Published
2026-06-16
Section
Articles
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Copyright (c) 2026 Courtney Walker, Stephanie Gingerich
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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How to Cite
Informal Clinical Leadership Development: Cohort-Based Quality Improvement
Courtney Walker
https://orcid.org/0009-0008-8659-0879
Stephanie D Gingerich
University of Minnesota, Twin Cities - School of Nursing
https://orcid.org/0009-0003-6538-1510
DOI: https://doi.org/10.24926/ijps.v13i1.7610
Keywords: informal nurse leader, development, cohort, partnership, quality improvement
Abstract
Introduction: Informal clinical nurse leaders, bedside nurses without formal training and authority who influence their peers, are essential to quality care and team functioning, yet often lack structured leadership preparation. A needs assessment of a unit coordinating council in a 37-bed cardiovascular progressive care unit identified gaps in leadership confidence, leadership competencies, and change management skills.
Purpose: This quality improvement project aimed to increase the intrinsic leadership capability and preparation among unit-based informal nurse leaders through a structured development cohort.
Methods: Based on the theoretical framework of partnership, a three-month cohort intervention was implemented at a large Midwestern academic medical center. The program included three didactic sessions aligned with American Organization for Nursing Leadership “Leader Within” competencies, individualized mentoring, and visual cue reinforcement. Using iterative Plan-Do-Study-Act cycles, the curriculum was co-developed with participants. Pre- and post-intervention surveys assessed self-reported leadership identity, knowledge, confidence, and application.
Results: Eight participants completed the project. Mean scores from pre and post Likert questions improved across all domains, with the largest increase in competency identification. Neutral responses were largely eliminated post-intervention in favor of positive results. Qualitative leadership findings shifted from relational descriptions of leadership to systems-level influence, change management, and accountability.
Conclusion: A cohort-based leadership development model was associated with self-reported improved leadership confidence, knowledge, and application among informal nurse leaders. Collectively, these findings suggest that intentional, unit-based leadership development initiatives provide measurable value for informal nurse leaders at the bedside.
