collaborative leadership literature review

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Why Employees Who Work Across Silos Get Burned Out

• Eric Quintane,
• Jung Won Lee,
• Camila Umaña Ruiz,
• Martin Kilduff

And how companies can better support these important cross-functional workers.

When employees collaborate across silos, there are numerous benefits for organizations. But the employees who do this critical work — also known as boundary spanners or network brokers — may end up overwhelmed, burned out, and can even develop abusive behavior toward their fellow employees. Research shows why this can happen, and suggests three key strategies companies can use to mitigate any negative effects: strategically integrating cross-silo collaboration into formal roles, providing adequate resources, and developing check-in mechanisms and opportunities to disengage.

In today’s fast-paced and complex business environment, fostering collaboration across organizational silos, whether between different teams, divisions, or regional offices, is no longer a luxury — it’s a necessity. It is key to improving performance, unlocking innovation, and speeding up coordination .

• Eric Quintane is an associate professor of organizational behavior at ESMT Berlin. He holds a PhD in management from the University of Melbourne in Australia. His research focuses on understanding the dynamics of interpersonal networks and their consequences for individuals (such as innovative performance or burnout).
• SL Sunny Lee is an Associate Professor of Organizational Behavior and the Deputy Director of Diversity and Inclusion at UCL School of Management. She has a PhD from London Business School. Her research focuses on identifying biases within human resources processes, such as recruitment and promotion, and the psychological implications of workplace behaviors.
• JL Jung Won Lee is an assistant professor of organizational behavior at ESSEC Business School. She has a PhD from UCL School of Management. Her research focuses on psychological antecedents and consequences of interpersonal networks.
• CR Camila Umaña Ruiz is a consultant and Assistant Professor in Organizational Behavior and HR at Pontificia Universidad Javeriana. She has a PhD from Universidad de los Andes. Her research focuses on interpersonal and organizational antecedents and consequences of job stress and burnout.
• Martin Kilduff is Professor and Director of Research at UCL School of Management. He has a PhD from Cornell University. His research focuses on interpersonal social networks in organizations.

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Effect of interventions to improve safety culture on healthcare workers in hospital settings: a systematic review of the international literature.

Finn M, Walsh A, Rafter N, et al. Effect of interventions to improve safety culture on healthcare workers in hospital settings: a systematic review of the international literature. BMJ Open Qual. 2024;13(2):e002506. doi:10.1136/bmjoq-2023-002506.

Along with improvements to patient safety, interventions to optimize safety culture can also improve staff outcomes. This review highlights the effects safety culture interventions have on hospital staff, what may explain these effects, and how staff experience these changes. Teamwork and collaboration, leadership support for safety, and just culture were the most reported themes.

Videos of simulated after action reviews: a training resource to support social and inclusive learning from patient safety events. September 6, 2023

The Irish National Adverse Events Study (INAES): the frequency and nature of adverse events in Irish hospitals—a retrospective record review study. February 8, 2017

National and institutional trends in adverse events over time: a systematic review and meta-analysis of longitudinal retrospective patient record review studies. March 3, 2021

The Irish National Adverse Event Study-2 (INAES-2): longitudinal trends in adverse event rates in the Irish healthcare system. February 3, 2021

Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network--13 academic medical centers, April-June 2020. September 23, 2020

An international perspective on definitions and terminology used to describe serious reportable patient safety incidents: a systematic review. December 8, 2021

Potential costs and consequences associated with medication error at hospital discharge: an expert judgement study. May 10, 2023

A controlled trial of a rapid response system in an academic medical center. June 25, 2008

Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program. February 1, 2023

Medication errors among adults and children with cancer in the outpatient setting. January 14, 2009

Assertive communication training for nurses to speak up in cases of medical errors: a systematic review and meta-analysis. June 14, 2023

Does increased schedule flexibility lead to change? A national survey of program directors on 2017 work hours requirements. September 23, 2020

Electronic prescribing systems in hospitals to improve medication safety: a multi-methods research programme. December 21, 2022

A randomized trial of a multifactorial strategy to prevent serious fall injuries. July 29, 2020

A framework for patient safety: a defense nuclear industry-based high-reliability model. May 1, 2013

Screening for medication errors using an outlier detection system. February 8, 2017

Adverse events in healthcare: learning from mistakes. September 3, 2014

Changes to primary care delivery during the COVID-19 pandemic and perceived impact on medication safety: a survey study. June 29, 2022

Medication safety incidents associated with the remote delivery of primary care: a rapid review. January 18, 2023

Experiences and perspectives of transgender youths in accessing health care: a systematic review. August 4, 2021

International evaluation of an AI system for breast cancer screening. January 29, 2020

Diagnostic accuracy of prehospital triage tools for identifying major trauma in elderly injured patients: a systematic review. May 5, 2021

Preventing potential patient harm through clinical content interventions during oncology clinical trial implementation. September 20, 2023

Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals. February 27, 2019

HIM functions in healthcare quality and patient safety. August 10, 2011

Prospective evaluation of a multifaceted intervention to improve outcomes in intensive care: the Promoting Respect and Ongoing Safety through Patient Engagement Communication and Technology study. May 24, 2017

Severe illness getting noticed sooner - SIGNS-for-Kids: developing an illness recognition tool to connect home and hospital. January 15, 2020

Prospective study of the multisite spread of a medication safety intervention: factors common to hospitals with improved outcomes. February 7, 2024

The occurrence of potential patient safety events among trauma patients: are they random? March 5, 2008

Impact of interventions designed to reduce medication administration errors in hospitals: a systematic review. June 25, 2014

Mitigating the July effect. July 7, 2021

State-mandated hospital infection reporting is not associated with decreased pediatric health care–associated infections. September 9, 2015

Risk factors and outcomes for foreign body left during a procedure: analysis of 413 incidents after 1,946,831 operations in children. November 24, 2010

Measurement of ambulatory medication errors in children: a scoping review. December 13, 2023

Unplanned early hospital readmission among critical care survivors: a mixed methods study of patients and carers. June 27, 2018

Barriers and facilitators of adverse event reporting by adolescent patients and their families. March 29, 2017

Quantification of surgical resident stress "on call". November 30, 2005

Impact of inpatient harms on hospital finances and patient clinical outcomes. April 15, 2015

Findings of a naloxone database and its utilization to improve safety and education in a tertiary care medical center. February 1, 2017

The "weekend effect" in pediatric surgery—increased mortality for children undergoing urgent surgery during the weekend. August 6, 2014

Agency for Healthcare Research and Quality pediatric indicators as a quality metric for surgery in children: do they predict adverse outcomes? February 1, 2012

A systematic review of the prevalence and types of adverse events in interfacility critical care transfers by paramedics. June 7, 2017

Effects of patient safety culture interventions on incident reporting in general practice: a cluster randomised trial. June 17, 2015

Improving patient safety culture in primary care: a systematic review. September 7, 2016

Scoping review of the second victim syndrome among surgeons: understanding the impact, responses, and support systems. March 27, 2024

A toolkit to disseminate best practices in inpatient medication reconciliation: Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS). July 31, 2013

Effect of a postdischarge virtual ward on readmission or death for high-risk patients: a randomized clinical trial. June 17, 2015

Impact of time pressure on dentists' diagnostic performance. May 8, 2019

Development of a tool within the electronic medical record to facilitate medication reconciliation after hospital discharge. May 4, 2011

What did the doctor say? Health literacy and recall of medical instructions. May 16, 2012

Complying with ACGME resident duty hours restrictions: restructuring the 80-hour workweek to enhance education and patient safety at Texas A&M/Scott & White Memorial Hospital. December 13, 2006

Diagnostic reliability in teledermatology: a systematic review and a meta-analysis. August 30, 2023

Supporting carers to improve patient safety and maintain their well-being in transitions from mental health hospitals to the community: a prioritisation nominal group technique. August 16, 2023

Computerized decision support to reduce potentially inappropriate prescribing to older emergency department patients: a randomized, controlled trial. September 30, 2009

Computerized decision support for medication dosing in renal insufficiency: a randomized, controlled trial. June 16, 2010

Leapfrog Hospital Safety Score, Magnet designation, and healthcare-associated infections in United States hospitals. May 17, 2017

Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study. March 10, 2010

Advancing the science of patient safety. May 25, 2011

Using evidence, rigorous measurement, and collaboration to eliminate central catheter-associated bloodstream infections. August 25, 2010

Using potentially preventable severe maternal morbidity to monitor hospital performance. February 8, 2023

Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study. October 21, 2020

Caregiver and clinician perspectives on discharge medication counseling: a qualitative study. July 12, 2023

Family safety reporting in medically complex children: parent, staff, and leader perspectives. July 6, 2022

Understanding patient-centred readmission factors: a multi-site, mixed-methods study. January 25, 2017

Prevalence, nature, severity and risk factors for prescribing errors in hospital inpatients: prospective study in 20 UK hospitals. August 26, 2015

Repeat medication errors in nursing homes: contributing factors and their association with patient harm. July 28, 2010

Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two 'early adopter' hospitals. February 19, 2014

Assessing medical students' perceptions of patient safety: The Medical Student Safety Attitudes and Professionalism Survey. January 29, 2014

Effect of a pharmacist intervention on clinically important medication errors after hospital discharge: a randomized trial. July 18, 2012

Effect of clinical decision-support systems: a systematic review. July 18, 2012

Comparison of traditional trigger tool to data warehouse based screening for identifying hospital adverse events. October 24, 2012

Using a machine learning system to identify and prevent medication prescribing errors: a clinical and cost analysis evaluation. December 18, 2019

Changes in efficiency and safety culture after integration of an I-PASS-supported handoff process. February 3, 2016

Factors associated with hospital admission after outpatient surgery in the Veterans Health Administration. February 28, 2018

Building safer systems by ecological design: using restoration science to develop a medication safety intervention. April 12, 2006

Description and evaluation of an interprofessional patient safety course for health professions and related sciences students. January 10, 2007

Design and implementation of an application and associated services to support interdisciplinary medication reconciliation efforts at an integrated healthcare delivery network. December 6, 2006

Reducing potential errors associated with insulin administration: an integrative review. December 14, 2022

Resident work hour limits and patient safety. June 8, 2005

Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study. November 16, 2022

Ethical considerations and patient safety concerns for cancelling non-urgent surgeries during the COVID-19 pandemic: a review. May 12, 2021

Health care-associated invasive MRSA infections, 2005-2008. August 18, 2010

The impacts of using community health volunteers to coach medication safety behaviors among rural elders with chronic illnesses. May 22, 2013

Day of discharge does not impact hospital readmission after major cardiac surgery. November 7, 2018

Executive/senior leader checklist to improve culture and reduce central line–associated bloodstream infections. November 3, 2010

Adverse events in the paediatric emergency department: a prospective cohort study. May 20, 2020

A system factors analysis of "line, tube, and drain" incidents in the intensive care unit. August 24, 2005

Intensive care unit safety incidents for medical versus surgical patients: a prospective multicenter study. October 3, 2007

Accuracy of practitioner estimates of probability of diagnosis before and after testing. May 5, 2021

Changes in medication safety indicators in England throughout the covid-19 pandemic using OpenSAFELY: population based, retrospective cohort study of 57 million patients using federated analytics. June 7, 2023

Problems after discharge and understanding of communication with their primary care physicians (PCPs) among hospitalized seniors: a mixed methods study. September 22, 2010

Patient safety, resident well-being and continuity of care with different resident duty schedules in the intensive care unit: a randomized trial. March 18, 2015

Tune-in and time-out: toward surgeon-led prevention of "never" events. February 17, 2016

Exclusion of residents from surgery-intensive care team communication: a qualitative study. April 27, 2016

Interventions to address potentially inappropriate prescribing in community-dwelling older adults: a systematic review of randomized controlled trials. July 27, 2016

Ward round template: enhancing patient safety on ward rounds. June 13, 2018

A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies. January 25, 2023

Opioid stewardship program and postoperative adverse events: a difference-in-differences cohort study. September 16, 2020

Voluntary medical incident reporting tool to improve physician reporting of medical errors in an emergency department. February 17, 2016

Effects on resident work hours, sleep duration and work experience in a Randomized Order Safety Trial Evaluating Resident-physician Schedules (ROSTERS). June 26, 2019

Speaking up and taking action: psychological safety and joint problem-solving orientation in safety improvement. May 15, 2024

Perceptions of U.S. and U.K. incident reporting systems: a scoping review. May 15, 2024

Reframing the morbidity and mortality conference: the impact of a just culture. May 8, 2024

Teamwork matters: team situation awareness to build high-performing healthcare teams, a narrative review. April 10, 2024

Annual Perspective

Describing the evidence linking interprofessional education interventions to improving the delivery of safe and effective patient care: a scoping review. March 27, 2024

Patient safety near misses – still missing opportunities to learn. March 13, 2024

Power of saying ‘I Don’t Know’: psychological safety and participatory strategies for healthcare leaders. March 13, 2024

"Plans are worthless, but planning is everything": advancing patient safety by better managing the paradox of planning versus adaptation. March 6, 2024

Perspective

Special Section: IEA Health Care 2021. February 28, 2024

The TeamSTEPPS for Improving Diagnosis Team Assessment Tool: scale development and psychometric evaluation. February 7, 2024

Interventions to support nurses as second victims of patient safety incidents: a qualitative study of nurse managers' perceptions. February 7, 2024

Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023. February 7, 2024

Application of "Human Factor Analysis and Classification System" (HFACS) model to the prevention of medical errors and adverse events: a systematic review. February 7, 2024

Hospital staff reports of coworker positive and unprofessional behaviours across eight hospitals: who reports what about whom? January 31, 2024

Rapid expansion of the Healing Emotional Lives of Peers program during COVID-19: a second victim peer support program for healthcare professionals. January 31, 2024

Interprofessional learning in multidisciplinary healthcare teams is associated with reduced patient mortality: a quantitative systematic review and meta-analysis. January 24, 2024

What and when to debrief: a scoping review examining interprofessional clinical debriefing. January 24, 2024

Validation and use of the Second Victim Experience and Support Tool questionnaire: a scoping review. December 20, 2023

React, reframe and engage. Establishing a receiver mindset for more effective safety negotiations. November 8, 2023

Supporting nurses in acute and emergency care settings to speak up. November 8, 2023

Healthcare wants to fly as high as the aviation industry. Can it? November 8, 2023

Right Kind of Wrong: Why Learning to Fail can Teach us to Thrive. October 18, 2023

A scoping review exploring the confidence of healthcare professionals in assessing all skin tones. October 4, 2023

Perspectives on Safety

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• Open access
• Published: 15 May 2024

Supply chain transformational leadership and resilience: the mediating role of ambidextrous business model

• Taiwen Feng 1   na1 ,
• Zhihui Si 1   na1 ,
• Wenbo Jiang 2 &
• Jianyu Tan 3  

Humanities and Social Sciences Communications volume  11 , Article number:  628 ( 2024 ) Cite this article

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• Business and management

The global prevalence of COVID-19 has caused many supply chain disruptions, which calls for firms to build resilient supply chains. Prior research primarily examined the effects of firm resources or capabilities on supply chain resilience (SCR), with limited attention given to the critical role of supply chain transformational leadership (SCTL). Based on social learning theory, we explore how SCTL impacts SCR via an ambidextrous business model and the moderating role of paradox cognition. We employ hierarchical regression analysis to verify the hypotheses with data from 317 Chinese firms. The results show that SCTL has a positive impact on proactive and reactive SCR, and the ambidextrous business model mediates this relationship. Furthermore, paradox cognition strengthens the effect of SCTL on the ambidextrous business model. This study contributes to literature and practices in the field of transformational leadership and SCR by providing unique insights into how to improve SCR from a leadership perspective.

