ArticleJournal of nursing management2026
From Shadows to Spotlight: Courageous Followers Shape Leaders Perceptions and Influence Followers' Job Performance.
Article in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- From Shadows to Spotlight: Courageous Followers Shape Leaders Perceptions and Influence Followers' Job Performance.Journal of nursing management · 2026Article
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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 ( 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.
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Registered trials
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