Clinical leadership as an integral curriculum thread in pre-registration nursing programmes Angela Brown a,1 , Jan Dewing a,b,c,2 , Patrick Crookes a,3 a School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia b Sue Pembrey Chair of Nursing, Division of Nursing, School of Health Sciences, Queen Margaret University, Edinburgh, Scotland, United Kingdom c University of Ulster Northern Ireland, United Kingdom summary article info Article history: Accepted 24 November 2015 Background: In recent years there has been a growth in leadership development frameworks in health for the existing workforce. There has also been a related abundance of leadership programmes developed specifically for qualified nurses. There is a groundswell of opinion that clinical leadership preparation needs to extend to preparatory programmes leading to registration as a nurse. To this end a doctoral research study has been completed that focused specifically on the identification and verification of the antecedents of clinical leadership (leadership and management) so they can shape the curriculum content and the best way to deliver the curriculum content as a curriculum thread. Objectives: To conceptualise how the curriculum content, identified and verified empirically, can be structured within a curriculum thread and to contribute to the discussion on effective pedagogical approaches and educational strategies for learning and teaching of clinical leadership. Design: A multi-method design was utilised in the research in Australia. Drawing on core principles in critical social theory, an integral curriculum thread is proposed for pre-registration nursing programmes that identifies the antecedents of clinical leadership; the core concepts, together with the continuum of enlightenment, empowerment, and emancipation. Conclusions: The curriculum content, the effective pedagogical approaches and the educational strategies are supported theoretically and we believe this offers a design template for action and a way of thinking about this important aspect of preparatory nursing education. Moreover, we hope to have created a process contributing to a heighten sense of awareness in the nursing student (and other key stakeholders) of the what, how and when of clinical leadership for a novice registered nurse. The next stage is to further test through research the proposed integral curriculum thread. © 2015 Elsevier Ltd. All rights reserved. Keywords: Clinical leadership Antecedents Curriculum Education Students Nursing Introduction Leadership, and especially clinical leadership has become one of the most frequently highlighted requirements for safe, effective and high quality health care and services (Storey and Holti, 2013) ‘doing the right thing and doing things right’ (Bennis, 1989). As a result there has been a concerted effort to develop leadership frameworks and role/skill development opportunities in health, the majority focused on the existing workforce (Curtis et al., 2011b). Simultaneously, there has also been a proliferation of leadership programmes developed spe- cifically for qualified nurses (Curtis et al., 2011a). Given the importance placed on clinical leadership, it is our contention and the view of others (Scott and Miles, 2013; Ailey et al., 2015) that there is a need to extend clinical leadership development to preparatory programmes leading to registration as a nurse. Within this support there are suggestions that we need more ‘effective pedagogies’ (Scott and Miles, 2013, p. 77) and more ‘discussion of educational strategies for teaching leadership’ (Ailey et al., 2015, p. 24). The outcome of such curriculum development, it is argued, would ensure that nursing students realise that leadership is an expectation of all registered nurses (Ross and Crusoe, 2014) whether in formal or informal roles (Australian College of Nursing, 2015; Health Education England, 2015) but most importantly at the point of care (Millward and Bryan, 2005). The doctoral research study underpinning this paper has focused specifically on the identification and verification of the antecedents of clinical leadership (leadership and management), that is the curriculum content and the best way to deliver this curriculum content as a curriculum thread. In this paper we will present the curriculum content (antecedents) associated with clinical leadership development, derived empirically from our research and set out a discussion on educational strategies and effective Nurse Education Today 38 (2016) 9–14 E-mail addresses: angelab@uow.edu.au (A. Brown), JDewing@qmu.ac.uk (J. Dewing), pcrookes@uow.edu.au (P. Crookes). 1 Tel.: + 61 2 4221 3123; fax: + 61 2 4221 3137. 2 Tel.: +44 0 7944192619. 3 Tel.: + 61 2 4221 3174; fax: + 61 2 4221 3137. http://dx.doi.org/10.1016/j.nedt.2015.11.024 0260-6917/© 2015 Elsevier Ltd. All rights reserved. Contents lists available at ScienceDirect Nurse Education Today journal homepage: www.elsevier.com/nedt