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Introduction.

Affected by the global prevalence of COVID-19, frequent supply chain disruptions have occurred (Nikolopoulos et al., 2021 ; Jiang et al., 2023 ; Shen and Sun, 2023 ). Since supply chains are increasingly complex, firms are more likely to suffer from supply chain disruptions (Lechler et al., 2019 ; Spieske and Birkel, 2021 ; Xi et al., 2024 ). It will be difficult for a firm lacking resilient supply chains to survive and compete within a dynamic and uncertain condition. Supply chain resilience (SCR) reflects the capability of a system to maintain desirable functions before/during disruptions and/or timely recover to its normal functions after disruptive events (Gu et al., 2021 ). Understanding the enablers of SCR would help the firm better respond to potential risks caused by supply chain disruptions (Vanpoucke and Ellis, 2020 ).

Firm leaders could play critical roles in reducing disruption risk in supply chains and building a more resilient supply chain (Khunwishit et al., 2018 ). However, little research has checked the effect of transformational leadership within the supply chain context. We define supply chain transformational leadership (SCTL) as a continual influence that the focal firm demonstrates modeling values and reformative behaviors, which motivates its supply chain partners to act similarly with inspiration and close relationships.

While previous studies mainly focused on the roles of specific resources or capabilities on SCR, such as agility, redundancy, and collaboration (Al Naimi et al., 2021 ; Tukamuhabwa et al., 2015 ), the strategic role of SCTL has largely been ignored. Previous studies suggest that transformational leadership encourages employees’ reaction to changes in a firm (Peng et al., 2021 ) and increases team resilience (Dimas et al., 2018 ). Hence, high levels of SCTL could operate as role-modeling behaviors for the focal firm’s partners and foster a more resilient supply chain. According to social learning theory (Bandura, 1977 ; Brown et al., 2005 ), the focal firm with high levels of SCTL acts as a reliable role model whom its followers trust and attempt to emulate. That is to say, supply chain partners can learn transformative behaviors by observing the focal firm. As a result, the focal firm with high levels of SCTL acts as a benchmark for its supply chain followers to build a resilient supply chain. Therefore, we propose that SCTL may strengthen SCR.

Firms throughout supply chains often face conflicting objectives while implementing organizational learning to improve SCR (Lee and Rha, 2016 ). That is, they must balance different types of learning strategies, such as exploring potential opportunities to transform supply chains while also exploiting current resources to optimize supply chains. The tension of balancing exploitation and exploration is termed organizational ambidexterity (Kristal et al., 2010 ). According to an ambidexterity perspective (Aslam et al., 2022 ; Eng et al., 2023 ), the focal firm with high levels of SCTL prefers to deal with supply chain disruptions through both exploring external opportunities and exploiting internal resources. However, little is known about how SCTL affects SCR via organizational ambidexterity.

Our research devotes to filling this research gap through clarifying the mediating effect of an ambidextrous business model that encompasses both novelty and efficiency within the SCTL–SCR link. We define an ambidextrous business model as a firm’s boundary-spanning transaction mode developed to create and capture value by both balancing activities of redesigning a novel business model and reorganizing elements of an existing one. Specifically, a novelty-centered business model could help firms explore a new value proposition to meet changing demands in disruptions, whereas an efficiency-centered business model improves inter-organizational transaction efficiency by facilitating supply chain visibility and reducing transaction cost (Wei et al., 2017 ; Zott and Amit, 2008 ). Drawing on social learning theory (Ojha et al., 2018 ), the focal firm with high levels of SCTL may demonstratively build an ambidextrous business model by fostering a supportive organizational context. Then, the ambidextrous business model in the focal firm motivates other supply chain partners to emulate and actively take a similar business model, improving SCR through shared supply chain ambidexterity. In this manner, an ambidextrous business model may mediate the SCTL–SCR relationship.

Furthermore, the focal firm with paradoxical thinking and cognition could also influence its learning strategies (Brusoni and Rosenkranz, 2014 ). That is, paradoxical thinking and cognition would affect the focal firm’s attitude and identification towards tensions (explore or exploit) arising from its contrasting strategic agendas (Smith and Lewis, 2011 ). When the focal firm possesses high levels of paradox cognition, it is more likely to recognize and embrace tensions, making well-balanced strategic decisions through developing transformational leadership. Hence, we propose that paradox cognition enhances the impact of SCTL on an ambidextrous business model.

In sum, this study explores three questions to uncover the impact of SCTL on SCR. First, whether SCTL is positively related to SCR? Second, does ambidextrous business model mediate the SCTL–SCR relationship? Third, does paradox cognition strengthen the role of SCTL on ambidextrous business model? By answering the above questions, this study makes a contribution to research and practices in the field of transformational leadership and SCR.

Literature review and hypotheses development

Supply chain resilience.

Resilience, a multidisciplinary construct originating from engineering, ecology, and psychology (Holling, 1973 ; Novak et al., 2021 ). Although most scholars have viewed resilience as an ability to resist and/or rebound from disruptive events (El Baz and Ruel, 2021 ; Namdar et al., 2018 ), there still lacks a normative definition widely accepted. Later, resilience is extended and applied to the field of social sciences, such as supply chain management and operational management. Due to the prevalence of COVID-19, resilience is particularly valued in global supply chains as supply chains become increasingly complex (Spieske and Birkel, 2021 ).

The major divergences of SCR concentrate on two aspects: influencing scope and attributive level. With regard to the influencing scope, some authors only treat SCR as a reactive capability (Brandon-Jones et al., 2014 ; El Baz and Ruel, 2021 ), while others propose that both reactive and proactive components are indispensable (Gu et al., 2021 ). With regard to the attributive level, SCR is often viewed as a firm’s capability (Ambulkar et al., 2015 ); however, it is more acceptable to belong to a whole supply chain system (Scholten et al., 2020 ). Hence, we define SCR as the capability of a system to maintain its expected functions before disruptions and timely recover to its normal functions during facing interruptions.

SCR has been segmented into various dimensions corresponding to different nodes, disruptive phases, or sub-capabilities. For example, Pournader et al. ( 2016 ) argue that SCR could be divided by the organizational boundary into supplier, internal, and customer resilience. Han et al. ( 2020 ) suggest that SCR could be classified into stages of readiness, response, and recovery. Jüttner and Maklan ( 2011 ) propose that flexibility, velocity, visibility, and collaboration are essential sub-capabilities comprising SCR. Following Cheng and Lu’s study ( 2017 ), we divide SCR into two dimensions: proactive and reactive SCR. Proactive SCR is the capability of a supply chain system to mitigate shocks and keep its normal state before/during possible disruptions. Reactive SCR means the capability of a supply chain system to quickly respond and return to its normal state after experiencing disruptions.

Although previous research has revealed diverse factors in formulating SCR (Razak et al., 2023 ; Scholten and Schilder, 2015 ), transformational leadership is rarely discussed. Prior studies mainly examine the roles of four groups of resources and capabilities in building SCR, including reengineering, collaboration, agility, and risk management culture (Belhadi et al., 2022 ). First, supply chain reengineering is positively related to SCR. Resources and capabilities, such as network structure, security, redundancy, efficiency, innovation, contingency planning, and market position, usually contribute to the realignment of structures and processes within supply chains (Han et al., 2020 ; Tukamuhabwa et al., 2017 ), which could help firms deal with new changes. Second, supply chain collaboration is valuable to build SCR. By developing information sharing, risk and revenue sharing, trust, communication, coordination, and integration, the cooperation among different supply chain partners becomes mutually high-quality (Ali et al., 2017 ; Dubey et al., 2021 ; Zhu et al., 2024 ). Third, supply chain agility facilitates the construction of SCR. Flexibility, velocity, visibility, ambidexterity, market sensitiveness, and disruption mitigation (El Baz and Ruel, 2021 ; Gu et al., 2021 ; Jain et al., 2017 ; Kochan and Nowicki, 2018 ) can increase the responsiveness of a supply chain system when facing dynamic business environment. Fourth, supply chain risk management culture, which involves risk awareness, knowledge management, and training and development of a risk management team, can create a proper culture atmosphere in favor of SCR (Belhadi et al., 2022 ).

Beyond four fostering factors, some research has also identified the interactive effects of mixed resources or capabilities on SCR, like industry 4.0 technologies, social capital, leadership, and business model (Belhadi et al., 2024 ; Gölgeci and Kuivalainen, 2020 ; Shashi et al., 2020 ; Shin and Park, 2021 ). However, we still lack knowledge about the strategic role of transformational leadership in fostering SCR. Antecedents of SCR in existing literature are shown in Table 1 .

Supply chain transformational leadership and supply chain resilience

Transformational leadership refers to leaders’ suitable behaviors that drive their followers’ reformative behaviors through continuous motivation and partnership (Bass, 1985 , 1999 ). Existing literature demonstrates that transformational leadership could affect employee attitude (Peng et al., 2021 ) and team resilience in a firm (Dimas et al., 2018 ), while the strategic role of transformational leadership across an entire supply chain system needs more explanation. According to social learning theory (Brown et al., 2005 ), we regard the focal firm with high levels of SCTL as a credible role model whom other supply chain partners respect, trust, and emulate. In this manner, other supply chain partners are likely to learn transformative behaviors by observing the focal firm.

We view the development of SCTL as a role modeling-learning process. That is, the focal firm with high levels of SCTL has an exemplary influence on other supply chain partners via observing and learning from benchmarks. Specifically, SCTL includes three elements: inspiration, intellectual stimulation, and individualized consideration (Defee et al., 2010 ). Inspiration implies that the focal firm with high levels of SCTL often articulates a compelling vision about a desirable future for the supply chain system. The focal firm, with intellectual stimulation, tends to stimulate other supply chain partners to solve issues by adopting creative and innovative methods. Individualized consideration helps the focal firm understand differentiated demands of supply chain followers, and assists them respectively. Based on social learning theory (Bommer et al., 2005 ), the focal firm’s transformative behaviors benefit its followers by the conveyance of competence. Before/during disruptive events, the focal firm clarifies a reliable vision and motivates followers to observe what it does to improve firm resilience. Targeted support makes it easier for other supply chain partners to master and emulate the focal firm’s resilient actions. In addition, coordination and trust among firms are developed in the social learning process (Mostafa, 2019 ), constructing closer supply chain relationships. Therefore, SCTL could enhance the proactive dimension of SCR.

The focal firm with high levels of SCTL would not only strengthen the proactive dimension of SCR, but also contribute to the reactive dimension of SCR. Drawing on social learning theory (Bommer et al., 2005 ), the focal firm’s transformative behaviors increase the self-efficacy of other supply chain partners. After supply chain disruptions, the focal firm demonstrates its response and encourages followers to achieve quick recovery through their differentially new insights. Besides, as firms in the supply chain are closely connected, all members’ resilient actions would transform into SCR when there are common goals and effective interactions (Gölgeci and Kuivalainen, 2020 ). In this manner, SCTL contributes to the reactive aspect of SCR. Hence, we hypothesize:

H1: SCTL has a positive influence on (a) proactive dimension and (b) reactive dimension of SCR.

Supply chain transformational leadership and ambidextrous business model

Ambidexterity is a special dynamic ability balancing exploration and exploitation simultaneously (Kristal et al., 2010 ; Lee and Rha, 2016 ). Previous literature has identified that different leadership styles, such as transformational leadership, could foster ambidexterity in firms (Jansen et al., 2008 ; Tarba et al., 2020 ). Ambidextrous business model means a firm’s boundary-spanning transaction mode developed to create and catch business value by balancing activities of redesigning novel governance, content, and structure and reorganizing elements of an existing business model. Miller ( 1996 ) identifies that novelty and efficiency are classic themes of designing business models. Specifically, a novelty-centered business model aims to create value and catch potential opportunities by redesigning a new business model, while an efficiency-centered business model devotes to increasing efficiency and decreasing operational cost by reconstructing the current business model (Feng et al., 2022 ; Wei et al., 2017 ; Zott and Amit, 2008 ). Under the context of plurality, change, and scarcity, leaders in firms have more intentions to make decisions from an ambidexterity perspective (Smith and Lewis, 2011 ). According to social learning theory (Wang and Feng, 2023 ), leaders in the focal firm with high levels of SCTL tend to express a committed attitude and take exemplary actions to maintain balancing operations. In other words, employees would be guided to conduct certain transformative behaviors, raising a flexible organizational culture with their leaders’ values.

SCTL, which is viewed as a role model-building process, includes three components: inspiration, intellectual stimulation, and individualized consideration (Defee et al., 2010 ). First, the focal firm with high levels of SCTL often articulates a compelling vision and sets high-quality standards. Inspiration by the focal firm’s leaders shows necessary confidence in their subordinates’ abilities and encourages employees to recognize the importance of individual effort in creating and capturing value through exploring and exploiting business opportunities. Additionally, the focal firm’s leaders promote collective goal-setting and collaboration among employees based on a shared vision, creating a supportive organizational context characterized by discipline, stretch, and trust (Ojha et al., 2018 ; Xi et al., 2023 ). Second, the focal firm with high levels of SCTL pays much attention to meeting emerging challenges. Intellectual stimulation by the focal firm’s leaders demonstrates transformative ideas and stimulates their employees to provide new insights under a challenging but supportive atmosphere, increasing organizational creativity and contributing to a stretch context (Elkins and Keller, 2003 ). Third, the focal firm with high levels of SCTL actively understands and helps its internal members. Individualized consideration by the focal firm’s leaders offers differentiated support via one-to-one knowledge exchange and creates a heartwarming condition that promotes more assistance among employees, fostering a culture of support and trust (Bommer et al., 2005 ). While a supportive organizational context is developed (Pan et al., 2021 ), a firm with high levels of SCTL prefers to design an ambidextrous business model. Thus, we hypothesize:

H2: SCTL has a positive influence on an ambidextrous business model.

Ambidextrous business model and supply chain resilience

The development of an ambidextrous business model could be recognized as a role model-engaging process. According to social learning theory (Wang and Feng, 2023 ), the focal firm with high levels of ambidextrous business model would serve as an example that provides a flexible business model for its followers. Then, supply chain followers are likely to trust and attempt to emulate the focal firm’s business model when sensing or experiencing frequent supply chain disruptions.

