professional and non-professional personnel, including physicians, therapists, social workers, psychologists, technicians, aides, and unit managers. This multidisciplinary environment requires nurses to coordinate and communicate effectively across various skill levels to ensure continuity of care. In addition to providing direct patient care, nurses are often responsible for managing teams with varying competencies, which requires strong leadership and management skills to ensure smooth workflow and high-quality patient outcomes ( 1 ). Clinical leadership is defined as the ability of nurses who are directly involved in bedside care, and without formal authority, to influence healthcare team members toward achieving desired patient outcomes ( 2 ). However, several barriers hinder effective clinical leadership, including power dynamics, interdisciplinary challenges, and insufficient early professional socialization, as seen in Jordanian hospitals ( 3 ). Nursing experience significantly influences leadership development among staff nurses and intern students in Saudi Arabia, with clinical supervision and education enhancing leadership while work pressure, environmental stressors, and poor communication serve as obstacles ( 4 ). Transformational leadership skills, particularly among head nurses, are essential for improving organizational outcomes and should be cultivated through structured development roadmaps and continuous training ( 5 ). In Saudi Arabia, the nursing profession faces challenges such as staffing shortages, unclear scopes of practice, and inadequate policy frameworks. Addressing these issues is crucial to achieving alignment with Saudi Vision 2030, which seeks to elevate healthcare delivery to meet the highest international standards ( 6 ). Strong administrative, interpersonal, and conceptual leadership skills have been shown to positively influence employee performance and overall institutional quality ( 7 ). Effective leadership among senior registered nurses is pivotal for driving positive organizational change, optimizing team performance, and improving patient outcomes ( 8 ). Transformational leadership has been shown to positively influence work environments, organizational commitment, and patient safety outcomes, emphasizing the importance of enhancing leadership training ( 9 ). Conversely, high workload demands, lack of support, and poor leadership contribute to burnout among nurses, negatively affecting the quality of nursing work life ( 10 ). Transformational leadership mitigates these effects by fostering supportive environments and improving the Quality of Nursing Work Life (QNWL) through inspirational motivation and empowerment ( 11 ). The COVID-19 pandemic amplified these leadership challenges, underscoring the critical role of nurse leaders in fostering job satisfaction, autonomy, and retention. The Strengths-Based Nursing and Healthcare Leadership (SBNH-L) framework offers strategies to create empowering environments that support nurses during such crises ( 12 ). Programs like the Advanced Leadership Initiative have been shown to enhance structural empowerment among senior nurse leaders, reduce turnover, and improve patient experiences ( 13 ). Leadership gaps are particularly evident in specialized settings such as residential aged care, where limited educational opportunities and lack of after-hours leadership training impede quality and safety. Targeted interventions to enhance leadership competencies in these settings are essential ( 14 ). Nurse unit managers play a pivotal role in influencing nursing performance, making targeted management training critical for improving outcomes ( 15 ). Furthermore, effective communication by nurse managers has been linked to higher job satisfaction, innovative practices, and improved patient safety ( 16 ). Structured leadership programs have demonstrated success in improving clinical leadership competencies. For example, ICU charge nurses initially reported low levels of clinical leadership knowledge and competency, which improved significantly after participating in a focused leadership training program ( 17 ). Work-related well-being among nurse leaders is strongly associated with leadership skills, supportive working conditions, and lower burnout levels, highlighting the need for robust leadership development initiatives ( 18 ). Transformational leadership has consistently been shown to improve job satisfaction by emphasizing respect, care, and professional growth, while transactional leadership often results in dissatisfaction ( 19 ). Among pediatric registered nurses, both transformational and transactional leadership positively influenced job satisfaction, with autonomy being the most significant factor ( 20 ). In Saudi hospitals, clinical nursing leadership remains underdeveloped due to weak governance structures, limited professional involvement in decision-making, and insufficient leadership training. Strengthening nursing councils, expanding educational opportunities, and implementing transformational leadership programs are recommended to address these gaps ( 21 ). Empowering nurses through transformational leadership has also been linked to reduced adverse patient outcomes by fostering structural empowerment and clinical leadership practices at the point of care ( 22 ). Self-assessment studies have revealed significant variability in nurses perceived clinical leadership skills and emotional intelligence, indicating a need for workshops and mentorship programs to build capacity ( 23 ). Supportive nurse managers, adequate staffing, and positive nurse-physician relationships have been associated with healthier work environments and improved nursing performance quality ( 24 ). However, engagement in evidence-based practice (EBP) remains limited due to weak managerial support and underdeveloped knowledge management systems, emphasizing the need for organizational mentorship and supportive environments ( 25 ). The current study builds on these findings by examining the relationship between demographic and experiential factors and leadership competencies among registered nurses. Understanding how experiential learning, mentorship, and shift leadership roles influence leadership development can inform targeted interventions to enhance clinical leadership capacity. Prior studies have highlighted the importance of practical leadership exposure in fostering critical decision-making and problem-solving skills, with experiential learning playing a more significant role than demographic factors such as age or education ( 26 , 27 , 29 ) Materials and Methods Study Design and Setting Study Approach → Quantitative approach to measure leadership competencies Study Design → Cross-sectional descriptive design (Assess leadership competencies and Examine relationship with demographics) Study Setting → King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, Large multi-specialty tertiary care hospital (~ 1,500 beds) Study Population → Registered nurses at National Neuroscience Institute (NNI), SN1 level (bedside clinical nurses) Research Tool Questionnaire The data for this study were collected using two structured questionnaires. The first captured participants’ sociodemographic and professional characteristics, including age, gender, marital status, educational background, nationality, years of nursing experience, shift leadership role, and tenure at King Fahad Medical City (KFMC). The second questionnaire assessed clinical leadership skills using a modified version of the Leadership Practices Inventory (LPI) Self-Assessment, originally developed by Kouzes and Posner. The researcher adapted the tool to reflect the leadership competencies relevant to registered nurses and shift managers in the clinical setting. It comprises 40 items across five dimensions demonstrating personal qualities, collaborating with others, managing duties, setting direction, and making decisions rated on a five-point Likert scale, with higher scores indicating more frequent engagement in leadership behaviors. To ensure content validity, the modified instrument was reviewed by five PhD nursing experts, whose feedback was incorporated before finalization. The total score provides an overall measure of clinical leadership engagement among participants. Study Population and Sampling Technique All Registered Nurses in NNI at KFMC] →Purposive Sampling: Bedside Nurses Only →Target Sample: 100 Senior Registered Nurses (SN1, 12-hour shifts) →Voluntary Participation: 81 Nurses Agreed →Final Study Sample: 81 Bedside Nurses Prior to recruitment, the nursing leadership team and unit managers were informed about the study objectives and procedures. Eligible nurses were approached individually by the principal investigator, who explained the purpose of the study and obtained verbal informed consent. Participation was voluntary, and confidentiality was emphasized throughout the recruitment process. Sample Size Calculation Out of approximately 200 registered nurses working in the National Neuroscience Institute (NNI), the researcher targeted 100 nurses, including both male and female staff, who were working 12-hour shifts and held senior registered nurse positions at the SN1 level. The target sample size of 100 was determined based on the availability of SN1 nurses among the total 200 nurses. Based on the literature, the estimated prevalence of high clinical leadership competency among registered nurses was assumed to be 50% due to the absence of previous local data, which provides the maximum sample size and ensures adequate study power. The sample size was calculated using the standard formula for cross-sectional studies: n = Z2×p×(1 − p)/d2n = Z^2 \times p \times (1-p) / d^2n = Z2×p×(1 − p)/d2, where Z is the Z statistic for a 95% confidence level (1.96), p is the estimated prevalence (0.50), and d is the allowable margin of error (0.05). Substituting these values, the initial sample size was 384. Since the total number of registered nurses in NNI was only 200, the finite population correction (FPC) was applied, resulting in an adjusted sample size of 133. To account for a possible 10% non-response rate, the sample size was increased to 100. However, due to voluntary participation, a final sample of 81 nurses agreed to participate in the study. Statistical Analysis Data were analyzed with SPSS software version 25 (IBM Corp., Armonk, NY, USA). Categorical data (e.g., age group, gender, marital status, education) were tabulated as frequencies and percentages, while continuous data (e.g., leadership skills scores) were tabulated as mean ± standard deviation. Kolmogorov-Smirnov test was applied to check the normality of continuous data. Nonparametric tests were applied where normality did not exist. Internal consistency of leadership scale and subscales was assessed using Cronbach's alpha, with ≥ 0.70 being acceptable. