Perceptions of leader self-efficacy of physical therapists in the United States from academic and clinical environments

Abstract

Background The rapidly changing world of health care, the calls for interprofessional collaboration, and the need for public health care policies necessitate a conscious deliberation of the status of leadership within the profession of physical therapy. Within health care upper administration and higher education administration, there are few physical therapists that have attained these formal leadership positions. Historically and currently, the profession of physical therapy in the United States exhibits a skewed gender ratio with a greater number of females over males without a concomitant ratio in academic or clinical formal leadership positions. And more than one survey indicates that females are significantly more likely to achieve a mid-level position than a top level such as president or CEO. Recent conceptual models link emotional intelligence as an important characteristic to leadership success. Emotional intelligence is derived from five different components: selfawareness, self-regulation, motivation, social skill and empathy [1]. Self-regulation encompasses both the cognitive and behavioural aspects of a person which drive the person to act on their concept of self, elicit behaviour change or change the environment/recruit resources which drive towards outcomes in line with their sense of self. Self-efficacy is the personal judgement that one can successfully execute the behaviours for a desired course of action. Self-efficacy is contextually specific. A person's level of self-efficacy influences self-regulation, a component of emotional intelligence. High levels of self-efficacy in leadership contribute to selfregulation as the person with high self-efficacy will seek out activities of leadership or will persist at the task chosen [2], whereas a person with low self-efficacy beliefs or doubts regarding their skills will avoid situations of leadership or may quit the task sooner. Therefore, leader self-efficacy is the personal judgement or conviction that one can successfully execute the leader behaviour(s) or the desired course of action to produce certain outcomes. There is a significant influence of positive/high self-efficacy on leader identification and general performance in the workplace [3]. Three constructs of leader self-efficacy are leader action self-efficacy (capabilities to organise the psychological necessities), leader self-regulation efficacy (motivation to garner success) and leader means efficacy (ability to orchestrate resources) [4]. The perceptions of physical therapists on leader self-efficacy are not known. This is the first study of leader self-efficacy of physical therapists. Purpose The purpose of this study was to explore the perceptions of physical therapists in the United States on the topic of leader self-efficacy with consideration of the impact of demographics such as gender, age and board certification in specialty practice. Methods Subjects included 646 physical therapists who responded to email recruitment. The recruitment email was sent to personal contacts and publically available email addresses. Snowball sampling was used for the online delivery of the Leadership Efficacy Questionnaire (LEQ). This validated instrument measures the three proposed constructs of leader selfefficacy [4]. Physical therapists were queried on their perception of confidence for the each of the constructs of leader self-efficacy. The questions requested each respondent to give a score from 0 (no confidence) to 100 (totally confident) for each statement beginning with 'As a Leader I can'. An average was calculated for the grouping of questions pertaining to leader action self-efficacy, leader self-regulation efficacy or leader means efficacy. Additional demographic questions were at the end of the survey. Results The LEQ indicated a moderately high confidence self-rating on all three constructs of leader self-efficacy measured by the LEQ. Independent sample t-tests were conducted for each of the constructs of the LEQ. There was no difference between males and females on the scores of leader action self-efficacy (females: M=72.38, SD=16.41; males: M=72.24, SD=16.74), leader self-regulation efficacy (females: M=78.68, SD=16.55; males: M=78.82, SD=14.60) or leader means self-efficacy (females: M=72.46, SD=19.42; males: M=70.92, SD=18.66). Of the respondents (N=646), 170 physical therapists indicated earning an American Board of Physical Therapy Specialty (ABPTS) certification. There was no statistical significant difference in the three constructs of leader self-efficacy when considering if a physical therapist had earned ABPTS board certification in an area of specialty practice. A one-way between-groups analysis of variance was conducted to explore the impact of age on leader self-efficacy scores. Age was grouped by decade in accordance with previously reported data by the American Physical Therapy Association (i.e. -29; 30-39, 40-49, 50-59, 60+) with the less than 29 years of age and over 60 years of age groups being the least represented within the respondents. There was no statistical significant difference between age groups in the three constructs of the LEQ. Conclusions This is the first study of the perceptions of physical therapists in the United States on leader self-efficacy using the Leadership Efficacy Questionnaire (LEQ). The study respondents indicated a moderately high confidence self-rating on all three constructs of leader self-efficacy measured by the LEQ. In previous studies, a link has been demonstrated between positive/high self-efficacy on leader identification and general performance in the workplace [3]. In the United States, there are fewer physical therapists in formal leadership positions than expected and the ratio of women in formal leadership positions does not match the skewed ratio of females over males demonstrated within the profession. The scores of the LEQ with analysis considering the impact of gender, age and board certification in a specialty practice can neither explain the lack of physical therapists in formal leadership positions such as deans, vice presidents, etc., nor the lack of a corresponding gender ratio in administrative positions. Implications The large study population will assist in the establishment of baseline knowledge of the perceptions of physical therapists on leader self-efficacy in the United States. Establishment of a baseline of information regarding the perception of physical therapists' leader self-efficacy is essential as the profession continues to address the calls for strong leadership through the examination of entry-level education curriculum for leadership topics and to prepare graduates for full participation in the changing landscape of health care.