In detail, the focal firm with a high level of ambidextrous business model shows its supply chain partners how to maintain agility before/during disruptions through a proper organization arrangement. A novelty-centered business model could help other firms realize that they must create and capture value through designing new activities of governance, content, and structure to predict/respond to changing environments before/during disruptions. An efficiency-centered business model guides followers to continuously change the current supply chain into a more robust system (Wei et al., 2017 ; Zott and Amit, 2008 ). Besides, when all firms with high levels of ambidextrous business models tend to balance novelty and efficiency simultaneously, they would contribute to a more robust supply chain by preventive supply chain ambidexterity. Therefore, the ambidextrous business model enhances the proactive dimension of SCR.

The focal firm with high levels of the ambidextrous business model provides other supply chain members a valuable frame to quickly react after disruptions as well. Specifically, a novelty-centered business model stimulates other firms to adopt new ideas and norms in solving issues after disruptive events, improving their adaptability and responsiveness. An efficiency-centered business model helps followers achieve greater transaction efficiency and lower transaction costs, facilitating the adjustment of actions and strategies to rapidly respond to disruptions. In addition, firms with high levels of ambidextrous business models jointly balance novelty and efficiency, establishing a more resilient supply chain through responsive supply chain ambidexterity. SCTL contributes to the reactive dimension of SCR. Hence, we hypothesize:

H3: Ambidextrous business model has a positive influence on (a) proactive dimension and (b) reactive dimension of SCR.

In sum, the ambidextrous business model serves as a proper mediator within the role modeling-learning process. Drawing on social learning theory, the focal firm with high levels of SCTL demonstrates an ambidextrous business model through fostering a supportive organizational context. And then other supply chain partners would actively learn and emulate the focal firm’s typical business model based on their trust and common values, improving SCR by supply chain ambidexterity. An ambidextrous business model could transform SCTL into proactive and reactive dimensions of SCR. Thus, we hypothesize:

H4: Ambidextrous business model mediates the relationship between SCTL and (a) proactive dimension and (b) reactive dimension of SCR.

The moderating role of paradox cognition

Paradox cognition refers to an epistemic framework and process recognizing and juxtaposing contradictory demands, which could make latent tensions within organizations more explicit (Smith and Tushman, 2005 ). The focal firm with paradoxical thinking and cognition could influence learning strategies (Brusoni and Rosenkranz, 2014 ; Sheng et al., 2023 ). That is, paradox cognition may affect the focal firm’s attitude and identification towards tensions (explore or exploit) arising from its contrasting strategic agendas (Smith and Lewis, 2011 ). Based on social learning theory (Bandura, 1977 ), when the focal firm possesses high levels of paradox cognition, it is more likely to recognize the importance of ambidexterity. In this manner, leaders’ transformative behaviors in the focal firm with high levels of SCTL would be more easily accepted and emulated by employees to balance both explorative and exploitive learning activities (Han et al., 2022 ), which may help build an ambidextrous business model. By contrast, when the focal firm has low levels of paradox cognition, it tends to choose either novelty or efficiency in designing a business model. The SCTL-ambidextrous business model relationship becomes less important because contradictions in the focal firm are latent. Hence, we hypothesize:

H5: Paradox cognition enhances the impact of SCTL on an ambidextrous business model.

Combining the hypotheses above, we build a conceptual model to check the influence of SCTL on SCR (including proactive and reactive SCR), the mediating role of the ambidextrous business model within the SCTL–SCR relationship, and the moderating effect of paradox cognition. The conceptual model is illustrated in Fig. 1 .

This figure represents the hypothetical relationships among constructs.

Research design

Procedures and data collection.

We gathered data from Chinese manufacturers. Affected by the COVID-19 pandemic, manufacturing firms in China suffered from many supply chain disruptions, prompting leaders to realize the necessity of keeping a resilient supply chain (Lin et al., 2021 ; Shen and Sun, 2023 ). It is a challenging objective for manufacturing firms in China as they account for a large share of total exports in the global supply chains. Thus, China provided an appropriate context to explore the antecedents of SCR.

Due to the regional imbalanced characteristic of the Chinese economic force and transportation network (Feng et al., 2019 ; Hosseini et al., 2019 ), we selected sampling firms in five typical provinces: Guangdong, Jiangsu, Shandong, Henan, and Inner Mongolia. Guangdong, Jiangsu, and Shandong, in the eastern coastal areas of China, had relatively high levels of economic force and transportation networks. Henan, in the middle area of China, had average levels of economic force and transportation network. By contrast, Inner Mongolia, in the north and west of China, had relatively low levels of economic force and transportation network.

We adopted three steps to design a questionnaire. First, 12 firm executives, including the chief executive officer, general manager, or vice president, were interviewed to confirm the content validity of our study issue. All these individuals were required to be knowledgeable about their firms’ internal operations as well as external partnerships. Second, an initial questionnaire was developed through literature and expert review, translation, and back-translation. Third, a pre-test with another 20 executives was conducted to provide useful suggestions for modification, forming the formal questionnaire.

We randomly chose 200 firms in each province above and sought cooperation via a cover letter introducing the research intention. All participants were ensured confidentiality. Invitations were sent through emails or telephones, and 435 firms agreed to join our survey total. To mitigate common method bias (CMB), we split each questionnaire into two parts (including parts A and B) and invited different respondents in each firm to complete one part respectively. Part A featured demographic characteristics, competitive intensity, SCTL, novelty-centered business model, and SCR, whereas part B included paradox cognition and efficiency-centered business model.

We distributed and received back the questionnaires through emails from May 2020 to December 2020. 317 valid questionnaires were gathered, with an effective response rate of 72.9%. The final sample included 72 firms in Guangdong, 62 firms in Jiangsu, 67 firms in Shandong, 56 firms in Henan, and 60 firms in Inner Mongolia. The average working experience of 634 respondents was 7.19 years. 64.8% of our respondents held the posts of chief executive officer, general manager, or vice president, and 35.2% were operations directors. The detailed features of sampled firms are presented in Table 2 .

We utilized two steps to verify non-response bias (Armstrong and Overton, 1977 ). First, firm size and ownership were compared for the nonresponding and responding firms. Second, differences in firm size, firm age, industry, and ownership between the early and late responses were also examined. These results of the independent t -test suggested that non-response bias in this study was not a serious issue.

We selected the seven-point Likert scale adopted or adapted from previous studies to measure all constructs in the questionnaire (1 = strongly disagree, 7 = strongly agree).

Supply chain transformational leadership

A refined seven-item scale from Defee et al. ( 2010 ) was applied to measure SCTL. SCTL was operationalized as respondents’ perceptions of their firms’ influences, which are often the outcome of behavioral factors, including inspiration, intellectual stimulation, and individualized consideration.

Paradox cognition

A seven-item scale from Smith and Lewis ( 2011 ) was used to measure paradox cognition. Respondents were requested to evaluate the degree of their own firms’ dual awareness when making strategic decisions in the last three years.

Ambidextrous business model

A ten-item scale and a nine-item scale were adjusted by Zott and Amit ( 2007 ) to measure the novelty-centered business model and efficiency-centered business model in turn. Additionally, the average value of these two variables was calculated to measure the ambidextrous business model. This approach not only kept convenience to reserve and made logical interpretations for the useful information from both parts but reflected the nature of ambidexterity–seemingly contradictory yet coexisting tensions (Lubatkin et al., 2006 ; Zhang et al., 2015 ).

Following Cheng and Lu ( 2017 ), SCR was divided into two dimensions: proactive and reactive SCR Two altered four-item scales were adopted for proactive and reactive SCR separately (Ambulkar et al., 2015 ; Brandon-Jones et al., 2014 ; Wieland and Wallenburg, 2013 ).

Control variables

To mitigate the roles of other factors on analytical results as much as possible, we controlled five demographic characteristics, including firm size, firm age, industry, ownership, and competitive intensity (Ambulkar et al., 2015 ; Gölgeci and Ponomarov, 2015 ). Firm age and firm size were measured by the natural logarithm of the number of years since foundation and the natural logarithm of the number of employees, respectively (Li et al., 2008 ). One dummy variable was to control industry (1 = high-tech firm, 0 = otherwise), and two dummy variables (including state-owned and collective firms and private firms) were to control ownership. A four-item scale was adjusted by Jaworski and Kohli ( 1993 ) to measure competitive intensity.

Reliability and validity

First, we did a reliability test and explorative factor analysis (EFA). All constructs revealed high reliability with a Cronbach’s alpha value of more than 0.7 (Flynn et al., 1990 ). Seven principal components were extracted, which was consistent with constructs in the scales (Table 3 ). Second, we made a confirmatory factor analysis (CFA) by AMOS 24.0 to ensure validity. The results indicated that the measurement model had good fit indices: χ ²/d f  = 2.034; RMSEA = 0.057; CFI = 0.928; NNFI = 0.923; SRMR = 0.038. All constructs’ composite reliability (CR) was more than 0.7, with item loadings varying from 0.760 to 0.939, and all average variance extracted (AVE) values were more than 0.5 (Table 3 ). Thus, the results indicated sufficient convergent validity. Besides, the comparison between shared variances of constructs and the square root of AVE demonstrated that all correlations were less than the corresponding square roots of AVEs (Table 4 ), identifying acceptable discriminant validity. Tables 3 and 4 reported the measure items, reliability, and validity assessment.

Common method bias

We utilized three means to test CMB. First, Harman’s single-factor test was conducted, revealing that there were seven principal components (Table 3 ), and no single factor accounted for most variances in these measures. Second, the fit indices of CFA between the actual seven-factor model and the one-factor model were compared, indicating that the one-factor model got significantly worse fit indices. Third, another common method factor was supplemented to the seven-factor CFA model above and it discovered that the fit indices did not change significantly. As a result, there was no serious CMB.

We adopted hierarchical regression analysis and the bootstrapping method by SPSS 23.0 to examine the research hypotheses. First, the effect of SCTL on SCR was examined. Then, the influence of SCTL on the ambidextrous business model, the effect of the ambidextrous business model on SCR, and the mediating impact of the ambidextrous business model within the SCTL–SCR link were tested. Finally, the moderating effect of paradox cognition in the SCTL–ambidextrous business model relationship was examined. Table 5 reports the results of the hierarchical regression model.

To minimize possible multicollinearity, we generated an interaction with mean-centering of both the independent variable and the moderating variable (Aiken and West, 1991 ). The maximal value of the variance inflation factor (VIF) is 1.739, which is much less than the recommended cut-off of 10. Thus, the multicollinearity is not serious.

H1a and H1b predict the positive impact of SCTL on both dimensions of SCR. Models 5 and 9 in Table 5 show that SCTL has a significantly positive effect on the proactive dimension ( β  = 0.122, p  < 0.05) and reactive dimension ( β  = 0.166, p  < 0.01). Therefore, H1a and H1b are supported.

H2 predicts the positive influence of SCTL on the ambidextrous business model. Model 2 in Table 5 indicates that SCTL has a significantly positive impact on ambidextrous business models ( β  = 0.140, p  < 0.05). Hence, H2 is supported.

H3a and H3b predict the positive role of the ambidextrous business model on both dimensions of SCR. Models 6 and 10 in Table 5 suggest that the ambidextrous business model has a positive effect on the proactive dimension ( β  = 0.241, p  < 0.001) and reactive dimension ( β  = 0.256, p  < 0.001). Therefore, H3a and H3b are supported.

H4a and H4b hypothesize that the ambidextrous business model mediates the relationships between SCTL and two dimensions of SCR. According to Baron and Kenny ( 1986 ), Models 2, 5, and 7 in Table 5 jointly demonstrate that the ambidextrous business model ( β  = 0.228, p  < 0.001) fully mediates the relationship between SCTL ( β  = 0.090, p  > 0.1) and proactive dimension, which supports H4a. Similarly, Models 2, 9, and 11 in Table 5 collectively exhibit that the ambidextrous business model ( β  = 0.237, p  < 0.001) partially mediates the relationship between SCTL ( β  = 0.133, p  < 0.05) and reactive dimension, which supports H4b.

To ensure the robustness of the results, we further used the PROCESS macro to conduct a bootstrapped mediation analysis. As depicted in Table 6 , the results keep consistency with the corresponding results in Table 5 , ensuring the effectiveness of analytical findings before.

H5 hypothesizes that paradox cognition strengthens the impact of SCTL on the ambidextrous business model. Model 3 in Table 5 presents that the interaction of SCTL and paradox cognition is significantly positive ( β  = 0.094, p  < 0.1), which supports H5. Moreover, we applied a simple slope analysis to verify the moderating effect of paradox cognition so that a clearer explanation could be given. As illustrated in Fig. 2 , when levels of paradox cognition are higher, the role of SCTL in the ambidextrous business model becomes stronger. Hence, the result further supports a strengthened effect of paradox cognition in the SCTL–ambidextrous business model relationship.

This figure reflects the moderating effect of paradox cognition on the relationship between supply chain transformational leadership and ambidextrous business model.

Discussions and implications

Discussions.

This study intends to verify the impact of SCTL on both dimensions of SCR (including proactive and reactive SCR) through the ambidextrous business model and the moderating role of paradox cognition. Our results exhibit that SCTL has a positive influence on proactive and reactive SCR. This finding is similar to studies that explore the effect of leader–member exchange on network resilience performance in the supply chain context (Shin and Park, 2021 ) or the effect of transformational supply chain leadership on operational performance (Defee et al., 2010 ). However, these studies only emphasize the necessity of inter-organizational relationships and capabilities within the influential process of supply chain leadership on supply chain performance. Our results show that SCTL contributes to proactive and reactive SCR in a social learning process where both firm resilience and supply chain collaboration are indispensable parts.

Our results demonstrate that an ambidextrous business model mediates the impact of SCTL on SCR. This finding is inconsistent with existing studies about the antecedents or consequences of business models (Schoemaker et al., 2018 ; Shashi et al., 2020 ). One possible explanation is that the ambidextrous business model aims at designing new business models to capture and create value while also reconfiguring new combinations to improve transaction efficiency. Our results also indicate that the ambidextrous business model fully mediates the relationship between SCTL and proactive SCR while partially mediates the relationship between SCTL and reactive SCR. That is, the ambidextrous business model occupies a more important position in the SCTL-proactive dimension link. A possible reason could be that compared with intellectual stimulation, the influence of inspiration and individualized consideration is more dispersive within a longer time, improving the necessity of an ambidextrous business model. These results provide new insights to realize how SCTL enhances SCR.

In addition, we identify that paradox cognition strengthens the effect of SCTL on an ambidextrous business model. When the focal firm has high levels of paradox cognition, it tends to recognize the importance of ambidexterity. In this manner, the focal firm’s transformative behaviors would be more easily accepted and emulated by employees to balance both explorative and exploitive learning activities (Han et al., 2022 ), building an ambidextrous business model. This outcome verifies our research hypothesis, indicating the importance of paradox cognition in the SCTL–ambidextrous business model link.

