The effects of authentic leadership, organizational identification, and occupational coping self-efficacy on new graduate nurses' job turnover intentions in Canada

Accepted Manuscript The Effects of Authentic Leadership, Organizational Identification, and Occupational Coping Self-efficacy on New Graduate Nurses’ Job Turnover Intentions in Canada Fatmah Fallatah, RN, MScN, Doctoral Student, Heather K.S. Laschinger, RN, PhD, FAAN, FCAHS, Distinguished University Professor and Arthur Labatt Nursing Research Chair, Emily A. Read, RN, MSc, Doctoral Candidate PII:

S0029-6554(16)30395-5

DOI:

10.1016/j.outlook.2016.11.020

Reference:

YMNO 1196

To appear in:

Nursing Outlook

Received Date: 23 June 2016 Revised Date:

1 November 2016

Accepted Date: 21 November 2016

Please cite this article as: Fallatah F, Laschinger HKS, Read EA, The Effects of Authentic Leadership, Organizational Identification, and Occupational Coping Self-efficacy on New Graduate Nurses’ Job Turnover Intentions in Canada, Nursing Outlook (2017), doi: 10.1016/j.outlook.2016.11.020. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT 1 Title: The Effects of Authentic Leadership, Organizational Identification, and Occupational Coping Self-efficacy on New Graduate Nurses’ Job Turnover Intentions in Canada Authors:

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Doctoral Student Arthur and Sonia Labatt Family School of Nursing The University of Western Ontario Health Sciences Addition H38, London, Ontario, N6A 5C1 Email: [email protected] Phone: (519) 661-2111 ext. 86585

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Affiliations:

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Fatmah Fallatah, RN, MScNa, Heather K. S. Laschinger, RN, PhD, FAAN, FCAHSb, Emily A. Read, RN, MScc

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Distinguished University Professor and Arthur Labatt Nursing Research Chair in Health Human Resource Optimization Arthur and Sonia Labatt Family School of Nursing The University of Western Ontario, Health Sciences Addition, H41 1151 Richmond Street, London, Ontario, Canada N6A 5C1 Phone: 519-661-2111 x86567 Email: [email protected]

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Doctoral Candidate, Arthur and Sonia Labatt Family School of Nursing The University of Western Ontario Health Sciences Addition H38, London, Ontario, N6A 5C1 Email: [email protected] Phone: (519) 661-2111 ext. 86585

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Corresponding Author: Fatmah Fallatah

ACCEPTED MANUSCRIPT 2 Introduction Nursing shortages have become a pressing issue for many countries because of an aging population that requires greater healthcare services (Kalache, Barreto, and Keller, 2005) and an

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increasing number of nurses approaching retirement age (Buchan, Duffield, and Jordan, 2015). However, many nurses are postponing their retirement because of economic downturn (Phua and Hue, 2015), which may delay nursing shortages for five to ten years (North, Leung, and Lee,

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2014). The change in the nursing shortage is temporary (Buchan, Duffield, and Jordan, 2015), therefore, new nurses are a valuable resource to reduce the impact of nursing shortage and every

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effort should be made to improve retention and reduce turnover of this important segment of the nursing workforce.

Nursing turnover has adverse effects on healthcare organizations, patients, and nurses (O'Brien-Pallas et al., 2006; Rondeau, Williams, and Wagar, 2008). To replace departing nurses,

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healthcare organizations face a financial burden that is associated with advertising, recruiting, orientating, and training new employees (Jones and Gates, 2007). The cost of new nurses’ turnover has been estimated to be $1.4 and $2.1 million for US healthcare organizations at 2006

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salary figures (Brewer, Kovner, Greene, Tukov-Shuser, and Djukic, 2012). Nursing turnover also has human costs and has been linked to lower patient care quality and patient outcomes, poor

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continuity of care (Duffield, Roche, O’Brien-Pallas, Catling-Paull, 2009), and poor communication among healthcare providers, medication errors, decreases in patient satisfaction, increased morbidity, and caregiver burnout (Minore et al., 2005). Several studies have identified the detrimental effect that high nurse turnover has on the remaining nurses on the unit. Nurses who remained in their position reported lower levels of job satisfaction and mental health issues

ACCEPTED MANUSCRIPT 3 (O’Brien-Pallas, Murphy, Shamian, Li, Hayes, 2010), factors which may lead them to seek alternative jobs as well. Given the costly impact of turnover on organizations, patients, and nurses, it is important

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to identify ways to reduce nurses’ turnover. Numerous studies have highlighted the critical role of nursing leadership in enhancing new nurses’ retention. Knowledge of mechanisms by which nursing leaders influence new nurses’ work attitudes and behaviors and how these attitudes and

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behaviors influence their intentions to leave their current position are lacking. We aim to

examine the influence of authentic leadership on new nurses’ job turnover intentions through

occupational coping self-efficacy.