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC, average measure). Statistical significance used a two-sided p-value < 0.05. Table 1 Internal Consistency of Leadership Skills Scale Items (N = 81) Item Code Mean ± SD Scale Mean if Item Deleted Scale Variance if Item Deleted Corrected Item-Total Correlation Cronbach’s Alpha if Item Deleted DPQ1 4.18 ± 0.78 168.48 210.586 .444 .943 DPQ2 4.01 ± 0.71 168.65 212.027 .424 .943 DPQ3 4.30 ± 0.56 168.35 214.027 .420 .942 SDMD10 4.33 ± 0.63 168.33 211.172 .524 .942 Internal Consistency of the Leadership Skills Scale The internal consistency of the leadership skills scale and its subscales was assessed using Cronbach’s alpha. The overall scale demonstrated excellent reliability, with a Cronbach’s alpha of 0.943. The corrected item-total correlations ranged from 0.420 to 0.668, indicating acceptable to strong correlations between each item and the overall scale. Furthermore, the removal of any single item did not significantly alter the overall reliability, as Cronbach’s alpha remained within a narrow range (0.941 to 0.943). These findings confirm that the leadership skills scale possesses high internal consistency and is a reliable tool for evaluating leadership competencies among nurses. Ethical approval and Consent to participate Ethical approval was obtained from the Institutional Review Board (IRB) of King Fahad Medical City (Approval No.26–063) Verbal informed consent was obtained from each participant. Confidentiality and anonymity of participant information were strictly maintained throughout the study. Results The Leadership Competency Scores demonstrate a high level of overall leadership competence among all participants. The majority of respondents scored in the "Good" (70–84%) to "Excellent" (85–100%) range, indicating a strong foundation in key leadership areas. No participants scored below 50%, suggesting that none required significant development. Duty Management received the highest proportion of "Excellent" marks, with 51 participants (63.0%) scoring above 85%, reflecting strong capabilities in managing duties, prioritizing tasks, and ensuring operational effectiveness. Working with Others also had a high proportion of top scores, with 49 participants (60.5%) rated as "Excellent," indicating well-developed interpersonal and teamwork skills. In Setting Direction and Making Decisions, over half of participants (53.1%) were rated "Excellent," highlighting strong decision-making and strategic thinking abilities. This domain also had the highest percentage of "Developing Needs Improvement" scores (6.2%, n = 5), but overall, 93.8% scored in the "Good" or better categories. Demonstrating Personal Attributes including self-awareness, integrity, and resilience showed a balanced distribution: 49.4% "Good" and 48.1% "Excellent," with only 2 participants (2.5%) at the "Developing" level, indicating minimal need for targeted personal development. Overall, 59.3% of participants demonstrated "Excellent" leadership ability, 39.5% were rated "Good," and just 1 participant (1.2%) was rated "Developing." No participant fell into the "Needs Significant Development" category, confirming a strong and mature leadership profile. Associations Between Demographics and Leadership Competencies Analysis of demographic factors revealed few statistically significant associations: Demonstrating Personal Qualities: No significant associations with age, gender, marital status, education, nationality, years of experience, or shift leadership role (p > 0.05 for all). This suggests uniform understanding across participant subgroups. Working with Others: No significant associations with any demographic factors (p > 0.05). Participants with shift leadership roles tended to score higher, but this was not statistically significant. Duty Management: Shift leadership role was significantly associated with higher scores (p = 0.022), indicating that nurses with leadership responsibilities were more likely to excel. Other variables showed trends toward significance (years of experience, p = 0.057; nationality, p = 0.062) but were not statistically significant. Setting Direction and Making Decisions: No demographic variables were significantly associated with competency scores (p > 0.05), though trends suggested higher scores among nurses over 30 years old, those educated outside KSA, and those with shift leadership roles. Baseline demographic characteristics of participants (N = 81) are summarized in Table 2 . The majority were female (82.7%), over 30 years old (85.2%), married (65.4%), held a BSN (65.4%), and had more than 10 years of nursing experience (42%). Most participants (61.7%) had a shift leadership role, and 90.1% were educated outside KSA. The full associations between demographic factors and each leadership competency are presented in Tables 3 – 6 . Across most domains, no significant associations were found, except for the Duty Management domain, where shift leadership role was significant (p = 0.022). Demographic Characteristics of Participants at Baseline (N = 81) Table 2 summarizes the baseline demographic and professional characteristics of the 81 participants. Variables Category n (%) Age 20–30 Years 12 14.8) > 30 years 69(85.2) Gender Male 14 (17.3) Female 67(82.7) Marital status Single 28 (34.6) Married 53(65.4) Educational Level Diploma 25(30.9) BSN 53(65.4) MSN 03(3.7) University graduated KSA 08 (9.9) Outside KSA 73(90.1) Nationality Saudi 10(12.3) Non -Saudi 71(87.7) Years of Nursing experience 1–5 years 26(32.1) 6–10 years 21(25.9) > 10 years 34(42.0) Shift leadership Role Yes 50(61.7) No 31(45.7) Years of Experience in KFMC 1–5 years 37(45.7) 6–10 years 17(21.0) > 10 years 27(33.3) The Leadership Competency Scores results demonstrate a high level of overall leadership competence in all areas for all of the participants. The majority of the respondents ranged from the "Good" (70–84%) to "Excellent" (85–100%) ranges, indicating a strong foundation in the key areas of leadership. No participants were seen to score less than 50% in any area, indicating that none of the participants were assessed as needing significant development. Table 3 Association Between Demographic Factors and Understanding of Demonstrating Personal Qualities (N = 81) Factor Category 30 years 0 (0.0%) 1 (50.0%) 32 (80.0%) 36 (92.3%) Gender Male 0 (0.0%) 1 (50.0%) 8 (20.0%) 5 (12.8%) 0.325 Female 0 (0.0%) 1 (50.0%) 32 (80.0%) 34 (87.2%) Marital Status Single 0 (0.0%) 1 (50.0%) 15 (37.5%) 12 (30.8%) 0.737 Married 0 (0.0%) 1 (50.0%) 25 (62.5%) 27 (69.2%) Education Diploma 0 (0.0%) 2 (100.0%) 15 (37.5%) 8 (20.5%) 0.115 BSN 0 (0.0%) 0 (0.0%) 24 (60.0%) 29 (74.4%) MSN 0 (0.0%) 0 (0.0%) 1 (2.5%) 2 (5.1%) University KSA 0 (0.0%) 0 (0.0%) 5 (12.5%) 3 (7.7%) 0.692 Outside KSA 0 (0.0%) 2 (100.0%) 35 (87.5%) 36 (92.3%) Nationality Saudi 0 (0.0%) 0 (0.0%) 7 (17.5%) 3 (7.7%) 0.361 Non -Saudi 0 (0.0%) 2 (100.0%) 33 (82.5%) 36 (92.3%) Years of Experience (Nursing) 1–5 years 0 (0.0%) 1 (50.0%) 15 (37.5%) 10 (25.6%) 0.989 6–10 years 0 (0.0%) 0 (0.0%) 14 (35.0%) 7 (17.9%) > 10 years 0 (0.0%) 1 (50.0%) 11 (27.5%) 22 (56.4%) Shift Leadership Role Yes 0 (0.0%) 1 (50.0%) 20 (50.0%) 29 (74.4%) 0.079 No 0 (0.0%) 1 (50.0%) 20 (50.0%) 10 (25.6%) Years of Experience (KFMC) 1–5 years 0 (0.0%) 1 (50.0%) 21 (52.5%) 15 (38.5%) 0.319 6–10 years 0 (0.0%) 1 (50.0%) 5 (12.5%) 11 (28.2%) > 10 years 0 (0.0%) 0 (0.0%) 14 (35.0%) 13 (33.3%) Note: Categorical data are presented as frequencies and percentages. Statistical significance was set at p < 0.05. The analysis examined associations between demographic factors and participants’ understanding of “Demonstrating Personal Qualities”, a core leadership competency. Across all demographic variables including age, gender, marital status, education, nationality, experience, and shift leadership role no statistically significant associations were found (all p-values > 0.05). This suggests that understanding of personal leadership qualities was uniform across participant subgroups. Table 4 Association Between Demographic Factors and Working with Others Competency (N = 81) Factor Category 30 years 0 (0.0%) 0 (0.0%) 27 (87.1%) 42 (85.7%) Gender Male 0 (0.0%) 1 (100.0%) 5 (16.1%) 8 (16.3%) 0.089 Female 0 (0.0%) 0 (0.0%) 26 (83.9%) 41 (83.7%) Marital Status Single 0 (0.0%) 0 (0.0%) 11 (35.5%) 17 (34.7%) 0.763 Married 0 (0.0%) 1 (100.0%) 20 (64.5%) 32 (65.3%) Education Diploma 0 (0.0%) 1 (100.0%) 12 (38.7%) 12 (24.5%) 0.397 BSN 0 (0.0%) 0 (0.0%) 18 (58.1%) 35 (71.4%) MSN 0 (0.0%) 0 (0.0%) 1 (3.2%) 2 (4.1%) University KSA 0 (0.0%) 0 (0.0%) 3 (9.7%) 5 (10.2%) 0.943 Outside KSA 0 (0.0%) 1 (100.0%) 28 (90.3%) 44 (89.8%) Nationality Saudi 0 (0.0%) 0 (0.0%) 5 (16.1%) 5 (10.2%) 0.684 Non -Saudi 0 (0.0%) 1 (100.0%) 26 (83.9%) 44 (89.8%) Years of Experience (Nursing) 1–5 years 0 (0.0%) 1 (100.0%) 12 (38.7%) 13 (26.5%) 0.461 6–10 years 0 (0.0%) 0 (0.0%) 8 (25.8%) 13 (26.5%) > 10 years 0 (0.0%) 0 (0.0%) 11 (35.5%) 23 (46.9%) Shift Leadership Role Yes 0 (0.0%) 0 (0.0%) 16 (51.6%) 34 (69.4%) 0.124 No 0 (0.0%) 1 (100.0%) 15 (48.4%) 15 (30.6%) Years of Experience (KFMC) 1–5 years 0 (0.0%) 1 (100.0%) 16 (51.6%) 20 (40.8%) 0.671 6–10 years 0 (0.0%) 0 (0.0%) 5 (16.1%) 12 (24.5%) > 10 years 0 (0.0%) 0 (0.0%) 10 (32.3%) 17 (34.7%) Note: Categorical data are presented as frequencies and percentages. Statistical significance This table examines the influence of demographic characteristics on participants’ performance in the "Working with Others" leadership competency. The distribution of scores across all categories showed no statistically significant association with variables such as age, gender, marital status, education, nationality, or years of experience (p > 0.05 for all). While some trends were observed such as participants with shift leadership roles tending to score higher these were not statistically significant. The findings suggest that the ability to work collaboratively was consistently demonstrated regardless of demographic background. Table 5 Association Between Demographic Factors and Duty Management Competency (N = 81) Factor Category 30 years 0 (0.0%) 3 (75.0%) 24 (92.3%) 44 (86.3%) Gender Male 0 (0.0%) 2 (50.0%) 3 (11.5%) 10 (19.6%) 0.619 Female 0 (0.0%) 2 (50.0%) 23 (88.5%) 41 (80.4%) Marital Status Single 0 (0.0%) 4 (100.0%) 7 (26.9%) 18 (35.3%) 0.741 Married 0 (0.0%) 0 (0.0%) 8 (30.8%) 33 (64.7%) Education Diploma 0 (0.0%) 0 (0.0%) 11 (42.3%) 14 (27.5%) 0.874 BSN 0 (0.0%) 0 (0.0%) 15 (57.7%) 35 (68.6%) MSN 0 (0.0%) 4 (100.0%) 11 (42.3%) 2 (3.9%) University KSA 0 (0.0%) 4 (100.0%) 10 (38.5%) 5 (9.8%) 0.558 Outside KSA 0 (0.0%) 0 (0.0%) 6 (23.1%) 46 (90.2%) Nationality Saudi 0 (0.0%) 0 (0.0%) 10 (38.5%) 5 (9.8%) 0.062 Non -Saudi 0 (0.0%) 1 (25.0%) 2 (7.7%) 46 (90.2%) Years of Experience (Nursing) 1–5 years 0 (0.0%) 3 (75.0%) 24 (92.3%) 15 (29.4%) 0.057 6–10 years 0 (0.0%) 2 (50.0%) 3 (11.5%) 13 (25.5%) > 10 years 0 (0.0%) 2 (50.0%) 23 (88.5%) 23 (45.1%) Shift Leadership Role Yes 0 (0.0%) 4 (100.0%) 7 (26.9%) 35 (68.6%) 0.022 * No 0 (0.0%) 0 (0.0%) 8 (30.8%) 16 (31.4%) Years of Experience (KFMC) 1–5 years 0 (0.0%) 0 (0.0%) 11 (42.3%) 23 (45.1%) 0.256 6–10 years 0 (0.0%) 0 (0.0%) 15 (57.7%) 11 (21.6%) > 10 years 0 (0.0%) 4 (100.0%) 11 (42.3%) 17 (33.3%) Note: Data are presented as frequency (percentage). Statistical significance was set at p < 0.05. Bolded p-values indicate statistical significance. Table 5 shows the association between demographic factors and nurses’ competency in Duty Management. The only demographic factor found to have a statistically significant association was shift leadership role (p = 0.022). Nurses with leadership responsibilities were more likely to score in the “Excellent” category for duty management. Other variables, such as age, education level, nationality, or years of experience, did not show significant associations (p > 0.05), although a few trends approached significance particularly years of nursing experience (p = 0.057) and nationality (p = 0.062). Table 6 Association Between Demographic Factors and Setting Direction and Making Decisions Competency (N = 81) Factor Category < 50% (n, %) 50–69% (n, %) 70–84% (n, %) 85–100% (n, %) p-value Age 20–30 Years 30 years 0 (0.0%) 2 (50.0%) 23 (88.5%) 44 (86.3%) Gender Male 0 (0.0%) 1 (25.0%) 3 (11.5%) 10 (19.6%) 0.619 Female 0 (0.0%) 3 (75.0%) 23 (88.5%) 41 (80.4%) Marital Status Single 0 (0.0%) 2 (50.0%) 8 (30.8%) 18 (35.3%) 0.741 Married 0 (0.0%) 2 (50.0%) 18 (69.2%) 33 (64.7%) Education Diploma 0 (0.0%) 2 (50.0%) 9 (34.6%) 14 (27.5%) 0.874 BSN 0 (0.0%) 2 (50.0%) 16 (61.5%) 35 (68.6%) MSN 0 (0.0%) 0 (0.0%) 1 (3.8%) 2 (3.9%) University KSA 0 (0.0%) 1 (25.0%) 2 (7.7%) 5 (9.8%) 0.558 Outside KSA 0 (0.0%) 3 (75.0%) 24 (92.3%) 46 (90.2%) Nationality Saudi 0 (0.0%) 2 (50.0%) 3 (11.5%) 5 (9.8%) 0.062 Non -Saudi 0 (0.0%) 2 (50.0%) 23 (88.5%) 46 (90.2%) Years of Experience (Nursing) 1–5 years 0 (0.0%) 4 (100.0%) 7 (26.9%) 15 (29.4%) 0.057 6–10 years 0 (0.0%) 0 (0.0%) 8 (30.8%) 13 (25.5%) > 10 years 0 (0.0%) 0 (0.0%) 11 (42.3%) 23 (45.1%) Shift Leadership Role Yes 0 (0.0%) 0 (0.0%) 15 (57.7%) 35 (68.6%) 0.022 * No 0 (0.0%) 4 (100.0%) 11 (42.3%) 16 (31.4%) Years of Experience (KFMC) 1–5 years 0 (0.0%) 4 (100.0%) 10 (38.5%) 23 (45.1%) 0.256 6–10 years 0 (0.0%) 0 (0.0%) 6 (23.1%) 11 (21.6%) > 10 years 0 (0.0%) 0 (0.0%) 10 (38.5%) 17 (33.3%) Note: Data presented as frequency (percentage). Statistical significance set at p < 0.05. No statistically significant associations were found. Interpretation Table 6 explores the relationship between demographic variables and nurses’ competency in Setting Direction and Making Decisions. While descriptive differences are evident for example, those with higher education levels and shift leadership roles more frequently score in the “Excellent” category none of the associations reached statistical significance (p > 0.05). Notably, nurses over the age of 30 and those educated outside KSA were more likely to score higher, but this did not reach statistical significance. These findings suggest that while trends exist, other factors beyond basic demographics may more strongly influence decision-making competencies. Discussion This study synthesizes evidence regarding factors influencing nursing leadership competencies and the impact on patient care outcomes. Experiential learning and shift leadership roles emerged as the most significant determinants of effective leadership, particularly in duty management, decision-making, teamwork, and demonstration of personal qualities. Nurses with direct leadership responsibilities scored higher in duty management, underscoring the importance of hands-on leadership experience in clinical settings [26]. Demographic variables, including age, gender, education level, and years of experience, were not significantly associated with leadership competencies, suggesting that practical exposure and engagement in leadership tasks play a more crucial role than formal qualifications [27,28]. Experiential learning, mentorship, and structured leadership programs have been consistently shown to enhance strategic thinking, critical decision-making, and problem-solving competencies among nurses [29,31]. Transformational leadership consistently demonstrates positive effects on nurse outcomes, including improved work environments, higher job satisfaction, enhanced organizational commitment, and reduced adverse patient events [19,20,22]. In contrast, transactional leadership, particularly when focused on error monitoring and punitive measures, negatively impacts staff satisfaction and performance [19]. Empowering nurses through transformational leadership fosters structural empowerment, clinical leadership at the point of care, and ultimately safer patient outcomes [22]. Organizational support, including adequate staffing, resource allocation, positive nurse-physician relationships, and opportunities for professional development, further enhances nurses’ health-promoting behaviors and perceived performance quality [24]. Moreover, evidence-based practice (EBP) implementation and knowledge management (KM) require strong managerial support and structured training programs, highlighting the need for visible leadership engagement and mentorship [25]. The findings underscore that while demographic factors have limited influence, practical leadership exposure and structured experiential opportunities are pivotal in cultivating effective nursing leadership. Healthcare organizations should prioritize formal leadership programs, mentorship, and skill development workshops to ensure that bedside nurses can manage clinical duties effectively, collaborate efficiently, and make informed decisions. Additionally, aligning leadership development strategies with national healthcare objectives, such as Saudi Vision 2030, can strengthen workforce capacity and improve patient care quality [6]. Overall, the synthesis emphasizes that investing in transformational leadership development, organizational support, and experiential learning opportunities is essential for enhancing nursing leadership competencies, improving staff satisfaction, and promoting high-quality patient outcomes across diverse healthcare settings. Conclusions The findings highlight shift leadership role and number of years as vital predictors of the development of registered nurses' leadership competency. Formal training in leadership and immediate involvement in leadership activities are noted to have a significant effect on acquiring skills, particularly in duty management and decision-making. The findings highlight practical leadership experience and targeted training as vital interventions in boosting nursing professionals' capability. Conversely, age, sex, educational background, and employment experience within the current institution lacked any pattern or impact, which indicates that demographic factors are not sufficient in leadership competency prediction. It might not lead to leadership quality solely based on experience but must be supported by appropriate mentorship as well as leadership development programs. Recommendations: Based on the study findings, it is recommended that nursing leadership competency be enhanced through a combination of formal training, practical experience, and mentorship. Structured leadership development programs focusing on duty management, decision-making, and team coordination should be implemented, alongside opportunities for nurses to gain hands-on leadership experience, such as assuming shift-lead responsibilities or leading small projects. Mentorship initiatives are also essential, pairing less experienced nurses with seasoned leaders to guide and support the application of leadership skills in practice. Interventions should be tailored to role-specific needs rather than demographic factors, as age, sex, education, and institutional experience were not significant predictors of leadership competency. Finally, continuous assessment and feedback mechanisms should be established to monitor progress and ensure ongoing development of leadership capabilities among nursing professionals. Abbreviations WHO World Health Organization COVID-19 Coronavirus Disease 2019 EBP Evidence-Based Practice KM Knowledge Management SE Structural Empowerment QNWL Quality of Nursing Work Life RN Registered Nurse NNI National Neuroscience Institute MRI Magnetic Resonance Imaging ICU Intensive Care Unit., SPSS:Statistical Package for the Social Sciences. Declarations Ethics approval and consent to participate : Ethical approval for this study was obtained from the Institutional Review Board (IRB) of King Fahad Medical City (Approval No.: 25–063). Official permissions were also obtained from the relevant hospital administration. All participants provided informed consent, and their identities were strictly kept confidential. Consent for publication : Not applicable. Competing interests : The authors declare that they have no competing interests. Authors’ contributions PJC, AAR, DLS, and RJD conceptualized the study. PJC collected the data and conducted statistical analysis. PJC, AAR, DLS, and YAR contributed to data interpretation and manuscript preparation. All authors read and approved the final manuscript. Funding: This study did not receive any financial support from King Fahad Medical City or any other institution. Acknowledgments: The authors would like to thank the hospital administration and nursing staff for their support and cooperation throughout the study. Availability of data and materials: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. References Tappen, R. M., Weiss, S. A., & Whitehead, D. K. 3 rd edition 2001, Essentials of nursing leadership and management. F. A. Davis Company. Dbass et al. (2011) Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review. International Journal of Evidence-Based Healthcare December 9(4): pp 388-402 Algunmeeyn A, Mrayyan MT, Suliman WA, Abunab HY, Al-Rjoub S. Effective clinical nursing leadership in hospitals: barriers from the perspectives of nurse managers. BMJ Lead. 2024 Mar 18;8(1):20-24. doi: 10.1136/leader-2022-000681. PMID: 37248037; PMCID: PMC12038153. Alilyyani B, Althobaiti E, Al-Talhi M, Almalki T, Alharthy T, Alnefaie M, Talbi H, Abuzaid A. Nursing experience and leadership skills among staff nurses and intern nursing students in Saudi Arabia: a mixed methods study. BMC Nurs. 2024 Feb 2;23(1):87. doi: 10.1186/s12912-024-01750-1. PMID: 38308273; PMCID: PMC10835976. Amer (2023). A cross-sectional study of leadership styles and transformational leadership skills among nurse leaders in Qatar. PubMed, National Library of Medicine, Jun;10(6):3440-3446. Alsufyani AM, Alforihidi MA, Almalki KE, Aljuaid SM, Alamri AA, Alghamdi MS. Linking the Saudi Arabian 2030 vision with nursing transformation in Saudi Arabia: Roadmap for nursing policies and strategies. Int J Afr Nurs Sci. 2020; 13:100256. doi: 10.1016/j.ijans.2020.100256. Epub 2020 Oct 14. PMID: 33072514; PMCID: PMC7553899. Deepa, P. (2020). A study on leadership skills and its impact on employee performance. International Journal of Creative Research Thoughts (IJCRT), 8 (4), 2320-2882 Bryan et al. (2021). Developing Effective Senior Nurse Leaders: The Impact of an Advanced Leadership Initiative. JONA: The Journal of Nursing Administration 51(5):p 271-278, May 2021. Ystaas LMK, Nikitara M, Ghobrial S, Latzourakis E, Polychronis G, Constantinou CS. The Impact of Transformational Leadership in the Nursing Work Environment and Patients' Outcomes: A Systematic Review. Nurs Rep. 2023 Sep 11;13(3):1271-1290. Alves P.C., Oliveira A.D.F., Paro H. Quality of life and burnout among faculty members: How much does the field of knowledge matter? PLoS ONE. 2019;14: e0214217. doi: 10.1371/journal.pone.0214217. Suratno K. The relationship between transformational leadership and quality of nursing work life in hospital. Int. J. Caring Sci. 2018; 11:1416–1422. Gottlieb LN, Gottlieb B, Bitzas V. Creating Empowering Conditions for Nurses with Workplace Autonomy and Agency: How Healthcare Leaders Could Be Guided by Strengths-Based Nursing and Healthcare Leadership (SBNH-L). J Health Leadership. 2021 Jul 27; 13:169-181. Sisk BW, Mosier SS, Williams MD, Coppin JD, Robinson D. Developing Effective Senior Nurse Leaders: The Impact of an Advanced Leadership Initiative. J Nurs Adm. 2021 May 1;51(5):271-278. Nhongo D, Hendricks J, Bradshaw J, Bail K. Leadership and registered nurses (RNs) working after-hours in Residential Aged Care Facilities (RACFs): A structured literature review. J Clin Nurs. 2018 Nov;27(21-22):3872-3881. Patarru, F., Weu, B. Y., & Handini, F. S. (2020). The role of the nurse unit manager function on nursing work performance: A systematic review. Jurnal NERS, 14(3), 231. Fowler KR, Robbins LK, Lucero A. Nurse manager communication and outcomes for nursing: An integrative review. J Nurs Manag. 2021 Sep;29(6):1486-1495. Hoda Hassan et al (2020). Efficacy of Application of Clinical Leadership Competencies Program on Charge Nurses Based on Self Need Assessment. Tanta Scientific Nursing Journal, Volume 19, Issue 1, Pages 60-92. Niinihuhta M, Terkamo-Moisio A, Kvist T, Häggman-Laitila A. A comprehensive evaluation of factors affecting nurse leaders' work-related well-being. Leadersh Health Serv (Bradf Engl). 2022 May 13; ahead-of-print(ahead-of-print):460–74. Morsiani, G., Bagnasco, A., & Sasso, L. (2017). How staff nurses perceive the impact of nurse managers" leadership style in terms of job satisfaction: a mixed method study. Journal of nursing management, 25(2), 119-128 Reneé Roberts-Turner et al. (2014). Effects of Leadership Characteristics on Pediatric Registered Nurses' Job Satisfaction. pediatric nursing/September-October 2014/Vol. 40/No. 5 236-41, 256. Salha F. Alasiri (2019). Strengthening Nurses Clinical Leadership in Saudi Hospitals. IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 8, Issue 1 Ser. IX. (Jan. - Feb .2019), PP 55–64. Sheila Boamah (2017). Linking Nurses' Clinical Leadership to Patient Care Quality: The Role of Transformational Leadership and Workplace Empowerment. Canadian Journal of Nursing Research. 2018;50(1):9-19. Valerie Wright et al. (2020). Registered Nurses' Self-Assessment of Their Clinical Leadership Knowledge and Competence, Journal of Excellence in Nursing and Healthcare Practice 2020, Volume 2, Issue 2, Pages 17–23 Cho H, Han K. (2018) Associations among nursing work environment, health-promoting behaviors of nurses, and nursing performance quality: a multilevel modeling approach. J Nur's Scholarsh. 50(4):403-410. Anne Lunden et al. (2020). Readiness and leadership in evidence-based practice and knowledge management: A cross-sectional survey of nurses' perceptions, Nordic Journal of Nursing Research, December Issue 41(4):187–196. Cummings G, Tate K, Lee S, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. Int J Nurs Stud. 2018; 85:19-60. Wong CA, Cummings GG. The relationship between nursing leadership and patient outcomes: A systematic review. J Nurs Manag. 2007; 15:508–521. Gilmartin MJ. Leadership in healthcare: A review of research. Nurs Manage. 2017;48(3):26-33. Wang D, Hu Q, Zhang T, et al. The impact of experiential learning on leadership competencies among clinical nurses. J Nurs Adm. 2020;50(4):210-216. Aiken LH, Sloane DM, Bruyneel L, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet. 2012; 383:1824–1830. Drenkard K. The journey to leadership excellence in nursing: Strategies for success. Nurs Clin North Am. 2014;49(4):537-549 Bessie Marquis (2017 Leadership Roles and Management functions in Nursing AJN BOOK, Michigan Publications. Pp 45–48) Other references: Bennis WG (2009). On becoming a leader. New York, NY: Basic Books. https://www.tripodpartners.com › Nursing -2024 https://www.spencerclarkegroup.co.uk/about-us/careers/2017 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7784879","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":524911507,"identity":"6cad8714-cb84-4423-a4ea-af8333b811e1","order_by":0,"name":"Dr.Premalatha 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09:40:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1989246,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7784879/v1/25bb37cd-9169-4bed-bad3-b820be124ba1.