Theoretical contributions

This study contributes to managerial research in three aspects. First, we enrich the antecedents of SCR by confirming the role of SCTL. Existing studies emphasize the impacts of specific resources or capabilities on SCR, such as agility, redundancy, and collaboration (Al Naimi et al., 2021 ; Tukamuhabwa et al., 2015 ), while the strategic effect of SCTL is rarely discussed. Previous literature has identified that transformational leadership could improve employee attitude (Peng et al., 2021 ) and team resilience (Dimas et al., 2018 ) at the firm level. Our research extends the concept of transformational leadership to the whole supply chain system and proposes that the focal firm with high levels of SCTL can improve proactive and reactive SCR. Hence, we contribute to the field of SCTL and SCR.

Second, we reveal the ‘black box’ of how SCTL impacts SCR by examining the mediating role of the ambidextrous business model. Existing studies reveal the influence of transformational leadership on organizational ambidexterity (Eng et al., 2023 ) and the impact of organizational ambidexterity on SCR (Aslam et al., 2022 ), while we still lack understanding of how SCTL affects SCR. Previous literature has demonstrated that redesigning a supply chain with high levels of concentration plays a significant role in protecting firm performance when suffering from disruptions (Liu et al., 2023 ). Hence, we contribute to the SCTL and SCR literature by showing a partial mediating effect of the ambidextrous business model in the SCTL–proactive SCR relationship and a fully mediating effect of ambidextrous business model in the SCTL–reactive SCR relationship.

Third, we clarify the boundary condition for the SCTL–ambidextrous business model relationship by examining the moderating effect of paradox cognition. Existing studies show that the efficiency of the learning process would be influenced by external stakeholders (Song et al., 2020 ; Wang and Feng, 2023 ), while the interactive role of internal factors is largely ignored. Previous literature has argued that organizational learning may be influenced by paradoxical thinking and cognition (Brusoni and Rosenkranz, 2014 ). Our findings suggest that paradox cognition would affect the focal firm’s attitude and identification towards tensions (explore or exploit) arising from its contrasting strategic agendas. Under high levels of paradox cognition, the focal firm is more likely to recognize and embrace tensions, making well-balanced decisions. Thus, the efficiency of social learning from SCTL to ambidextrous business model improves, which further emphasizes the necessity of developing paradox cognition within the learning process.

Managerial implications

This study offers three suggestions for managerial practice. First, managers should undertake leading roles and encourage member firms within the supply chain to improve SCR. In a dynamic and uncertain context, the focal firm with high levels of SCTL is effective to motivate its supply chain partners’ transformative behaviors. Managers should develop a reliable role model whom their followers trust and attempt to emulate. They should also develop two types of SCR, including proactive and reactive SCR. Additionally, they should articulate a compelling vision for all supply chain members, providing individualized training to meet the differentiated needs of firms and stimulating supply chain partners to create new insights with a supportive and challenging atmosphere.

Second, managers should establish an ambidextrous business model in firms. The focal firm with high levels of SCTL often demonstrates an ambidextrous business model by fostering a supportive organizational context. Managers should design an ambidextrous business model balancing both novelty and efficiency. Furthermore, they are suggested to motivate other supply chain followers to learn and emulate the focal firm’s transformative behaviors through a shared system vision, promoting communication and coordination among supply chain members.

Third, managers should foster a paradox cognition framework within their firms. Under high levels of paradox cognition, the focal firm is more likely to recognize the importance of ambidexterity and solve tensions from an ambidexterity perspective. Transformative behaviors of the focal firm would be more easily accepted and emulated by its employees. Managers should provide a proper organizational context for employees to improve their paradoxical thinking and cognition to quickly respond to disruptions.

Conclusion and limitations

Drawing on social learning theory, this study clarifies the impact of SCTL on SCR. Our findings reveal that SCTL has a positive influence on both proactive and reactive SCR. In addition, the ambidextrous business model fully mediates the relationship between SCTL and proactive SCR while also partially mediating the relationship between SCTL and reactive SCR. Paradox cognition strengthens the effect of SCTL on the ambidextrous business model.

This study has a few limitations, of course. First, we must demonstrate the effect of SCTL on SCR. Future research could try investigating the roles of other factors, such as transactional leadership to enrich antecedents of SCR. Second, this study only explores the mediating role of the ambidextrous business model between SCTL and SCR. In the future, other possible realization paths from the configurational perspective should be verified (Feng and Sheng, 2023 ). Third, we must identify the moderating impact of paradox cognition within the SCTL–ambidextrous business model relationship. Scholars are suggested to discover more possible boundary conditions like dynamic environment, and build a moderated mediation model to further explore the roles of potential moderators.

Data availability

All data generated and analyzed during the current study are included in this article and a supplementary Excel spreadsheet called ‘Dataset’ which contains all items’ values from questionnaires and other control variables’ values.

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Acknowledgements

This work was partially supported by the National Natural Science Foundation of China (72172040), the Fundamental Research Funds for the Central Universities (HIT.HSS.ESD202333), and the Taishan Scholar Project of Shandong Province (tsqn201909154).

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School of Economics and Management, Dalian University of Technology, Dalian, China

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Taiwen Feng: Conceptualization, investigation, data curation, funding acquisition, supervision, writing-review and editing. Zhihui Si: Methodology, data curation, formal analysis, writing-original draft, and editing. Wenbo Jiang: Investigation, data curation, writing-review, and editing. Jianyu Tan: Data curation, writing-review, and editing.

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A systematic literature review of empirical research on ChatGPT in education

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• Published: 26 May 2024
• Volume 3 , article number  60 , ( 2024 )

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• Yazid Albadarin   ORCID: orcid.org/0009-0005-8068-8902 1 ,
• Mohammed Saqr 1 ,
• Nicolas Pope 1 &
• Markku Tukiainen 1  

Over the last four decades, studies have investigated the incorporation of Artificial Intelligence (AI) into education. A recent prominent AI-powered technology that has impacted the education sector is ChatGPT. This article provides a systematic review of 14 empirical studies incorporating ChatGPT into various educational settings, published in 2022 and before the 10th of April 2023—the date of conducting the search process. It carefully followed the essential steps outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines, as well as Okoli’s (Okoli in Commun Assoc Inf Syst, 2015) steps for conducting a rigorous and transparent systematic review. In this review, we aimed to explore how students and teachers have utilized ChatGPT in various educational settings, as well as the primary findings of those studies. By employing Creswell’s (Creswell in Educational research: planning, conducting, and evaluating quantitative and qualitative research [Ebook], Pearson Education, London, 2015) coding techniques for data extraction and interpretation, we sought to gain insight into their initial attempts at ChatGPT incorporation into education. This approach also enabled us to extract insights and considerations that can facilitate its effective and responsible use in future educational contexts. The results of this review show that learners have utilized ChatGPT as a virtual intelligent assistant, where it offered instant feedback, on-demand answers, and explanations of complex topics. Additionally, learners have used it to enhance their writing and language skills by generating ideas, composing essays, summarizing, translating, paraphrasing texts, or checking grammar. Moreover, learners turned to it as an aiding tool to facilitate their directed and personalized learning by assisting in understanding concepts and homework, providing structured learning plans, and clarifying assignments and tasks. However, the results of specific studies (n = 3, 21.4%) show that overuse of ChatGPT may negatively impact innovative capacities and collaborative learning competencies among learners. Educators, on the other hand, have utilized ChatGPT to create lesson plans, generate quizzes, and provide additional resources, which helped them enhance their productivity and efficiency and promote different teaching methodologies. Despite these benefits, the majority of the reviewed studies recommend the importance of conducting structured training, support, and clear guidelines for both learners and educators to mitigate the drawbacks. This includes developing critical evaluation skills to assess the accuracy and relevance of information provided by ChatGPT, as well as strategies for integrating human interaction and collaboration into learning activities that involve AI tools. Furthermore, they also recommend ongoing research and proactive dialogue with policymakers, stakeholders, and educational practitioners to refine and enhance the use of AI in learning environments. This review could serve as an insightful resource for practitioners who seek to integrate ChatGPT into education and stimulate further research in the field.

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1 Introduction

Educational technology, a rapidly evolving field, plays a crucial role in reshaping the landscape of teaching and learning [ 82 ]. One of the most transformative technological innovations of our era that has influenced the field of education is Artificial Intelligence (AI) [ 50 ]. Over the last four decades, AI in education (AIEd) has gained remarkable attention for its potential to make significant advancements in learning, instructional methods, and administrative tasks within educational settings [ 11 ]. In particular, a large language model (LLM), a type of AI algorithm that applies artificial neural networks (ANNs) and uses massively large data sets to understand, summarize, generate, and predict new content that is almost difficult to differentiate from human creations [ 79 ], has opened up novel possibilities for enhancing various aspects of education, from content creation to personalized instruction [ 35 ]. Chatbots that leverage the capabilities of LLMs to understand and generate human-like responses have also presented the capacity to enhance student learning and educational outcomes by engaging students, offering timely support, and fostering interactive learning experiences [ 46 ].

The ongoing and remarkable technological advancements in chatbots have made their use more convenient, increasingly natural and effortless, and have expanded their potential for deployment across various domains [ 70 ]. One prominent example of chatbot applications is the Chat Generative Pre-Trained Transformer, known as ChatGPT, which was introduced by OpenAI, a leading AI research lab, on November 30th, 2022. ChatGPT employs a variety of deep learning techniques to generate human-like text, with a particular focus on recurrent neural networks (RNNs). Long short-term memory (LSTM) allows it to grasp the context of the text being processed and retain information from previous inputs. Also, the transformer architecture, a neural network architecture based on the self-attention mechanism, allows it to analyze specific parts of the input, thereby enabling it to produce more natural-sounding and coherent output. Additionally, the unsupervised generative pre-training and the fine-tuning methods allow ChatGPT to generate more relevant and accurate text for specific tasks [ 31 , 62 ]. Furthermore, reinforcement learning from human feedback (RLHF), a machine learning approach that combines reinforcement learning techniques with human-provided feedback, has helped improve ChatGPT’s model by accelerating the learning process and making it significantly more efficient.

This cutting-edge natural language processing (NLP) tool is widely recognized as one of today's most advanced LLMs-based chatbots [ 70 ], allowing users to ask questions and receive detailed, coherent, systematic, personalized, convincing, and informative human-like responses [ 55 ], even within complex and ambiguous contexts [ 63 , 77 ]. ChatGPT is considered the fastest-growing technology in history: in just three months following its public launch, it amassed an estimated 120 million monthly active users [ 16 ] with an estimated 13 million daily queries [ 49 ], surpassing all other applications [ 64 ]. This remarkable growth can be attributed to the unique features and user-friendly interface that ChatGPT offers. Its intuitive design allows users to interact seamlessly with the technology, making it accessible to a diverse range of individuals, regardless of their technical expertise [ 78 ]. Additionally, its exceptional performance results from a combination of advanced algorithms, continuous enhancements, and extensive training on a diverse dataset that includes various text sources such as books, articles, websites, and online forums [ 63 ], have contributed to a more engaging and satisfying user experience [ 62 ]. These factors collectively explain its remarkable global growth and set it apart from predecessors like Bard, Bing Chat, ERNIE, and others.

In this context, several studies have explored the technological advancements of chatbots. One noteworthy recent research effort, conducted by Schöbel et al. [ 70 ], stands out for its comprehensive analysis of more than 5,000 studies on communication agents. This study offered a comprehensive overview of the historical progression and future prospects of communication agents, including ChatGPT. Moreover, other studies have focused on making comparisons, particularly between ChatGPT and alternative chatbots like Bard, Bing Chat, ERNIE, LaMDA, BlenderBot, and various others. For example, O’Leary [ 53 ] compared two chatbots, LaMDA and BlenderBot, with ChatGPT and revealed that ChatGPT outperformed both. This superiority arises from ChatGPT’s capacity to handle a wider range of questions and generate slightly varied perspectives within specific contexts. Similarly, ChatGPT exhibited an impressive ability to formulate interpretable responses that were easily understood when compared with Google's feature snippet [ 34 ]. Additionally, ChatGPT was compared to other LLMs-based chatbots, including Bard and BERT, as well as ERNIE. The findings indicated that ChatGPT exhibited strong performance in the given tasks, often outperforming the other models [ 59 ].

Furthermore, in the education context, a comprehensive study systematically compared a range of the most promising chatbots, including Bard, Bing Chat, ChatGPT, and Ernie across a multidisciplinary test that required higher-order thinking. The study revealed that ChatGPT achieved the highest score, surpassing Bing Chat and Bard [ 64 ]. Similarly, a comparative analysis was conducted to compare ChatGPT with Bard in answering a set of 30 mathematical questions and logic problems, grouped into two question sets. Set (A) is unavailable online, while Set (B) is available online. The results revealed ChatGPT's superiority in Set (A) over Bard. Nevertheless, Bard's advantage emerged in Set (B) due to its capacity to access the internet directly and retrieve answers, a capability that ChatGPT does not possess [ 57 ]. However, through these varied assessments, ChatGPT consistently highlights its exceptional prowess compared to various alternatives in the ever-evolving chatbot technology.

The widespread adoption of chatbots, especially ChatGPT, by millions of students and educators, has sparked extensive discussions regarding its incorporation into the education sector [ 64 ]. Accordingly, many scholars have contributed to the discourse, expressing both optimism and pessimism regarding the incorporation of ChatGPT into education. For example, ChatGPT has been highlighted for its capabilities in enriching the learning and teaching experience through its ability to support different learning approaches, including adaptive learning, personalized learning, and self-directed learning [ 58 , 60 , 91 ]), deliver summative and formative feedback to students and provide real-time responses to questions, increase the accessibility of information [ 22 , 40 , 43 ], foster students’ performance, engagement and motivation [ 14 , 44 , 58 ], and enhance teaching practices [ 17 , 18 , 64 , 74 ].

On the other hand, concerns have been also raised regarding its potential negative effects on learning and teaching. These include the dissemination of false information and references [ 12 , 23 , 61 , 85 ], biased reinforcement [ 47 , 50 ], compromised academic integrity [ 18 , 40 , 66 , 74 ], and the potential decline in students' skills [ 43 , 61 , 64 , 74 ]. As a result, ChatGPT has been banned in multiple countries, including Russia, China, Venezuela, Belarus, and Iran, as well as in various educational institutions in India, Italy, Western Australia, France, and the United States [ 52 , 90 ].

Clearly, the advent of chatbots, especially ChatGPT, has provoked significant controversy due to their potential impact on learning and teaching. This indicates the necessity for further exploration to gain a deeper understanding of this technology and carefully evaluate its potential benefits, limitations, challenges, and threats to education [ 79 ]. Therefore, conducting a systematic literature review will provide valuable insights into the potential prospects and obstacles linked to its incorporation into education. This systematic literature review will primarily focus on ChatGPT, driven by the aforementioned key factors outlined above.