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new graduate nurses’ personal identification with their leader, organizational identification, and

Theoretical framework

Authentic leadership theory (Avolio et al., 2004) guides the theoretical framework for this

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study. It describes a positive form of leadership that focuses on integrity, honesty, and high moral values (Avolio, Gardner, Walumbwa, Luthans, and May, 2004). Authentic leaders are “those who are deeply aware of how they think and behave and are perceived by others as being aware

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of their own and others' values/moral perspectives, knowledge, and strengths; aware of the context in which they operate; and who are confident, hopeful, optimistic, resilient, and of high

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moral character” (Avolio, Luthans, and Walumbwa, 2004, p. 4). Authentic leaders create supportive and positive work environments using four behavioral dimensions: self-awareness, balanced processing, relational transparency, and an internalized moral perspective (Walumbwa, Avolio, Gardner, Wernsing, and Peterson, 2008). Self-awareness refers to leaders’ behaviors that show their awareness of their own values and beliefs (Avolio and Gardner, 2005) as well as their strengths and weaknesses (Kernis, 2003). Balanced processing describes leaders’ ability to

ACCEPTED MANUSCRIPT 4 objectively consider all relevant information before making decisions (Leroy, Palanski, and Simons, 2012). In relational transparency, leaders reveal their thoughts and feelings to others (Avolio and Gardner, 2005). Finally, an internalized moral perspective reflects leaders’ moral

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principles that are compatible with their behaviors (Walumbwa et al., 2008).

Authentic leadership theory proposes a number of mediating processes by which leaders influence the work attitudes and behaviors of their followers (Avolio et al., 2004). These include

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followers’ personal and social identification with the leader and the organization. Followers’ personal identification with leaders is influenced by a leader’s openness, integrity, and

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willingness to establish and maintain honest relationships that build followers’ trust in the leader (Leroy, Palanski, and Simons, 2012; Wong and Cummings, 2009). Followers’ identification with an organization enhances their sense of belonging, which leads to increased employee and organizational performance (Avolio, Walumbwa, and Weber, 2009). Additionally, positive

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attitudes such as trust, hope, and optimism (Walumbwa et al., 2008) are mechanisms that help leaders maximize followers’ work engagement, which in turn, increase their job satisfaction and organizational commitment (Avolio et al., 2004). Authentic leaders enhance followers’

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motivation and self-determination by creating positive work conditions that encourage open communication, maintaining follower autonomy, and providing coaching and positive feedback

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(Gardner, Avolio, Luthans, May, and Walumbwa, 2005). Such leaders build positive and supportive relationships with followers that allow for honest conversations regarding what is functional and non-functional in work settings (Laschinger, Wong, and Grau, 2012). Authentic leadership

Previous research has documented the influence of authentic leadership on new graduate nurses’ turnover intentions. Laschinger, Wong and Grau (2012) found that authentic leadership

ACCEPTED MANUSCRIPT 5 resulted in lower levels of workplace bullying, which subsequently improved new nurses’ job satisfaction and reduced their intentions to leave. Wong, Laschinger and Cummings (2010) found that authentic leadership was more strongly related to nurses’ personal identification with their

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leader than to social identification with a work group, and that authentic leadership influenced nurses’ workgroup identification through personal identification with the leader. This suggests that social identification might be influenced by leaders’ behaviors and other workplace factors

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(Wong, Laschinger and Cummings, 2010). These findings also confirm the pivotal role authentic leaders play in influencing new graduate nurses’ work attitudes and behaviors by building

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positive and honest relationships that aim to facilitate their transition to practice. Through these relationships, leaders are able to manage work characteristics that negatively influence new nurses’ retention outcomes. The relationship between authentic leadership and new nurses’ identification with their leader and the organization has yet to be studied. However, we expect

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that authentic leaders who provide new nurses with conditions that support their professional development and successful transition are likely to influence their personal identification with their leader.

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Personal identification

Employees are involved in at least two types of workplace relationships: one with their

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immediate manager and one with the organization (Masterson, Lewis, Goldman, and Taylor, 2000). The follower-leader relationship is influenced by the extent to which followers selfidentify with their leader (Steffens, Haslam, and Reicher, 2014). Such identification reflects the personal aspect of the follower-leader interaction, one that is described as “the definition of oneself in terms of a given relationship” (Sluss and Ashforth, 2007, p. 15). Personal identification helps to explain how authentic leaders influence the development of followers. As

ACCEPTED MANUSCRIPT 6 managers frequently interact with followers through work-related activities, such as assigning tasks, providing guidance and feedback, followers perceive this relationship as significant for their learning and as a positive influence on their work attitudes and behaviors (Sluss and

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Ashforth, 2008). This aligns with the influential role of the follower-leader relationships

proposed in authentic leadership theory. Managers who demonstrate authentic leadership

behaviors by maintaining high moral standards that are consistent with their actions, involving

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followers in the process of decision-making, being aware of their own and others’ strengths and weaknesses, and promoting openness, are able to build positive and honest interactions with

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followers. As a result, followers identify with the behaviors, values, emotions, and goals that they share with the leaders (Luthans, Norman, and Hughes, 2006). This may result in followers developing a personal identification with their leaders, which fosters the development of positive attitudes and behaviors (Sluss and Ashforth, 2007; Sluss, Ployhart, Cobb, and Ashforth, 2012).

