TRANSFORMATIONAL LEADERSHIP, TRAITS, AND COMPETENCIES OF NURSING STUDENTS IN THE COMMUNITY HEALTH NURSING

The transformational leadership attributes and leadership traits of nursing students are essential components in their competency development in Community Health Nursing. The study explored the level of transformational leadership and leadership traits of nursing students in relation to their level of competency in Community Health Nursing. The study employed a descriptive-correlational research design. 175 Level Two Bachelor of Science in Nursing (BSN) students were chosen as respondents through purposive sampling. The researcher utilized Mean, Standard Deviation, Frequency, Percentage, and Pearson Product Moment Correlation Coefficient in the data analysis. Results revealed that the nursing students possessed high transformational leadership attributes and skills, leadership traits, and have a fair competency in their Community Health Nursing clinical exposure. Among the six constructs of transformational leadership, only delegation showed a highly influential relationship with competency. Meanwhile, no leadership trait manifested to correlate with nursing students’ competency at present. The study implies that nursing students with high transformational leadership attributes and high leadership traits will be future successful nurse leaders. Moreover, delegation skill is the key to becoming a competent leader and thus it is important to be introduced to nursing students even at their entry into the baccalaureate nursing education. This study also suggests that nursing educators ensure that they provide high-quality undergraduate nursing education, as this is vital in developing transformational leadership skills and improving leadership traits needed to produce competent nursing graduates who are well-equipped to work in the community setting.


INTRODUCTION
Community health nursing is considered a practice to advocate health and halt the proliferation of disease in communities where people live and interact (Mager, 2019).Cai (2020) asserted that there is an estimated 50% shortage of community health workforce comprising of nurses.Therefore, Community Health Nursing education is a huge challenge for nurse educators and clinical leaders to develop nursing students working in this dynamic healthcare setting.
Leadership in nursing refers to the capacity of the nurse leader to influence the team, thus, achieving their shared goals and attending to the health needs of patients and families (Moura, 2019).James et al. (2022) expressed that leadership is a significant dimension of the role of a qualified nurse and should therefore be recognized as the core of learning and personal growth of undergraduate students.
Since nurses are part of the entire public health programs and face more independent tasks in the absence of physicians, community nursing leadership is required (Li et al., 2019).However, new nursing graduates are not always well-equipped to handle leadership roles.Nursing students must be introduced to effective leadership practices during their clinical exposures to facilitate the integration of knowledge, traits, and competencies required to practice as nurses (Scammell et al., 2020).Alloubani et al. (2019) suggested that nursing students should be introduced to different leadership styles during their undergraduate training, specifically transformational leadership, which was proven to positively influence the quality of nursing care provision and so beneficial to them to be qualified as future nursing professionals.
Transformational leadership is an approach that aims to engender the followers' sense of self-motivation, boost their morale, and recognize their strengths and weaknesses, allowing them to evolve as leaders (Top et al., 2020).It has a firm focus on persuading and immersing followers by offering them a working environment that will enhance their efficiency and creativity; providing nurses with a sense of mission to care for patients and to do what is good and ethical (Collins et al., 2020).Transformational leadership is considered the most effective approach for nursing students promoting self-awareness, self-confidence, and a sense of achievement by foreseeing a future vision that will inspire subordinates, colleagues, and clients (Major, 2019).Zaccaro et al. (2018) speculated that leadership trait is a comparably steady and systematic combination of personal characteristics, promoting a uniform pattern of leadership performance among various group and organizational circumstances.Such traits consider various stable personal differences, including intelligence, self-confidence, determination, integrity, and sociability.Productive and successful leaders have features and traits that, generally, non-leaders do not hold.Mansour et al. (2020) emphasized that undergraduate nursing education globally emphasizes acquiring the skills needed to practice efficiently in clinical settings.However, the nursing educations received by these students fail to address essential skills that would help the student nurses to function competently.The community health nursing practice poses challenges and opportunities that may require distinct training because community health nursing has different health care needs than other nursing specialty areas.
To promote leadership development among undergraduate nursing students, it is important to enhance students' ability to assume leadership roles and practice leadership skills upon entry to practice (Miles & Scott, 2019).However, after reviewing the literature, it is clear that limited studies focus on nursing students' leadership in Community Health Nursing, and there is almost no specific research related to this particular topic in the Philippine setting.
Hence, an exploration of nursing students' transformational leadership attributes, traits, and competencies in community health nursing is important for them to be prepared to meet the growing demands for these services.

METHOD A. Research Design
This quantitative study utilized a descriptive-correlational design describing the variables and relationships that occur naturally between and among transformational leadership and traits, independent variables, and competencies, the dependent variable (Walters, 2020).

