Investigating the Impact of Professional Certification on Leadership Practices and Effectiveness in Health Administration in Saudi Arabia: A Cross-Sectional Mixed-Methods Study.

Background: Professional certification is increasingly promoted as a strategy for enhancing leadership competencies among healthcare administrators. However, evidence on its influence on leadership practices and effectiveness remains limited. Objective: To examine the relationship between professional certification, leadership practices, and leadership effectiveness among healthcare administrators. Methods: A cross-sectional mixed-methods study was conducted among healthcare administrators working in diverse healthcare settings. Using purposive sampling, 200 administrators were invited through email, institutional networks, and professional forums; 163 completed the survey. Leadership practices were assessed using a six-item Leadership Practices Scale, and leadership effectiveness was measured using a two-item Leadership Effectiveness Score. We evaluated Reliability and validity using Cronbach's alpha and exploratory factor analysis. We examined associations between certification status and leadership outcomes through Independent-samples t-tests, multiple linear regression, and logistic regression. We use thematic content analysis method for qualitative responses. Results: Participants reported high levels of leadership practices (M = 4.48, SD = 0.44) and leadership effectiveness (M = 4.12, SD = 0.69). The Leadership Practices Scale showed acceptable reliability (Cronbach's α = 0.772) and a unidimensional structure. Although certified respondents reported slightly higher leadership practices and leadership effectiveness scores than non-certified respondents, these differences were not statistically significant in either bivariate or multivariate analyses. Certification was not an independent predictor of leadership practices or leadership effectiveness after controlling for education level and years of experience. Nevertheless, respondents perceived certification as beneficial to leadership development. Frequently reported areas of improvement included decision-making (71.7%), strategic thinking (68.6%), communication (67.9%), and organisational planning (63.5%). Additionally, 89.0% of respondents reported that certification increased or significantly increased their confidence as leaders. Qualitative findings highlighted enhanced leadership competencies, increased professional credibility, positive organisational outcomes, barriers to certification, and recommendations to expand certification opportunities. Conclusion: Professional certification was not significantly associated with leadership practices or leadership effectiveness. In contrast, participants reported improvements in leadership competencies following certification and viewed it as contributing to teamwork, decision-making, and organisational effectiveness. These findings suggest that expanding access to certification programs may support leadership development in healthcare organizations.