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Organizational identification

Organizational identification is another type of self-identity that drives individuals’ sense of belonging. An individual’s identification with their work organization consists of cognitive

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and emotional dimensions (Zhu, Sosik, Riggio, and Yang, 2012). The cognitive dimension of organizational identification reflects the shared characteristics and goals between employees and

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organizations (Ashforth and Mael, 1989) and the perception of gaining benefit from categorizing oneself as a member of the organization (Zhu, Sosik, Riggio, and Yang, 2012). The emotional dimension evokes a sense of pride in belonging to the organization in individuals (Zhu, Sosik, Riggio, and Yang, 2012). Tajfel (1972) asserted that the emotional dimension of organizational identification helps develop employees’ identification with the organization by presenting employees with a favourable image of the organization. According to Avolio et al. (2004)

ACCEPTED MANUSCRIPT 7 authentic leaders influence followers’ work attitudes and behaviors through the mechanism of organizational identification. Individuals who identify with an organization are more likely to adopt the organization’s mission and values, and functions to achieve the organizational goals

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(Mael and Ashforth, 1992). We suggest that authentic leaders who lead by example and

demonstrate leadership behaviors that represent the values of the organization are more likely to develop strong organizational identification in their followers.

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It has been argued that followers’ identification with their leader can extend to their identification with the organization (Sluss, Ployhart, Cobb, and Ashforth, 2012). Sluss and

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Ashforth (2008) asserted that an individual’s personal identification is woven into their organizational identification because followers’ relationship with their manager is embedded within their relationship with the organization. The convergence of personal and organizational identification may be influenced by leadership behaviors (Sluss and Ashforth, 2007). This seems

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logical because a leader is perceived by his or her followers to be the organization’s representative, who embodies and endorses the organization’s mission, goals, and values (Sluss and Ashforth, 2008). Therefore, when followers identify themselves with the leader they will

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ultimately identify with the organization. This proposition aligns with a growing body of research indicating that individuals’ organizational identification is influenced by their

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identification with the leader. For instance, Sluss and colleagues (2012) found that newcomers’ personal identification with their supervisor was directly and indirectly (through affective, cognitive, and behavioral mechanisms) associated with their identification with the organization. In addition, they found that personal identification with the leader led to organizational identification when newcomers perceived that their leaders’ behaviors reflected the organization’s goals, norms and values. Carmeli, Atwater, and Levi (2011) found that managers

ACCEPTED MANUSCRIPT 8 who exhibited positive leadership behaviors and had relationships characterized by high-quality leader-member exchange were more likely to develop personal and organizational identifications in followers which, in turn, resulted in more knowledge sharing activities. In line with these

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findings, we argue that a manager who demonstrates authentic leadership behaviors encourages new nurses to identify with them personally; and since that manager reflects the organization’s culture and goals (theoretically), he or she is more likely to influence new graduate nurses’

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identification with the work organization. Occupational coping self-efficacy

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Bandura (1994) defined self-efficacy as individuals’ beliefs in their ability to successfully perform a specific task. Given that self-efficacy reflects a person’s perception of particular behaviors, the concept is situation-specific (Kurbanoglu, 2003), meaning that a person may show high self-efficacy in one situation, but low self-efficacy in another (Cassidy and Eachus, 2002).

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Occupational coping self-efficacy is a specific type of self-efficacy that is separated from the more general job related self-efficacy (Pisanti et al., 2015). In that respect it focuses on an individual’s view of his or her ability to cope with job demands (Laschinger, Borgogni,

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Consiglio, and Read, 2015). According to Pisanti et al. (2015), employees with high levels of coping self-efficacy, are more likely to view job demands as positive and challenging

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experiences, a view that positively influences their willingness to persist and to invest their efforts in overcoming these difficulties. Employees’ effort to promote and support their leader’s goals and values lead them to engage in activities that contribute to organizational success. Thus, it is reasonable to expect that when new graduate nurses identify with the organization, they are more likely to perceive the demands of their role as professional development opportunities. They become willing to apply

ACCEPTED MANUSCRIPT 9 every effort to deal with work stressors, thereby increasing their confidence in their ability to successfully cope with job demands. Job turnover intentions

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Job turnover intent is an important retention variable associated with actual turnover rates among nurses. Kovner, Brewer, Yingrengreung, and Fairchild’s (2010) findings that 41% of new nurses planned to quit their job within the first three years of practice, and 26.2% left their first

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employer after two years of practice are alarming. New nurses in the millennial generation intend to leave their position due to high level of psychological distress, increased job demand, and lack

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of support (Lavoie-Tremblay et al., 2010). However, the main reason for these nurses to quit was to pursue career advancement opportunities (Lavoie-Tremblay et al., 2008; Wieck, Dols, and Landrum, 2010). Lower levels of turnover among new nurses have been linked to the ability of nursing mangers to provide support and improve workplace conditions (Laschinger, and Fida,

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2014; Laschinger, Wong, and Grau, 2012). Nurse managers who exhibit authentic leadership behaviors are able to influence the establishment of personal identification with the leader in new graduate nurses and subsequently, strengthen their identification with the organization. This in

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turn, increases new graduate nurses’ confidence in their ability to handle stressful work situations and ultimately, lowers their intentions to exit the organization. Schmidt and Diestel (2013) found

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that nurses’ beliefs in their ability to cope with physical and psychological demands of their job had a significant and negative effect on turnover intentions. In the current study, we hypothesized the following: H1. Authentic leadership will have a positive effect on new nurses’ personal identification with their leader.