However, the existing literature lacks a systematic literature review of empirical studies. Thus, this systematic literature review aims to address this gap by synthesizing the existing empirical studies conducted on chatbots, particularly ChatGPT, in the field of education, highlighting how ChatGPT has been utilized in educational settings, and identifying any existing gaps. This review may be particularly useful for researchers in the field and educators who are contemplating the integration of ChatGPT or any chatbot into education. The following research questions will guide this study:

What are students' and teachers' initial attempts at utilizing ChatGPT in education?

What are the main findings derived from empirical studies that have incorporated ChatGPT into learning and teaching?

2 Methodology

To conduct this study, the authors followed the essential steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) and Okoli’s [ 54 ] steps for conducting a systematic review. These included identifying the study’s purpose, drafting a protocol, applying a practical screening process, searching the literature, extracting relevant data, evaluating the quality of the included studies, synthesizing the studies, and ultimately writing the review. The subsequent section provides an extensive explanation of how these steps were carried out in this study.

2.1 Identify the purpose

Given the widespread adoption of ChatGPT by students and teachers for various educational purposes, often without a thorough understanding of responsible and effective use or a clear recognition of its potential impact on learning and teaching, the authors recognized the need for further exploration of ChatGPT's impact on education in this early stage. Therefore, they have chosen to conduct a systematic literature review of existing empirical studies that incorporate ChatGPT into educational settings. Despite the limited number of empirical studies due to the novelty of the topic, their goal is to gain a deeper understanding of this technology and proactively evaluate its potential benefits, limitations, challenges, and threats to education. This effort could help to understand initial reactions and attempts at incorporating ChatGPT into education and bring out insights and considerations that can inform the future development of education.

2.2 Draft the protocol

The next step is formulating the protocol. This protocol serves to outline the study process in a rigorous and transparent manner, mitigating researcher bias in study selection and data extraction [ 88 ]. The protocol will include the following steps: generating the research question, predefining a literature search strategy, identifying search locations, establishing selection criteria, assessing the studies, developing a data extraction strategy, and creating a timeline.

2.3 Apply practical screen

The screening step aims to accurately filter the articles resulting from the searching step and select the empirical studies that have incorporated ChatGPT into educational contexts, which will guide us in answering the research questions and achieving the objectives of this study. To ensure the rigorous execution of this step, our inclusion and exclusion criteria were determined based on the authors' experience and informed by previous successful systematic reviews [ 21 ]. Table 1 summarizes the inclusion and exclusion criteria for study selection.

2.4 Literature search

We conducted a thorough literature search to identify articles that explored, examined, and addressed the use of ChatGPT in Educational contexts. We utilized two research databases: Dimensions.ai, which provides access to a large number of research publications, and lens.org, which offers access to over 300 million articles, patents, and other research outputs from diverse sources. Additionally, we included three databases, Scopus, Web of Knowledge, and ERIC, which contain relevant research on the topic that addresses our research questions. To browse and identify relevant articles, we used the following search formula: ("ChatGPT" AND "Education"), which included the Boolean operator "AND" to get more specific results. The subject area in the Scopus and ERIC databases were narrowed to "ChatGPT" and "Education" keywords, and in the WoS database was limited to the "Education" category. The search was conducted between the 3rd and 10th of April 2023, which resulted in 276 articles from all selected databases (111 articles from Dimensions.ai, 65 from Scopus, 28 from Web of Science, 14 from ERIC, and 58 from Lens.org). These articles were imported into the Rayyan web-based system for analysis. The duplicates were identified automatically by the system. Subsequently, the first author manually reviewed the duplicated articles ensured that they had the same content, and then removed them, leaving us with 135 unique articles. Afterward, the titles, abstracts, and keywords of the first 40 manuscripts were scanned and reviewed by the first author and were discussed with the second and third authors to resolve any disagreements. Subsequently, the first author proceeded with the filtering process for all articles and carefully applied the inclusion and exclusion criteria as presented in Table  1 . Articles that met any one of the exclusion criteria were eliminated, resulting in 26 articles. Afterward, the authors met to carefully scan and discuss them. The authors agreed to eliminate any empirical studies solely focused on checking ChatGPT capabilities, as these studies do not guide us in addressing the research questions and achieving the study's objectives. This resulted in 14 articles eligible for analysis.

2.5 Quality appraisal

The examination and evaluation of the quality of the extracted articles is a vital step [ 9 ]. Therefore, the extracted articles were carefully evaluated for quality using Fink’s [ 24 ] standards, which emphasize the necessity for detailed descriptions of methodology, results, conclusions, strengths, and limitations. The process began with a thorough assessment of each study's design, data collection, and analysis methods to ensure their appropriateness and comprehensive execution. The clarity, consistency, and logical progression from data to results and conclusions were also critically examined. Potential biases and recognized limitations within the studies were also scrutinized. Ultimately, two articles were excluded for failing to meet Fink’s criteria, particularly in providing sufficient detail on methodology, results, conclusions, strengths, or limitations. The review process is illustrated in Fig.  1 .

The study selection process

2.6 Data extraction

The next step is data extraction, the process of capturing the key information and categories from the included studies. To improve efficiency, reduce variation among authors, and minimize errors in data analysis, the coding categories were constructed using Creswell's [ 15 ] coding techniques for data extraction and interpretation. The coding process involves three sequential steps. The initial stage encompasses open coding , where the researcher examines the data, generates codes to describe and categorize it, and gains a deeper understanding without preconceived ideas. Following open coding is axial coding , where the interrelationships between codes from open coding are analyzed to establish more comprehensive categories or themes. The process concludes with selective coding , refining and integrating categories or themes to identify core concepts emerging from the data. The first coder performed the coding process, then engaged in discussions with the second and third authors to finalize the coding categories for the first five articles. The first coder then proceeded to code all studies and engaged again in discussions with the other authors to ensure the finalization of the coding process. After a comprehensive analysis and capturing of the key information from the included studies, the data extraction and interpretation process yielded several themes. These themes have been categorized and are presented in Table  2 . It is important to note that open coding results were removed from Table  2 for aesthetic reasons, as it included many generic aspects, such as words, short phrases, or sentences mentioned in the studies.

2.7 Synthesize studies

In this stage, we will gather, discuss, and analyze the key findings that emerged from the selected studies. The synthesis stage is considered a transition from an author-centric to a concept-centric focus, enabling us to map all the provided information to achieve the most effective evaluation of the data [ 87 ]. Initially, the authors extracted data that included general information about the selected studies, including the author(s)' names, study titles, years of publication, educational levels, research methodologies, sample sizes, participants, main aims or objectives, raw data sources, and analysis methods. Following that, all key information and significant results from the selected studies were compiled using Creswell’s [ 15 ] coding techniques for data extraction and interpretation to identify core concepts and themes emerging from the data, focusing on those that directly contributed to our research questions and objectives, such as the initial utilization of ChatGPT in learning and teaching, learners' and educators' familiarity with ChatGPT, and the main findings of each study. Finally, the data related to each selected study were extracted into an Excel spreadsheet for data processing. The Excel spreadsheet was reviewed by the authors, including a series of discussions to ensure the finalization of this process and prepare it for further analysis. Afterward, the final result being analyzed and presented in various types of charts and graphs. Table 4 presents the extracted data from the selected studies, with each study labeled with a capital 'S' followed by a number.

This section consists of two main parts. The first part provides a descriptive analysis of the data compiled from the reviewed studies. The second part presents the answers to the research questions and the main findings of these studies.

3.1 Part 1: descriptive analysis

This section will provide a descriptive analysis of the reviewed studies, including educational levels and fields, participants distribution, country contribution, research methodologies, study sample size, study population, publication year, list of journals, familiarity with ChatGPT, source of data, and the main aims and objectives of the studies. Table 4 presents a comprehensive overview of the extracted data from the selected studies.

3.1.1 The number of the reviewed studies and publication years

The total number of the reviewed studies was 14. All studies were empirical studies and published in different journals focusing on Education and Technology. One study was published in 2022 [S1], while the remaining were published in 2023 [S2]-[S14]. Table 3 illustrates the year of publication, the names of the journals, and the number of reviewed studies published in each journal for the studies reviewed.

3.1.2 Educational levels and fields

The majority of the reviewed studies, 11 studies, were conducted in higher education institutions [S1]-[S10] and [S13]. Two studies did not specify the educational level of the population [S12] and [S14], while one study focused on elementary education [S11]. However, the reviewed studies covered various fields of education. Three studies focused on Arts and Humanities Education [S8], [S11], and [S14], specifically English Education. Two studies focused on Engineering Education, with one in Computer Engineering [S2] and the other in Construction Education [S3]. Two studies focused on Mathematics Education [S5] and [S12]. One study focused on Social Science Education [S13]. One study focused on Early Education [S4]. One study focused on Journalism Education [S9]. Finally, three studies did not specify the field of education [S1], [S6], and [S7]. Figure  2 represents the educational levels in the reviewed studies, while Fig.  3 represents the context of the reviewed studies.

Educational levels in the reviewed studies

Context of the reviewed studies

3.1.3 Participants distribution and countries contribution

The reviewed studies have been conducted across different geographic regions, providing a diverse representation of the studies. The majority of the studies, 10 in total, [S1]-[S3], [S5]-[S9], [S11], and [S14], primarily focused on participants from single countries such as Pakistan, the United Arab Emirates, China, Indonesia, Poland, Saudi Arabia, South Korea, Spain, Tajikistan, and the United States. In contrast, four studies, [S4], [S10], [S12], and [S13], involved participants from multiple countries, including China and the United States [S4], China, the United Kingdom, and the United States [S10], the United Arab Emirates, Oman, Saudi Arabia, and Jordan [S12], Turkey, Sweden, Canada, and Australia [ 13 ]. Figures  4 and 5 illustrate the distribution of participants, whether from single or multiple countries, and the contribution of each country in the reviewed studies, respectively.

The reviewed studies conducted in single or multiple countries

The Contribution of each country in the studies

3.1.4 Study population and sample size

Four study populations were included: university students, university teachers, university teachers and students, and elementary school teachers. Six studies involved university students [S2], [S3], [S5] and [S6]-[S8]. Three studies focused on university teachers [S1], [S4], and [S6], while one study specifically targeted elementary school teachers [S11]. Additionally, four studies included both university teachers and students [S10] and [ 12 , 13 , 14 ], and among them, study [S13] specifically included postgraduate students. In terms of the sample size of the reviewed studies, nine studies included a small sample size of less than 50 participants [S1], [S3], [S6], [S8], and [S10]-[S13]. Three studies had 50–100 participants [S2], [S9], and [S14]. Only one study had more than 100 participants [S7]. It is worth mentioning that study [S4] adopted a mixed methods approach, including 10 participants for qualitative analysis and 110 participants for quantitative analysis.

3.1.5 Participants’ familiarity with using ChatGPT

The reviewed studies recruited a diverse range of participants with varying levels of familiarity with ChatGPT. Five studies [S2], [S4], [S6], [S8], and [S12] involved participants already familiar with ChatGPT, while eight studies [S1], [S3], [S5], [S7], [S9], [S10], [S13] and [S14] included individuals with differing levels of familiarity. Notably, one study [S11] had participants who were entirely unfamiliar with ChatGPT. It is important to note that four studies [S3], [S5], [S9], and [S11] provided training or guidance to their participants before conducting their studies, while ten studies [S1], [S2], [S4], [S6]-[S8], [S10], and [S12]-[S14] did not provide training due to the participants' existing familiarity with ChatGPT.

3.1.6 Research methodology approaches and source(S) of data

The reviewed studies adopted various research methodology approaches. Seven studies adopted qualitative research methodology [S1], [S4], [S6], [S8], [S10], [S11], and [S12], while three studies adopted quantitative research methodology [S3], [S7], and [S14], and four studies employed mixed-methods, which involved a combination of both the strengths of qualitative and quantitative methods [S2], [S5], [S9], and [S13].

In terms of the source(s) of data, the reviewed studies obtained their data from various sources, such as interviews, questionnaires, and pre-and post-tests. Six studies relied on interviews as their primary source of data collection [S1], [S4], [S6], [S10], [S11], and [S12], four studies relied on questionnaires [S2], [S7], [S13], and [S14], two studies combined the use of pre-and post-tests and questionnaires for data collection [S3] and [S9], while two studies combined the use of questionnaires and interviews to obtain the data [S5] and [S8]. It is important to note that six of the reviewed studies were quasi-experimental [S3], [S5], [S8], [S9], [S12], and [S14], while the remaining ones were experimental studies [S1], [S2], [S4], [S6], [S7], [S10], [S11], and [S13]. Figures  6 and 7 illustrate the research methodologies and the source (s) of data used in the reviewed studies, respectively.

Research methodologies in the reviewed studies

Source of data in the reviewed studies

3.1.7 The aim and objectives of the studies

The reviewed studies encompassed a diverse set of aims, with several of them incorporating multiple primary objectives. Six studies [S3], [S6], [S7], [S8], [S11], and [S12] examined the integration of ChatGPT in educational contexts, and four studies [S4], [S5], [S13], and [S14] investigated the various implications of its use in education, while three studies [S2], [S9], and [S10] aimed to explore both its integration and implications in education. Additionally, seven studies explicitly explored attitudes and perceptions of students [S2] and [S3], educators [S1] and [S6], or both [S10], [S12], and [S13] regarding the utilization of ChatGPT in educational settings.

3.2 Part 2: research questions and main findings of the reviewed studies

This part will present the answers to the research questions and the main findings of the reviewed studies, classified into two main categories (learning and teaching) according to AI Education classification by [ 36 ]. Figure  8 summarizes the main findings of the reviewed studies in a visually informative diagram. Table 4 provides a detailed list of the key information extracted from the selected studies that led to generating these themes.

The main findings in the reviewed studies

4 Students' initial attempts at utilizing ChatGPT in learning and main findings from students' perspective

4.1 virtual intelligent assistant.

Nine studies demonstrated that ChatGPT has been utilized by students as an intelligent assistant to enhance and support their learning. Students employed it for various purposes, such as answering on-demand questions [S2]-[S5], [S8], [S10], and [S12], providing valuable information and learning resources [S2]-[S5], [S6], and [S8], as well as receiving immediate feedback [S2], [S4], [S9], [S10], and [S12]. In this regard, students generally were confident in the accuracy of ChatGPT's responses, considering them relevant, reliable, and detailed [S3], [S4], [S5], and [S8]. However, some students indicated the need for improvement, as they found that answers are not always accurate [S2], and that misleading information may have been provided or that it may not always align with their expectations [S6] and [S10]. It was also observed by the students that the accuracy of ChatGPT is dependent on several factors, including the quality and specificity of the user's input, the complexity of the question or topic, and the scope and relevance of its training data [S12]. Many students felt that ChatGPT's answers were not always accurate and most of them believed that it requires good background knowledge to work with.

