How Followers Create Leaders The Impact of Effective Follower

How Followers Create Leaders: The Impact of Effective
Followership
on Leader Emergence in Self-Managing Teams
Xueting Jiang1, Kevin Snyder2, Jia Li3, and Charles C. Manz4
1 School of Management, New York Institute of Technology,
Old Westbury, New York, United States
2 Department of Sport Management, Southern New Hampshire
University
3 Business School, Nanjing University
4 Department of Management, University of Massachusetts
Amherst
Objective: In this study, we investigate how effective
followership influences leader
emergence in a nonhierarchical organizational context. By
taking a “reversing the lens”
view of leadership, we propose that an individual’s leadership
behaviors and leadership
self-identity are significantly affected by effective fol lowership
of his or her peers in self-
managing teams. Method: We used a three-wave survey design
and collected data from
58 self-managing student teams to test our model. Results: Our
findings indicate that team
members are more likely to become leaders in a leaderless
group context when being
exposed to more effective followership. Conclusions: This
research presents empirical
evidence on the importance of followers to the creation of

leaders.
Highlights and Implications
• Organizations should purposefully increase interdependent
team mem-
ber activities to facilitate leadership development.
• Organizations need to encourage the expression of authentic
opinions
(positive and negative) about managers’ behaviors and
performance.
• Organizations can pair leader development with followership
develop-
ment programs to cultivate effective followers and prospective
leaders concurrently.
Keywords: followership, leader emergence, self-managing team
Managementofmodernorganizationsisbecom-
ing more team based (Sundstrom, 1999) and more
empowering (Argyris, 1998; Spreitzer, 1995). As
organizations increasingly use project-specific
teams, the need for team leaders to emerge quickly
and effectively becomes paramount (Morgeson
et al., 2010). The past 4 decades have shown a
wider use of self-managing teams as a leading
managerial innovation in many large United
States corporations (Magpili & Pazos, 2018).
A self-managing team features no hierarchical
role differentiation among members (DeRue
et al., 2009) and an equal sharing of leadership
(Crossman & Crossman, 2011). Researchers have
found that self-managing teams lead to higher

motivation, satisfaction, and team effectiveness
(Cohen et al., 1996; Cohen & Ledford, 1994;
Cordery et al., 1991; Langfred & Moye, 2004).
This article was published Online First July 29, 2021.
Xueting Jiang https://orcid.org/0000-0003-1321-7332
Kevin Snyder https://orcid.org/0000-0003-3968-4174
Jia Li https://orcid.org/0000-0001-6532-4063
We extend our appreciation to D. Anthony Butterfield,
Jane K. Giacobbe-Miller, Daniel J. Miller, and Ryan M.
Acton for helpful comments on earlier versions of this
article. We also thank Craig S. Wells, Aline G. Sayer,
and Bruce Desmarais for assistance with data analysis.
Jia Li is supported by grants from the National Natural
Science Foundation of China (Grant Number: 71902084).
Correspondence concerning this article should be ad-
dressed to Jia Li, Business School, Nanjing University,
AnZhong Building, JinYin Street, Nanjing 210093, China.
Email: [email protected]
303
Group Dynamics:
Theory, Research, and Practice
© 2021 American Psychological Association 2021, Vol. 25, No.
4, 303–318
ISSN: 1089-2699 https://doi.org/10.1037/gdn0000159
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https://orcid.org/0000-0003-1321-7332
https://orcid.org/0000-0003-3968-4174
https://orcid.org/0000-0001-6532-4063
mailto:[email protected]
https://doi.org/10.1037/gdn0000159
Previousliteratureindicatesthatmul tiplegroup
members may engage in leader-like behaviors to
realize leadership functions in groups (Carson
et al.,2007;Pearce&Conger,2003).Pluralforms

of leadership have a strong presence in self-
managing teams because members experience
greaterresponsibilityandauthorityingoalsetting,
monitoringprogress,anddecision-making(Denis
et al., 2012). As self-managing teams assemble,
roles are uncertain, and the leader–follower
relationship advances through the leadership
development process (DeRue & Ashford,
2010). Compared with other types of teams, in
self-managing teams, members of the work
groups identify leaders rather than receiving a
formal designation from the larger organization
(Paunova, 2015; Zhang et al., 2012).
Leader emergence refers to “whether (or to
what degree) an individual is viewed as a leader
by others” (Judge et al., 2002). Emergent leader-
ship literature suggests that an individual can
acquire leadership status through functional be-
haviors or leadership personality traits and abili -
ties (Paunova, 2015). Leadership can also be a
product of social interactions among organiza-
tional members, recognized through a socially
constructed process between leaders and fol-
lowers (DeRue & Ashford, 2010; Uhl-Bien,
2006). Meindl (1995) suggested that leadership
is an emergent phenomenon where leaders and
followers make sense of themselves and their
relationships with other group members. The
individual highlights the self in an attempt to
win followers’ acceptance and to reinforce self-
perception as a leader, as their identity shifts from
an individual to a collective level. Similarly,
followers seek those with leadership authority
to be a vehicle for their ideas and beliefs. Public
behaviors entail messages about each individual

during identity negotiation, the process through
which team members can establish and validate
their respective social identities in a group
(Lührmann & Eberl, 2007).
Researchers suggest that social influences shape
the individual identity of each group member
(DeRue & Ashford, 2010; Uhl-Bien et al.,
2014). The breadth and intensity of interaction
among leaders and followers contribute to the
growth and development of leadership within a
team (Carsten et al., 2010; DeRue, 2011;DeRue &
Myers, 2014; Uhl-Bien et al., 2014). The leader
and follower represent consensual in-group social
identities shared by group members (Collinson,
2006; Haslam & Platow, 2001). Group member
behaviors affirm these relational identities (Haslam
& Platow, 2001) and are associated with formal
leading or following positions in organizational
hierarchies (DeRue & Wellman, 2009). Thus,
the identities of leaders and followers are not
only mutually reinforced (Collinson, 2006), but
also can be revised and reconstructed during work
role transitions (Ibarra & Barbulescu, 2010).
Self-managing teams have high levels of emer-
gent leadership (Gerpott et al., 2019). Individual
team members are involved in both leadership and
followership roles and functions. Each may act in
differentroles at different pointsintime, serving as
either leader or follower, contingent upon the
environments and team process (Collinson,
2006; Lord & Hall, 2005). In a group without a
designated leader(s), several individuals may col-
lectively perform leadership or multiple leaders

