Leadership education for nurse practitioners: a systematic review of interventions, pedagogies and gaps

Abstract

Nurse practitioners (NPs) often lead interprofessional healthcare teams, yet many receive little or no formal leadership training. As healthcare systems grow in complexity and demand greater accountability, the need for strong and effective NP leadership has intensified. However, leadership development within NP education remains poorly defined and often lacks theoretical grounding. This systematic review explores interventions designed to build NP leadership skills. Following PRISMA and BEME Guide No. 13 guidelines, a search (July 2022, updated April 2024) identified peer-reviewed English-language articles from 1980 onward. Studies involving NPs at any training or practice stage were included if they described a leadership intervention. Of 3,058 articles, eight met inclusion criteria. Most studies originated in the U.S., featured isolated leadership interventions, and lacked NP clinical faculty involvement. Experiential learning and mentorship were common. Leadership domains emphasized cognitive and emotional intelligence, with little focus on leader character development. Evaluation of leadership interventions were limited. Overall, few theoretically informed, robust NP leadership interventions exist. Future efforts should prioritize comprehensive, longitudinal, and theory-based approaches to strengthen leadership capacity within NP education and practice.