Nursing Leadership in Rural Hospitals: A Competency Needs Assessment


  • Teresa Welch The University of Alabama
  • Christina Glenn The University of Alabama


Purpose:  Assess competence and competency needs of nursing leadership in rural hospitals located in the Alabama Black Belt Region. Determine the preferred method of continuing education to meet those identified competency needs. 

Sample: A purposeful sample of registered nurses currently working in leadership roles identified by the Chief Nursing Officer as nurse manager or nursing directors in a participating rural hospital within the Alabama Black Belt Region. 

Method: A pilot study using descriptive statistical analysis to assess competency needs of nursing leadership and preferred method of educational delivery through email survey and Likert-style questions. For purposes of recruitment, Chief Nursing Officers were personally introduced to the purpose and design of the study and asked to distribute the email survey to their staff. Descriptive statistics analysis was used to examine role preparation and experience of nurse managers and mean self-rated competency scores. Bivariate correlations were examined exploring relationships between nurse manager experience, education, and competency. 

Findings: Statistically significant at p=0.031, participants with <5 years of experience reported non-proficiency in their knowledge of quality improvement strategies and non-proficiency in their ability to lead multi-generational work teams as compared to those with > 5 years of experience who reported proficiency, p=0.026. 

Conclusions: In an environment where constant change and quality drive organizational success, nurse leaders with < 5 years of experience are not proficient in managing multi-generational work teams or in understanding or managing focused quality improvement strategies to monitor, analyze, and improve the quality of patient care processes to improve the healthcare outcomes in an organization.

Realizing that more than 50% of the current nursing leadership has < 5 years of experience these findings would suggest that leading and managing, striving for clinical excellence in a diverse workforce would be difficult if not impossible to achieve.

Keywords: Rural Hospital, Competency, Leadership, Needs Assessment, Nurse Manager


Author Biographies

Teresa Welch, The University of Alabama


Assistant Professor, University of Alabama, Capstone College of Nursing

Christina Glenn, The University of Alabama


Assistant Professor, University of Alabama, Capstone College of Nursing