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IJPL
20,3/4 Effects of transformational
leadership on the learning
organization and nurses’
256 innovative behavior in
Received 8 April 2024
Revised 11 June 2024
Vietnamese public hospitals
Accepted 16 June 2024
Phuoc Nguyen
Thu Dau Mot University, Thu Dau Mot City, Vietnam and
International School of Business, University of Economics Ho Chi Minh City,
Ho Chi Minh City, Vietnam

Abstract
Purpose – The purpose of this study is to explore the effects of transformational leadership on learning
organization and nurses’ innovative behavior. Furthermore, this study aims to explore the mediating role of
learning organization in the relationship between transformational leadership and nurse innovative behavior
in the healthcare context. As there is a paucity of research examining these relationships, this study bridges the
research gaps in the literature.
Design/methodology/approach – A cross-sectional survey was used. Using convenience sampling, the data
of 228 nurses from 5 public hospitals in Vietnam were collected via questionnaires. A structural equation model
(SEM) was used to empirically test the hypotheses.
Findings – The findings show significant positive effects of transformational leadership on learning
organization and nurses’ innovative behavior. Furthermore, a significant positive relationship between
learning organization and nurses’ innovative behavior was also supported. Finally, the partial mediating role of
learning organization is significant in this study.
Originality/value – To the best of the author’s knowledge, this article is the first of its kind to identify the
minimal literature available on the impact of transformational leadership on learning organization and nurses’
innovative behavior. This article also contributes to extending knowledge about the mediating role of learning
organization in the healthcare context. Highlighting the importance of transformational leadership, the
findings offer guidance for healthcare organizations that aim to strengthen nurses’ innovative behavior.
Keywords Transformational leadership, Learning organization, Nurses’ innovative behavior,
Healthcare context
Paper type Research paper

Introduction
In Industry 4.0, the learning organization is considered to be a strong foundation for successful
transformation and innovation (Hoe, 2020). The connection between the learning organization
and effective leadership might play an important role in organizational development
(Firmansyah et al., 2022). The characteristics of transformational leadership are reasonable
for building an effective learning organization (Ytterstad and Olaisen, 2023). This style of
leadership might promote followers’ performance beyond expectations and transform self-
interest for the sake of the organization (Bass and Riggio, 2006). However, few studies have
examined the relationship between transformational leadership and learning organization (Xie,
2020). As most previous studies focused on organizational learning, it is narrower than the
International Journal of Public
Leadership
€
concept of learning organization (Ortenblad, 2018). Specifically, the learning organization
Vol. 20 No. 3/4, 2024
pp. 256-269
includes organizational learning, learning at work, climate for learning and learning structure.
© Emerald Publishing Limited
2056-4929
While public contextual factors are related to the learning organization (Anand and Brix,
DOI 10.1108/IJPL-04-2024-0035 2022), the effect of transformational leadership on the learning organization is still
unexplored in the healthcare context (Goula et al., 2019). Specifically, the empirical setting of International
this study is that of Vietnam’s public healthcare industry. As hospital leaders and nurses in Journal of Public
this emerging country face a changing environment (Khan and Lega, 2021), Vietnam is Leadership
suitable for testing theories. Furthermore, leadership and the learning organization in this
dynamic country should be explored for diverse knowledge in the Asia–Pacific region
(McClelland et al., 2023).
Due to the COVID-19 pandemic, healthcare leaders were highly responsible for a strategic
climate about innovation, quality and efficiency (Haque, 2021). Nurse-driven innovation 257
became the top priority for these problems (Le, 2020). By applying a bottom-up approach, the
incremental innovation of nurses contributes to not only the quality of healthcare services but
also the performance and effectiveness of healthcare organizations. Most previous studies
focused only on organizational innovation as positive outcomes (Samuelsson et al., 2019).
Furthermore, some studies have been limited to the predictors of individual learning, team
learning or organizational learning on nurses’ innovative behavior (Timmermans et al., 2018).
Practitioners are also interested in the impact of learning organization on innovation (Kalıpçı,
2023). However, the effect of learning organization on nurses’ innovative behavior is still
limited in the healthcare context.
In the literature, the relationship between transformational leadership and employee
innovative behavior might be mediated by several organizational and individual factors, such
as organizational commitment, innovation climate, leader–member exchange, job satisfaction,
self-efficacy and work engagement (Ng, 2017). However, the previous studies about
transformational leadership focused more on organizational objectives than subordinate
objectives, such as nurses’ innovative behavior (Nguyen et al., 2023). Therefore, the unexplored
mediating role of the learning organization should be considered to promote the linkage
between transformational leadership and nurse innovation behavior. This study investigates
this mediating mechanism for theoretical contribution.
Furthermore, transformational leadership is a positive direct driver of nurses’ innovative
behavior (Lega et al., 2017). This relationship might be enhanced differently across countries
and industries (Chau et al., 2022). However, Koh et al. (2019) found the direct impact of
transformational leadership on innovation might be negative when mediators were included.
Due to this main contradiction, the study also examines this direct linkage between
transformational leadership and nurses’ innovative behavior in the healthcare context for
more empirical evidence.
This study presents a cross-sectional model based on survey data. This study makes the
following three contributions. First, it investigates the direct impact of transformational
leadership on the learning organization and nurses’ innovative behavior in the healthcare
context. Second, the present study investigates the direct effect of the learning organization
on nurses’ innovative behavior. Third, this research tests the unexplored mediating role of
learning organization in the linkage between transformational leadership and nurses’
innovative behavior.

