Virtual Leadership in Nursing Education

Pamela Levesque, MS, APRN, FNP-BC

The transition to online education with faculty teaching at a distance has created ‘‘virtual departments’’ of nursing thatnecessitates a new way of leading. The author discusses leadership theory and team-building methods to support leadersengaged in virtual departments of nursing.

Rapid technological advancements have resulted ina new paradigm of work and learning that can beperformed anywhere, any time.1 Many nursing

programs have transitioned away from face-to-face conver-sations as the predominant communication method. Stu-dents are texting, e-mailing, ‘‘tweeting,’’ and ‘‘facebooking’’each other and their faculty. Faculty hold class in an onlinecommunity where uploaded photographs may be the onlyway to ‘‘see’’ the student. A nursing department in a virtual,or online, world consists of diverse faculty from aroundthe country, or world, with a director located either at homeor the home campus. The term global virtual teams refersto teams that are separated by time, geographic distance,culture, and/or organizational boundaries; they rely almostexclusively on communication technology to interact andcomplete their projects.2 All academic teams are dependenton communication and collaboration that require a leaderwho is able to motivate, inspire, and build trusting relation-ships. With 400 RN to BSN, as well as many master’s anddoctoral programs, at least partially online, the successfulleader in the virtual environment needs to embrace a newset of skills along with an evolved leadership philosophy tocreate a cohesive and high-performance group.3 There are4 overarching themes that inform the work of virtual teamleaders: virtual leadership, communication, connection, andteam management.

Virtual LeadershipTheoryA successful virtual leader learns how to cross time, space,and culture barriers to create communities with cohesionand shared commitment. The academic nursing depart-ment of today may have a director housed at the ‘‘home’’institution (or working from home) with faculty locatedthroughout the country, or globally. This dispersed depart-

ment, or virtual team, requires a leader who is groundedin a philosophical way of being that supports this newparadigm.

Leadership has been defined many ways but is usedhere as the process of influencing people to accomplish goals.4

Leadership theories, seeking to understand the characteristicsand qualities of leaders, have included trait theories, contin-gency theories, situational theories, behavioral theories, andrelational theories.4 These theories, many from the 20th cen-tury, do not embrace the context of our multifaceted worldwhere complexity science shows ways to think about andunderstand a world that is no longer linear yet still very muchrelationship based.5 A new leadership science has unfoldedthat is congruent with complexity science and offers a newway of inspiring and communicating. For example, onegroup of authors speak to Bass and Avolio’s Full RangeLeadership Theory that has integrated transformational,transactional, and laissez-faire leadership styles.1

Two other leadership theories to consider are the Com-plexity Leadership Model and Transformational Leadership.5

Both theories offer new ways to lead that is removed fromthe top-down, distancing, and mechanistic leadership of thepast. Both theories have a leadership definition that includesemotional intelligence, a self-reflective practice, active pres-encing, interdependence, and transparency, as well as sharedvalues and attitudes reflecting the mission within a trustingenvironment.5 The virtual leader in nursing education ispoised to integrate the science of complexity theory, withchaos and change inherent, while planning for the future.They must do this while uniting individuals from afar, allwhile remembering the task at hand of educating the nextgeneration of nurses.

CommunicatingThe development of emotional intelligence appropriate forthe virtual leadership role involves ‘‘reading and seeing’’ thecontext of conversations. This is a situation where mindfulintuitive listening is key; as example when using phoneconferencing, do not multitask, put down competingactivities, and listen with your eyes closed.6 The work ofthe leader in these situations is to develop a high level oflistening in order to creating ‘‘seeing.’’6