may emerge (Paunova, 2015). Team members
mightseethemselvesaspartnersintherelationship
(Uhl-Bien et al., 2000), coproducers of leadership
(Shamir, 2007), coleaders (Heenan & Bennis,
1999), or self-leaders (Manz, 1986).
In reality, self-managing teams vary from cen-
tralized individualleadership toshared leadership
among all group members, or to some intermedi-
ate configuration (DeRue, 2011). How does a
team member emerge as an informal leader in a
self-managing team? The answer to this question
is important to leadership development research
and practices because a better understanding of
individual team members’ leader emergence is
critical to the collective leadership capacity of the
team as well as the overall team effectiveness
(Day & Dragoni, 2015; Zhang et al., 2012).
Leadership development researchers suggest
that leadership is a learning exercise for indivi-
duals, in which they develop as leaders by learn-
ing the criticism and feedback from others to
complete managerial jobs (DeRue et al., 2012;
DeRue & Wellman, 2009; Dragoni et al., 2009).
Since “leaders neither exist nor act in a vacuum
without followers” (Kelley, 2008, p. 5), fol-
lowers play a vital role in constructing leadership
by “empowering the leader and influencing his or
her behavior, and ultimately determining the
consequences of the leadership relationship”
(Howell & Shamir, 2005, p. 97). Although lead-
ership researchers traditionally view followers as
passive, obedient, and deferent subordinates
(Kelley, 1988; Zaleznik, 1965), the more recent
scholarship recognizes the importance of the

304 JIANG, SNYDER, LI, AND MANZ
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followers’ role in the leadership construction
(Uhl-Bien et al., 2014). The role of followers is
not subordinate, but codependent as followers
help leaders develop skills through regular criti-
cism and feedback (Chaleff, 1995; DeRue &
Wellman, 2009). Followers may work as part-
ners, participants, and coleaders (Chaleff, 1995)

to shape organizational leadership (Kelley, 1992;
Uhl-Bien et al., 2014).
In traditional leadership research, followers
have long been the recipients of leader influence
in such a way that leaders are casual agents for
followers’ characteristics and behaviors (Shamir,
2007; Uhl-Bien et al., 2014). However, several
researchers have demonstrated “reverse” causal-
ity in leader–subordinate behavioral relationships
(e.g., Barrow, 1976; Farris & Lim, 1969;
Lowin & Craig, 1968; Sims & Manz, 1984).
Although these early studies suggest that subor-
dinates’ performance and behaviors can influence
leaders’ behaviors and their managerial styles,
this “reciprocal determinism” approach to lead-
ership did not capture much attention until rela-
tively recently.
For instance, Dvir and Shamir (2003) examined
the followers’ role in shaping their leader’s style.
Their findings show that followers’ initial devel-
opmental level predicts their leaders’ transforma-
tional leadership over time. Carsten et al. (2018)
found that followers’ role orientations influence
leaders’ perceptions, motivations, and outcomes.
More recently, Khan et al.’s (2020) study indicates
that followership positively affects transforma-
tional leadership behavior through the trust in
the leader–follower relationship. Camps et al.
(2020) found that abusive followership of subor-
dinatescausessupervisorstoexperiencelowlevels
of interpersonal justice and to respond with abu-
sive supervision. Most of this work is consistent
with Shamir’s (2007) “reversing the lens” model,
which illustrates how followers use their charac-

teristics and behaviors to influence leadership and
relational outcomes at the workplace within
leader–follower/manager–subordinate hierarchies
(Uhl-Bien & Carsten, 2018).
Despiteincreasingscholarshiponfollowersover
the past two decades, the literature lacks sufficient
consideration of how followership affects leader
emergence (Day & Dragoni, 2015; DeRue &
Myers, 2014; Uhl-Bien et al., 2014). In particular,
there is scant empirical evidence of how follower-
ship in a leaderless working unit allows individuals
to emerge as team leaders. In this research, we seek
to articulate how followers’ effective followership
can create leaders in a nonhierarchical context. We
propose a conceptual model illustrating how effec-
tive followership can affect an individual’s leader-
ship behaviors and leadership self-identity, and
further decide the member’s leadership role in
the team. By using multiphase data collected
from 58 self-managing student teams, we find
that followers are critical for an individual to obtain
leadership status due to the influence of their
effective followership upon leadership behaviors
and the prospective leader’s leadership self-
identity.
We believe this research contributes to the
followership literature by providing empirical
support for a framework where leader emergence
is a constructive process involving all team
members (Kelley, 2008; Uhl-Bien & Carsten,
2018; Uhl-Bien et al., 2014). Through the “bot-
tom-up” lens of followership, our study extends
Shamir’s (2007) “reversing the lens” model in the

nonhierarchical context and explores the cogni-
tive and behavioral factors associated with leader
emergence in self-managing teams. In particular,
effective followership shapes the ways prospec-
tive leaders see themselves and behave toward
others. This research also demonstrates that lead-
ership in groups is a result of coordinated choices
made by both leaders and followers. As such,
we explain why full participation of team mem-
bers in leading a self-managing team is “a rare
accomplishment” (Offermann & Scuderi, 2007).
Our findings support the notion that some team
members are more likely to become leaders
throughout the team process (Crossman &
Crossman, 2011).Asaresult, thisstudyfacilitates
a more expanded and dynamic view of team
leadership.
Followers and Their Impact Upon Leader
Emergence
Previous research demonstrates that followers
influence leaders through a variety of proactive
behaviors such as obedience, resistance, and
rejection (Grant & Ashford, 2008; Higgins
et al., 2003). Followers might take an active
role to complement and support leadership, an
independent role to substitute for leadership, or a
shifting role to alternate between leadership
and followership (Howell & Méndez, 2008).
Additionally, followers further direct and drive
HOW FOLLOWERS CREATE LEADERS 305
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leadership effectiveness and organizational out-
comes (Carsten et al., 2010; Uhl-Bien et al.,
2014). For instance, followers grant permission
for those with shared goals to be the designated
leader as a means of influencing the group’s
objectives. If the leader violates the group norms
or attempts to shift to an undesired direction, the
followers might revoke the leader’s power, trans-
fer authority to a more amenable individual or just
choose to leave (Carsten & Uhl-Bien, 2012;
Chaleff, 1995; DeRue, 2011; Kelley, 1992).
Kelley (1988, 2008) described five basic styles