Theoretical background and hypothesis development

Transformational leadership
Burns (1978) defined transformational leadership as a leadership style in which leaders and
followers help each other advance to a higher level of morality and motivation. Bass and
Avolio (1997) developed that concept with five subdimensions, namely idealized attributes,
idealized behavior, inspirational motivation, intellectual stimulation and individualized
consideration. Carless et al. (2000) defined seven characteristics of transformational
leadership: vision, employee development, support, empowerment, innovative thinking,
leading by example and charisma. In the healthcare context, transformational leadership is
IJPL considered an effective style of leadership that might increase psychological capital, job
20,3/4 satisfaction and organizational commitment in a positive hospital environment (Shah et al.,
2023). Transformational leadership could facilitate empowerment, work engagement,
teamwork and career success, as well as reduce nurses’ burnout and turnover intention
(Hasan et al., 2023). Furthermore, this style of leadership might foster productivity, the quality
of healthcare services and patients’ safety (Alanazi et al., 2023).
258
Transformational leadership and nurses’ innovative behavior
Innovative behavior is a set of different tasks through which employees generate, promote
and implement new ideas (Scott and Bruce, 1994). Nurses’ innovative behavior might foster
healthcare organizations’ performance (Alshahrani et al., 2024). Furthermore, nurses might
generate and implement ideas for difficult or complicated situations (Zappala et al., 2021).
Moreover, their innovation was strongly related to the support of hospital managers and
colleagues (Alshahrani, 2023). Therefore, nurses needed to receive strong support and
champions for their creative ideas.
According to Bass and Riggio (2006), transformational leadership might promote nurses’
innovative behavior. Transformational leadership fostered empowerment, knowledge
sharing and intrinsic motivation for innovative behaviors (Nguyen et al., 2022). Through
intellectual stimulation, leaders might inspire his or her nurses’ intelligent and critical
thinking (Raoush, 2023). Furthermore, the individualized consideration of transformational
leadership also promoted self-efficacy and optimism; in turn, this situation might lead to
nurses’ innovative behavior (Lei et al., 2020). Similarly, transformational leadership might
foster efficiency, positive attitudes and the successful implementation of innovation
(Farahnak et al., 2020). Therefore, it is hypothesized that:
H1. Transformational leadership has a direct positive effect on nurses’ innovative
behavior.

