Nursing Leadership Development and the Contribution of the Robert Wood Johnson Foundation Executive Nurse Fellows Program

The Program Being Evaluated

The Robert Wood Johnson Executive Nurse Fellows Program is a leadership development program designed to prepare a select cadre of registered nurse executives for leadership roles in shaping the U.S. health care system of the future. The ultimate goal was to help the nursing profession gain a more influential voice in setting and implementing health care policy.

Each year, 15 fellows were chosen from senior executive positions in three fields of nursing considered vital to shaping the U.S. health care system of the future: clinical practice, nursing education and public health. Each fellowship would last for three years. Fellows would continue to work for their employing institution, but would be guaranteed time off for program activities.

Four core elements of the program would provide fellows with learning opportunities:

  1. Seminars: A sequence of group seminars would emphasize creative problem solving and insights into the exercise of managerial leadership. Since most nurse executives have done graduate work, the curriculum would strive not to duplicate that training.
  2. Projects: Each fellow would design and implement a "leadership project" at their employing institution. The project's leaders expected it to address an essential need of the home organization and at the same time provide the fellow with an opportunity for professional growth.
  3. Mentorships: An individual mentor distinguished for leadership outside the health care field would provide each fellow with guidance and counseling. Planners believed a role model from another area of interest would help expand the fellow's perspective.
  4. Individual activities: Fellows would pursue individual study and leadership development activities as part of a personal learning plan. These might include enrollment in an academic course, attendance at a professional conference and/or reading books on a certain subject.

About the Evaluation

The Robert Wood Johnson Foundation (RWJF) commissioned The Lewin Group led by Colleen Hirschkorn, M.P.A., of The Lewin Group working in collaboration with Health Workforce Solutions to conduct a study of the usefulness and impact of nursing leadership programs in general, and the Foundation’s Executive Nurse Fellows Program (ENFP), in advancing the field of leadership development and other national health care priorities. The study also gathered information on nurse leaders who have participated in the ENFP since 1998, to better understand the program’s impact on the field of nurse leadership development and the ability of participants to advance organizational priorities and apply leadership skills to contribute to system innovation and change.

Major Evaluative Topics and Questions

The objectives of the study were to:

  • Describe the characteristics of existing leadership development programs for nurses and other members of the health care workforce;
  • Examine the most important leadership development needs of nurses;
  • Identify the gaps in what is known about the leadership capacity of nurses across practice areas;
  • Evaluate the contribution of the ENFP made in building the field of nurse leadership development.

Summary of Methods

The evaluation included:

  • a telephone survey of RN and non-RN health care professions;
  • an environmental scan of leadership development programs;
  • a literature review;
  • a Web-based survey of ENFP alumni; and
  • interviews with program participants.

Knowledge and Impact

The findings of this study demonstrate that effective executive nurse leadership has a positive impact at both the organizational and the broader health system levels. At the same time, there remains enormous leadership challenges and inadequate leadership development offerings available to nursing leaders. The ENFP occupies a unique niche, providing rich opportunities to translate enhanced leadership skills into heightened effectiveness across service, education and public health sectors. It also increasingly serves as a model and catalyst in seeding new leadership development programs.