ACCEPTED MANUSCRIPT 10 H2. Authentic leadership will be positively related to new graduate nurses’ organizational identification.

related to organizational identification.

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H3. New graduate nurses’ personal identification with authentic leaders will be positively

H4. Personal identification with authentic leaders will mediate the relationship between authentic leadership and organizational identification.

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H5. Organizational identification will have a positive effect on new graduate nurses’ occupational coping self- efficacy

nurses’ turnover intention.

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H6. Occupational coping self-efficacy will have a negative relationship with new graduate

Our hypothesized model is presented in Figure 1.

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Figure 1. Hypothesized model

Methods

Study Design and Data Collection Procedures We used cross-sectional data from Time 1 of a two-wave national study of Canadian new graduate nurses (Author et al., 2016). After obtaining university ethics approval, data

ACCEPTED MANUSCRIPT 11 collection was conducted using the procedures recommended by Dillman et al. (2014) to maximize participation. Participants received a mail package with a letter explaining the study, study questionnaire, return envelope, and $2 coffee voucher. Four weeks later, non-responders

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received a reminder letter, followed by a replacement survey package one month later. Participants

A total of 3,906 new graduate nurses from across all 10 Canadian provinces were

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invited to participate. Of these, 1020 returned completed questionnaires but 22 did not respond to one or more of the variables in the current study, resulting in a sample of 998. Participants were

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new graduate nurses with less than three years of experience currently working in acute care and community settings. Those who had more than three years of nursing experience or who were not providing direct patient care were ineligible. Instruments

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Standardized questionnaires with acceptable reliability and validity were used to measure the main study variables. Authentic leadership was measured using the Authentic Leadership Questionnaire (Walumbwa et al., 2008), consisting of 16 items that measure four components of

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authentic leadership behavior: self-awareness (4 items), balanced processing (3 items), relational transparency (5 items), and internalized moral perspective (4 items). Participants rated each item

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on a five-point Likert scale ranging from 0 = “Not at all”, to 4 = “Frequently, if not always”. Walumbwa and colleagues (2008) have established acceptable reliability and validity of this instrument. The questionnaire validity was demonstrated through convergent, discriminant and content validity (Walumbwa et al., 2008). Among graduate nurses, Laschinger and colleagues (2015) reported Cronbach’s alpha of .96, and in Giallonardo et al.’s (2010) study the subscales Cronbach’s alphas ranged from .69 to .88. In the current study overall Cronbach’s alpha was .93,

ACCEPTED MANUSCRIPT 12 while the subscales ranged from .82 to .92. Personal identification was assessed using the Relational Identification Scale (Sluss, Ployhart, Cobb and Ashforth, 2012). It consists of four items rated on a seven-point Likert scale

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ranging from 1 = “Strongly Disagree” to 7 = “Strongly Agree”. Sluss and colleagues (2012) conducted discriminant, face and content validity to establish instrument’s validity. Also, the researcher established the instrument’s reliability (Cronbach’s alpha = .85) and in this study

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Cronbach’s alpha was .89.

The Organizational Identification Scale developed by Sluss and colleagues (2012) was

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used to assess new graduate nurses’ organizational identification. The scale consists of three items that respondents rated on a seven-point Likert scale from 1 = “Strongly Disagree” to 7 = “Strongly Agree”. The validity of the scale was established through discriminant, face and content validity (Sluss et al., 2012). The scale showed acceptable internal consistency with

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Cronbach’s alpha of .85 to .88 in Sluss et al.’s (2012) study and .87 in the current study. The Occupational Coping Self-Efficacy Questionnaire (Pisanti, Lombardo, Lucidi, Lazzari and Bertini, 2008) was employed to measure new nurses’ occupational coping self-efficacy. This

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questionnaire consists of two subscales: coping self-efficacy related to general nursing burden (6 items) and coping self-efficacy regarding relational difficulties (3 items). Participants rated the

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items on a five-point Likert scale ranging from 1 = “Strongly Disagree” to 5 = “Strongly Agree”. Higher scores indicates greater confidence in one’s ability to cope effectively with job-related stressors. Pisanti and colleagues (2008) provided support for criterion-related validity. Previous studies have reported acceptable reliability of this scale (Cronbach’s alpha = .83) (Laschinger, Borgogni, Consiglio, and Read, 2015; Pisanti, Lombardo, Lucidi, Lazzari, and Bertini, 2008). Cronbach’s alpha was .82 in the current study.

ACCEPTED MANUSCRIPT 13 Intent to leave one’s current job was measured with three items from the Turnover Intention Scale (Kelloway, Gottlieb, and Barham, 1999) rated on a five-point Likert scale (ranging from 1 = “strongly disagree” to 5 = “strongly agree”). The scale has shown acceptable

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Cronbach’s alpha from .87 and .92 (Laschinger and Grau 2012) and demonstrated construct validity (Kelloway, Gottlieb, and Barham, 1999; Laschinger, Finegan, Wilk, 2011). In this study, Cronbach’s alpha was .87.