Transformational leadership and the learning organization

The concept of a learning organization is defined as an organization skilled at creating,
acquiring and transferring knowledge and at modifying its behaviors to reflect new
knowledge and insights (Garvin, 1993). In particular, Peter (1990) proposed that the five
disciplines of the learning organization are personal master, mental models, shared vision,
team learning and system thinking. Furthermore, Watkins and Marsick (1997) suggested
seven characteristics of the learning organization: continuous learning, inquiry and dialog,
team learning, empowerment, embedded systems, connection to environment and strategic
leadership.
Healthcare organizations might promote a learning environment for organization
development (Goula et al., 2020). Consequently, the learning organization might promote
nurses organizational commitment and job satisfaction (Njilo et al., 2020). In the healthcare
context, the learning organization is a promising tool for knowledge management and
professional development (Alrashidi et al., 2023). While the perceptions of learning
organization were strongly related to the beliefs of evidence-based practice (Hartstein and
Yackel, 2021), learning organization might promote nursing practices, knowledge transfer
and the quality of healthcare services (Nordin et al., 2017).
Bass (2000) proposed that transformational leadership might promote learning
organization. Specifically, transformational leaders might have an open and respectful
dialog in the healthcare context (O’Donovan et al., 2021). Their changed-orientation also
promoted learning demands (Mikkelsen and Olsen, 2019). They supported their staff for
continuous learning, which in turn might lead to improved patient outcomes and
collaboration (Boamah, 2019). Furthermore, transformational leadership is necessary for International
collective learning and team learning (Chen and Cuervo, 2022). Both transformational Journal of Public
leadership and the learning organization share the characteristics of empowerment to Leadership
promote positive outcomes for nurses, patients and healthcare organizations, such as job
satisfaction, work engagement, patient care quality, patient safety outcomes and
organizational identification (Garcıa-Sierra and Fernandez-Castro, 2018). Moreover,
transformational leaders might develop embedded systems and system connections for the
learning organization (Goula et al., 2019). They also promoted strategic leadership in 259
knowledge management for human capital effectiveness (Firmansyah et al., 2022). Based on
the above discussion, this study hypothesizes that:
H2. Transformational leadership has a direct positive effect on the learning organization.

The learning organization and nurses’ innovative behavior

The learning organization targeted new knowledge and insights (Garvin, 1993).
According to the integrated model for the learning organization (Ortenblad, € 2004),
learning by working and organizational learning might promote flexible action through
learning structure. The climate for learning might indirectly promote front liners’
innovative behavior through workplace learning and work engagement (Hoang et al.,
2024). Moreover, learning orientation might increase readiness for change, which in turn
leads to front liners’ innovative behaviors in the workplace (Le and Le, 2021). Similarly,
organizational support might promote front liners’ creativity through knowledge sharing
(Vo et al., 2024).
Due to continuous learning, nurses might seek and collect knowledge to improve their
professional skills, practical methods and work performance (Zhong et al., 2018). The learning
organization might foster interactive learning and dialog for innovation (Dirani et al., 2021).
Nurses might share their experience and know-how with colleagues in the learning
organization. Thus, individual learning, team learning and organizational learning might
lead to nurses’ innovative behavior (Timmermans et al., 2018). Furthermore, healthcare
leaders might establish embedded system and system connections for knowledge integration
(Aas, 2020). Consequently, learning structure and climate for learning might promote
learning opportunities, which in turn leads to nurses’ innovative behavior (Meng et al., 2021).
Therefore, it is hypothesized that:
H3. The learning organization has a direct positive effect on nurses’ innovative behavior.

The mediating role of the learning organization

Transformational leadership might increase organizational innovation capacity from the
perspective of the learning organization (Tu et al., 2022). Similarly, positive emotions (e.g.
happiness at work) might be created by that mediating mechanism (Salas-Vallina et al., 2017).
According to the dynamic componential model of creativity and innovation of Amabile and
Pratt (2016), both organizational innovation and positive emotions at work might promote
front liners’ innovative behavior. Similarly, the empowerment of transformational leadership
promoted knowledge sharing or team learning, which in turn might lead to innovative work
behavior (Phung et al., 2019).
In the healthcare context, positive styles of leadership and effective knowledge
management were considered readiness for innovation (Le and Le, 2021). Therefore, both
transformational leadership and the positive climate of the learning organization might foster
nurses’ innovative behavior (Korku and Kaya, 2023). Moreover, transformational leadership
directly promoted the learning organization in the healthcare context as discussed above.
Therefore, this study hypothesizes the following:
IJPL H4. The learning organization mediates the relationship between transformational
20,3/4 leadership and nurses’ innovative behavior.