Nurse Educator Volume 37 & Number 5 & September /October 2012 211

Nurse EducatorNurse EducatorNurse Educator

Vol. 37, No. 5, pp. 211-213

Copyright * 2012 Wolters Kluwer Health |

Lippincott Williams & Wilkins

Author Affiliation: Associate Professor and Associate Director, Depart-ment of Nursing, New England Institute of Technology, East Greenwich,Rhode Island.The author declares no conflict of interest.Correspondence: Ms Levesque, New England Institute of Technology,1900 Division Road, East Greenwich, RI 02886 (pjl2110@gmail.com).DOI: 10.1097/NNE.0b013e318262abb6

Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

Countless tools, such as e-mail, Skype, smart phones,text messaging, and message boards help virtual teams stayin close communication. Upon hire, it is imperative that fac-ulty understand the school of nursing’s communication guide-lines and requirements regarding their ownership and useof technology. For instance, will there be a monthly fullfaculty meeting and what technology, such as Skype, will beused? In addition, establishment of e-mail response guide-lines is essential. Faculty should have a clear understandingof the expectations for timeliness in responding to e-mail,both to each other and to leadership. Issues of power out-ages or weather challenges need to be proactively anticipatedand planned for prior to an event. E-mail response guidelines.Clear communication of e-mail response guidelines will avoidunnecessary confusion and misunderstanding.

Varying time zones represent challenges to ‘‘live’’ meet-ings. An understanding regarding meeting times should bedetermined by all participants who will be correspondingacross time zones. In general, if it is only a couple of timezones, team members may have some overlapping timesthat can be used for communication. However, if thereare no overlapping times, for example, weekend and week-nights, expectations should be communicated with all thoseinvolved.

The virtual leader communication style should bedevoted to creating mechanisms for transparency of infor-mation and open communication. This might be a semi-weekly newsletter to all virtual faculty or a page link, solelyfor nursing department communication, on the college’sonline learning platform. Leveraging expertise in virtualmeeting media is extremely important. Preparation forvirtual meetings is time intensive, with the suggestion that4 hours of preparation is often needed for 1 hour of actualmeeting time.7

To manage a productive virtual meeting, the leaderhas to ensure that expectations for involvement have beenestablished, materials are provided at least 1 week in advance,and everyone has been queried to ensure that anyone whowants to contribute can and the meeting is tightly organizedto address the factual agenda aspects and the emotionalconnectedness of the team.8 To foster trust and thwartdissonance when communicating in the virtual community,the leader must be an astute listener and pay diligent atten-tion to participation.

Consistent and clear communication, key to any orga-nization, is complicated in the virtual setting by physicaldistance and time zone differences. Transparency in com-munication is congruent with transformational or complex-ity leadership theory and is aligned with complexity science.However, achieving this level of communication requiresa mindful approach. Frequency of communication shouldbe a priority consideration as it is critical for relationship de-velopment, which includes trust. Regular and ongoing con-tact along with careful consideration to message content isessential. It is important to engage distance emotional in-telligence in the virtual relationship and clear up any appar-ent miscommunications quickly. Although it may seemnatural to respond via e-mail to a situation, leaders shouldremember that using the telephone or using Skype may bemore beneficial as it can thwart unnecessary or prolongedconfusion that might erode trust.

ConnectionThere are 2 key challenges in the virtual environment: oneis isolation, and the other is confusion.7 Creating a senseof connection and ‘‘aliveness’’ is a key element in addressingboth of these issues. How is this accomplished? Begin-ning with the job interview and throughout employment,community-building priorities such as identification of cul-ture, establishing clear expectations, and engagement indepartmental activities need to be present and transparent.7

Leader intentionality toward trust building and engagementassists in ensuring a sense of connection among faculty.This can be done initially through the orientation process,establishing new-hire announcements at both the institu-tional and department levels, frequent invitations to meet-ings in both the department and organization, delegation,clear and consistent communication through technology,and being personally available and responsive as a leaderone-to-one.7

A transformational leader also fosters a supportive andsafe climate by creating a milieu where team members feelthat it is safe to offer intellectual input with unique per-spectives, where the leader challenges assumptions, reframesproblems, and approaches situations in new ways.9 Relation-ship building and trust require time and effort. The wiseand heartfelt leader will acknowledge the importance ofrelationship building through knowing each member indi-vidually and encouraging engagement between members ofthe department. Implementing strategies and a way-of-beingthat illuminates the importance of these elements will es-tablish a virtual climate of safety that provides a foundationfor building trust and relationships where the vision of thework can be embraced and actualized.