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Data Analysis

Descriptive statistics, scale reliabilities, and Pearson’s r correlations were analyzed using

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SPSS, version 23.0 (IBM, 2015). Preliminary missing data analysis revealed that 22 participants (2.2%) had missing data for one or more subscales. We excluded these cases from our data, as a significant amount of data was missing. Full information maximum likelihood estimation, which uses all cases to estimate the values of missing data for structural equation modeling, was used to

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handle remaining missing data points (Buhi, Goodson, and Neilands, 2008). Following Kline’s (2011) recommendations for structural equation modeling (SEM), the hypothesized model was tested in two steps. First, the measurement model was tested using

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confirmatory factor analysis (CFA). After confirming the measurement model, we tested the structural model. The analyses were conducted using maximum likelihood estimation with

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Mplus, version 7.4 (Muthén and Muthén, 1998-2014). The following fit indices were used to assess how well the observed data fit the hypothesized measurement and structural models: chi-square test (χ2), root-mean-square error of approximation (RMSEA), standardized root-mean-square residual (SRMR), comparative fit index (CFI), and the Tucker-Lewis index (TLI) (Kline, 2011). For a model to have an acceptable fit, χ2 would be nonsignificant, that allows us to accept the null hypothesis that there is no

ACCEPTED MANUSCRIPT 14 difference between the hypothesized model and the observed data (Iacobucci, 2010). However, χ2 is sensitive to sample size, that is, a large sample will lead to rejecting the null hypothesis (Gerbing and Anderson, 1985). Therefore, we used additional fit indices (CFI, TLI, and

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RMSEA). The acceptable value for RMSEA and SRMR is < .08 (Browne and Cudeck, 1993; Hu and Bentler 1999), while CFI and TLI values should be > .90 (Kline, 2011).

We also generated 95% confidence intervals for the indirect effects by using bootstrapping

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with 500 iterations. The indirect effect is determined statistically significant when the confidence interval does not include zero (Lillis, Levin, and Hayes, 2011).

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Results

Participants

The demographic characteristics for the study sample are presented in Table 1. The majority of the participants were female (91%) with an average age of 27.43 years (SD = 6.35)

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making them from the Millennial generation. Most participants were baccalaureate-prepared (92.6%), and employed as full-time RNs (60.2%). Fifty percent of new nurses in this sample

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worked in medical or surgical units and 17.8% on critical care units.

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Table 1. Demographic characteristics of the sample (n=998)

Age Years as an RN

Mean 27.44 1.21

%

Gender Female Male

917 74

Education Baccalaureate degree Masters degree in nursing College nursing diploma

942 3 70

92.6 0.3 7

449 178 151 102 61

50 17.8 15.1 10.2 6.1

601 288 106

60.2 28.2 10.6

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Employment status Full-time Part-time Casual

91.9 7.4

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Specialty area Medical-surgical Critical care Non-acute care Maternal-Child Mental health

SD

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Frequency (n) 993 984

6.33 0.56

ACCEPTED MANUSCRIPT 16 Descriptive results The means, standard deviations, Cronbach alphas and correlations for the major study variables are presented in Table 2. Overall, new nurses perceived their managers to have a

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moderate level of authentic leadership (M = 2.60, SD =0.87). They reported a moderate level of personal identification with their leaders (M = 3.62, SD = .89) and identification with the

organization (M = 4.34, SD = 1.67) on a 7-point Likert scale. New graduate nurses perceived

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their occupational coping self-efficacy to be moderate (M = 3.60, SD = 0.54). The participants in our study reported low intentions to leave their current position (M = 2.38, SD = 1.20).

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Correlations among the major variables of the study were assessed for significance. AL was related to personal identification (.38), identification with the organization (.37), occupational coping self-efficacy (.19), and job turnover intentions (-.23). Personal identification with the leader was significantly associated with identification with the organization (.32) and

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job turnover intentions (-.09), while occupational coping self-efficacy (-.17) was not significant. Identification with the organization was significantly correlated with occupational coping selfefficacy (.20) and job turnover intentions (-.34). In addition, occupational coping self-efficacy

Results

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was significantly related to job turnover intentions (-.22).

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SEM the measurement model

In the measurement model, authentic leadership was modeled as a second-order latent variable with its four subscales as observed variables. Similarly, occupational coping selfefficacy was modeled as second-order latent variable with its two factors as indicators. Personal and organizational identification, and job turnover intentions were modeled as latent variables with their respective indicators. Our measurement model showed satisfactory fit (χ2 (542) =

ACCEPTED MANUSCRIPT 17 1813.075, RMSEA= .048, SRMR= .051, TLI= .94, CFI= .94, p < .001). Standardized factor loadings ranged from .74-.97 (p < .001) (Table 3). SEM the structural model

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The hypothesized model revealed satisfactory fit, indicating that the observed data fit the hypothesized model: χ 2 (547) = 1962.466, df= 547, RMSEA= .05, SRMR= .075, TLI= .93, CFI= .94, p < .001). All hypothesized paths were significant at p <. 001 level. As hypothesized,

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authentic leadership had a significant positive direct effect on personal identification with the leader (ߚ = 0.38) and organizational identification (ߚ = .29). Personal identification had a

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significant positive direct effect on new nurses’ organizational identification (ߚ = .23). Organizational identification had a significant positive direct effect on occupational coping selfefficacy (ߚ = .27). Occupational coping-self-efficacy had a negative effect on new graduate nurses’ job turnover intentions (ߚ = -.29). All results are displayed in Figure 2.