Research model
The research model used in this study is shown in Figure 1. Transformational leadership then
directly impacts nurses’ innovative behavior and the learning organization (H1 and H2,
260 respectively). The learning organization has a direct effect on nurses’ innovative behavior
(H3). Then, the learning organization mediates the effect of transformational leadership on
nurses’ innovative behavior (H4).

Research method
To test the proposed hypotheses, this study adopted a quantitative approach in which data
were collected through a survey. The empirical setting and research design are reported as
follows.

Empirical setting
Vietnam has 1,030 public hospitals and 62 private hospitals with more than 128,000 beds
(Shillabeer, 2016). Its centralized healthcare system is organized into four bottom-up levels:
commune health centers, polyclinic hospitals, provincial hospitals and national hospitals. We
selected Ho Chi Minh City, which is the most populous city and has the most economic
development in Vietnam. This city is located in the south of Vietnam and has 24 districts.

Research design
As mentioned above, the survey was conducted at five hospitals in Ho Chi Minh City. Two
national public hospitals and three district public hospitals were chosen for this study.
According to Yammarino et al. (2005), the main unit of analysis focuses on individual leader
behavior, which promotes learning organization (hospital) and individual nurse behavior.
Nurses were given extra break time during their workdays to complete the surveys. A total of
228 questionnaires were collected without missing data. Rather, it is based on convenience
sampling. For each case, we asked nurses about leaders’ transformational leadership, the
learning organization and nurses’ innovative behavior. Demographic information was also
collected for statistical analysis.
The questionnaire was first prepared in English. It was then translated into Vietnamese
via a translation and back-translation process (Douglas and Craig, 2007). This procedure was
undertaken by two university academics. After comparing the two English versions,
mismatches were discussed and adjusted using the Vietnamese version. The pretest was also
conducted through interviews with five nurses to refine the wording of the
questionnaire items.

Transformational Learning Nurse work

leadership organization behavior
H2 H3

Figure 1. H1
The research model
Note(s): Author’s compilation
Transformational leadership was measured using the seven-item scale of Carless et al. (2000). International
The learning organization was measured using seven items from Yang et al. (2004). Journal of Public
To measure nurses’ innovative behavior, the scale of Scott and Bruce (1994) with six items Leadership
was used. All scales were in the form of Likert five-point type, anchored from 1 (strongly
disagree) to 5 (strongly agree).

Empirical result
261
Sample characteristics
A total of 228 nurses were recruited and qualified for data analysis. The data were analyzed
using Statistical Package for Social Science (SPSS) version 21 and were analyzed for the socio-
demographic characteristics of the respondents. The gender of the nurses was 81.1% female
and 18.9% male. By age groups, 25.9% of the sample were among the ages of 21–25 years,
45.6% among 26–30 years, 18.9% among 31–35 years and 9.6% above 35 years. Regarding
educational background, 38.6% had a bachelor degree in nursing and 61.4% had a college
nursing diploma. Regarding marital status, 58.8% were single and 41.2% were married. By
job tenure, 17.5% were below 2 years, 59.6% were 2–5 years and 22.8% were above 5 years.
Nurses also work for nine nursing specialties. The statistics showed that the sample covered
a variety of nurses in terms of gender, age, marital status, education, job tenure and nursing
specialty. Thus, this sample is appropriate for further analysis.