Team Building and ManagementHealthy behaviors seldom get the attention that toxic be-haviors or negative outcomes receive.10 Ensuring that indi-viduals in the virtual department understand establishedvalues and cultural norms of the organization is importantand begins with each new hire. The social complexity ofvirtual teams, defined as cultural diversity, geographical dis-persion, means of communication, and degree of languagefamiliarity, contributes an additional layer of complexity toteam building.11 Establishing a shared vision and healthy foun-dation through clear and consistent communication can setthe stage for building cohesive teams.

As in traditional settings, the leader is both mentor andcoach.10 Always ‘‘on,’’ the leader displays communicationthat is respect based, acknowledges each person’s unique-ness (culture, generational, and experience), reflects equity,and is open, free-flowing, and inclusive.5,10 The leader alsohelps establish a culture of safety through team building thatincludes time for meeting rule setting and then reinforcesthese rules when individuals or teams are not self-monitoring.

One approach to team building, the Team Spirit model,is a nonlinear, field theory–based model that addresses teamrelationships, quality, and service aspects of work.12 Themodel is based on the spiraling phases of initiating, vision-ing, claiming, celebrating, and letting go. Each phase hascharacteristic consonances and dissonances. As example,in the initiating phase, consonances are belonging andtrust, whereas dissonances are disorientation, alienation,

212 Volume 37 & Number 5 & September /October 2012 Nurse Educator

Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

and mistrust.12 The Team Spirit spiral model demonstratesthe evolving process of building a spirited team where theheart of the spiral is service.12 The model is useful as anevaluation method to assess team functioning where thedemonstration of all 5 aspects represents high perfor-mance.12 To read more about the Team Spirit model by itsdeveloper, Barry Heermann, go to Google Books and searchfor ‘‘Team Spirit model.’’ Team unity responsibility in thevirtual academic nursing department relies heavily on strongleadership skills. Leaders should be fluent with technologyand understand the challenges associated with differentcommunication media. Establishing clear goals with teamsthat are concrete and inclusive of all team members’voices, as well as establishing regular one-on-one meet-ings with followers, all that reflect the transformationalleader, will go far in facilitating team cohesion and trust.11

ConclusionJohn Heider,13 in his 1985 adaptation of The Tao of Lead-ership, wrote, ‘‘When you cannot see what is happening ina group, do not stare harder. Relax and look gently withyour inner eye.’’ Although this written for a different con-text, it certainly applies to the virtual leader. Successfulvirtual leaders learn how to cross time, space, and culturebarriers.9 There are many similarities between the tradi-tional leader and the virtual leader, but the virtual leadermust do these things without the advantage of a sharedsame-space meeting.8 Acknowledging the uniqueness andneeds of the situation is an essential reality that will allowthe nursing education leader to facilitate a caring and safevirtual relationship.

References1. Hambley LA, O’Neill AT, Kline JBT. Virtual team leadership:

perspectives from the field. Int J e-Collab. 2007;3(1):40-64.2. Marquis LB, Huston JC. Leadership Roles and Management Func-tions in Nursing: Theory and Application. 7th ed. Philadelphia,PA: Lippincott Williams & Wilkins; 2012.

3. American Association of Colleges of Nursing. Fact Sheet: DegreeCompletion Programs for Registered Nurses: RN to Master’s De-gree and RN to Baccalaureate Programs. Available at http://www.aacn.nche.edu/media-relations/fact-sheets. AccessedMay 24, 2012.