of followers: the sheep, the yes-people, the alien-
ated, the pragmatics, and the star followers. The
“sheep” and “yes-people” are usually “passive
and uncritical, lacking in initiative and sense of
responsibility” (Kelley, 1988, p. 3). Alienated
followers are cynical and passive with disruptive
energy in organizations. They might refuse to
offer solutions to problems in the workplace even
if they have the capacity to help. Pragmatic
followers are chameleonic and adept at surviving
changes to avoid risk and maintain the status quo.
Effective followers demonstrate self-
management, commitment, competence, focus,
and courage (Kelley, 1988). They actively coop-
erate with their leader in achieving organizational
goals and facilitating leader–follower interaction
for healthy and sustainable leadership develop-
ment (Howell & Méndez, 2008). Kelley (1992)
further conceptualized two dimensions to outline
followership behaviors: independent critical
thinking and active engagement. Followers
who are high in independent critical thinking
tend to voluntarily innovate, analyze information,
develop independence, and influence their lea-
ders. Followers who are high in active engage-
ment eagerly participate in group activities, offer
helpful contributions, and support coworkers.
Effective followers are those who are high in
both active engagement and independent critical
thinking.
Followership occurs when individuals see
themselves as followers and allow for the influ-
ence of leaders. In this study, we refer to effective
followership as the behaviors enacted from the

standpoint of an effective follower role or in the
act of effective following (Uhl-Bien & Carsten,
2018; Uhl-Bien et al., 2014). Since leadership
construction, by nature, is a social process
through which potential leaders gain acceptance
and recognition of others (DeRue, 2011), we
suggest that the followers’ effective followership
is essential to leader emergence (Uhl-Bien et al.,
2014). Effective followers usually see themselves
as “partners or co-contributors to the leadership
process” (Uhl-Bien & Carsten, 2018, p. 199).
They may question and challenge leaders con-
structively when assisting in decision-making
and problem-solving (Carsten et al., 2018;
Kelley, 1988). Efforts made by effective fol-
lowers during the early stages of self-managing
teamwork help role clarification in teams and
facilitate the shared group ideas about potential
leaders based upon the needs of the work unit.
Hogg and associates suggested that individuals
are mostly viewed as matches to context-specific
prototypes, redefining their collective self in
terms of group membership (Hogg, 2001; van
Knippenberg & Hogg, 2003). As the in-group
prototype emerges from group interaction, indi-
viduals assimilated to such prototypes may attract
more social attention,cyclicallyleading to greater
association with prototypical positions in a group
context (Hogg, 2001; Hogg et al., 2012). Accord-
ingly, when conforming to effective followers’
normative behaviors, the prospective leaders
attract consensual in-group support that would
eventually allow their leadership to become more
salient to the group. On the contrary, if indivi-
duals choose not to project sufficient effective

followership, their leaders may not perceive the
effectiveness of their influence.These nonfollow -
ing situations could disrupt the leaders’ leading
attempt, cause a power struggle among the team
members and consequently attenuate emergent
leadership in the team (Uhl-Bien et al., 2014).
Based on the previous rationale, we propose
the first hypothesis:
Hypothesis 1: Effective followership of
team members is positively related to the
leadership emergence of their prospective
leader(s) in a self-managing team.
The Role of Leadership Behavior
In a leaderless group context, group members
seek to reduce uncertainty by making sense
ofpronouncedbehaviorsofindividualswithsalient
prototypical properties (Hogg, 2001). Leadership
behaviors are the types of behaviors used by a
leader in interactions with subordinates and other
people to influence their attitudes, performance,
and activities in the work unit (Yukl, 2012; Yukl &
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Gardner, 2020). Since leadership is in the eyes of
beholders (Meindl, 1995; Schyns & Sanders,
2007), people tend to compare the traits and beha-
viors of a focal individual with their leadership
cognitive schema (Lord et al., 1984). When an
individual behaves more like a leader, peers are
more easily able to observe and perceive his or her
leadership behaviors, thus stimulating their mental
matching process between the prospect and attri-
butes of a preexisting leader prototype (Epitropaki
et al., 2013). When people find a match between
the traits and behaviors of a focal individual and
their leadership cognitive schema, they attribute
leadership status to that individual (DeRue &
Ashford, 2010).
If a prospective leader is looking to change the
leaderless condition in the group, he or she needs

to display more leadership behaviors to exercise
influence upon others (Hogg, 2001; Uhl-Bien
et al., 2014). Effective followership could
encourage an individual to perform more leader-
ship behaviors and facilitate their leader emer-
gence in a self-managing team. Effective
followers are hardworking, dedicated, positive,
reliable, and tend to match a leader’s performance
expectations of prototypic followers (Sy, 2010).
Carsten et al. (2018) suggest that effective fol-
lowership behavior is positively related to lea-
der’s motivation toward the leadership position.
Although effective followers may sometimes
express criticism or resistance, such behaviors
could motivate prospective leaders to behave
more saliently as leaders for a public endorsement
of their status within a team (Magee & Galinsky,
2008). The inactivity of passive followers,
instead, may add extra work and responsibilities
to their leader(s), and deplete leaders’ energy and
motivation (Carsten et al., 2018). Because pas-
sive followers treat any prospective leader with
deference and compliance, leaders might also be
discouraged and confused about how to practice
appropriate leadership behaviors (Howell &
Méndez, 2008;Uhl-Bien &Carsten,2018). Com-
pared with the passive followers who remain
silent and hand over all decision-making or
problem-solving to their leaders, effective fol-
lowers could place their leader(s) in a more
proactive status and make the tough managerial
work less challenging and time-consuming. Their
effective followership initiates more leadership
behaviors from their prospective leader(s) that
further advance his or her leadership develop-
ment within a team.