Validity and reliability of the measures

First, using SPSS, an exploratory factor analysis was performed for a preliminary
assessment of dimensionality. The items were loaded mainly on three designated factors.
However, three items were eliminated because of low loadings (Hair et al., 2019). The factor
loadings of 17 remaining items ranged from 0.698 to 0.912.
Using AMOS, confirmatory factor analysis (CFA) was performed for reliability,
convergent and discriminant validity. The significant factor loadings of the 17 remaining
items on seven constructs ranged from 0.567 to 0.869 (Table 1). The test for normality showed
that the skewness values ranged from 1.037 to 0.206. The kurtosis values ranged from
0.609 to 1.928. These absolute values were within the criteria of skewness (<3) and kurtosis
(<8) (Kline, 2016).
From the refined measurements, the model yielded satisfactory fit indices. Specifically, χ 2/
df 5 259.033/107 5 2.421 is below 4; comparative fit index (CFI) 5 0.940 and Tucker–Lewis
index (TLI) 5 0.924 exceeded 0.9 and root mean squared error of approximation
(RMSEA) 5 0.079 is below 0.08 (Hu and Bentler, 1999). As presented in Table 2, the
composite reliabilities (CR) of the three constructs ranged from 0.866 to 0.901 and above 0.7,
respectively (Hair et al., 2019). The average variance extracted (AVE) of all constructs ranged
from 0.566 to 0.609 and above 0.50 (Fornell and Larcker, 1981). Therefore, the results
indicated significant reliability and convergent validity.
Table 2 shows the correlations between pairs of constructs, with values ranging from
0.467 to 0.680. Kline (2016) suggests that the estimated correlations between factors should
not be higher than 0.85 for discriminant validity. Furthermore, while the square roots of
AVEs were larger than factor correlations, discriminant validity was supported (Fornell and
Larcker, 1981). In short, the measurement scales of the concepts were satisfactory in terms of
reliability, convergent validity and discriminant validity.
According to Podsakoff et al. (2003), common method issues are the problem of method
biases, such as common rater effects, item characteristic effects, item context effects or
measurement context effects. Therefore, common method variance (CMV) is variance that is
attributable to the measurement method rather than to the constructs the measures represent.
IJPL Constructs and items Loading
20,3/4
Transformational leadership
My leader communicates a clear and positive vision of the future 0.712
My leader treats staff as individuals, supports and encourages their development 0.853
My leader gives encouragement and recognition to staff 0.753
My leader fosters trust, involvement and cooperation among team members 0.719
262 My leader encourages thinking about problems in new ways and questions assumptions 0.716
My leader is clear about his/her values and practises what he/she preaches 0.763
My leader instills pride and respect in others and inspires me by being highly competent 0.742
The learning organization
In my hospital, leaders continually look for opportunities to learn 0.746
In my hospital, people spend time building trust with each other 0.739
In my hospital, teams/groups revise their thinking as a result of group discussions or information 0.824
collected
My hospital makes its lessons learned available to all nurses 0.746
My hospital recognizes people for taking initiative 0.839
My hospital works together with the outside community to meet mutual needs Eliminated
In my hospital, people are rewarded for learning Eliminated
Nurses’ innovative behavior
I often generate creative ideas 0.853
I often search out new processes, techniques or service ideas for solving the problems of patients 0.683
and hospital
I often promote and champion innovative ideas to others 0.738
I often investigate and secure funds needed to implement new ideas 0.594
Table 1. I often develop adequate plans or schedules for implementing my new ideas 0.867
Results of I often evaluate the utility of innovative ideas Eliminated
confirmatory factor Note(s): All standardized loadings reported p < 0.001
analysis Source(s): Author’s compilation

Mean Std. Deviation CR AVE 1 2 3

1. Transformational leadership 3.73 0.655 0.901 0.566 0.752

2. The learning organization 3.47 0.802 0.886 0.609 0.467*** 0.78
Table 2. 3. Nurses’ innovative behavior 3.75 0.600 0.866 0.569 0.606*** 0.680*** 0.754
Descriptive statistics, Note(s): Values in the diagonal display the square root of AVE
correlation matrix and -Standardized correlations reported ***p < 0.001
square root of AVE Source(s): Author’s compilation

Due to common method issues, the response biases were controlled in self-reports by the
anonymity of the respondents. Furthermore, Harman single-factor CFA, which is the most
widely known approach, was undertaken (Podsakoff et al., 2003). The results of CFA showed
very low fit indices (χ 2/df 5 727.489/110 5 6.614; CFI 5 0.757; TLI 5 0.699 and
RMSEA 5 0.157). Therefore, CMV was not the major source of variation in the
observed items.