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eAssessment of Knowledge on Clinical Leadership Skills Among Registered Nurses in Selected Units of a Tertiary Hospital, Riyadh, KSA: A Cross-Sectional Study\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction/Background","content":"\u003cp\u003eNurses collaborate with a diverse team of professional and non-professional personnel, including physicians, therapists, social workers, psychologists, technicians, aides, and unit managers. This multidisciplinary environment requires nurses to coordinate and communicate effectively across various skill levels to ensure continuity of care. In addition to providing direct patient care, nurses are often responsible for managing teams with varying competencies, which requires strong leadership and management skills to ensure smooth workflow and high-quality patient outcomes (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eClinical leadership is defined as the ability of nurses who are directly involved in bedside care, and without formal authority, to influence healthcare team members toward achieving desired patient outcomes (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). However, several barriers hinder effective clinical leadership, including power dynamics, interdisciplinary challenges, and insufficient early professional socialization, as seen in Jordanian hospitals (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Nursing experience significantly influences leadership development among staff nurses and intern students in Saudi Arabia, with clinical supervision and education enhancing leadership while work pressure, environmental stressors, and poor communication serve as obstacles (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTransformational leadership skills, particularly among head nurses, are essential for improving organizational outcomes and should be cultivated through structured development roadmaps and continuous training (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In Saudi Arabia, the nursing profession faces challenges such as staffing shortages, unclear scopes of practice, and inadequate policy frameworks. Addressing these issues is crucial to achieving alignment with Saudi Vision 2030, which seeks to elevate healthcare delivery to meet the highest international standards (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Strong administrative, interpersonal, and conceptual leadership skills have been shown to positively influence employee performance and overall institutional quality (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eEffective leadership among senior registered nurses is pivotal for driving positive organizational change, optimizing team performance, and improving patient outcomes (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Transformational leadership has been shown to positively influence work environments, organizational commitment, and patient safety outcomes, emphasizing the importance of enhancing leadership training (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Conversely, high workload demands, lack of support, and poor leadership contribute to burnout among nurses, negatively affecting the quality of nursing work life (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Transformational leadership mitigates these effects by fostering supportive environments and improving the Quality of Nursing Work Life (QNWL) through inspirational motivation and empowerment (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe COVID-19 pandemic amplified these leadership challenges, underscoring the critical role of nurse leaders in fostering job satisfaction, autonomy, and retention. The Strengths-Based Nursing and Healthcare Leadership (SBNH-L) framework offers strategies to create empowering environments that support nurses during such crises (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Programs like the Advanced Leadership Initiative have been shown to enhance structural empowerment among senior nurse leaders, reduce turnover, and improve patient experiences (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eLeadership gaps are particularly evident in specialized settings such as residential aged care, where limited educational opportunities and lack of after-hours leadership training impede quality and safety. Targeted interventions to enhance leadership competencies in these settings are essential (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Nurse unit managers play a pivotal role in influencing nursing performance, making targeted management training critical for improving outcomes (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Furthermore, effective communication by nurse managers has been linked to higher job satisfaction, innovative practices, and improved patient safety (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eStructured leadership programs have demonstrated success in improving clinical leadership competencies. For example, ICU charge nurses initially reported low levels of clinical leadership knowledge and competency, which improved significantly after participating in a focused leadership training program (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Work-related well-being among nurse leaders is strongly associated with leadership skills, supportive working conditions, and lower burnout levels, highlighting the need for robust leadership development initiatives (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTransformational leadership has consistently been shown to improve job satisfaction by emphasizing respect, care, and professional growth, while transactional leadership often results in dissatisfaction (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Among pediatric registered nurses, both transformational and transactional leadership positively influenced job satisfaction, with autonomy being the most significant factor (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn Saudi hospitals, clinical nursing leadership remains underdeveloped due to weak governance structures, limited professional involvement in decision-making, and insufficient leadership training. Strengthening nursing councils, expanding educational opportunities, and implementing transformational leadership programs are recommended to address these gaps (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Empowering nurses through transformational leadership has also been linked to reduced adverse patient outcomes by fostering structural empowerment and clinical leadership practices at the point of care (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSelf-assessment studies have revealed significant variability in nurses perceived clinical leadership skills and emotional intelligence, indicating a need for workshops and mentorship programs to build capacity (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Supportive nurse managers, adequate staffing, and positive nurse-physician relationships have been associated with healthier work environments and improved nursing performance quality (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). However, engagement in evidence-based practice (EBP) remains limited due to weak managerial support and underdeveloped knowledge management systems, emphasizing the need for organizational mentorship and supportive environments (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe current study builds on these findings by examining the relationship between demographic and experiential factors and leadership competencies among registered nurses. Understanding how experiential learning, mentorship, and shift leadership roles influence leadership development can inform targeted interventions to enhance clinical leadership capacity. Prior studies have highlighted the importance of practical leadership exposure in fostering critical decision-making and problem-solving skills, with experiential learning playing a more significant role than demographic factors such as age or education (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e)\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy Design and Setting\u003c/h2\u003e\u003cp\u003eStudy Approach \u0026rarr; Quantitative approach to measure leadership competencies\u003c/p\u003e\u003cp\u003eStudy Design \u0026rarr; Cross-sectional descriptive design (Assess leadership competencies and Examine relationship with demographics)\u003c/p\u003e\u003cp\u003eStudy Setting \u0026rarr; King Fahad Medical City (KFMC), Riyadh, Saudi Arabia, Large multi-specialty tertiary care hospital (~\u0026thinsp;1,500 beds)\u003c/p\u003e\u003cp\u003eStudy Population \u0026rarr; Registered nurses at National Neuroscience Institute (NNI), SN1 level (bedside clinical nurses)\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eResearch Tool Questionnaire\u003c/h3\u003e\n\u003cp\u003eThe data for this study were collected using two structured questionnaires. The first captured participants\u0026rsquo; sociodemographic and professional characteristics, including age, gender, marital status, educational background, nationality, years of nursing experience, shift leadership role, and tenure at King Fahad Medical City (KFMC).\u003c/p\u003e\u003cp\u003eThe second questionnaire assessed clinical leadership skills using a modified version of the Leadership Practices Inventory (LPI) Self-Assessment, originally developed by Kouzes and Posner. The researcher adapted the tool to reflect the leadership competencies relevant to registered nurses and shift managers in the clinical setting.\u003c/p\u003e\u003cp\u003eIt comprises 40 items across five dimensions demonstrating personal qualities, collaborating with others, managing duties, setting direction, and making decisions rated on a five-point Likert scale, with higher scores indicating more frequent engagement in leadership behaviors.\u003c/p\u003e\u003cp\u003eTo ensure content validity, the modified instrument was reviewed by five PhD nursing experts, whose feedback was incorporated before finalization. The total score provides an overall measure of clinical leadership engagement among participants.\u003c/p\u003e\n\u003ch3\u003eStudy Population and Sampling Technique\u003c/h3\u003e\n\u003cp\u003eAll Registered Nurses in NNI at KFMC] \u0026rarr;Purposive Sampling: Bedside Nurses Only \u0026rarr;Target Sample: 100 Senior Registered Nurses (SN1, 12-hour shifts) \u0026rarr;Voluntary Participation: 81 Nurses Agreed \u0026rarr;Final Study Sample: 81 Bedside Nurses\u003c/p\u003e\u003cp\u003ePrior to recruitment, the nursing leadership team and unit managers were informed about the study objectives and procedures. Eligible nurses were approached individually by the principal investigator, who explained the purpose of the study and obtained verbal informed consent. Participation was voluntary, and confidentiality was emphasized throughout the recruitment process.\u003c/p\u003e\n\u003ch3\u003eSample Size Calculation\u003c/h3\u003e\n\u003cp\u003eOut of approximately 200 registered nurses working in the National Neuroscience Institute (NNI), the researcher targeted 100 nurses, including both male and female staff, who were working 12-hour shifts and held senior registered nurse positions at the SN1 level. The target sample size of 100 was determined based on the availability of SN1 nurses among the total 200 nurses.\u003c/p\u003e\u003cp\u003e Based on the literature, the estimated prevalence of high clinical leadership competency among registered nurses was assumed to be 50% due to the absence of previous local data, which provides the maximum sample size and ensures adequate study power. The sample size was calculated using the standard formula for cross-sectional studies: n\u0026thinsp;=\u0026thinsp;Z2\u0026times;p\u0026times;(1\u0026thinsp;\u0026minus;\u0026thinsp;p)/d2n\u0026thinsp;=\u0026thinsp;Z^2 \\times p \\times (1-p) / d^2n\u0026thinsp;=\u0026thinsp;Z2\u0026times;p\u0026times;(1\u0026thinsp;\u0026minus;\u0026thinsp;p)/d2, where Z is the Z statistic for a 95% confidence level (1.96), p is the estimated prevalence (0.50), and d is the allowable margin of error (0.05).\u003c/p\u003e\u003cp\u003eSubstituting these values, the initial sample size was 384. Since the total number of registered nurses in NNI was only 200, the finite population correction (FPC) was applied, resulting in an adjusted sample size of 133. To account for a possible 10% non-response rate, the sample size was increased to 100. However, due to voluntary participation, a final sample of 81 nurses agreed to participate in the study.\u003c/p\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eData were analyzed with SPSS software version 25 (IBM Corp., Armonk, NY, USA). Categorical data (e.g., age group, gender, marital status, education) were tabulated as frequencies and percentages, while continuous data (e.g., leadership skills scores) were tabulated as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation. Kolmogorov-Smirnov test was applied to check the normality of continuous data. Nonparametric tests were applied where normality did not exist.