4.2 Writing and language proficiency assistant

Six of the reviewed studies highlighted that ChatGPT has been utilized by students as a valuable assistant tool to improve their academic writing skills and language proficiency. Among these studies, three mainly focused on English education, demonstrating that students showed sufficient mastery in using ChatGPT for generating ideas, summarizing, paraphrasing texts, and completing writing essays [S8], [S11], and [S14]. Furthermore, ChatGPT helped them in writing by making students active investigators rather than passive knowledge recipients and facilitated the development of their writing skills [S11] and [S14]. Similarly, ChatGPT allowed students to generate unique ideas and perspectives, leading to deeper analysis and reflection on their journalism writing [S9]. In terms of language proficiency, ChatGPT allowed participants to translate content into their home languages, making it more accessible and relevant to their context [S4]. It also enabled them to request changes in linguistic tones or flavors [S8]. Moreover, participants used it to check grammar or as a dictionary [S11].

4.3 Valuable resource for learning approaches

Five studies demonstrated that students used ChatGPT as a valuable complementary resource for self-directed learning. It provided learning resources and guidance on diverse educational topics and created a supportive home learning environment [S2] and [S4]. Moreover, it offered step-by-step guidance to grasp concepts at their own pace and enhance their understanding [S5], streamlined task and project completion carried out independently [S7], provided comprehensive and easy-to-understand explanations on various subjects [S10], and assisted in studying geometry operations, thereby empowering them to explore geometry operations at their own pace [S12]. Three studies showed that students used ChatGPT as a valuable learning resource for personalized learning. It delivered age-appropriate conversations and tailored teaching based on a child's interests [S4], acted as a personalized learning assistant, adapted to their needs and pace, which assisted them in understanding mathematical concepts [S12], and enabled personalized learning experiences in social sciences by adapting to students' needs and learning styles [S13]. On the other hand, it is important to note that, according to one study [S5], students suggested that using ChatGPT may negatively affect collaborative learning competencies between students.

4.4 Enhancing students' competencies

Six of the reviewed studies have shown that ChatGPT is a valuable tool for improving a wide range of skills among students. Two studies have provided evidence that ChatGPT led to improvements in students' critical thinking, reasoning skills, and hazard recognition competencies through engaging them in interactive conversations or activities and providing responses related to their disciplines in journalism [S5] and construction education [S9]. Furthermore, two studies focused on mathematical education have shown the positive impact of ChatGPT on students' problem-solving abilities in unraveling problem-solving questions [S12] and enhancing the students' understanding of the problem-solving process [S5]. Lastly, one study indicated that ChatGPT effectively contributed to the enhancement of conversational social skills [S4].

4.5 Supporting students' academic success

Seven of the reviewed studies highlighted that students found ChatGPT to be beneficial for learning as it enhanced learning efficiency and improved the learning experience. It has been observed to improve students' efficiency in computer engineering studies by providing well-structured responses and good explanations [S2]. Additionally, students found it extremely useful for hazard reporting [S3], and it also enhanced their efficiency in solving mathematics problems and capabilities [S5] and [S12]. Furthermore, by finding information, generating ideas, translating texts, and providing alternative questions, ChatGPT aided students in deepening their understanding of various subjects [S6]. It contributed to an increase in students' overall productivity [S7] and improved efficiency in composing written tasks [S8]. Regarding learning experiences, ChatGPT was instrumental in assisting students in identifying hazards that they might have otherwise overlooked [S3]. It also improved students' learning experiences in solving mathematics problems and developing abilities [S5] and [S12]. Moreover, it increased students' successful completion of important tasks in their studies [S7], particularly those involving average difficulty writing tasks [S8]. Additionally, ChatGPT increased the chances of educational success by providing students with baseline knowledge on various topics [S10].

5 Teachers' initial attempts at utilizing ChatGPT in teaching and main findings from teachers' perspective

5.1 valuable resource for teaching.

The reviewed studies showed that teachers have employed ChatGPT to recommend, modify, and generate diverse, creative, organized, and engaging educational contents, teaching materials, and testing resources more rapidly [S4], [S6], [S10] and [S11]. Additionally, teachers experienced increased productivity as ChatGPT facilitated quick and accurate responses to questions, fact-checking, and information searches [S1]. It also proved valuable in constructing new knowledge [S6] and providing timely answers to students' questions in classrooms [S11]. Moreover, ChatGPT enhanced teachers' efficiency by generating new ideas for activities and preplanning activities for their students [S4] and [S6], including interactive language game partners [S11].

5.2 Improving productivity and efficiency

The reviewed studies showed that participants' productivity and work efficiency have been significantly enhanced by using ChatGPT as it enabled them to allocate more time to other tasks and reduce their overall workloads [S6], [S10], [S11], [S13], and [S14]. However, three studies [S1], [S4], and [S11], indicated a negative perception and attitude among teachers toward using ChatGPT. This negativity stemmed from a lack of necessary skills to use it effectively [S1], a limited familiarity with it [S4], and occasional inaccuracies in the content provided by it [S10].

5.3 Catalyzing new teaching methodologies

Five of the reviewed studies highlighted that educators found the necessity of redefining their teaching profession with the assistance of ChatGPT [S11], developing new effective learning strategies [S4], and adapting teaching strategies and methodologies to ensure the development of essential skills for future engineers [S5]. They also emphasized the importance of adopting new educational philosophies and approaches that can evolve with the introduction of ChatGPT into the classroom [S12]. Furthermore, updating curricula to focus on improving human-specific features, such as emotional intelligence, creativity, and philosophical perspectives [S13], was found to be essential.

5.4 Effective utilization of CHATGPT in teaching

According to the reviewed studies, effective utilization of ChatGPT in education requires providing teachers with well-structured training, support, and adequate background on how to use ChatGPT responsibly [S1], [S3], [S11], and [S12]. Establishing clear rules and regulations regarding its usage is essential to ensure it positively impacts the teaching and learning processes, including students' skills [S1], [S4], [S5], [S8], [S9], and [S11]-[S14]. Moreover, conducting further research and engaging in discussions with policymakers and stakeholders is indeed crucial for the successful integration of ChatGPT in education and to maximize the benefits for both educators and students [S1], [S6]-[S10], and [S12]-[S14].

6 Discussion

The purpose of this review is to conduct a systematic review of empirical studies that have explored the utilization of ChatGPT, one of today’s most advanced LLM-based chatbots, in education. The findings of the reviewed studies showed several ways of ChatGPT utilization in different learning and teaching practices as well as it provided insights and considerations that can facilitate its effective and responsible use in future educational contexts. The results of the reviewed studies came from diverse fields of education, which helped us avoid a biased review that is limited to a specific field. Similarly, the reviewed studies have been conducted across different geographic regions. This kind of variety in geographic representation enriched the findings of this review.

In response to RQ1 , "What are students' and teachers' initial attempts at utilizing ChatGPT in education?", the findings from this review provide comprehensive insights. Chatbots, including ChatGPT, play a crucial role in supporting student learning, enhancing their learning experiences, and facilitating diverse learning approaches [ 42 , 43 ]. This review found that this tool, ChatGPT, has been instrumental in enhancing students' learning experiences by serving as a virtual intelligent assistant, providing immediate feedback, on-demand answers, and engaging in educational conversations. Additionally, students have benefited from ChatGPT’s ability to generate ideas, compose essays, and perform tasks like summarizing, translating, paraphrasing texts, or checking grammar, thereby enhancing their writing and language competencies. Furthermore, students have turned to ChatGPT for assistance in understanding concepts and homework, providing structured learning plans, and clarifying assignments and tasks, which fosters a supportive home learning environment, allowing them to take responsibility for their own learning and cultivate the skills and approaches essential for supportive home learning environment [ 26 , 27 , 28 ]. This finding aligns with the study of Saqr et al. [ 68 , 69 ] who highlighted that, when students actively engage in their own learning process, it yields additional advantages, such as heightened motivation, enhanced achievement, and the cultivation of enthusiasm, turning them into advocates for their own learning.

Moreover, students have utilized ChatGPT for tailored teaching and step-by-step guidance on diverse educational topics, streamlining task and project completion, and generating and recommending educational content. This personalization enhances the learning environment, leading to increased academic success. This finding aligns with other recent studies [ 26 , 27 , 28 , 60 , 66 ] which revealed that ChatGPT has the potential to offer personalized learning experiences and support an effective learning process by providing students with customized feedback and explanations tailored to their needs and abilities. Ultimately, fostering students' performance, engagement, and motivation, leading to increase students' academic success [ 14 , 44 , 58 ]. This ultimate outcome is in line with the findings of Saqr et al. [ 68 , 69 ], which emphasized that learning strategies are important catalysts of students' learning, as students who utilize effective learning strategies are more likely to have better academic achievement.

Teachers, too, have capitalized on ChatGPT's capabilities to enhance productivity and efficiency, using it for creating lesson plans, generating quizzes, providing additional resources, generating and preplanning new ideas for activities, and aiding in answering students’ questions. This adoption of technology introduces new opportunities to support teaching and learning practices, enhancing teacher productivity. This finding aligns with those of Day [ 17 ], De Castro [ 18 ], and Su and Yang [ 74 ] as well as with those of Valtonen et al. [ 82 ], who revealed that emerging technological advancements have opened up novel opportunities and means to support teaching and learning practices, and enhance teachers’ productivity.

In response to RQ2 , "What are the main findings derived from empirical studies that have incorporated ChatGPT into learning and teaching?", the findings from this review provide profound insights and raise significant concerns. Starting with the insights, chatbots, including ChatGPT, have demonstrated the potential to reshape and revolutionize education, creating new, novel opportunities for enhancing the learning process and outcomes [ 83 ], facilitating different learning approaches, and offering a range of pedagogical benefits [ 19 , 43 , 72 ]. In this context, this review found that ChatGPT could open avenues for educators to adopt or develop new effective learning and teaching strategies that can evolve with the introduction of ChatGPT into the classroom. Nonetheless, there is an evident lack of research understanding regarding the potential impact of generative machine learning models within diverse educational settings [ 83 ]. This necessitates teachers to attain a high level of proficiency in incorporating chatbots, such as ChatGPT, into their classrooms to create inventive, well-structured, and captivating learning strategies. In the same vein, the review also found that teachers without the requisite skills to utilize ChatGPT realized that it did not contribute positively to their work and could potentially have adverse effects [ 37 ]. This concern could lead to inequity of access to the benefits of chatbots, including ChatGPT, as individuals who lack the necessary expertise may not be able to harness their full potential, resulting in disparities in educational outcomes and opportunities. Therefore, immediate action is needed to address these potential issues. A potential solution is offering training, support, and competency development for teachers to ensure that all of them can leverage chatbots, including ChatGPT, effectively and equitably in their educational practices [ 5 , 28 , 80 ], which could enhance accessibility and inclusivity, and potentially result in innovative outcomes [ 82 , 83 ].

Additionally, chatbots, including ChatGPT, have the potential to significantly impact students' thinking abilities, including retention, reasoning, analysis skills [ 19 , 45 ], and foster innovation and creativity capabilities [ 83 ]. This review found that ChatGPT could contribute to improving a wide range of skills among students. However, it found that frequent use of ChatGPT may result in a decrease in innovative capacities, collaborative skills and cognitive capacities, and students' motivation to attend classes, as well as could lead to reduced higher-order thinking skills among students [ 22 , 29 ]. Therefore, immediate action is needed to carefully examine the long-term impact of chatbots such as ChatGPT, on learning outcomes as well as to explore its incorporation into educational settings as a supportive tool without compromising students' cognitive development and critical thinking abilities. In the same vein, the review also found that it is challenging to draw a consistent conclusion regarding the potential of ChatGPT to aid self-directed learning approach. This finding aligns with the recent study of Baskara [ 8 ]. Therefore, further research is needed to explore the potential of ChatGPT for self-directed learning. One potential solution involves utilizing learning analytics as a novel approach to examine various aspects of students' learning and support them in their individual endeavors [ 32 ]. This approach can bridge this gap by facilitating an in-depth analysis of how learners engage with ChatGPT, identifying trends in self-directed learning behavior, and assessing its influence on their outcomes.

Turning to the significant concerns, on the other hand, a fundamental challenge with LLM-based chatbots, including ChatGPT, is the accuracy and quality of the provided information and responses, as they provide false information as truth—a phenomenon often referred to as "hallucination" [ 3 , 49 ]. In this context, this review found that the provided information was not entirely satisfactory. Consequently, the utilization of chatbots presents potential concerns, such as generating and providing inaccurate or misleading information, especially for students who utilize it to support their learning. This finding aligns with other findings [ 6 , 30 , 35 , 40 ] which revealed that incorporating chatbots such as ChatGPT, into education presents challenges related to its accuracy and reliability due to its training on a large corpus of data, which may contain inaccuracies and the way users formulate or ask ChatGPT. Therefore, immediate action is needed to address these potential issues. One possible solution is to equip students with the necessary skills and competencies, which include a background understanding of how to use it effectively and the ability to assess and evaluate the information it generates, as the accuracy and the quality of the provided information depend on the input, its complexity, the topic, and the relevance of its training data [ 28 , 49 , 86 ]. However, it's also essential to examine how learners can be educated about how these models operate, the data used in their training, and how to recognize their limitations, challenges, and issues [ 79 ].

Furthermore, chatbots present a substantial challenge concerning maintaining academic integrity [ 20 , 56 ] and copyright violations [ 83 ], which are significant concerns in education. The review found that the potential misuse of ChatGPT might foster cheating, facilitate plagiarism, and threaten academic integrity. This issue is also affirmed by the research conducted by Basic et al. [ 7 ], who presented evidence that students who utilized ChatGPT in their writing assignments had more plagiarism cases than those who did not. These findings align with the conclusions drawn by Cotton et al. [ 13 ], Hisan and Amri [ 33 ] and Sullivan et al. [ 75 ], who revealed that the integration of chatbots such as ChatGPT into education poses a significant challenge to the preservation of academic integrity. Moreover, chatbots, including ChatGPT, have increased the difficulty in identifying plagiarism [ 47 , 67 , 76 ]. The findings from previous studies [ 1 , 84 ] indicate that AI-generated text often went undetected by plagiarism software, such as Turnitin. However, Turnitin and other similar plagiarism detection tools, such as ZeroGPT, GPTZero, and Copyleaks, have since evolved, incorporating enhanced techniques to detect AI-generated text, despite the possibility of false positives, as noted in different studies that have found these tools still not yet fully ready to accurately and reliably identify AI-generated text [ 10 , 51 ], and new novel detection methods may need to be created and implemented for AI-generated text detection [ 4 ]. This potential issue could lead to another concern, which is the difficulty of accurately evaluating student performance when they utilize chatbots such as ChatGPT assistance in their assignments. Consequently, the most LLM-driven chatbots present a substantial challenge to traditional assessments [ 64 ]. The findings from previous studies indicate the importance of rethinking, improving, and redesigning innovative assessment methods in the era of chatbots [ 14 , 20 , 64 , 75 ]. These methods should prioritize the process of evaluating students' ability to apply knowledge to complex cases and demonstrate comprehension, rather than solely focusing on the final product for assessment. Therefore, immediate action is needed to address these potential issues. One possible solution would be the development of clear guidelines, regulatory policies, and pedagogical guidance. These measures would help regulate the proper and ethical utilization of chatbots, such as ChatGPT, and must be established before their introduction to students [ 35 , 38 , 39 , 41 , 89 ].

