CLeaFA: Development and Validation of the Clinical Leadership Contextual Factors Self‐Assessment Tool in Belgian Hospitals

Abstract

Background Healthcare professionals who actively engage in clinical leadership contribute to a culture of continuous improvement of quality of care. However, the enactment of clinical leadership strongly depends on contextual factors. Although previous research has identified several enabling contextual factors, there is no validated self‐assessment tool to systematically capture and analyze these factors in practice. This gap limits the ability to assess and support clinical leadership development. Objective To develop and validate a self‐assessment tool that identifies contextual factors influencing the development of clinical leadership among healthcare professionals. Methods The Clinical Leadership Contextual Factors (CLeaFA) tool was developed and validated through a three‐phase process: (1) item development informed by qualitative focus group data, (2) content validation via a Delphi procedure with experts, and (3) psychometric validation using exploratory factor analysis, confirmatory factor analysis, and internal consistency analysis. The tool was tested in a sample of 1024 healthcare professionals from diverse disciplines and levels of seniority working in Belgian hospitals. Results The CLeaFA tool consists of 35 items across four factors: (a) departmental culture, (b) leadership style of the formal leader, (c) professional competence, and (d) team dynamics. Conclusions The CLeaFA is a valid and reliable self‐assessment tool intended for both self‐reflection and offering potential use to evaluate contextual factors that influence their clinical leadership development, while also offering potential for use in training, management, and research. Future studies should further examine its applicability across diverse hospitals. Implications for Nursing Management The four CLeaFA subscales may help nurse managers identify organizational and leadership‐related factors influencing clinical leadership and support leadership development planning. Further research is needed before using the CLeaFA to evaluate change or intervention responsiveness.