\u003c/p\u003e\u003cp\u003eInternal consistency of leadership scale and subscales was assessed using Cronbach's alpha, with \u0026ge;\u0026thinsp;0.70 being acceptable. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC, average measure). Statistical significance used a two-sided p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eInternal Consistency of Leadership Skills Scale Items (N\u0026thinsp;=\u0026thinsp;81)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eItem Code\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eScale Mean if Item Deleted\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eScale Variance if Item Deleted\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCorrected Item-Total Correlation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eCronbach\u0026rsquo;s Alpha if Item Deleted\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDPQ1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e168.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e210.586\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.444\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.943\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDPQ2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e168.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e212.027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.424\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.943\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDPQ3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e168.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e214.027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.420\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.942\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSDMD10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e168.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e211.172\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.524\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.942\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003eInternal Consistency of the Leadership Skills Scale\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe internal consistency of the leadership skills scale and its subscales was assessed using Cronbach\u0026rsquo;s alpha. The overall scale demonstrated excellent reliability, with a Cronbach\u0026rsquo;s alpha of 0.943. The corrected item-total correlations ranged from 0.420 to 0.668, indicating acceptable to strong correlations between each item and the overall scale.\u003c/p\u003e\u003cp\u003eFurthermore, the removal of any single item did not significantly alter the overall reliability, as Cronbach\u0026rsquo;s alpha remained within a narrow range (0.941 to 0.943). These findings confirm that the leadership skills scale possesses high internal consistency and is a reliable tool for evaluating leadership competencies among nurses.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eEthical approval and Consent to participate\u003c/strong\u003e\u003cp\u003e Ethical approval was obtained from the Institutional Review Board (IRB) of King Fahad Medical City (Approval No.26\u0026ndash;063) Verbal informed consent was obtained from each participant. Confidentiality and anonymity of participant information were strictly maintained throughout the study.\u003c/p\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe Leadership Competency Scores demonstrate a high level of overall leadership competence among all participants. The majority of respondents scored in the \"Good\" (70\u0026ndash;84%) to \"Excellent\" (85\u0026ndash;100%) range, indicating a strong foundation in key leadership areas. No participants scored below 50%, suggesting that none required significant development.\u003c/p\u003e\u003cp\u003eDuty Management received the highest proportion of \"Excellent\" marks, with 51 participants (63.0%) scoring above 85%, reflecting strong capabilities in managing duties, prioritizing tasks, and ensuring operational effectiveness. Working with Others also had a high proportion of top scores, with 49 participants (60.5%) rated as \"Excellent,\" indicating well-developed interpersonal and teamwork skills.\u003c/p\u003e\u003cp\u003e In Setting Direction and Making Decisions, over half of participants (53.1%) were rated \"Excellent,\" highlighting strong decision-making and strategic thinking abilities. This domain also had the highest percentage of \"Developing Needs Improvement\" scores (6.2%, n\u0026thinsp;=\u0026thinsp;5), but overall, 93.8% scored in the \"Good\" or better categories.\u003c/p\u003e\u003cp\u003e Demonstrating Personal Attributes including self-awareness, integrity, and resilience showed a balanced distribution: 49.4% \"Good\" and 48.1% \"Excellent,\" with only 2 participants (2.5%) at the \"Developing\" level, indicating minimal need for targeted personal development.\u003c/p\u003e\u003cp\u003e Overall, 59.3% of participants demonstrated \"Excellent\" leadership ability, 39.5% were rated \"Good,\" and just 1 participant (1.2%) was rated \"Developing.\" No participant fell into the \"Needs Significant Development\" category, confirming a strong and mature leadership profile.\u003c/p\u003e\n\u003ch3\u003eAssociations Between Demographics and Leadership Competencies\u003c/h3\u003e\n\u003cp\u003eAnalysis of demographic factors revealed few statistically significant associations:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eDemonstrating Personal Qualities: No significant associations with age, gender, marital status, education, nationality, years of experience, or shift leadership role (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05 for all). This suggests uniform understanding across participant subgroups.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eWorking with Others: No significant associations with any demographic factors (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Participants with shift leadership roles tended to score higher, but this was not statistically significant.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eDuty Management: Shift leadership role was significantly associated with higher scores (p\u0026thinsp;=\u0026thinsp;0.022), indicating that nurses with leadership responsibilities were more likely to excel. Other variables showed trends toward significance (years of experience, p\u0026thinsp;=\u0026thinsp;0.057; nationality, p\u0026thinsp;=\u0026thinsp;0.062) but were not statistically significant.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eSetting Direction and Making Decisions: No demographic variables were significantly associated with competency scores (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), though trends suggested higher scores among nurses over 30 years old, those educated outside KSA, and those with shift leadership roles.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eBaseline demographic characteristics of participants (N\u0026thinsp;=\u0026thinsp;81) are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The majority were female (82.7%), over 30 years old (85.2%), married (65.4%), held a BSN (65.4%), and had more than 10 years of nursing experience (42%). Most participants (61.7%) had a shift leadership role, and 90.1% were educated outside KSA.\u003c/p\u003e\u003cp\u003eThe full associations between demographic factors and each leadership competency are presented in Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. Across most domains, no significant associations were found, except for the Duty Management domain, where shift leadership role was significant (p\u0026thinsp;=\u0026thinsp;0.022).\u003c/p\u003e\n\u003ch3\u003eDemographic Characteristics of Participants at Baseline (N = 81)\u003c/h3\u003e\n\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003esummarizes the baseline demographic and professional characteristics of the 81 participants.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u0026ndash;30 Years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12 14.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e69(85.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14 (17.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e67(82.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28 (34.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e53(65.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eEducational Level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiploma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25(30.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e53(65.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e03(3.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eUniversity graduated\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e08 (9.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOutside KSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e73(90.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNationality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSaudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10(12.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNon -Saudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e71(87.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Nursing experience\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26(32.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21(25.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34(42.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eShift leadership Role\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e50(61.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31(45.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience in KFMC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e37(45.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17(21.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27(33.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe Leadership Competency Scores results demonstrate a high level of overall leadership competence in all areas for all of the participants. The majority of the respondents ranged from the \"Good\" (70\u0026ndash;84%) to \"Excellent\" (85\u0026ndash;100%) ranges, indicating a strong foundation in the key areas of leadership. No participants were seen to score less than 50% in any area, indicating that none of the participants were assessed as needing significant development.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation Between Demographic Factors and Understanding of Demonstrating Personal Qualities (N\u0026thinsp;=\u0026thinsp;81)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;50% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50\u0026ndash;69% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e70\u0026ndash;84% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e85\u0026ndash;100% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u0026ndash;30 Years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8 (20.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3 (7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.112\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e32 (80.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e36 (92.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8 (20.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5 (12.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.325\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e32 (80.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e34 (87.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15 (37.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12 (30.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.737\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e25 (62.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e27 (69.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiploma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15 (37.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e8 (20.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.115\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e24 (60.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e29 (74.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1 (2.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2 (5.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eUniversity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (12.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3 (7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.692\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOutside KSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e35 (87.