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Bootstrapped indirect effects revealed that personal identification mediated the relationship between authentic leadership and organizational identification (ߚ = .091, 95% CI: .058 to .125).

.049 to -.012).

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Authentic leadership had a significant total indirect effect on job turnover (ߚ = -0.031, 95% CI: -

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Figure 2. Structural model.

Model Fit: χ2= 1962.466, df= 547, χ2/df (3.60), RMSEA= .05, SRMR= .075, TLI= .93, CFI= 0.94, p < 0.001. Note: Latent variable indicators not included. All paths were significant at p <. 001 level.

ACCEPTED MANUSCRIPT 18 Demographic analyses Few demographic variables were significantly related to the major study variables. A oneway ANOVA was performed to examine the impact of nursing specialty on job turnover

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intentions. Results revealed that specialty area was significantly associated with new graduate nurses’ job turnover intentions (p< .05) [F(4, 986) = 3.15, p = .014]. Further analysis with a Scheffé post hoc test showed that the mean score of new graduate nurses working in

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medical/surgical units (M = 2.49, SD = 1.17) was statistically different from new graduate nurses working in critical care units (M = 2.16, SD = 1.19). New graduate nurses working in other areas

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did not differ significantly from either new graduate nurses working in medical/surgical or

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critical care units.

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19

SD 0.87 1.06 0.95 0.89

α .93 .92 .82 .88

1 .92* .91* .91*

2

3

4

.83* .79*

.76*

-

2.75

0.89

.87

.90*

.74*

.76*

3.62

0.54

.89

.38*

.36*

.33*

4.34

1.67

.87

.37*

.34*

3.60

0.54

.82

.19*

3.70

0.55

.76

.14*

10. OCSE - relational SE

3.50

0.76

.79

.23*

11. Job Turnover Intentions

2.38

1.20

.87

*p< 0.01 (2-tailed). **p< .05 (2-tailed).

-.23*

6

7

8

9

10

-

.36*

.34*

-

.35*

.31*

.34*

.32*

-

.19*

.18*

.14*

.19*

-.17

.20*

-

.13*

.13*

.08**

.15*

-.02

.20*

.92*

-

.24*

.22*

.20*

.20*

0

.20*

.83*

.60*

-

-.21*

-.19*

-.22*

-.09*

-.34*

-.22*

-.20*

.22*

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.81*

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8. Occupational Coping Selfefficacy (OCSE) 9.OCSE – task SE

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7. Organizational Identification

5

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Mean 2.60 2.40 2.56 2.69

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Scale/Subscale 1. Authentic Leadership 2. Self-awareness 3. Balanced processing 4. Relational transparency 5. Internalized moral perspective 6. Personal Identification

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Table 2. Means, standard deviations, scale reliabilities, and Pearson’s correlations

-.22*

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Table 3. Standardized factor loadings for each study variable Subscales/Items

AL

PI

OI

OCSE

JTO

Self-awareness

.94

Balanced processing

.97

Relational transparency

.96

Internalized moral perspective

.93

2. Personal Identification (PI)

.82

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Personal Identification - Item 1 Personal Identification - Item 2

.66

Personal Identification - Item 3 3. Organizational Identification (OI) Organizational Identification - Item1 Organizational Identification - Item 2 Organizational Identification - Item 3 4. Occupational Coping Self-efficacy (OCSE) OCSE - relational SE

.90

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OCSE – task SE

.96

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Personal Identification - Item 4

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1. Authentic Leadership (AL)

.74 .93 .90 .81 .80 .94

Job Turnover Intentions - Item 2

.75

Job Turnover Intentions - Item 3

.84

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5. Job Turnover Intentions (JTO) Job Turnover Intentions - Item 1

Discussion

The objective of the current study was to test a hypothesized model that linked authentic

leadership to new graduate nurses’ identification with their leader and the organization, and subsequently to occupational coping self-efficacy and job turnover intentions. Our results support authentic leadership theory and expand on previous empirical work by demonstrating that authentic leaders play a fundamental role in enhancing new graduate nurses’ retention

ACCEPTED MANUSCRIPT 21 outcomes (Laschinger and Fida, 2014; Laschinger, Wong, and Grau, 2012). The findings highlight the influence of authentic leaders on new nurses’ intentions to stay in their current position by building positive and supportive relationships that foster new graduate nurses’

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identification with their leader and the organization. Furthermore, these identifications increase new nurses’ confidence in their ability to manage work-related challenges that result in positive outcomes in both new graduate nurses and the organization.