Structural model estimation and hypothesis testing

Structural equation modeling (SEM) was used to test the hypothesized model using AMOS
software. The results suggest that the hypothesized model fits the data well. Specifically,
χ 2/df 5 259.033/107 5 2.421; CFI 5 0.940 and TLI 5 0.924 and RMSEA 5 0.079 (Hu and International
Bentler, 1999). Moreover, the mediating effect was assessed using the bias-corrected Journal of Public
bootstrapping technique (Preacher and Hayes, 2008). Leadership
As presented in Table 3, the study attained the significance of standardized coefficients.
All the hypotheses were supported at p < 0.001. The bootstrapped 95% confidence interval
(CI) around the indirect and direct effects does not contain zero. For hypotheses H1 and H2,
the direct paths from transformational leadership to nurses’ innovative behavior and the
learning organization were significantly positive with γ1 5 0.369; p < 0.001 and γ2 5 0.467; 263
p < 0.001, respectively. For hypothesis H3, the effect of the learning organization on nurses’
innovative behavior is significant (β3 5 0.508; p < 0.001). Finally, for hypothesis H4, the
mediating role of the learning organization is significant for the linkage between
transformational leadership and nurses’ innovative behavior (β4 5 0.237; p < 0.001).

Discussion
Theoretical contribution
This study makes several contributions to the literature. First, this study shows the positive
impact of transformational leadership on the learning organization and nurses’ innovative
behavior. The results are consistent with those of Tu et al. (2022) and Nguyen et al. (2022)
about knowledge management and employee creativity in a Vietnamese setting. Moreover,
the statistical figures show that the impact of transformational leadership is higher on the
learning organization than on nurses’ innovative behavior (0.467 vs 0.369). This result is
consistent with that of Tu et al. (2022), in which transformational leadership has a greater
impact on knowledge management capability than innovation capability. The findings show
that transformational leadership focuses more on organizational outcomes than on
subordinate outcomes. Therefore, this empirical evidence might broaden our
understanding of transformational leadership and its positive outcomes in the Vietnamese
healthcare context.
Furthermore, this study found a significant positive correlation between the learning
organization and nurses’ innovative behavior in the healthcare context. As previous studies
have focused on the effects of individual learning, team learning or organizational learning on
nurses’ innovative behavior (Timmermans et al., 2018), the results show the meaningful
contribution for the outcomes of the learning organization. Moreover, as previous studies
have focused on organizational innovation and service innovation, employee innovation (i.e.

Direct and indirect paths Standardized coefficient P 95% CI Result

Direct paths
H1 Transformational leadership 0.369 0.001 [0.157; 0.556] Supported
5> Nurses’ innovative behavior
H2 Transformational leadership 0.467 0.001 [0.313; 0.604] Supported
5> The learning organization
H3 The learning organization 0.508 0.001 [0.346; 0.672] Supported
5> Nurses’ innovative behavior
Indirect paths
H4 Transformational leadership 0.237 0.001 [0.136; 0.374] Supported
5> The learning organization Table 3.
5> Nurses’ innovative behavior Results of structural
Source(s): Author’s compilation equation modeling
IJPL nurses) is meaningful (Nguyen et al., 2023). Consequently, the significant findings expand our
20,3/4 understanding and bridge the research gap in the literature.
Moreover, the mediation effect of the learning organization is determined for the
theoretical contribution. Specifically, the learning organization takes on the role of the partial
mediator in the relationship between transformational leadership and nurses’ innovative
behavior. In comparison, the results show that the indirect impact of transformational
leadership is lower than its direct impact on nurses’ innovative behavior (0.237 vs 0.369).
264 Therefore, this new understanding leads to several reasonable implications for promoting
nurses’ innovative behavior in hospitals.
Finally, as this study responds to the research call of McClelland et al. (2023), it explores
the relationship between transformational leadership and the learning organization in the
Asia–Pacific region. While this region is highly diverse, the healthcare setting in Vietnam is
meaningful for contributing to new knowledge. Scholars have a full picture of
transformational leadership and the learning organization in different industries and
countries.