The previous arguments lead to our second
hypothesis:
Hypothesis 2: An individual’s leadership
behaviors mediate the relationship between
effective followership of team members and
his or her likelihood of being an emergent
leader within a self-managing team.
The Role of Leadership Self-Identity
Leadership self-identity refers to an indivi-
dual’s self-concept and self-representation that
guides thoughts and actions in the leadership
domain (Hiller, 2005). Since a leader’s self-
concept is based on personal characteristics and
group membership (Lord & Brown, 2001), the
development of an individual’s leadership self-
identity involves the influences of his or her
followers (Collinson, 2006; Hiller, 2005). While
leaders are traditionally assumed to influence
followers’ identities (Haslam & Platow, 2001),
followers can also influence leaders’ identities by
enacting conformity with or resistance against
organizational leadership (Collinson, 2006).
Hiller (2005) suggests that leadership self-
identity relates to core self-evaluations, motiva-
tion to lead, self-monitoring, and previous
leadership experience. Leadership self-identity
can develop and be strengthened or activated at
different times and conditions (Hiller, 2005). An
individual with strong leadership self-identity
has high interest in participating in leadership
practices to show their abilities in the leadership

domain (Hiller, 2005). Since an individual’s
leadership self-identity is an internal self-concept
linked with public behaviors (Tice, 1992), indi-
viduals with high self-efficacy beliefs are
more likely to demonstrate leading skills and
to perform effective leadership in organizations
(Anderson et al., 2008; Machida &
Schaubroeck, 2011). As one aspect of self-
concept, leadership self-identity drives one’s
desire for recognition as a leader. Individuals
begin signaling their abilities and interest in
leadership to other group members by acting
in ways consistent with the identity (Kwok
et al., 2018). Signaling can serve as one form
of identification enhancement within the group
to attract other members. More social attraction
work may actively influence other members’
perceptions, gain their compliance, and eventu-
ally result in leadership status (Hogg, 2001).
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Effective followership facilitates the identity
formation of prospective leaders (Hogg et al.,
2012). When a leaderless group has effective
followers, prospective leaders might attribute
the followership of effective followers to their
leadershiptraits.Theyaremorelikelytoconstruct
an intrinsic leadership identity and separate them-
selves(asleaders)fromtherestofthegroup.Once
these prospective leaders become more certain in
their role, they make greater efforts to enhance
their identification with group leaders (Hogg,
2001; Hogg et al., 2012). On the contrary, in
the absence of effective followers, prospective
leaders struggle to develop and sustain their
leadership self-identity because they do not per-
ceive and attribute their influence to internal
leadership characteristics. If team members are
too passive and short of independent, ethical
evaluation of qualified candidates, prospective
leaders may find difficulty identifying them-
selves, thus increasing status-based differentia-
tion in self-managing teams.
Given the prior discussion, we propose our

third hypothesis:
Hypothesis 3: An individual’s leadership
self-identity mediates the relationship
between effective followership and his or
her likelihood of being an emergent leader
within a self-managing team.
Research Design and Method
Sample and Procedure
To test our model, we collected data from
undergraduate students at three large American
business schools. The sample consisted of 205
junior and senior business major students, includ-
ing 106 males and 99 females. Over 91% of these
students were between 20 and 25 years old. The
majorityofsubjects(87.2%)hadworkexperience
of more than 3 years and 29.8% had managerial
experience. The 205 students represented 58
project teams, including 22 four-member teams,
27 five-member teams, and 9 six-member teams.
Before recruiting study participants, we re-
viewed the syllabi of upper-level undergraduate
courses in management and international busi-
ness at these schools and selected 19 course
sessions with similar course designs, schedules,
teamwork, and group assessments over the
semester. We then coordinated with instructors
to assign compatible team projects and to align
the timing and intensity of the work. Once the
courses began, instructors placed students into
self-managing teams with four to six members

during the first or second week. Instead of ap-
pointing team leaders, the instructors asked stu-
dents to manage themselves and develop their
own leaders as they completed the projects. Since
student groups formed early in the semester, each
student had limited opportunities to interact with
others in the class, thus reducing the likelihood
that preconceived leadership roles would already
exist. These student teams remained stable
throughout the coursework. The study continued
throughout the coursework over one academic
semester (14–15 weeks). Each student com-
pleted online surveys independently, based on
their team experience at three discrete points in
time (see Figure 1 for a timeline of data collec-
tion). The first data collection occurred between
weeks four and five, after students had some
preliminary interaction with other members.
The second collection happened between weeks
8 and 9, at the midpoint of the semester, after
several team assignments and group activities
were completed. The last data set, captured from
weeks 12 to 13, occurred before final project
reports were due. Although 132 student teams
voluntarily provided data for this research, we
followed Newman and Sin’s (2009) and
Hirschfeld et al.’s (2013) approaches and only
retained 205 valid subjects from 58 teams whose
within-group participation rates exceeded 60%
over the three data collection times.
Measure
Effective Followership
We adapted Kelley’s (1992) followership

behavior instrument with social network analysis
to assess how much exposure to effective follow-
ership each individual receives (See Appendix).
We took three steps to calculate the impact of
effective followership upon every prospective
leader, that is, the average of the weighed effec-
tive followership behavior of the focal indivi-
dual’s followers.
In Step 1, we calculated each team member’s
self-assessment of effective followership behav-
ior. Based on Blanchard et al.’s (2009) factor
analysis of followership, we selected six items
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from Kelley’s (1992) instrument that were highly
loaded on active engagement and independent
critical thinking, and adapted them to fit the
context of student teams. The sample items
include “Do you help out other coworkers, mak-
ing them look good, even when you don’t get any
credit?” and “Do you assert your views on impor-
tant issues, even though it might mean conflict
with your group or reprisals from your team
leader?” Participants responded to items using
a 6-point response scale, ranging from 1, never, to
6, always.
In Step 2, we focused on assessing the propor-
tional effective followership given by one team
member to specific prospective leaders through
the weighed network analysis (Opsahl et al.,
2010). We first asked each participant to rate
the extent to which he or she followed other
team members, using a 5-point response scale,
ranging from 1, not at all, to 5, very much. This
rating showed various degrees of following
expressed by an individual toward each of their
peers. Such information reflects every partici-
pant’s willingness to be led by any of the potential
leaders on the team (Carsten et al., 2010; Uhl-
Bien & Pillai, 2007). By knowing the overall
following scores of an individual given to others,
we assessed the exact proportion of his or her
following to any of their peers. Based on this

ratio, we calculate the shares of one’s follower-
ship score in every dyadic relationship.
For instance, for a team consisting of n
members: A1, A2, : : : , and An, Rij refers to
the following rating given by Ai to peer Aj; k
identifies any of possible Ai peers (potential
leaders) in this n-member team; Hi refers to Ai’s
self-reported effective followership behavior
score; Hij represents Ai’s proportion of effective
followership behavior toward Aj. We denote Hij
as:
Hij = Hi
Rij
P1≤k≤n
k≠i Rik
:
In Step 3, we computed the weighted influ-
ence of effective followership on each individ-
ual. For every team member (as a prospective
leader), we averaged peers’ (as their potential
followers) proportional effective followership
behavior to estimate the aggregative effective
followership from the team. For instance, the
overall effective followership, Fj, to which
individual Aj is subjected, is the average of
the weighted effective followership behavior
of Aj’s peers as, where k identifies any of possi-
ble Aj peers (potential followers) in this n-mem-
ber team:

Fj =
P1≤k≤n
k≠j Hkj
ðn − 1Þ :
The collection of participants’ effective fol-
lowership behavior and following scores
occurred in the first wave. Cronbach’s α was .93.
Leadership Behavior
We measured this construct by using adapted
items from Halpin’s (1957) Leader Behavior
Description Questionnaires (LBDQ) (See
Appendix). Based on DeRue et al.’s (2012)
approach of adapting LBDQ instruments, we
chose three items to assess task-related leadership
behaviors and three items to assess relational
Figure 1
Timeline of Data Collection
First Data Collection Second Data Collection Third Data
Collection
retsemes fo 31-21 keeWretsemes fo 9-8 keeWretsemes fo 5-4
keeW
ecnegreme redaeLroivaheb pihsredaeLroivahebpihsrewolloF
ytitnedi-fles pihsredaeLerocsgniwolloF
Control variables

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leadership behaviors. The selected six items are
highly loaded on “consideration,” “encourage-
ment of standardized procedures and produc-
tion,” “friendly interest in follower welfare,”
“supportive encouragement of follower contribu-
tions,” and “initiating structure” in accordance
with Schriesheim and Stogdill’s (1975) LBDQ
factor analysis. Sample items include “He/She
does personal favors for group members,” and

“He/She asks that group members follow stan-
dard rules and regulations.” We combined these
six items into one single leadership behavior
measurement. Using items from the LBDQ scale,
each participant rated the frequency (5-point
scale, ranging from 1, barely, to 5, almost always)
that each of their peers engages in these beha-
viors.Next,wecalculated the leadership behavior
scores for each team member by averaging the
ratings from the peer evaluations. For instance, if
an individual worked with four members in their
team, he or she would receive four independent
peer assessments for each leadership behavior
item. The means of the four appraisal values
are calculated using leadership behavior scores
for that person. Measurement of participants’
leadership behaviors came in the second wave
of data collection. Cronbach’s α was .86.
Leadership Self-Identity
We used Hiller’s (2005) four-item self-rated
leader identity measure to assess the extent to
which leader identity is considered to be descrip-
tive of and important to the respondent (Day &
Sin, 2011) (See Appendix). Participants rated
themselves (ranging from 1, not at all descriptive,
to 6, extremely descriptive) based on how accu-
rately each statement described their self-assess-
ment. Sample items included “I see myself as a
leader” and “If I had to describe myself to others, I
would include the word “leader”.” In order to
capture self-identity in regard to this group (rather
than past team experiences), we measured the
participants’ leadership self-identity at the second
wave of data collection and reminded participants

to rate each item based only on their experiences
as a member of their respective teams rather than
their past experience. Additionally, we chose not
to include the item of “I prefer being seen by
othersasaleader” inthedataanalysisbecausethis
item was designed in Hiller’s (2005) instrument
to assess individuals’ self-schema for being a
leader, which could be largely derived from
past experience (Cross & Markus, 1994). Cron-
bach’s α was .90.
Leader Emergence
We adopted General Leadership Impression
(GLI) measures (Lord et al., 1984; Smith &
Foti, 1998) and used a leadership network
approach to assess this construct (Mehra et al.,
2006) (See Appendix). Every respondent was
asked to create a list of all team members and
evaluate each teammate by responding to one
question “To what extent do you consider this
person a leader of your team?” (from 1, not at all a
leader,to5,verymuchateamleader).Theaverage
ratingofallteammatesrepresentstheleaderemer-
gence score for each individual. The average
number of raters for a focal person is 3.79. Mea-
surement of participants’ leader emergence
occurred at the last wave of data collection.
Although GLI implies the existence of differing
impressions ofteamleaders within self-managing
teams, weexamined the interrater agreement about
leader emergence. We found that the Rwg(j) for
leader emergence ranged between 0 and 1, with a
median of .62 (average = .52). The intraclass cor-
relation (ICC1) and reliability of group mean

(ICC2) values of leader emergence were .02 and
.08. As early group literature has suggested hetero-
geneousviewsofinformalleadersinself-managing
teams (e.g., Manz & Sims, 1982; Millikin et al.,
2010),wetook acompilation approach tocalculate
leader emergence by averaging participants’ rating
scoreswiththeassumptionthatindividualorlower-
level data does not need to demonstrate consensus
prior to aggregation (Kozlowski & Klein, 2000;
LeBreton & Senter, 2008). In addition, we con-
ducted one-way analysis of variance (ANOVA) to
check the nest effects and found no significant
difference between-groups variances for leader
emergence (F = 1.09, p > .05).
Control Variables
Although previous literature on leader emer-
genceincludes mixedresults onthe importance of
gender (Goktepe & Schneier, 1989; Neubert &
Taggar, 2004), we do control for gender to mini-
mize the effect of seniority in the analysis. Addi-
tionally, despite a small range of ages in student
samples, approximately 9% of participants are
between the ages of 24 and 39, older than the
typical age of college students. The absence or
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presence of managerial experience is also con-
trolled because of previous findings in the leader
development literature showing that past experi-
ences help individuals build leadership self-
efficacy and leader identity (Day & Dragoni,
2015; Day et al., 2014).
Results
First, we ran a Confirmatory Factor Analysis
(CFA) to examine the overall fit of the measure-
ment model. Since leader emergence depends
on leadership network approaches, we tested a
three-factor measurement model (effective fol-
lowership, leadership behavior, and leadership
self-identity) which included 15 items. The three-
factor measurement model with all latent vari-

ables showed good fit indices (χ2 = 201.56, df =
87, p < .001, CFI = .95, TLI = .94; RMSEA =
.08, SRMR = .05). All manifest variables signif-
icantly loaded on their corresponding latent vari-
ables (p < .001).
Table 1 presents descriptive statistics and cor-
relations among observed variables. To analyze
the direct effect of effective followership of team
members, leadership emergence of their prospec-
tive leader(s), and mediation through leadership
behavior and leadership self-identity, we used
Hayes’ (2017) PROCESS macro (Model 4),
with 20,000 bootstrap samples to calculate the
95% confidence intervals. We conducted the anal-
ysis with all variables simultaneously. The result
of the paths and their standardized coefficient
estimates are shown in Figure 2.
Hypothesis 1 predicts a positive relationship
between effective followership of team members
and leader emergence of the prospective lea-
der(s). As expected, the total effect of effective
followership on leader emergence (c path) was
significant (β = .42, p < .001). Therefore,
Hypothesis 1 is supported.
Hypotheses 2 and 3 propose that leadership
behavior and leadership self-identity, respec-
tively,mediatestherelationshipbetweeneffective
followership of team members and their likeli-
hood of being an emergent leader within a self-
managingteam.InFigure 2,wenotethateffective
followership has a significant direct effect on
leadershipbehavior(β = .29,p < .001)andlead-