B. Research Setting
Ozamiz is a component city of the province of Misamis Occidental, Philippines.In Ozamiz City, four (4) Higher Education Institutions and three

C. Respondents of the Study
The study's respondents were the one hundred seventy-five (175) Bachelor of Science in Nursing (BSN) Level 2 students with community health nursing exposure.They were identified utilizing purposive sampling with a criterion of students who are (1) presently enrolled in the nursing courses, (2) who have community health nursing exposure, and (3) willing to participate as respondents in the study.

D. Research Instruments
The study used two questionnaires as data gathering instruments.
First, the Transformational Leadership Survey Tool which was adopted from Donald Clark (2015).It contained 18 items about the six factors of Transformational Leadership: charisma, sociality, visionary, transactional, delegation, and execution.The questionnaire used the four-point Likert scale.In determining the nursing students' level of transformational leadership attributes, the following scale was used: Second is the Leadership Trait Questionnaire (LTQ) adopted from Peter Northouse (2021).This standardized questionnaire provided information on how a leader sees him or her as a leader and assessed the leader's strengths and weaknesses.This assessment helped a leader understand their assets and areas where they needed improvement.Responses were classified using a fivepoint Likert scale.
To determine the nursing students' level of leadership traits, the study used the following continuum.To determine the nursing students' competencies, documentary analysis was performed and interpreted based on the following scale.

E. Data Collection
The researcher sought approval from the Dean of the Graduate School of the study to be conducted as well as a letter of request to conduct the study was also addressed to the President of the university thru the Dean of the College of Nursing.All informed consent forms were collected and verified before distributing the questionnaires personally to the respondents.Lastly, the gathered data were tallied using Excel and digital computation was done.Results were presented in tabular forms and data analysis and interpretation were also performed.

F. Ethical Considerations
To reach a fully informed, and freely given decision about whether or not to participate in the study, the researcher provided sufficient information such as the study's title, purpose and description of the research, and its potential benefits.The researcher expounded that the respondents' participation in the study was voluntary.Research respondents were not subjected to harm in any way.Respect for the respondents' dignity was also a priority.Assurance of privacy of research respondents and their anonymity were practiced.Lastly, to prove the respondents' willingness to participate in the study, the researcher asked them to sign the informed consent.

G. Data Analysis
This study used Frequency and Percentage, Mean and Standard Deviation, and Pearson Product Moment Correlation Coefficient in the data analysis through the use of the Minitab Software.Frequency and Percentage were used to determine the number of respondents who possessed the transformational leadership attributes of charisma, sociality, visionary, transactional, delegation, and execution; leadership traits of intelligence, selfconfidence, determination, integrity, and sociability; and competencies based on the grades they obtained from Community Health Nursing.Mean and Standard Deviation determined nursing students' transformational leadership attributes, traits, and competencies.Finally, Pearson Correlation determined the relationship between transformational leadership and leadership traits and competencies.

A. Nursing Students' Level of transformational Leadership
The transformational leadership attributes of nursing students were measured on the six factors namely: charisma, sociality, visionary, transactional, delegation, and execution (Table 4).The nursing students possessed high transformational leadership attributes (M= 3.05, SD= 0.16).These students use transformational leadership to enable their followers to maximize their potential in providing good quality health care to their clients during their community health nursing clinical exposure.Moreover, these nursing students can empower fellow student nurses to share their ideas and motivate them to be productive, resourceful, and self-sufficient followers.The study's findings supported that nursing students are prepared enough to perform as transformational leaders collaborating within a team.They have the potential that a community health nurse should possess and will be able to perform independent tasks efficiently even without a physician.The finding implies that nursing students' transformational leadership attributes can still be honed to further transfigure them into transformational leaders.Further, the findings also conformed with Seljemo et al., (2020) study supporting that transformational leadership style is vital in building and maintaining patient safety and equilibrium between job resources and job demands which is helpful in the context of health care delivery services.1.00-1.74-VeryLow

B. Nursing Students' Level of Leadership Traits
The data revealed that nursing students hold positive leadership traits of intelligence, self-confidence, determination, integrity, and sociability (Table 5).The students gave themselves high marks on all of the constructs of leadership traits (M= 4.04, SD= 0.13).While these students are still in their second level of the Bachelor of Science in Nursing program, it is a positive indication that they have the potential to become successful nurse leaders in the future.Consequently, since the clinical community setting requires distinct leadership traits than that of the acute care setting, nursing students with leadership traits of intelligence, selfconfidence, determination, integrity, and sociability will become successful leaders in the context of community health nursing.
The findings of this study revealed that nursing students, even in their undergraduate studies, have the potential to be effective nurse leaders in the future since most of them possess traits that will be relevant in the Community Health Nursing practice.Their present leadership traits can be heightened to improve the future of the nursing profession resulting to a refined quality of patient care rendered improved patient outcomes, increased staff satisfaction as well as decreased nurses' burnout.