Leadership implications
This study has several leadership implications for hospital leaders. First, in the healthcare
context, transformational leadership is considered an effective style of leadership. The results
show that in Vietnamese hospitals undergoing restructuring, leaders who use
transformational leadership will promote the learning organization and nurses’ innovative
behavior. Thus, hospital regulators may benefit from this study by developing
transformational leadership for hospital leaders to enhance these positive outcomes.
Especially in the era of post-COVID-19 in Southeast Asia, transformational leadership was so
effective that hospital leaders used their idealized attributes, idealized behaviors,
inspirational motivation, intellectual stimulation and individual consideration in order to
promote nurse innovative works toward service improvements.
Furthermore, hospital leaders should have a vision for the learning organization. In
healthcare organizations, learning programs should be developed and implemented for
knowledge management and professional development. Hospital leaders with
transformational leadership might encourage, support and develop their nurses for the
learning organization. While the learning organization has a positive impact on nurses’
innovative behavior, it might become a useful tool. For instance, nurses also took advantages
of the telehealth during the COVID-19 pandemic. Without physical contacts, patients and
nurses were virtually brought together.
Finally, nurses should be given several opportunities for continuous learning, knowledge
sharing and innovation. For example, nurses were encouraged to make do-it-yourself medical
devices for emergency requirements during the COVID-19 pandemic. Therefore, hospital
leaders should promote dialog and empowerment to increase both the learning organization
and nurses’ innovative behavior. Moreover, the development of reward systems may
encourage nurses’ innovative behavior for organizational development.

Conclusion
In this study, we explore the effects of transformational leadership on positive outcomes,
specifically learning organization and nurses’ innovative behavior. The results from a
structural equation model support the hypotheses. We also investigate the mediation of
learning organization in the relationship between transformational leadership and nurses’
innovative behavior. The results showed that the partial mediating role of the learning
organization was supported in this study. While researchers and practitioners continue to
look for ways to enhance transformational leadership and followers’ positive outcomes, we International
expect our findings may promote more studies in this field. Journal of Public
As this study has some limitations, it also suggests a number of avenues for further Leadership
research into how transformational leadership is explored using appropriate empirical
research. The first limitation involves the use of self-report measures and a single source of
information. The followers were asked to report themselves and rate the transformational
leadership of their nursing managers. This might lead to CMV bias.
Although common method bias is not evident in this study, future research should use 265
multiple respondents (e.g. subordinates, colleagues or leaders) or multiple points of times.
Specifically, cross-sectional design in fields is known to limit the ability to infer causality.
Cross-sectional-mediated effects are also more biased than longitudinal-mediated effects.
Therefore, longitudinal research should be conducted to enhance the causality of the
relationships in our model. As the conclusions presented here are based on the healthcare
context in Vietnam, the findings should be cautiously transferable. Similarly, as Ho Chi Minh
City is the most populous city and has the most economic development in Vietnam, future
research should investigate other industries within this city for generalizability across
industries. Therefore, future scholars should examine these topics in healthcare contexts in
other countries for generalizability across cultures.

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About the author

Phuoc Nguyen is research scholar at Faculty of Economics, Thu Dau Mot University,
Vietnam. The author holds a Ph.D. in Business Administration degree at International
School of Business, University of Economics Ho Chi Minh City, Vietnam. His research
interests are leadership, learning organization, innovation and value co-creation. The
author published two papers in Service Business and the IIM Ranchi Journal of
Management Studies. Furthermore, he has been a reviewer for three journals: The
Learning Organization, Journal of General Management and International Journal of
Organizational Analysis. Phuoc Nguyen can be contacted at: [email protected]

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