ershipself-identity(β = .17,p < .05).Also,lead-
ership behavior (β = .43, p < .001) and
leadership self-identity (β = .15, p < .05) are
positively relatedtoleader emergence. Moreover,
the bootstrap procedure reveals an indirect effect
of effective followership on leader emergence
through leadership behavior (indirect effect =
.12, bootstrap bias-corrected 95% CI from .05
to .20). We also find an indirect effect of effective
followership on leader emergence through lead-
ership self-identity (indirect effect = .03, boot-
strap bias-corrected 95% CI from .00 to .06).
Because the CIs did not contain zero, the two
indirectrelationshipsweresignificant.Thesefind-
ings support Hypotheses 2 and 3. Conclusions of
our hypothesis tests remain unchanged with or
without controlling for age, gender, and manage-
rial experience.
In summary, the results of our analysis sug-
gest that when an individual receives a high level
of effective followership from team members at
the beginning of teamwork, this person is
encouraged to develop leadership self-identity
and to present leadership behaviors in the team
process. Consequently, this individual is more
likely to emerge as a leader from a leaderless
self-managing team.
Table 1
Means, Standard Deviation, and Correlations
Variable Mean SD 1 2 3 4 5 6 7
1. Gender (1 = male) .48 .50 — — — — — — —
2. Age 21.74 2.41 −.02 — — — — — —

3. Managerial experience (1 = have) .27 .45 .02 .20** — — —
— —
4. Effective followership 4.66 .90 −.07 −.03 .07 .93 — — —
5. Leadership behavior 4.17 .48 −.09 .06 .09 .29** .86 — —
6. Leadership self-identity 4.53 1.10 .09 −.25** .12 .18** .10
.90 —
7. Leader emergence 3.59 1.03 −.01 .05 .11 .42** .52** .24**
—
Note. N = 205. Cronbach’s α is in italic on the diagonal.
** p < .01.
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Contributions and Limitations
This study contributes to the leadership and
team literature by demonstrating that both cogni-
tive and behavioral factors are critical for under-
standing how individuals emerge as leaders in
self-managed teams. Our proposed model com-
plements existing leader emergence research by
describing the contribution of followers’ effec-
tive followership to intragroup leadership devel-
opment. Building on early scholars’ claims of
“understanding followers is as important as
understanding leaders” (Howell & Shamir,
2005, p. 110), this research explains why fol-
lowers matter to the creation of leaders. By pre-
senting some of the first empirical investigation
into the impact of followership behavior upon
leader emergence, we illustrate how effective
followership influences leadership behavior and
leadership self-identity of prospective leaders.
Our study complements the current team leader-
ship literature by taking a balanced view of
followership and leadership to explain the
dynamic, fluid, and relational nature of leadership
development (Day & Dragoni, 2015; Uhl-Bien &
Carsten, 2018).
Additionally, this research is among the few
attempts to explain why leadership varies in self-
managing teams. Since the emergence of a team
leader(s) is a result of coordinated choices made

by followers and leader(s), a self-managing team
can exist as centralized leadership with a single
individual, shared leadership among all group
members, or some intermediate configuration
(DeRue, 2011). The followership perspectives
adopted in this research also demonstrate how
leadership structures emerge in a bottom-up fash-
ion, including a weak identity context, and under-
line the notion that leadership is the collective
responsibility of all members (Wellman, 2017).
Findings from this study have several impor-
tant implications for managerial practice in team-
based organizations. First, organizations should
consider purposefully increasing interdependent
Figure 2
A Multiple Mediator Model of the Relationship Between
Effective Followership and Leader Emergence Through
Leadership Behavior and Leadership Self-Identity
c = .42***
.15*
.43***
.17*
.29***
c = .27*** Effective
Followership
Leadership
Behavior

Leadership
Self-identity
Leader
Emergence
Effective
Followership
Leader
Emergence
Note. c = total effect; c′ = direct effect.
* p < .05. *** p < .01.
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team member activities to facilitate leadership
development. Our findings suggest that followers
contribute to leader emergence by influencing
prospective leader(s) behaviors and self-identities.
It is hard to imagine that influence could be
achievedwithoutsufficientconnectionsinagroup.
Thus, organizations could design projects involv-
ing more joint effort and collaborative work that
enable team members to enact effective follower-
ship throughout the team process. Additionally,
organizations need to encourage the expression
of authentic opinions (even critical inputs) about
managers’ behaviors and performance. Our
research points to the importance of effective
followers and their traits of both active engage-
ment and independent critical thinking in support
oftheirleader(s).Althoughcomplimentsandcom-
pliance could be pleasing to leaders, individuals
cannot gain a clear understanding of their leader-
ship effectiveness unless constructive feedback is
available. Organizations should reward effective
followership in the workplace and motivate more
employees to take a collective responsibility of
helping develop new leaders. Finally, organiza-
tions could implement leader development pro-
grams and pair them with followership
development programs to provide 360° feedback
given by subordinates, colleagues, and supervi-

sors.Organizationsmayderivesubstantialbenefits
from cultivating effective followers and prospec-
tive leaders concurrently. Timely leadership
assessments from multiple resources, especially
from followers, may help potential leaders
better understand their leadership style and wisely
use power for organizational effectiveness
(Chaleff, 2008).
This study has several limitations. First, the
sample consists of undergraduate student teams
in universities. The results from student partici-
pants may not generalize to working teams in real
organizations. Second, student’s academic
engagement and performance may influence their
assessment of self-identities and leading–
following interactions. Although we attempted
to minimize the differences in the team-based
learning experience, we suggest that future re-
searchers could include robust multilevel designs
with a large sample to assess the relationship
between leadership and followership at different
levels. In our study, we also observed that team
members might not always agree on the team
leader(s), reflected as a low interrater agreement
among team members concerning leader
emergence. We suggest further research on deter-
minants of opinions of informal leaders when
members are practicing shared leadership or
self-management in teams. Additionally, the con-
trols and variable manipulations incorporated to
prevent extraneous interference in this study are
somewhat limited. Finally, although we identify
paths to leader emergence, we do not specifically
test or examine the recursive relationship between