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e36 (92.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNationality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSaudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7 (17.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3 (7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.361\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNon -Saudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e33 (82.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e36 (92.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience (Nursing)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15 (37.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e10 (25.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.989\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14 (35.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e7 (17.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (27.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e22 (56.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eShift Leadership Role\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e20 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e29 (74.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.079\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e20 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e10 (25.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience (KFMC)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e21 (52.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e15 (38.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.319\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (12.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e11 (28.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14 (35.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13 (33.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003eNote: Categorical data are presented as frequencies and percentages. Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe analysis examined associations between demographic factors and participants\u0026rsquo; understanding of \u0026ldquo;Demonstrating Personal Qualities\u0026rdquo;, a core leadership competency. Across all demographic variables including age, gender, marital status, education, nationality, experience, and shift leadership role no statistically significant associations were found (all p-values\u0026thinsp;\u0026gt;\u0026thinsp;0.05). This suggests that understanding of personal leadership qualities was uniform across participant subgroups.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation Between Demographic Factors and Working with Others Competency (N\u0026thinsp;=\u0026thinsp;81)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;50% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50\u0026ndash;69% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e70\u0026ndash;84% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e85\u0026ndash;100% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u0026ndash;30 Years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4 (12.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e7 (14.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.066\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e27 (87.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e42 (85.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (16.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e8 (16.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.089\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e26 (83.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e41 (83.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (35.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17 (34.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.763\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e20 (64.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e32 (65.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiploma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12 (38.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12 (24.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.397\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e18 (58.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e35 (71.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1 (3.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2 (4.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eUniversity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3 (9.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5 (10.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.943\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOutside KSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e28 (90.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e44 (89.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNationality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSaudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (16.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5 (10.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.684\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNon -Saudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e26 (83.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e44 (89.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience (Nursing)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12 (38.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13 (26.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.461\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8 (25.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13 (26.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (35.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23 (46.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eShift Leadership Role\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e16 (51.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e34 (69.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.124\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15 (48.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e15 (30.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience (KFMC)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e16 (51.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e20 (40.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.671\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e5 (16.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12 (24.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10 (32.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17 (34.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eNote: Categorical data are presented as frequencies and percentages. Statistical significance\u003c/h2\u003e\u003cp\u003eThis table examines the influence of demographic characteristics on participants\u0026rsquo; performance in the \"Working with Others\" leadership competency. The distribution of scores across all categories showed no statistically significant association with variables such as age, gender, marital status, education, nationality, or years of experience (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05 for all).\u003c/p\u003e\u003cp\u003eWhile some trends were observed such as participants with shift leadership roles tending to score higher these were not statistically significant. The findings suggest that the ability to work collaboratively was consistently demonstrated regardless of demographic background.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation Between Demographic Factors and Duty Management Competency (N\u0026thinsp;=\u0026thinsp;81)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;50% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50\u0026ndash;69% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e70\u0026ndash;84% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e85\u0026ndash;100% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u0026ndash;30 Years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (25.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2 (7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e7 (13.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.123\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3 (75.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e24 (92.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e44 (86.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3 (11.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e10 (19.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.619\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e23 (88.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e41 (80.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7 (26.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e18 (35.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.741\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8 (30.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e33 (64.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiploma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (42.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e14 (27.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.874\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15 (57.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e35 (68.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (42.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2 (3.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eUniversity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10 (38.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5 (9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.558\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOutside KSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6 (23.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e46 (90.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNationality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSaudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10 (38.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5 (9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.062\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNon -Saudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (25.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2 (7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e46 (90.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience (Nursing)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3 (75.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e24 (92.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e15 (29.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.057\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3 (11.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13 (25.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e23 (88.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23 (45.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eShift Leadership Role\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7 (26.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e35 (68.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.022 *\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8 (30.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16 (31.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience (KFMC)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (42.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23 (45.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.256\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15 (57.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e11 (21.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (42.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17 (33.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003eNote: Data are presented as frequency (percentage). Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Bolded p-values indicate statistical significance.\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows the association between demographic factors and nurses\u0026rsquo; competency in Duty Management. The only demographic factor found to have a statistically significant association was shift leadership role (p\u0026thinsp;=\u0026thinsp;0.022). Nurses with leadership responsibilities were more likely to score in the \u0026ldquo;Excellent\u0026rdquo; category for duty management.\u003c/p\u003e\u003cp\u003eOther variables, such as age, education level, nationality, or years of experience, did not show significant associations (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), although a few trends approached significance particularly years of nursing experience (p\u0026thinsp;=\u0026thinsp;0.057) and nationality (p\u0026thinsp;=\u0026thinsp;0.062).