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Consistent with authentic leadership theory, we found that authentic leadership had a direct influence on new graduate nurses’ identification with their leader and the organization. It

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has been proposed that leaders are viewed by organizational newcomers as representatives of the organization who help new employees learn about the organizational culture, values, and goals (Sluss, Ployhart, Cobb, and Ashforth, 2012). When new entrants to the workforce recognize attractive characteristics of the organization that are congruent with their own beliefs and values,

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they feel a sense of pride in their organizational membership (Zhu, Sosik, Riggio, and Yang, 2012). This facilitates the creation of a positive image of the organization in employees, which in turn aids in the development of their identification with the organization (Tajfel, 1972).

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The direct influence of authentic leadership on new graduate nurses’ organizational identification was significant, though contrary to the findings of a previous nursing study. Wong

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and colleagues (2010) found that the effect of authentic leadership on nurses’ workgroup identification was significant only through their personal identification with the authentic leader. Our results suggest that authentic leaders can influence new graduate nurses’ organizational identification directly, as well as indirectly, by creating work conditions that encourage openness and honesty, involving staff in the decision making process, and reinforcing positive organizational culture. This provides new nurses with needed support to advance their skills and

ACCEPTED MANUSCRIPT 22 knowledge, which strengthens their connection to the organization, and subsequent identification. As predicted, we found that new graduate nurses’ personal identification mediated the

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relationship between authentic leadership and organizational identification. The evidence

suggests that nursing mangers that engage in authentic leadership behaviors when interacting with staff promote new nurses’ identification with them personally. Subsequently, when new

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nurses recognize that their manager creates work conditions that are consistent with the organizational culture and mission, they start to feel sense of pride in belonging to the

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organization. These results support the claim that new employees’ identity is influenced by their leaders’ behaviors (Sluss et al., 2012). Because authentic leaders identify followers’ strengths and weaknesses and create supportive work environments that allow them to build and develop their skills and knowledge, while emphasizing the goals and values of the organization (Avolio

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et al., 2004), followers come to view the organization in a positive and desirable way, leading them to identify with the organization as well as the leader (Sluss and Asforth, 2008). Also, we found that as new graduate nurses identify themselves with the leader

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personally, and with the organization socially, their perceptions of their ability to overcome work-related difficulties increased. Our findings suggest that one mechanism through which

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authentic leadership influences new nurses’ occupational coping self-efficacy is personal and organizational identification. As managers provide coaching and create opportunities for new nurses to achieve professional goals by providing reasonable work assignments and assessing their development needs, new graduate nurses gain greater confidence in their ability to cope with the demands of the job. This is consistent with authentic leadership theory, which emphasizes the role of authentic leaders in facilitating the development of followers through

ACCEPTED MANUSCRIPT 23 positive modeling of authentic leadership behaviors and building leader-follower relationships that foster respect, positive emotion, and trust (Avolio and Gardner, 2005). One might note that in the current study the low correlation between personal

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identification with the leader and new graduate nurses’ intention to leave suggests that no

relationship between the two. However, our results indicate that authentic leaders through the mechanisms of identification and occupational coping self-efficacy may motivate new graduate

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nurses to stay in their position as they recognize the benefits of belonging to an organization where they are provided with various opportunities to advance their career. When leaders evoke

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self-identity in terms of the leader and the organization, new nurses recognize the value and goals they share with both the leader and the organization. This awareness contributes to their confidence in their ability to carry out their responsibilities and perform effectively, which subsequently reduces their intentions to leave their jobs.

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Finally, our findings suggest that new graduate nurses’ working in medical or surgical areas are more likely to leave than those in critical care. New graduate nurses have reported that they prefer critical care because they perceive it to be more challenging and high-pace with

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greater autonomy and a smaller patient-to-nurse ratio (Fenush & Hupcey, 2008). Meanwhile, medical and surgical units were less desirable due to heavy workloads and stressful working

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conditions that were also slow-paced and less challenging. A minority of students viewed medical and surgical units positively, with some seeing it as a stepping stone to something else, while others highlighted benefits such as autonomy, the opportunity to develop clinical assessment and critical thinking skills, and working with patients who were not critically ill (Fenush & Hupcey, 2008). This suggests that new nurses have preconceived notions about different specialty units that influence their specialty preferences and career goals and may affect

ACCEPTED MANUSCRIPT 24 their desire to leave, particular on medical and surgical units. In our study, the majority of new graduate nurses were employed in medical or surgical units, which may not be their first choice of specialty area. Medical and surgical units are

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characterized by heavy workloads, lower staffing levels, and increased patient acuity. These factors may contribute to inadequate support for new graduate nurses, resulting in a desire to quit and/or seek another position. Our findings also suggest that new graduate nurses working in

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critical care units were less likely to want to leave their job, suggesting that retention may be higher for new graduate nurses in highly specialized units. Nurses in critical care units are more

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involved in decision-making about patient care and have higher levels of autonomy than nurses practicing in other areas. The availability of career development, knowledge, and skills advancement opportunities have also been linked to lower job turnover among critical care nurses (van Dam, Meewis, va der Heijden, 2012) and may impact new graduate nurses’

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intentions to leave. Thus, establishing positive workplace conditions that support new graduate nurses’ professional development needs and contribute to experiential successes are important retention strategies for nurse leaders.