leadership and followership. For instance, fol-
lowers and leaders could dynamically influence
each other’s behavior and self-identity throughout
the team process. Previous leadership develop-
ment literature suggests leading and following as a
complex claiming-granting adaptive process in
which interactions stimulate the construction of
leader and follower identities (DeRue, 2011;
DeRue & Ashford, 2010; Uhl-Bien & Carsten,
2018).Furtherresearch maydeterminehow causal
inferences from leadership and followership may
integrate with our model. For instance, researchers
may consider introducing cross-lagged design or
experimental approaches to assess the causality
between leadership and followership behaviors
among team members, as well as a gradual transi-
tion from followers to leaders or vice-versa. Nev-
ertheless, despite these limitations, we believe that
the three-wave survey design for examining the
relationship of effective followership, leadership
self-identity, leadership behaviors, and leader
emergence makes a distinct contribution to the
literature.
We hope that this study provides helpful in-
sights for future research. Our research suggests
that members construct roles throughout the team
process.Leadershipandfollowershipmayshiftor
coexist conditionally in the same person. Further
work may evaluate competencies of group mem-
ber’s abilities to influence the exchange of lead-
ership and followership roles in the work of the
group. Researchers could assess how individuals
manage the potential conflict between leader and
follower identities due to the complexity and
pluralism of multiple subidentities within a per-

son (Day & Harrison, 2007). In addition, the
current literature is still limited in describing
how individuals are motivated to produce effec-
tive followership (Kelley, 2008) and how indivi-
duals prioritize leadership and followership
throughout their leadershipdevelopment process.
Nonhierarchical organizations and self-
managing teams remain a potential context for
this type of research. Further organizational
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studies may focus on the relationship between
effective followership development and proac-
tivity (Grant & Ashford, 2008). We hope that this
research encourages further investigation of the
role of followers in the leader emergence process.
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(Appendix follows)
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https://doi.org/10.1177/1094428106298969
https://doi.org/10.1177/1094428106298969
https://doi.org/10.1177/1094428106298969
https://doi.org/10.1016/j.socnet.2010.03.006
https://doi.org/10.1111/j.1744-6570.1975.tb01380.x
https://doi.org/10.1111/j.1559-1816.2007.00261.x
https://doi.org/10.1111/j.1559-1816.2007.00261.x
https://doi.org/10.1111/j.1559-1816.2007.00261.x
https://doi.org/10.1111/j.1559-1816.2007.00261.x
https://doi.org/10.1111/j.1559-1816.2007.00261.x
https://doi.org/10.1111/j.1559-1816.2007.00261.x
https://doi.org/10.1037/0021-9010.69.2.222
https://doi.org/10.1037/0021-9010.69.2.222

https://doi.org/10.1037/0021-9010.69.2.222
https://doi.org/10.1037/0021-9010.69.2.222
https://doi.org/10.1037/0021-9010.69.2.222
https://doi.org/10.1016/S1048-9843(98)90002-9
https://doi.org/10.1016/S1048-9843(98)90002-9
https://doi.org/10.1016/S1048-9843(98)90002-9
https://doi.org/10.5465/256865
https://doi.org/10.5465/256865
https://doi.org/10.1016/j.obhdp.2010.06.001
https://doi.org/10.1016/j.obhdp.2010.0 6.001
https://doi.org/10.1037/0022-3514.63.3.435
https://doi.org/10.1037/0022-3514.63.3.435
https://doi.org/10.1037/0022-3514.63.3.435
https://doi.org/10.1037/0022-3514.63.3.435
https://doi.org/10.1037/0022-3514.63.3.435
https://doi.org/10.1108/S1479-357120180000009005
https://doi.org/10.1108/S1479-357120180000009005
https://doi.org/10.1108/S1479-357120180000009005
https://doi.org/10.1016/S0191-3085(03)25006-1

https://doi.org/10.1016/S0191-3085(03)25006-1
https://doi.org/10.1016/S0191-3085(03)25006-1
https://doi.org/10.5465/amr.2015.0375
https://doi.org/10.5465/amr.2015.0375
https://doi.org/10.5465/amr.2015.0375
https://doi.org/10.5465/amr.2015.0375
https://doi.org/10.5465/amp.2012.0088
https://doi.org/10.5465/amp.2012.0088
https://doi.org/10.5465/amp.2012.0088
https://doi.org/10.5465/amp.2012.0088
https://doi.org/10.1111/j.1744-6570.2011.01238.x
https://doi.org/10.1111/j.1744-6570.2011.01238.x
https://doi.org/10.1111/j.1744-6570.2011.01238.x
https://doi.org/10.1111/j.1744-6570.2011.01238.x
https://doi.org/10.1111/j.1744-6570.2011.01238.x
https://doi.org/10.1111/j.1744-6570.2011.01238.x
Appendix
Items for Primary Measures
Followership Behavior [Adapted From Kelley
(1992)]
Respondents evaluated statements describing
howthey actintheir teamon ascale of1 (never) to
6 (always).
Active Engagement
1. Do you actively develop a distinctive
competence in those critical activities so
that you become more valuable to your
team leader and the team?

2. Do you take the initiative to seek out and
successfully complete assignments that go
above and beyond your job?
3. Do you help out other coworkers, making
them look good, even when you don’t get
any credit?
Critical Thinking
4. Do you make a habit of internally
questioning the wisdom of your team
leader’s decision rather than just doing
what you are told?
5. When your team leader asks you to do
something that runs contrary to your pro-
fessional or personal preferences, do you
say “no” rather than “yes”?
6. Do you assert your views on important
issues, even though it might mean conflict
with your group or reprisals from your
team leader?
Following Score
Respondents listed the name of each team
member and answered the question: “To what
extent do you follow this person in your
team?” (1 = “Not at all”; 2 = “Somewhat”;
3 = “About average”; 4 = “Quite a bit” and
5 = “Very much”).
Leadership Behavior [Adapted From Halpin
(1957)]

member and choose a number from 1 to 5 repre-
senting how frequently each member engages in
the behavior described by the item.
(1 = “Barely”; 2 = “Seldom”; 3 = “Occasion-
ally”; 4 = “Very often” and 5 = “Almost
always”).
Consideration
1. He/She is friendly and approachable.
2. He/She puts suggestions made by the
group into operation.
3. He/She does personal favors for group
members.
Initiating Structure
4. He/She makes sure that his/her part in the
group is understood by all group
members.
5. He/She tries out his/her new ideas with
the group.
6. He/She asks that group members follow
standard rules and regulations.
Leadership Self-Identity [Adapted From
Hiller (2005)]
Respondents evaluated statements describing
their view of themselves on a scale of 1 (not at all

