• From Shadows to Spotlight: Cou...

*Result*: From Shadows to Spotlight: Courageous Followers Shape Leaders Perceptions and Influence Followers' Job Performance.

Title:
From Shadows to Spotlight: Courageous Followers Shape Leaders Perceptions and Influence Followers' Job Performance.
Authors:
Ghias WB; Department of Leadership & Management Studies, National Defense University (NDU), Islamabad, Pakistan.; Faculty of Management Sciences, National University of Modern Languages (NUML), Islamabad, Pakistan., Zahur H; Faculty of Management Sciences, National University of Modern Languages (NUML), Islamabad, Pakistan.
Source:
Journal of nursing management [J Nurs Manag] 2026 Jan 19; Vol. 2026, pp. 9927655. Date of Electronic Publication: 2026 Jan 19 (Print Publication: 2026).
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 9306050 Publication Model: eCollection Cited Medium: Internet ISSN: 1365-2834 (Electronic) Linking ISSN: 09660429 NLM ISO Abbreviation: J Nurs Manag Subsets: MEDLINE
Imprint Name(s):
Original Publication: Oxford : Blackwell Scientific Publications, c1993-
MeSH Terms:
Work Performance*/standards , Work Performance*/statistics & numerical data , Leadership* , Perception* , Courage*, Humans ; Cross-Sectional Studies ; Adult ; Female ; Male ; Surveys and Questionnaires ; Pakistan ; Middle Aged
References:
J Healthc Leadersh. 2022 Apr 21;14:47-53. (PMID: 35480596)
Nurs Forum. 2022 Nov;57(6):1289-1298. (PMID: 36052985)
Leadersh Health Serv (Bradf Engl). 2024 Sep 30;37(4):570-586. (PMID: 39344570)
Nurs Open. 2022 Sep;9(5):2289-2303. (PMID: 34255937)
J Nurs Manag. 2015 Mar;23(2):156-68. (PMID: 23826762)
Int J Nurs Stud Adv. 2024 Jul 17;7:100222. (PMID: 39108546)
J Nurs Manag. 2025 Apr 7;2025:7920607. (PMID: 40230450)
Annu Rev Psychol. 2012;63:539-69. (PMID: 21838546)
Nurs Inq. 2025 Apr;32(2):e70022. (PMID: 40222026)
Front Psychol. 2022 May 19;13:815147. (PMID: 35664195)
BMJ Lead. 2024 Jul 1;8(2):127-133. (PMID: 37696538)
Contributed Indexing:
Keywords: courageous followership; follower performance; hierarchical culture; implicit theories; nursing leadership
Entry Date(s):
Date Created: 20260121 Date Completed: 20260121 Latest Revision: 20260123
Update Code:
20260130
PubMed Central ID:
PMC12814860
DOI:
10.1155/jonm/9927655
PMID:
41561075
Database:
MEDLINE

*Further Information*

*Background: In health care, leadership is often viewed through top-down lens, which leaves the active role of followers unrecognized. Nurses do not just comply with orders-they shape leadership, culture, and performance through their behavior. Courageous followership, reflected in accountability, integrity, and speaking up, is central to this influence. Yet, this perspective remains underexamined in hierarchal healthcare environments.
Aim: This study examines how courageous followership affects leaders' implicit followership theories (LIFTs) and followers' job performance. It also explores LIFTs as mediating mechanisms within healthcare teams.
Methods: Multisource data were collected from 472 healthcare professionals in Pakistan using cross-sectional survey design. Partial least squares structural equation modeling (PLS-SEM) was used to test direct and mediated relationships among five courageous followership dimensions, LIFTs and follower job performance.
Results: Four dimensions of courageous followership, that is, assume responsibility, serve, challenge, and participate in transformation-positively influence both LIFTs and job performance with LIFTs as a mediator. However, the dimension of "taking moral action" had a negative effect, suggesting that ethical dissent may be viewed unfavorably in high-power distance environments. The structural model demonstrated strong explanatory and predictive power (Q <sup>2</sup> for LIFT = 0.587 and Q <sup>2</sup> for performance = 0.478).
Conclusion: This study offers a novel theoretical integration of followership theory and implicit followership theories, emphasizing how followers' courage, ethics, and agency shape leadership perceptions and outcomes. It shifts attention from leader-centric views to more relational, followers-focused understanding of healthcare leadership.
Implications for Nursing Management: Health care leaders should recognize and encourage follower behaviors that promote responsibility with accountability. Leadership development must address perceptual biases, strengthen leader openness to follower contributions to fully harness the value of nursing followership.
(Copyright © 2026 Wajeeha Brar Ghias and Hafsah Zahur. Journal of Nursing Management published by John Wiley & Sons Ltd.)*

*The authors declare no conflicts of interest.*