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation Between Demographic Factors and Setting Direction and Making Decisions Competency (N\u0026thinsp;=\u0026thinsp;81)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;50% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50\u0026ndash;69% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e70\u0026ndash;84% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e85\u0026ndash;100% (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u0026ndash;30 Years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;50%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3 (11.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e7 (13.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.123\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e23 (88.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e44 (86.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (25.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3 (11.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e10 (19.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.619\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3 (75.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e23 (88.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e41 (80.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8 (30.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e18 (35.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.741\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e18 (69.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e33 (64.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiploma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e9 (34.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e14 (27.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.874\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e16 (61.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e35 (68.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMSN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1 (3.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2 (3.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eUniversity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1 (25.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2 (7.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5 (9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.558\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOutside KSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3 (75.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e24 (92.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e46 (90.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eNationality\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSaudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3 (11.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5 (9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.062\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNon -Saudi\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e23 (88.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e46 (90.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience (Nursing)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7 (26.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e15 (29.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.057\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8 (30.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13 (25.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (42.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23 (45.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eShift Leadership Role\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15 (57.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e35 (68.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.022 *\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11 (42.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16 (31.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eYears of Experience (KFMC)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10 (38.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e23 (45.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.256\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6 (23.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e11 (21.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;10 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10 (38.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17 (33.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eNote: Data presented as frequency (percentage). Statistical significance set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. No statistically significant associations were found.\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eInterpretation\u003c/h2\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e explores the relationship between demographic variables and nurses\u0026rsquo; competency in Setting Direction and Making Decisions. While descriptive differences are evident for example, those with higher education levels and shift leadership roles more frequently score in the \u0026ldquo;Excellent\u0026rdquo; category none of the associations reached statistical significance (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003eNotably, nurses over the age of 30 and those educated outside KSA were more likely to score higher, but this did not reach statistical significance. These findings suggest that while trends exist, other factors beyond basic demographics may more strongly influence decision-making competencies.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study synthesizes evidence regarding factors influencing nursing leadership competencies and the impact on patient care outcomes. Experiential learning and shift leadership roles emerged as the most significant determinants of effective leadership, particularly in duty management, decision-making, teamwork, and demonstration of personal qualities. Nurses with direct leadership responsibilities scored higher in duty management, underscoring the importance of hands-on leadership experience in clinical settings [26].\u003c/p\u003e\u003cp\u003eDemographic variables, including age, gender, education level, and years of experience, were not significantly associated with leadership competencies, suggesting that practical exposure and engagement in leadership tasks play a more crucial role than formal qualifications [27,28]. Experiential learning, mentorship, and structured leadership programs have been consistently shown to enhance strategic thinking, critical decision-making, and problem-solving competencies among nurses [29,31].\u003c/p\u003e\u003cp\u003eTransformational leadership consistently demonstrates positive effects on nurse outcomes, including improved work environments, higher job satisfaction, enhanced organizational commitment, and reduced adverse patient events [19,20,22]. In contrast, transactional leadership, particularly when focused on error monitoring and punitive measures, negatively impacts staff satisfaction and performance [19]. Empowering nurses through transformational leadership fosters structural empowerment, clinical leadership at the point of care, and ultimately safer patient outcomes [22].\u003c/p\u003e\u003cp\u003eOrganizational support, including adequate staffing, resource allocation, positive nurse-physician relationships, and opportunities for professional development, further enhances nurses\u0026rsquo; health-promoting behaviors and perceived performance quality [24]. Moreover, evidence-based practice (EBP) implementation and knowledge management (KM) require strong managerial support and structured training programs, highlighting the need for visible leadership engagement and mentorship [25].\u003c/p\u003e\u003cp\u003eThe findings underscore that while demographic factors have limited influence, practical leadership exposure and structured experiential opportunities are pivotal in cultivating effective nursing leadership. Healthcare organizations should prioritize formal leadership programs, mentorship, and skill development workshops to ensure that bedside nurses can manage clinical duties effectively, collaborate efficiently, and make informed decisions. Additionally, aligning leadership development strategies with national healthcare objectives, such as Saudi Vision 2030, can strengthen workforce capacity and improve patient care quality [6].\u003c/p\u003e\u003cp\u003eOverall, the synthesis emphasizes that investing in transformational leadership development, organizational support, and experiential learning opportunities is essential for enhancing nursing leadership competencies, improving staff satisfaction, and promoting high-quality patient outcomes across diverse healthcare settings.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe findings highlight shift leadership role and number of years as vital predictors of the development of registered nurses' leadership competency. Formal training in leadership and immediate involvement in leadership activities are noted to have a significant effect on acquiring skills, particularly in duty management and decision-making. The findings highlight practical leadership experience and targeted training as vital interventions in boosting nursing professionals' capability.\u003c/p\u003e\u003cp\u003eConversely, age, sex, educational background, and employment experience within the current institution lacked any pattern or impact, which indicates that demographic factors are not sufficient in leadership competency prediction. It might not lead to leadership quality solely based on experience but must be supported by appropriate mentorship as well as leadership development programs.\u003c/p\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eRecommendations:\u003c/h2\u003e\u003cp\u003eBased on the study findings, it is recommended that nursing leadership competency be enhanced through a combination of formal training, practical experience, and mentorship. Structured leadership development programs focusing on duty management, decision-making, and team coordination should be implemented, alongside opportunities for nurses to gain hands-on leadership experience, such as assuming shift-lead responsibilities or leading small projects. Mentorship initiatives are also essential, pairing less experienced nurses with seasoned leaders to guide and support the application of leadership skills in practice. Interventions should be tailored to role-specific needs rather than demographic factors, as age, sex, education, and institutional experience were not significant predictors of leadership competency. Finally, continuous assessment and feedback mechanisms should be established to monitor progress and ensure ongoing development of leadership capabilities among nursing professionals.\u003c/p\u003e\u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eWorld Health Organization\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCOVID-19\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCoronavirus Disease 2019\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEBP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEvidence-Based Practice\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eKM\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eKnowledge Management\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSE\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStructural Empowerment\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eQNWL\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eQuality of Nursing Work Life\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eRN\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eRegistered Nurse\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eNNI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eNational Neuroscience Institute\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMRI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMagnetic Resonance Imaging\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eICU\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eIntensive Care Unit., SPSS:Statistical Package for the Social Sciences.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e:\u003c/strong\u003e\u003cp\u003e Ethical approval for this study was obtained from the Institutional Review Board (IRB) of King Fahad Medical City (Approval No.: 25\u0026ndash;063). Official permissions were also obtained from the relevant hospital administration. All participants provided informed consent, and their identities were strictly kept confidential.