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Exploring the Influence of Leadership Identity on Radiologists' Leadership in German University Hospitals: A
Jawed Nawabi1, Christine Gockel2, Michael Scheel1
1Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin Institute of Health, Berlin, Germany.
Background:
Little is known about how physicians perceive their leadership identity and how this shapes their leadership behaviors. This study examines the relationship between leadership identification, leadership behavior, and leadership-related outcomes.
Methods:
A cross-sectional survey was conducted among consultant radiologists in German university hospitals from January to November 2023. Leadership identification, leadership behavior (task orientation, relationship orientation, change orientation, and external orientation), workload, and outcome measures (staff engagement, organizational commitment, and perceived team performance) were assessed with validated self-report instruments. Pearson correlation coefficients (r) were calculated to examine relationships among the variables. Mediation analysis examined whether leadership behavior mediates the relationship between leadership identification and outcome measures.
Results:
Consultant radiologists identified primarily as physicians (median = 60%, IQR: 40-80%), followed by leaders (median = 45%, IQR: 30-60%), with a negative correlation between physician and leadership identity (r = -0.34, p < 0.01). Participants reported moderate to high levels of exhaustion, with feeling physically overwhelmed receiving a median score of 4 (IQR: 3-4) on a 0-4 scale. Notably, only 25.8% of participants reported having sufficient time for leadership tasks, despite holding leadership responsibilities for a median of 75.5 months (IQR: 31.5-261). Conversely, leadership identity negatively correlated with workload (r = -0.30, p < 0.05). Leadership identification significantly predicted leadership behavior (β = 0.27, p < 0.001), which, in turn, was positively associated with staff engagement (β = 0.30, p < 0.009), confirming an indirect effect (CI: 0.0014-0.0162). However, leadership identification did not directly predict staff engagement (β= 0.001, p = 0.94).
Conclusion:
Stronger leadership identification is associated with lower perceived workload and greater engagement in leadership behaviors, which may serve as a coping mechanism for managing leadership-related demands. However, its impact on staff engagement operates through the leadership behaviors rather than through identification alone.
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