In summary, our review has delved into the utilization of ChatGPT, a prominent example of chatbots, in education, addressing the question of how ChatGPT has been utilized in education. However, there remain significant gaps, which necessitate further research to shed light on this area.

7 Conclusions

This systematic review has shed light on the varied initial attempts at incorporating ChatGPT into education by both learners and educators, while also offering insights and considerations that can facilitate its effective and responsible use in future educational contexts. From the analysis of 14 selected studies, the review revealed the dual-edged impact of ChatGPT in educational settings. On the positive side, ChatGPT significantly aided the learning process in various ways. Learners have used it as a virtual intelligent assistant, benefiting from its ability to provide immediate feedback, on-demand answers, and easy access to educational resources. Additionally, it was clear that learners have used it to enhance their writing and language skills, engaging in practices such as generating ideas, composing essays, and performing tasks like summarizing, translating, paraphrasing texts, or checking grammar. Importantly, other learners have utilized it in supporting and facilitating their directed and personalized learning on a broad range of educational topics, assisting in understanding concepts and homework, providing structured learning plans, and clarifying assignments and tasks. Educators, on the other hand, found ChatGPT beneficial for enhancing productivity and efficiency. They used it for creating lesson plans, generating quizzes, providing additional resources, and answers learners' questions, which saved time and allowed for more dynamic and engaging teaching strategies and methodologies.

However, the review also pointed out negative impacts. The results revealed that overuse of ChatGPT could decrease innovative capacities and collaborative learning among learners. Specifically, relying too much on ChatGPT for quick answers can inhibit learners' critical thinking and problem-solving skills. Learners might not engage deeply with the material or consider multiple solutions to a problem. This tendency was particularly evident in group projects, where learners preferred consulting ChatGPT individually for solutions over brainstorming and collaborating with peers, which negatively affected their teamwork abilities. On a broader level, integrating ChatGPT into education has also raised several concerns, including the potential for providing inaccurate or misleading information, issues of inequity in access, challenges related to academic integrity, and the possibility of misusing the technology.

Accordingly, this review emphasizes the urgency of developing clear rules, policies, and regulations to ensure ChatGPT's effective and responsible use in educational settings, alongside other chatbots, by both learners and educators. This requires providing well-structured training to educate them on responsible usage and understanding its limitations, along with offering sufficient background information. Moreover, it highlights the importance of rethinking, improving, and redesigning innovative teaching and assessment methods in the era of ChatGPT. Furthermore, conducting further research and engaging in discussions with policymakers and stakeholders are essential steps to maximize the benefits for both educators and learners and ensure academic integrity.

It is important to acknowledge that this review has certain limitations. Firstly, the limited inclusion of reviewed studies can be attributed to several reasons, including the novelty of the technology, as new technologies often face initial skepticism and cautious adoption; the lack of clear guidelines or best practices for leveraging this technology for educational purposes; and institutional or governmental policies affecting the utilization of this technology in educational contexts. These factors, in turn, have affected the number of studies available for review. Secondly, the utilization of the original version of ChatGPT, based on GPT-3 or GPT-3.5, implies that new studies utilizing the updated version, GPT-4 may lead to different findings. Therefore, conducting follow-up systematic reviews is essential once more empirical studies on ChatGPT are published. Additionally, long-term studies are necessary to thoroughly examine and assess the impact of ChatGPT on various educational practices.

Despite these limitations, this systematic review has highlighted the transformative potential of ChatGPT in education, revealing its diverse utilization by learners and educators alike and summarized the benefits of incorporating it into education, as well as the forefront critical concerns and challenges that must be addressed to facilitate its effective and responsible use in future educational contexts. This review could serve as an insightful resource for practitioners who seek to integrate ChatGPT into education and stimulate further research in the field.

Data availability

The data supporting our findings are available upon request.

Abbreviations

• Artificial intelligence

AI in education

Large language model

Artificial neural networks

Chat Generative Pre-Trained Transformer

Recurrent neural networks

Long short-term memory

Reinforcement learning from human feedback

Natural language processing

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

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See Table  4

The process of synthesizing the data presented in Table  4 involved identifying the relevant studies through a search process of databases (ERIC, Scopus, Web of Knowledge, Dimensions.ai, and lens.org) using specific keywords "ChatGPT" and "education". Following this, inclusion/exclusion criteria were applied, and data extraction was performed using Creswell's [ 15 ] coding techniques to capture key information and identify common themes across the included studies.

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Health profession education hackathons: a scoping review of current trends and best practices

• Azadeh Rooholamini   ORCID: orcid.org/0000-0002-9638-7953 1 &
• Mahla Salajegheh   ORCID: orcid.org/0000-0003-0651-3467 1  

BMC Medical Education volume  24 , Article number:  554 ( 2024 ) Cite this article

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Metrics details

While the concept of hacking in education has gained traction in recent years, there is still much uncertainty surrounding this approach. As such, this scoping review seeks to provide a detailed overview of the existing literature on hacking in health profession education and to explore what we know (and do not know) about this emerging trend.

This was a scoping review study using specific keywords conducted on 8 databases (PubMed, Embase, Scopus, Web of Science, ERIC, PsycINFO, Education Source, CINAHL) with no time limitation. To find additional relevant studies, we conducted a forward and backward searching strategy by checking the reference lists and citations of the included articles. Studies reporting the concept and application of hacking in education and those articles published in English were included. Titles, abstracts, and full texts were screened and the data were extracted by 2 authors.

Twenty-two articles were included. The findings are organized into two main categories, including (a) a Description of the interventions and expected outcomes and (b) Aspects of hacking in health profession education.

Hacking in health profession education refers to a positive application that has not been explored before as discovering creative and innovative solutions to enhance teaching and learning. This includes implementing new instructional methods, fostering collaboration, and critical thinking to utilize unconventional approaches.

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Introduction

Health professions education is a vital component of healthcare systems to provide students with the knowledge, skills, and attitudes necessary to provide high-quality care to patients [ 1 ]. However, with the advent of innovative technologies and changing global dynamics, there is a growing need to incorporate new educational methods to prepare medical science students for the future [ 2 ].

Although traditional methods can be effective for certain learning objectives and in specific contexts and may create a stable and predictable learning environment, beneficial for introducing foundational concepts, memorization, and repetition, however, they may not fully address the diverse needs and preferences of today’s learners [ 3 ]. Some of their limitations may be limited engagement, passive learning, lack of personalization, and limited creativity and critical thinking [ 4 ].

As Du et al. (2022) revealed the traditional teaching model fails to capture the complex needs of today’s students who require practical and collaborative learning experiences. Students nowadays crave interactive learning methods that enable them to apply theoretical knowledge in real-world situations [ 5 ].

To achieve innovation in health professions education, engaging students and helping them learn, educators should use diverse and new educational methods [ 6 ]. Leary et al. (2022) described how schools of nursing can integrate innovation into their mission and expressed that education officials must think strategically about the knowledge and skills the next generation of students will need to learn, to build an infrastructure that supports innovation in education, research, and practice, and provide meaningful collaboration with other disciplines to solve challenging problems. Such efforts should be structured and built on a deliberate plan and include curricular innovations, and experiential learning in the classroom, as well as in practice and research [ 7 ].

The incorporation of technology in education is another aspect that cannot be ignored. Technology has revolutionized the way we communicate and learn, providing opportunities for students to access information and resources beyond the traditional education setting. According to the advancement of technology in education, hacking in education is an important concept in this field [ 8 ].

Hack has become an increasingly popular term in recent years, with its roots in the world of computer programming and technology [ 9 ]. However, the term “hack” is not limited solely to the realm of computers and technology. It can also refer to a creative approach to problem-solving, a willingness to challenge established norms, and a desire to find new and innovative ways to accomplish tasks [ 10 ]. At its core, hacking involves exploring and manipulating technology systems to gain a deeper understanding of how they work. This process of experimentation and discovery can be applied to many different fields, including education [ 11 ].

In education, the concept of “hack” has become popular as educators seek innovative ways to engage students and improve learning outcomes. As Wizel (2019) described “hack in education” involves applying hacker mentality and techniques, such as using technology creatively and challenging traditional structures, to promote innovation within the educational system [ 12 ]. These hacking techniques encompass various strategies like gamification, hackathons, creating new tools and resources for education, use of multimedia presentations, online forums, and educational apps for project-based learning [ 9 ]. Butt et al. (2020) demonstrated the effectiveness of hack in education in promoting cross-disciplinary learning in medical education [ 13 ]. However, concerns exist about the negative connotations and ethical implications of hacking in education, with some educators hesitant to embrace these techniques in their classrooms [ 7 , 14 ].

However, while the concept of hack in education has gained traction in recent years, there is still a great deal of uncertainty surrounding its implementation and efficacy. As such, this scoping review seeks to provide a comprehensive overview of the existing literature on hacking in health profession education (HPE), to explore what we know (and do not know) about this emerging trend. To answer this research question, this study provided a comprehensive review of the literature related to hacking in HPE. Specifically, it explored the various ways in which educators are using hack techniques to improve learning outcomes, increase student engagement, and promote creativity in the classroom.

Methods and materials

This scoping review was performed based on the Arksey and O’Malley Framework [ 15 ] and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to answer some questions about the hacking approach in health professions education [ 16 ].

Search strategies

The research question was “What are the aspects of hacking in education?“. We used the PCC framework which is commonly used in scoping reviews to develop the research question [ 17 ]. In such a way the Population assumed as learners, the Concept supposed as aspects of hacking in education, and the Context is considered to be the health profession education.

A systematic literature search was conducted on June 2023, using the following terms and their combinations: hack OR hacking OR hackathon AND education, professional OR “medical education” OR “medical training” OR “nursing education” OR “dental education” OR “pharmacy education” OR “health professions education” OR “health professional education” OR “higher education” OR “healthcare education” OR “health care education” OR “students, health occupations” OR “medical student” OR “nursing student” OR “dental student” OR “pharmacy student” OR “schools, health occupations” OR “medical school” OR “nursing school” OR “dental school” OR “pharmacy school”) in 8 databases (PubMed, Embase, Scopus, Web of Science, ERIC, PsycINFO, Education Source, CINAHL) with no time limitation. (A copy of the search strategy is included in Appendix 1 ). To find additional relevant studies, we conducted a forward and backward searching strategy by checking the reference lists and citations of the included articles.

Inclusion and exclusion criteria

Original research reporting the different aspects of hacking in health professions education and published in English was included. We excluded commentaries, editorials, opinion pieces, perspectives, reviews, calls for change, needs assessments, and other studies in which no real interventions had been employed.

Study identification

After removing the duplicates, each study potentially meeting the inclusion criteria was independently screened by 2 authors (A.R. and M.S.). Then, the full texts of relevant papers were assessed independently by the 2 authors for relevance and inclusion. Disagreements at either step were resolved when needed until a consensus was reached.

Quality assessment of the studies

We used the BEME checklist [ 18 ], consisting of 11 indicators, to assess the quality of studies. Each indicator was rated as “met,” “unmet,” or “unclear.” To be deemed of high quality, articles should meet at least 7 indicators. The quality of the full text of potentially relevant studies was assessed by 2 authors (A.R. and M.S.). Disagreements were resolved through discussion. No study was removed based on the results of the quality assessment.

Data extraction and synthesis

To extract the data from the studies, a data extraction form was designed based on the results of the entered studies. A narrative synthesis was applied as a method for comparing, contrasting, synthesizing, and interpreting the results of the selected papers. All outcomes relevant to the review question were reported. The two authors reviewed and coded each included study using the data extraction form independently.

A total of 645 titles were found, with a further four titles identified through the hand-searching of reference lists of all reviewed articles. After removing the duplicate references, 422 references remained. After title screening, 250 studies were considered for abstract screening, and 172 studies were excluded. After the abstract screening, 73 studies were considered for full-text screening, and 177 studies were excluded due to reasons such as:1. being irrelevant, 2. loss of data, and 3. language limitation. 22 studies were included in the final analysis. The 2020 PRISMA diagram for the included studies is shown in Fig.  1 . The quality was evaluated as “high” in 12 studies, “moderate” in 7 studies, and “low” in 3 studies.

PRISMA flow diagram for included studies

The review findings are organized into two main categories: (a) Description of the interventions and expected outcomes and (b) Aspects of hacking in health profession education.

Description of the interventions and expected outcomes

The description of the studies included the geographical context of the interventions, type, and number of participants, focus of the intervention, evaluation methodology, and outcomes. Table  1 displays a summary of these features.

Geographical context

Of the 22 papers reviewed, 11 studies (45.4%) took place in the United States of America [ 7 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ], two studies in Pakistan [ 13 , 29 ], one study performed in international locations [ 30 ], and the remainder being in the United Kingdom [ 31 ], Germany [ 32 ], Finland [ 33 ], Australia [ 34 ], Austria [ 35 ], Thailand [ 36 ], Africa [ 37 ], and Canada [ 38 ].

Type and number of participants

Hacking in HPE interventions covered a wide range and multiple audiences. The majority of interventions targeted students (17 studies, 77.2%) [ 7 , 13 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 36 , 37 , 38 ]. Their field of education was reported differently including medicine, nursing, engineering, design, business, kinesiology, and computer sciences. Also, they were undergraduates, postgraduates, residents, and post-docs. Ten interventions (45.4%) were designed for physicians [ 13 , 19 , 21 , 24 , 25 , 26 , 28 , 29 , 33 , 35 ]. Their field of practice was reported diverse including psychology, radiology, surgery, and in some cases not specified. Eight (36.3%) studies focused on staff which included healthcare staff, employees of the university, nurses, care experts, and public health specialists [ 13 , 22 , 26 , 28 , 29 , 30 , 32 , 35 ]. Interestingly, nine of the hacking in HPE interventions (40.9%) welcomed specialists from other fields outside of health sciences and medicine [ 13 , 19 , 22 , 25 , 26 , 28 , 29 , 33 , 35 ]. Their field of practice was very diverse including engineers, theologians, artists, entrepreneurs, designers, informaticists, IT professionals, business professionals, industry members, data scientists, and user interface designers. The next group of participants was faculty with 5 studies (22.7%) [ 7 , 23 , 32 , 34 , 36 ]. An intervention (4.5%) targeted the researchers [ 27 ]. The number of participants in the interventions ranged from 12 to 396. Three studies did not specify the number of their participants.