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e:\u003c/strong\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003e\u003cem\u003eCompeting interests\u003c/em\u003e:\u003c/h2\u003e\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eAuthors\u0026rsquo; contributions\u003c/h2\u003e\u003cp\u003ePJC, AAR, DLS, and RJD conceptualized the study. PJC collected the data and conducted statistical analysis. PJC, AAR, DLS, and YAR contributed to data interpretation and manuscript preparation. All authors read and approved the final manuscript.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e\u003cp\u003eThis study did not receive any financial support from King Fahad Medical City or any other institution.\u003c/p\u003e\u003ch2\u003eAcknowledgments:\u003c/h2\u003e\u003cp\u003eThe authors would like to thank the hospital administration and nursing staff for their support and cooperation throughout the study.\u003c/p\u003e\u003ch2\u003eAvailability of data and materials:\u003c/h2\u003e\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eTappen, R. M., Weiss, S. A., \u0026amp; Whitehead, D. K. 3\u003csup\u003erd\u003c/sup\u003e edition 2001, Essentials of nursing leadership and management. F. A. Davis Company.\u003c/li\u003e\n \u003cli\u003eDbass et al. (2011) Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review. International Journal of Evidence-Based Healthcare December 9(4): pp 388-402\u003c/li\u003e\n \u003cli\u003eAlgunmeeyn A, Mrayyan MT, Suliman WA, Abunab HY, Al-Rjoub S. Effective clinical nursing leadership in hospitals: barriers from the perspectives of nurse managers. BMJ Lead. 2024 Mar 18;8(1):20-24. doi: 10.1136/leader-2022-000681. PMID: 37248037; PMCID: PMC12038153.\u003c/li\u003e\n \u003cli\u003eAlilyyani B, Althobaiti E, Al-Talhi M, Almalki T, Alharthy T, Alnefaie M, Talbi H, Abuzaid A. Nursing experience and leadership skills among staff nurses and intern nursing students in Saudi Arabia: a mixed methods study. BMC Nurs. 2024 Feb 2;23(1):87. doi: 10.1186/s12912-024-01750-1. PMID: 38308273; PMCID: PMC10835976.\u003c/li\u003e\n \u003cli\u003eAmer (2023). A cross-sectional study of leadership styles and transformational leadership skills among nurse leaders in Qatar. PubMed, National Library of Medicine, Jun;10(6):3440-3446.\u003c/li\u003e\n \u003cli\u003eAlsufyani AM, Alforihidi MA, Almalki KE, Aljuaid SM, Alamri AA, Alghamdi MS. Linking the Saudi Arabian 2030 vision with nursing transformation in Saudi Arabia: Roadmap for nursing policies and strategies. Int J Afr Nurs Sci. 2020; 13:100256. doi: 10.1016/j.ijans.2020.100256. Epub 2020 Oct 14. PMID: 33072514; PMCID: PMC7553899.\u003c/li\u003e\n \u003cli\u003eDeepa, P. (2020). A study on leadership skills and its impact on employee performance. \u003cem\u003eInternational Journal of Creative Research Thoughts (IJCRT), 8\u003c/em\u003e(4), 2320-2882\u003c/li\u003e\n \u003cli\u003eBryan et al. (2021). Developing Effective Senior Nurse Leaders: The Impact of an Advanced Leadership Initiative. JONA: The Journal of Nursing Administration 51(5):p 271-278, May 2021.\u003c/li\u003e\n \u003cli\u003eYstaas LMK, Nikitara M, Ghobrial S, Latzourakis E, Polychronis G, Constantinou CS. The Impact of Transformational Leadership in the Nursing Work Environment and Patients\u0026apos; Outcomes: A Systematic Review. Nurs Rep. 2023 Sep 11;13(3):1271-1290.\u003c/li\u003e\n \u003cli\u003eAlves P.C., Oliveira A.D.F., Paro H. Quality of life and burnout among faculty members: How much does the field of knowledge matter? PLoS ONE. 2019;14: e0214217. doi: 10.1371/journal.pone.0214217.\u003c/li\u003e\n \u003cli\u003eSuratno K. The relationship between transformational leadership and quality of nursing work life in hospital. Int. J. Caring Sci. 2018; 11:1416\u0026ndash;1422.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eGottlieb LN, Gottlieb B, Bitzas V. Creating Empowering Conditions for Nurses with Workplace Autonomy and Agency: How Healthcare Leaders Could Be Guided by Strengths-Based Nursing and Healthcare Leadership (SBNH-L). J Health Leadership. 2021 Jul 27; 13:169-181.\u003c/li\u003e\n \u003cli\u003eSisk BW, Mosier SS, Williams MD, Coppin JD, Robinson D. Developing Effective Senior Nurse Leaders: The Impact of an Advanced Leadership Initiative. J Nurs Adm. 2021 May 1;51(5):271-278.\u003c/li\u003e\n \u003cli\u003eNhongo D, Hendricks J, Bradshaw J, Bail K. Leadership and registered nurses (RNs) working after-hours in Residential Aged Care Facilities (RACFs): A structured literature review. J Clin Nurs. 2018 Nov;27(21-22):3872-3881.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Patarru, F., Weu, B. Y., \u0026amp; Handini, F. S. (2020). The role of the nurse unit manager function on nursing work performance: A systematic review. Jurnal NERS, 14(3), 231.\u003c/li\u003e\n \u003cli\u003eFowler KR, Robbins LK, Lucero A. Nurse manager communication and outcomes for nursing: An integrative review. J Nurs Manag. 2021 Sep;29(6):1486-1495.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eHoda Hassan et al (2020). Efficacy of Application of Clinical Leadership Competencies Program on Charge Nurses Based on Self Need Assessment. Tanta Scientific Nursing Journal, Volume 19, Issue 1, Pages 60-92.\u003c/li\u003e\n \u003cli\u003eNiinihuhta M, Terkamo-Moisio A, Kvist T, H\u0026auml;ggman-Laitila A. A comprehensive evaluation of factors affecting nurse leaders\u0026apos; work-related well-being. Leadersh Health Serv (Bradf Engl). 2022 May 13; ahead-of-print(ahead-of-print):460\u0026ndash;74.\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Morsiani, G., Bagnasco, A., \u0026amp; Sasso, L. (2017). How staff nurses perceive the impact of nurse managers\u0026quot; leadership style in terms of job satisfaction: a mixed method study. Journal of nursing management, 25(2), 119-128\u003c/li\u003e\n \u003cli\u003eRene\u0026eacute; Roberts-Turner et al. (2014). Effects of Leadership Characteristics on Pediatric Registered Nurses\u0026apos; Job Satisfaction. pediatric nursing/September-October 2014/Vol. 40/No. 5 236-41, 256.\u003c/li\u003e\n \u003cli\u003eSalha F. Alasiri (2019). Strengthening Nurses Clinical Leadership in Saudi Hospitals. IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320\u0026ndash;1959.p- ISSN: 2320\u0026ndash;1940 Volume 8, Issue 1 Ser. IX. (Jan. - Feb .2019), PP 55\u0026ndash;64.\u003c/li\u003e\n \u003cli\u003eSheila Boamah (2017). Linking Nurses\u0026apos; Clinical Leadership to Patient Care Quality: The Role of Transformational Leadership and Workplace Empowerment. Canadian Journal of Nursing Research. 2018;50(1):9-19.\u003c/li\u003e\n \u003cli\u003eValerie Wright et al. (2020). Registered Nurses\u0026apos; Self-Assessment of Their Clinical Leadership Knowledge and Competence, Journal of Excellence in Nursing and Healthcare Practice 2020, Volume 2, Issue 2, Pages 17\u0026ndash;23\u003c/li\u003e\n \u003cli\u003eCho H, Han K. (2018) Associations among nursing work environment, health-promoting behaviors of nurses, and nursing performance quality: a multilevel modeling approach. J Nur\u0026apos;s Scholarsh. 50(4):403-410.\u003c/li\u003e\n \u003cli\u003eAnne Lunden et al. (2020). Readiness and leadership in evidence-based practice and knowledge management: A cross-sectional survey of nurses\u0026apos; perceptions, Nordic Journal of Nursing Research, December Issue 41(4):187\u0026ndash;196.\u003c/li\u003e\n \u003cli\u003eCummings G, Tate K, Lee S, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. Int J Nurs Stud. 2018; 85:19-60.\u003c/li\u003e\n \u003cli\u003eWong CA, Cummings GG. The relationship between nursing leadership and patient outcomes: A systematic review. J Nurs Manag. 2007; 15:508\u0026ndash;521.\u003c/li\u003e\n \u003cli\u003eGilmartin MJ. Leadership in healthcare: A review of research. Nurs Manage. 2017;48(3):26-33.\u003c/li\u003e\n \u003cli\u003eWang D, Hu Q, Zhang T, et al. The impact of experiential learning on leadership competencies among clinical nurses. J Nurs Adm. 2020;50(4):210-216.\u003c/li\u003e\n \u003cli\u003eAiken LH, Sloane DM, Bruyneel L, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet. 2012; 383:1824\u0026ndash;1830.\u003c/li\u003e\n \u003cli\u003eDrenkard K. The journey to leadership excellence in nursing: Strategies for success. Nurs Clin North Am. 2014;49(4):537-549\u003c/li\u003e\n \u003cli\u003eBessie Marquis (2017 Leadership Roles and Management functions in Nursing AJN BOOK, Michigan Publications. Pp 45\u0026ndash;48)\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eOther references:\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eBennis WG (2009). On becoming a leader. New York, NY: Basic Books.\u003c/li\u003e\n \u003cli\u003ehttps://www.tripodpartners.com \u0026rsaquo; Nursing -2024\u003c/li\u003e\n \u003cli\u003ehttps://www.spencerclarkegroup.co.uk/about-us/careers/2017\u003c/li\u003e\n\u003c/ul\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"King Fahad Medical City","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Leadership skills, Registered nurses, Duty management, Training, Shift leader","lastPublishedDoi":"10.21203/rs.3.rs-7784879/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7784879/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003eThe healthcare environment, particularly among nurses, increasingly faces significant challenges, including the need for strong and effective leadership. Clinical leadership is essential for improving patient outcomes, enhancing teamwork, and ensuring efficient healthcare delivery. This study aimed to assess clinical leadership skills among registered nurses working in the neuro units of a tertiary hospital in Riyadh, Saudi Arabia.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eA quantitative cross-sectional research design was adopted. Data were collected from 81 registered nurses using a structured leadership assessment tool that measured five core categories: demonstrating personal qualities, working with others, duty management, setting directions, and making decisions. The data were analyzed using SPSS version 25, employing descriptive statistics, reliability testing, and non-parametric tests to explore correlations between leadership skills and demographic variables.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eThe results revealed that duty management had the highest percentage of nurses rated as excellent (63.0%), indicating strong competencies in operational management and task prioritization. Similarly, 60.5% were rated excellent in working with others, reflecting strong teamwork and interpersonal skills. Over half of the participants (53.1%) scored excellent in setting directions and making decisions, demonstrating strategic thinking and sound decision-making abilities, although some nurses required further development in this area. Demonstrating personal qualities showed a near-equal distribution between good (49.4%) and excellent (48.1%), indicating overall self-awareness and resilience. The overall leadership ability averaged 59.3% at an excellent level, with only a small number of nurses requiring improvement. The leadership skills scale demonstrated high reliability (Cronbach\u0026rsquo;s alpha\u0026thinsp;=\u0026thinsp;0.943). No significant correlations were found between leadership skills and demographic factors such as age, gender, education, or nationality, except for the shift leadership role, which significantly correlated with higher duty management scores (p\u0026thinsp;=\u0026thinsp;0.022).\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e\u003cp\u003eThis study highlights strong leadership capabilities among registered nurses, with decision-making and personal development identified as key areas for targeted growth. Structured leadership programs are recommended to further enhance nursing leadership performance and improve patient care outcomes.\u003c/p\u003e","manuscriptTitle":"Assessment of Knowledge on Clinical Leadership Skills Among Registered Nurses in Selected Units of a Tertiary Hospital, Riyadh, KSA: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-08 09:16:22","doi":"10.21203/rs.3.rs-7784879/v1","editorialEvents":[{"type":"communityComments","content":1}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9019c820-0ddf-4d89-9387-bb2624d1387b","owner":[],"postedDate":"October 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":55788599,"name":"Nursing"}],"tags":[],"updatedAt":"2025-10-08T09:16:22+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-08 09:16:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7784879","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7784879","identity":"rs-7784879","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}