C. Nursing Students' Level of Competency
The nursing students' level of competency in Community Health Nursing was measured through their CHN Related Learning Experience (RLE) grades.The overall result of the evaluation of Community Health Nursing Clinical exposure is generally fair (Table 6, M= 2.51; SD=0.65).Based on the study's results, nursing students are not yet competent enough in their performance as community health nurses.This is expected of them since they are still at the novice stage of nursing practice, still acquiring the skills and proficiency required to move to the next level of skill acquisition.
Meanwhile, Benner's (1984) Novice to Expert Theory can better explain the results of this study as it can describe a nurse's development in the actual clinical practice.Berglund (2019) emphasized that to be equipped to work in the clinical community setting; a student nurse should gain community health nursing competencies.Nursing education must incorporate creative strategies and utilize effective teaching modalities to give students a proficient community health nursing clinical experience thus helping them to acquire the right knowledge, skills, and attitude of a community health nurse (Steffy, 2019).
The study of Kuo et al., (2021) emphasized that competency in Community Health Nursing is dependent on age and communication skills.The respondents' age and their time in accumulating applicable learning experience showed a significant relationship in their competency in Community Health Nursing.Among the six constructs of transformational leadership, only the nursing students' delegation skills (r= -0.23; p= 0.00) were highly significant and correlated to their level of competency in Community Health Nursing clinical exposure.Their other transformational leadership attributes did not correlate with their level of competency in their clinical exposure in the Community Health Nursing course.
The data suggest that nursing students with higher delegation skills perform better academically.The more these students practice delegation skills, the more competent they become in their community health nursing competencies.This can be demonstrated by letting their followers work in ways they are comfortable with, by giving directions to their subordinates only when needed, and when they are satisfied as long as all tasks expected from them are going on smoothly.Hence this vital leadership skill should be incorporated during the preregistration education of nursing students to better prepare them to be competent nurses after graduation.

E. Significant Relationship between Nursing Students' Leadership Traits and their Level of Competency in their Community Health Nursing Clinical Exposure
Pearson Product Moment Correlation Coefficient was used to determine the significant relationship between the nursing students' leadership traits and their level of competency in their Community Health Nursing clinical exposure.The data showed that there was no correlation between the leadership traits and the nursing students' level of competency: intelligence (r= -0.06; p= 0.41); self-confidence (r= -0.14; p= 0.06); determination (r= -0.07; p= 0.34); integrity (r= -0.06; p= 0.36) and sociability (r= 0.09; p= 0.09).
In general, the results accepted the null hypothesis, meaning there is no significant relationship between the respondents' leadership traits and their level of competency in community health nursing.This implies that no leadership traits directly affect the nursing students' competencies in Community Health Nursing.Statistically, the positive leadership traits of the nursing students were not a significant factor in their academic performance at present since these nursing students are still in the novice stage of their skill acquisition and still require more time and training for their personal and professional growth in the field of Community Health Nursing.
Overall, the study implies that a little emphasis be given in enhancing the nursing students' leadership traits instead efforts be exerted more on nursing students' engagement activities that will improve their delegation skills.

CONCLUSION
Based on the findings and conclusion, it is recommended that nursing clinical instructors take initiatives to enhance their students' transformational leadership skills through effective teaching modalities.They need to ensure that they evaluate students' leadership traits prior to admission to the college to be able for them to assess the students thoroughly and focus on areas that need improvement.Meanwhile, nursing students engross themselves in effective learning strategies that will promote student engagement in both classroom and clinical learning exercises, in their Community Health Nursing (CHN) subject.On the other hand, nursing clinical instructors introduce and develop nursing students' delegation skills even during their first year in the (BSN) program, promoting their independence in assessment, decisionmaking, and patient care management.Further studies maybe conducted to follow up the development of nursing students' transformational leadership attributes, and traits, as they move through the stages of nursing skill acquisition.
(3) institutions offer nursing courses.It is the only autonomous university in Northwestern Mindanao as recognized by the Commission on Higher Education; an ISO Management System Certified and awarded as the Most Number of Accredited Programs in Region X by the Philippine Association of Colleges and Universities Commission on Accreditation (PACUCOA).

Table 1
Nursing Students' Transformational Leadership scale

Table 2
Nursing Students' Leadership Trait scale

Table 3
Nursing Students' Competency scale

Table 6
Respondents' Level of Competency in their Community Health Nursing Clinical Exposure