descriptive) to 6 (extremely descriptive).
1. I am a leader.
2. I see myself as a leader.
3. If I had to describe myself to others, I
would include the word “leader.”
4. I prefer being seen by others as a leader.
(not included).
Leader Emergence
member and answered the question: “To what
extent do youconsider this person a leader of your
team?” (1 = “Not at all”; 2 = “Somewhat”;
3 = “About average”; 4 = “Quite a bit” and
5 = “Very much”).
Received June 23, 2020
Revision received March 30, 2021
Accepted April 8, 2021 ▪
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How Followers Create Leaders: The Impact of Effective
Followership on Leader Emergence in Self-Managing
TeamsOutline placeholderFollowers and Their Impact Upon
Leader EmergenceThe Role of Leadership BehaviorThe Role of
Leadership Self-IdentityResearch Design and MethodSample
and ProcedureMeasureEffective FollowershipLeadership
BehaviorLeadership Self-IdentityLeader EmergenceControl
VariablesResultsContributions and
LimitationsReferencesFollowership Behavior [Adapted From
Kelley (1992)]Active EngagementCritical ThinkingFollowing
ScoreLeadership Behavior [Adapted From Halpin
(1957)]ConsiderationInitiating StructureLeadership Self-
Identity [Adapted From Hiller (2005)]Leader Emergence
When you wake in the morning, you may reach for your cell
phone to reply to a few text or email messages that you missed
overnight. On your drive to work, you may stop to refuel your
car. Upon your arrival, you might swipe a key card at the door
to gain entrance to the facility. And before finally reaching your
workstation, you may stop by the cafeteria to purchase a coffee.
From the moment you wake, you are in fact a data-generation
machine. Each use of your phone, every transaction you make

using a debit or credit card, even your entrance to your place of
work, creates data. It begs the question: How much data do you
generate each day? Many studies have been conducted on this,
and the numbers are staggering: Estimates suggest that nearly 1
million bytes of data are generated every second for every
person on earth.
As the volume of data increases, informatio n professionals have
looked for ways to use big data—large, complex sets of data
that require specialized approaches to use effectively. Big data
has the potential for significant rewards—and significant
risks—to healthcare. In this Discussion, you will consider these
risks and rewards.
To Prepare:
· Review the Resources and reflect on the web article Big Data
Means Big Potential, Challenges for Nurse Execs.
· Reflect on your own experience with complex health
information access and management and consider potential
challenges and risks you may have experienced or observed.
Post a description of at least one potential benefit of using big
data as part of a clinical system and explain why. Then,
describe at least one potential challenge or risk of using big
data as part of a clinical system and explain why. Propose at
least one strategy you have experienced, observed, or
researched that may effectively mitigate the challenges or risks
of using big data you described. Be specific and provide
examples.
https://www.healthleadersmedia.com/nursing/big-data-means-
big-potential-challenges-nurse-execs
https://www.sciencedirect.com/user/identity/landing?code=lSH
YxoWmnNR9lwhU0NCDSF7dYsPo-pZnNXwDG-

YN&state=retryCounter%3D0%26csrfToken%3D5643394c-
e429-4bec-9df5-
0f7c8fc363f0%26idpPolicy%3Durn%253Acom%253Aelsevier%
253Aidp%253Apolicy%253Aproduct%253Ainst_assoc%26retur
nUrl%3Dhttps%253A%252F%252Fwww.sciencedirect.com%252
Fscience%252Farticle%252Fpii%252FS0040162516000500%25
3Fvia%253Dihub%26prompt%3Dlogin%26cid%3Datp-
a7def609-f019-4c01-ae25-ac77f7ad42fe
https://www.youtube.com/watch?v=4W6zGmH_pOw
APA format and at 3 references
Then respond to two peers by offering one or more additional
mitigation strategies or further insight into your colleagues’
assessment of big data opportunities and risks.
in apa format and 2 references
peer 1
Nursing informatics is a common part of any medical structure.
Specifically, the specialty involves integrating healthcare
information and knowledge with technology to better patient
outcomes (McGonigle & Mastrian, 2022). In most instances,
clinical systems utilizing nursing informatics rely on big data
systems to collect, store, and disseminate medical care
information and knowledge to relevant parties. However, these
said big data structures are technologically-based, making them
vulnerable to different problems despite displaying multiple
benefits. Therefore, the assessment discusses the potential
benefits and risks of using big data in a clinical setting,
including strategies to mitigate identified risks.

Data usage is part and parcel of standard nursing
practice. According to Glassman (2017), nurses use data to
make informed medical practice decisions; specifically,
healthcare data helps nurses analyze, develop and assess patient
care by determining the ideal or efficient approach to prevent
and treat illnesses, resulting in improved health outcomes. The
extensive use of data in daily nursing operations has contributed
to big data incorporation in clinical systems. It comprises
massive patient or population information volumes created by
employing digital technologies to gather and store the data.
In furtherance, big data use in nursing is associated
with many benefits. Wang et al. (2018) describe how big data
analytics in healthcare operations like nursing supports high-
quality patient care through evidence-based practice promotion;
the analytics allows for caregivers to discover associations from
massive medical records, enabling a detailed identification of
care patterns which ensures sufficient evidence is obtained to
backup any medical intervention chosen to manage a specified
health condition. Moreover, it contributes to interprofessional
collaboration within a given healthcare organization by
improving communication among varying healthcare
practitioners and staff members. Other benefits constitute
avoiding unnecessary medical costs incurred by the healthcare
organization, such as information technology (IT) expenditure,
quick transfer of information among exiting medical IT systems,
shortening diagnosis periods, and reducing patient travel time.
Nonetheless, there are certain challenges affiliated with
big data use in nursing. One of the top challenges of using big
data is showcased during evaluating and synthesizing patient or
population data; the steps are usually conducted manually,
resulting in high demand for time and labor power (Thew,
2016). In particular, the big data structures are built in silos,
leading to a difference in data systems amongst existing units.
Thus, any nursing practitioner intending to use the information
may find the data standardization lack a great challenge,
primarily when examining how a healthcare organization

How Followers Create Leaders The Impact of Effective Follower

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