4. Huber LD. Leadership and Nursing Care Management. 4th ed.Maryland Heights, MS: Saunders Elsevier; 2011.

5. Porter-O’Grady T, Malloch K. Innovation Leadership. Boston,MA: Jones and Bartlett Publishers; 2010.

6. Kerfoot MK. Listening to see: the key to virtual leadership.Nurs Econ. 2010;28(2):114-116.

7. Holland BJ, Malvey D, Fottler DM. Health care globalization:a need for virtual leadership. Health Care Manag. 2009;28(2):117-123.

8. Hirsch MJ. Virtual team leadership: a case-study in Christianhigher education. Christian High Educ. 2011;10(2):97-111.

9. Huang R, Kahai S, Justice R. The contingent effects of lead-ership on team collaboration in virtual teams. Comput HumBehav. 2010;26:1098-1110.

10. Malloch K, Porter-O’Grady T. The Quantum Leader: Applica-tions for the New World of Work. 2nd ed. Boston, MA: Jonesand Bartlett Publishers; 2009.

11. Magnus BE. The conceptualization of social complexity inglobal teams. Nord Psychol. 2011;63(1):35-50.

12. Crowell MD. Complexity Leadership: Nursing’s Role in HealthCare Delivery. Philadelphia, PA: FA Davis Company; 2011.

13. Heider J. The Tao of Leadership: Leadership Strategies for aNew Age. New York, NY: Bantam Books; 1985.

Alarming Statistics for Preterm Births in the United States

Preterm birth rates are higher in the United States than in 130 other countries, according to international health agencies including theMarch ofDimes Foundation and the World Health Organization.1 This ranking places the incidence of preterm births in the United States between theCongo and Nigeria. For every 100 live births in the United States, 12 are preterm. Fortunately, more preterm infants do survive in the UnitedStates than in nations with fewer health resources.

Chris Howson, PhD, an author of the report, offers several explanations for this alarming ranking. One cause is the increasing rate ofobesity and associated risks of gestational diabetes and hypertension. The number of uninsured women has increased, thus decreasingeffective prenatal care. Howson also notes that elective cesarean deliveries scheduled too early in the pregnancy contribute to pretermbirths. Also, older women who have difficulty with conception frequently use fertility drugs. These drugs increase the chance for multiplebirths and consequently for preterm births.

More than 60% of all preterm births occur in Africa and South Asia. The very poorest countries report that up to 12% of the infants bornevery year are born prematurely. In comparison, countries with higher average incomes report a 9% preterm birth rate.

DrHyagriv Simhan,MD, ofMagee-Women’s Hospital of the University of PittsburghMedical Center reminds us that the best way tominimizepreterm births is to assist the mother with a carefully planned pregnancy. Seemingly simple choices, such as eating right, not smoking, andwaiting a year between pregnancies increase the chances of a full-term pregnancy.

The evidence provided by this report offers an excellent strategy for comparing healthcare outcomes in the United States with thoseworldwide. Howson’s comments imply that some of our advances in healthcare contribute to preterm births, that is, cesarean deliveriesand fertility drugs. Simhan reminds us of the basic needs of the pregnant mother. Surely, the ranking of the United States in preterm birthsshould improve and reflect the resources available to pregnant women in our country.

Reference1. Laino C. U.S. ranks 131st in preterm births: each year nearly 500,000 babies are born prematurely inU.S. WebMD. Health and Pregnancy. May 2, 2012. Available at http://www.webmd.com/baby/news/20120502/us-ranks-131st-in-preterm-births. Accessed May 3, 2012.

Source: ANA Smart Brief. U.S ranks 131st in world for preterm births. May 3, 2012. Available athttps://mail.google.com/mail/?hl=en&shva=1#search/preterm/137135bdaa8159d3. Accessed May 17, 2012.

Submitted by: Robin E. Pattillo, PhD, RN, CNL, news editor at NENewsEditor@gmail.com.

DOI: 10.1097/NNE.0b013e318262eb79

Nurse Educator Volume 37 & Number 5 & September /October 2012 213

Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.