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Limitations

A potential limitation of our study is the use of cross-sectional data, as this prevents strong

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causal inference (Polit and Beck, 2012). Future research needs to examine new graduate nurses’ transition experience over time by employing a longitudinal design. Generalizability of the study findings is limited to new graduate nurses working in acute care and community settings in Canada. In cross-sectional studies, the use self-report measures are associated with response bias (Polit and Beck, 2012). Participants completed all measures at the same time, which may increase the risk for common method variance (CMV). Nevertheless, it has been argued that

ACCEPTED MANUSCRIPT 25 well-designed, validated, and multi-item psychometric measures have the potential to reduce CMV biases (Spector, 2006). Implications

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Our findings have numerous implications for future research, nursing management, and policy. From a research standpoint, our study provides support for authentic leadership theory, which proposes that authentic leaders influence followers’ work attitudes and behaviors through

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the mechanisms of identification (Avolio et al., 2004). The results of this study suggest that authentic leaders who facilitate the development of new graduate nurses’ personal and

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organizational identification are more likely to enhance their occupational coping self-efficacy, which, in turn, lower their intentions to leave. We recommend that future studies examine additional mechanisms by which authentic leaders and identification influence new graduate nurses’ intentions to leave, such as, trust in their leader, positive emotions, and optimism.

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From a practical standpoint, the results of our study identify a number of implications for healthcare organizations. Specifically, the finding that authentic leaders positively influenced new nurses’ personal and organizational identification suggests the need for authentic leadership

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development programs that provide nursing managers with tools to become more authentic. Leadership development interventions may include self-reflection activities to raise leaders’ self-

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awareness (Leroy, Anseel, Gardner, Sels, 2012), or training sessions that teach leaders skills to integrate divers points of view. Our study also highlights the influence of authentic leadership on new nurses’ occupational coping self-efficacy through their identification. Implementation of training initiatives that focus on developing organizational identification in newcomers is a valuable strategy to increase the confidence in their ability to work effectively, especially, in stressful work environments. An organization can influence new graduate nurses’ organizational

ACCEPTED MANUSCRIPT 26 identification by developing a sense of pride in belonging to the organization. This can be achieved by communicating organizational goals and values through organization newsletters and events.

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The findings of our study identify a number of implications for nursing managers. Our study highlights the critical role that authentic leaders play in influencing new nurses’ intentions to leave their current position by enacting the four dimensions of authentic leadership. Therefore,

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it is important for managers to promote integrity and openness with their staff by creating a

deeper sense of moral principles, engaging staff in making critical decisions, and sharing their

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thoughts and feelings, so that they communicate values and beliefs that perhaps resonate with new graduate nurses. Also, assessing the developmental needs and providing guidance and support will allow new nurses to develop personal identification with their manager. Through identification nursing managers can encourage new nurses to evaluate their strength and

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weakness, allowing both managers and new nurses to create and implement development and training plans that help new nurses advance their knowledge and skills. Our results have a number of policy implications. We believe that senior leaders and

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policymakers should implement strategies to improve new graduate nurses’ retention and work experience. First, organizations should strive to recruit and promote managers who demonstrate

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all four features of authentic leadership (Ilies, Morgeson, and Nahrgang, 2005; Wong and Cumminings, 2009). Second, policymakers should pay close attention to new graduate nurses’ socialization programs. Well-defined socialization activities will provide opportunities to introduce new nurses to the workplace culture, and allow them to develop positive relationships with their managers and peers. These activities can reduce new graduate nurses stress and promote confidence in their ability to overcome work challenges.

ACCEPTED MANUSCRIPT 27 Conclusion Our study adds support to authentic leadership theory and empirical studies suggesting that authentic leaders have the capacity to influence the work attitudes and behaviors of their

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followers. Our results suggest that to enhance retention of new graduate nurses, nursing

managers should strengthen new nurses’ identification with the leader and the organization, which boosts their occupational coping self-efficacy. In doing so, managers facilitate the

that are likely to reduce the growing nursing shortage.

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Conflict of interest

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successful transition of newcomers to the nursing profession, thereby, contributing to conditions

The authors declare that they have no conflict of interest Acknowledgements

This study was funded by the Canadian Institutes for Health Research Partnerships for Health

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Systems Improvement (#122182) with contributions from the Registered Nurses’ Association of Ontario, the Nova Scotia Health Research Foundation (#139405), the Niagara Health System, Health Canada, Alberta Innovates – Health Solutions, St. Michael’s Hospital (Toronto, ON),

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VON Canada, Providence Care, Capital Health (Nova Scotia), Fraser Health (British Columbia), Victoria General Hospital (Winnipeg, MB), London Health Sciences Centre (London, ON),

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Health Force Ontario, and the McGill University Health Centre.

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Highlights

Authentic leaders indirectly influence new nurses’ intention to stay.

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Authentic leaders foster new nurses identification with the leader and the organization.

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Identifications increase new nurses’ occupational coping self-efficacy.

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New nurses’ identifications and occupational coping self-efficacy influence their job turnover intentions.

To enhance new nurses’ retention, their identification with the leader and the

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organization should be strengthened.

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