The focus of the intervention

The half of interventions aimed to improve HPE (12 studies, 54.5%) [ 7 , 13 , 21 , 23 , 24 , 26 , 28 , 30 , 31 , 32 , 34 , 38 ], with a secondary emphasis on enhancing clinical or health care [ 19 , 22 , 25 , 29 , 33 , 35 , 36 , 37 ]. Two studies highlighted the improvement in entrepreneurship skills of health professions [ 19 , 20 ]. One study aimed to improve the research skills of health professionals [ 27 ].

Evaluation methodology

Methods to evaluate hacking in HPE interventions included end-of-program questionnaires, pre-and post-test measures to assess attitudinal or cognitive change, self-assessment of post-training performance, project-based assessment through expert judgment and feedback, interviews with participants, and direct observations of behavior.

Hacking in HPE interventions has resulted in positive outcomes for participants. Five studies found high levels of satisfaction for participants with the intervention [ 21 , 31 , 32 , 33 , 37 ]. Some studies evaluated learning, which included changes in attitudes, knowledge, and skills. In most studies, participants demonstrated a gain in knowledge regarding awareness of education’s strengths and problems, in the desire to improve education by enhancement of awareness for technological possibilities [ 7 , 13 , 19 , 21 , 23 , 30 , 32 , 33 , 34 , 35 , 38 ]. Some studies found improving participant familiarity with healthcare innovation [ 19 , 22 , 24 , 25 , 26 , 33 , 36 , 37 ]. Some participants reported a positive change in attitudes towards HPE as a result of their involvement in hacking interventions. They cited a greater awareness of personal strengths and limitations, increased motivation, more confidence, and a notable appreciation of the benefits of professional development [ 20 , 21 , 29 , 34 ]. Some studies also demonstrated behavioral change. In one study, changes were noted in developing a successful proof-of-concept of a radiology training module with elements of gamification, enhancement engagement, and learning outcomes in radiology training [ 28 ]. In a study, participants reported building relationships when working with other members which may be students, faculty, or healthcare professionals [ 7 ]. Five studies found a high impact on participant perceptions and attitudes toward interdisciplinary collaboration [ 22 , 26 , 27 , 36 , 38 ].

Aspects of hacking in health profession education

The special insights of hacking in HPE included the adaptations considered in the interventions, the challenges of interventions, the suggestions for future interventions, and Lessons learned.

Adaptations

The adaptations are considered to improve the efficacy of hacking in HPE interventions. We found that 21 interventions were described as hackathons. Out of this number, some were only hackathons, and some others had benefited from hackathons besides other implications of hacking in education. Therefore, most of the details in this part of the findings are presented with a focus on hackathons. The hackathon concept has been limited to the industry and has not been existing much in education [ 39 , 40 ]. In the context of healthcare, hackathons are events exposing healthcare professionals to innovative methodologies while working with interdisciplinary teams to co-create solutions to the problems they see in their practice [ 19 , 22 , 24 , 25 , 30 , 41 , 42 ].

Some hackathons used various technologies for internal and external interactions during the hackathon including Zoom, Gmail, WhatsApp, Google Meet, etc [ 37 ]. . . Almost all hackathons were planned and performed in the following steps including team formation, team working around the challenges, finding innovative solutions collaboratively, presenting the solutions and being evaluating based on some criteria including whether they work, are good ideas with a suitable problem/solution fit, how a well-designed experience and execution, etc. For example, in the hackathon conducted by Pathanasethpong et al. (2017), the judging criteria included innovativeness, feasibility, and value of the projects [ 36 ]. Also, they managed the cultural differences between the participants through strong support of leadership, commitment, flexibility, respect for culture, and willingness to understand each other’s needs [ 36 ].

Despite valuable adaptations, several challenges were reported. The hackathons faced some challenges such as limited internet connectivity, time limitations, limited study sample, power supply, associated costs, lack of diversity among participants, start-up culture, and lack of organizational support [ 13 , 19 , 25 , 28 , 30 , 34 , 37 ]. Some interventions reported the duration of the hackathon was deemed too short to develop comprehensive solutions [ 37 ]. One study identified that encouraging experienced physicians and other healthcare experts to participate in healthcare hackathons is an important challenge [ 26 ].

Suggestions for the future

Future hackathons should provide internet support for participants and judges, invite investors and philanthropists to provide seed funding for winning teams, and enable equal engagement of all participants to foster interdisciplinary collaboration [ 37 ]. Subsequent hackathons have to evaluate the effect of implementation or durability of the new knowledge in practice [ 19 , 28 ]. Wang et al. (2018) performed a hackathon to bring together interdisciplinary teams of students and professionals to collaborate, brainstorm, and build solutions to unmet clinical needs. They suggested that future healthcare hackathon organizers a balanced distribution of participants and mentors, publicize the event to diverse clinical specialties, provide monetary prizes and investor networking opportunities for post-hackathon development, and establish a formal vetting process for submitted needs that incorporates faculty review and well-defined evaluation criteria [ 22 ]. Most interventions had an overreliance on self-assessments to assess their effectiveness. To move forward, we should consider the use of novel assessment methods [ 30 ].

Lessons learned

Based on the findings of hackathons, they have developed efficient solutions to different problems related to public health and medical education. Some of these solutions included developing novel computer algorithms, designing and building model imaging devices, designing more approachable online patient user websites, developing initial prototypes, developing or optimizing data analysis tools, and creating a mobile app to optimize hospital logistics [ 25 , 26 , 27 , 36 ]. Staziaki et al. (2022) performed an intervention to develop a radiology curriculum. Their strategies were creating new tools and resources, gamification, and conducting a hackathon with colleagues from five different countries. They revealed a radiology training module that utilized gamification elements, including experience points and a leaderboard, for annotation of chest radiographs of patients with tuberculosis [ 28 ].

Most hackathons provide an opportunity for medical health professionals to inter-professional and inter-university collaboration and use technology to produce innovative solutions to public health and medical education [ 7 , 23 , 26 , 30 , 37 , 38 ]. For example, one study discussed that hackathons allowed industry experts and mentors to connect with students [ 37 ]. In the study by Mosene et al. (2023), results offer an insight into the possibilities of hackathons as a teaching/learning event for educational development and thus can be used for large-scale-assessments and qualitative interviews for motivational aspects to participate in hackathons, development of social skills and impact on job orientation [ 32 ].

The participants’ willingness to continue working on the projects after the hackathons was also reported in some papers [ 13 , 29 , 33 ]. One study highlights the potential of hackathons to address unmet workforce needs and the preference of female surgeons for small-group discussions and workshops [ 24 ]. Craddock et al. (2016) discussed that their intervention provided a unique opportunity for junior researchers and those from developing economies who have limited opportunities to interact with peers and senior scientists outside their home institution [ 27 ].

Dameff et al. (2019) developed and evaluated a novel high-fidelity simulation-based cybersecurity training program for healthcare providers. They found significant improvements in the knowledge and confidence of participants related to clinical cybersecurity after completing the simulation exercise. They also reported high levels of satisfaction with the training program [ 21 ].

This scoping review provided a detailed overview of the existing literature on hacking in health profession education and explored what we know (and do not know) about this emerging trend. Our results emphasized the increasing pattern of utilizing hacking in HPE for enhancing teaching and learning, problem-solving, and product generation. Our findings revealed that elements of hacking in HPE can include; innovation, creativity, critical thinking, and collaboration. Innovation is a critical element of hacking in education that holds different meanings for different disciplines. Those involved in HPE consider innovation to create new tools and resources [ 7 , 28 ], hackathons [ 13 , 19 , 20 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], gamification [ 28 ], and simulation-based training [ 21 ].

This study by introducing a different perspective or a new application of hacking that has not been explored before allows for a broader understanding of hacking and its potential positive applications in HPE. Although it does mention “hacking,” it does not refer to the malicious or illegal activities often associated with the term [ 43 , 44 ]. The results of this study indicate incorporating hacking into HPE aimed at improving education and enhancing clinical or healthcare had positive outcomes in learning, attitudes, knowledge, and skills. Embracing hacking in HPE revolutionizes traditional teaching methods, promotes interdisciplinary collaboration, leverages cutting-edge technologies, and cultivates a culture of lifelong learning, ultimately enhancing clinical outcomes and the healthcare system as a whole [ 13 , 20 , 21 , 22 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 36 , 37 , 38 ].

This study reveals that hackathons are more prominent in the United States of America (USA) education system compared to other countries due to the culture of innovation and entrepreneurship [ 7 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. It is important to note that while hackathons are more prominent in the USA, they are also gaining popularity in other countries [ 13 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. This mindset directly contributes to designing effective interventions and driving innovation across different countries and regions around the world. In comparison to other educational interventions, in hacking within education studies, the geographical context, the focus of the intervention, and outcomes can play a significant role in shaping the educational intervention. The relationship between them can be explained through Socio-cultural theory which emphasizes the influence of social interactions and cultural factors in learning and development [ 45 ]. According to this theory, factors such as cultural values, societal norms, availability of technological resources, access to educational opportunities, and collaboration with local communities all play a role in shaping the outcomes of hacking in education. In light of the findings, creating a positive impact on education through “hacking” as innovation requires adaptations and overcoming challenges. Adaptations could involve modifying traditional teaching methods, incorporating new technologies into the learning process, or adopting new pedagogical approaches, such as project-based learning or blended learning [ 40 ]. Adapting education through hacking means finding innovative solutions to improve teaching methods, student engagement, and overall learning outcomes [ 46 ]. Challenges refer to the obstacles or barriers that educators, leaders, or organizations may face when trying to implement innovative changes in education could be related to resistance to change, lack of resources or funding, bureaucratic hurdles, or simply the complexities of navigating a rapidly changing educational landscape [ 47 ]. Therefore, driving positive change requires leading with creativity, perseverance, and collaboration [ 48 ]. In this way, different leadership and management approaches and models can help to create change. For example, studies show that Kotter’s 8-Step Change theory can be considered a guide for educators to lead innovation in education through hacking [ 49 ].

With a clear definition of innovation, the next is to consider how to systematize and embed a culture of innovation within the educational organization. An important component of this strategy is tying innovation to professional, school, and university priorities. Innovation is a human-centered endeavor and requires key stakeholders’ engagement to identify challenges and opportunities. Our findings emphasized that while meeting with multiple stakeholders is critical, developing other champions of an innovation focus is essential. Consider resources available in developing internal and external advisory members, local entrepreneurs, or leaders in innovation roles. Other strategies can be used to guide the design and development of innovation programs including co-design sessions, focus groups, and the use of external consultants.

Faculty members are the main actors of change and the most effective source of creativity in education. They have a significant role to play in driving change in education by preparing the ground for creativity, adapting to new changes, and stimulating change within the classroom. They can create a positive and innovative learning environment that benefits both students and the entire organization [ 50 , 51 ].

For many faculty members, innovation will be a new area of inquiry. Hence, based on our findings we recommend to the planners and organizers of faculty development programs to design and implement some programs about innovation in the teaching and learning process considering these three key elements: building knowledge, acquiring skills in applying rigorous innovation methodologies to identifying and solving problems, and generating opportunities to participate in innovation activities can way to develop an interest in innovation and elevate it as a school goal and priority [ 51 , 52 ].

Overall, these findings demonstrate that the hackathon effectively met its objectives in the case of HPE by promoting interdisciplinary collaboration, building relationships, facilitating learning, developing innovation, knowledge acquisition, practical problem-solving skills, cross-disciplinary tools for teaching and learning, and inquiry-based learning. In addition, findings reveal the positive outcomes of hackathons in HPE including increasing confidence levels as innovators, enhancing awareness of technological possibilities for future healthcare givers, improved familiarity with healthcare innovation and teaching entrepreneurship, improving engagement, and learning outcomes in training, high participant satisfaction, and increased motivation with the program. Also, Hackathon in HPE emphasizes the role of multidisciplinary teams and technology in solving medical education problems and encourages disciplinary collaborations to improve data collection and analysis [ 7 , 13 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. A potential gap of knowledge in this study is the lack of research on the long-term impact and sustainability of hacking in HPE. While the study highlights the positive outcomes of incorporating hacking into education, it does not delve into the long-term effects or address the potential challenges in maintaining and sustaining these innovative practices. Additionally, there is limited mention of the assessment methods used to measure the effectiveness of hacking in education, which could be an area for further investigation.

Some limitations of this study are including, this comprehensive study includes a straightforward research question, a predefined search strategy, and inclusion and exclusion criteria for studies that summarize all relevant studies, allowing for a detailed understanding of the available evidence. This had some limitations when it came to collecting eligible articles. Since this review extracted only published research, there are educational interventions that are reported at conferences but have not yet been published in the literature. The moderate quality of full-text studies is indeed a limitation of this study. Future research should consider including higher-quality full-text studies to enhance the robustness of the findings.

Although we searched for articles using general keywords, these were limited to hackathon keywords. Further research is needed to conduct hackathons in HPE to drive sustained innovation and crowd-source solutions. First, research should investigate how to enhance faculty and student engagement and retention to foster hackathons in HPE. Second, a multidisciplinary study is crucial to strike a balance between embracing innovation and evaluating its impact to ensure its successful integration into the education system. Third, future research could focus on exploring the long-term impact, sustainability, and assessment methods of incorporating hackathons in HPE.

Hacking in the health profession educational context refers to the positive applications in teaching and learning that have not been explored before. Embracing hacking requires adaptations, overcoming challenges, and driving change through creativity, perseverance, and collaboration. The goal of hacking in health profession education is to create a more dynamic, adaptable, and effective educational system that meets the needs of all learners and prepares them for success in the rapidly evolving 21st-century economy.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

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This study was conducted with the financial support of the Vice-Chancellor for Research and Technology of Kerman University of Medical Sciences (project number: 402000210).The role of the funding body was to provide support for data collection and analysis.

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Rooholamini, A., Salajegheh, M. Health profession education hackathons: a scoping review of current trends and best practices. BMC Med Educ 24 , 554 (2024). https://doi.org/10.1186/s12909-024-05519-7

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Leadership is one of the most discussed topics in literature across all different industries and sciences. There is a need for clarification and overview on the different types of leadership discussed in literature. This explorative research describes a systematic literature review to give a general overview of the types of leadership discussed in the literature in the time period between March 2013 and March 2018. In total 658 different types of leadership were mentioned in 380 analyzed articles. Of that transformational leadership was mentioned 200 times, effective leadership was mentioned 118 times, transactional leadership 110 times, participative leadership was mentioned 89 times and ethical leadership was mentioned 72 times. Often these types of leadership were also mentioned together and a great overlap on the different leadership styles was mentioned. Further research on leadership should therefore focus less on explorative research and more on developmental research of a new full range scientific leadership model including the different leadership styles discussed most often in the past five year.

Transformational Leadership , Effective Leadership , Leadership Style , Systematic Literature Review

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1. Introduction

Suddaby [1] wrote about the need for more construct clarity in management research and the need to “create precise and parsimonious categorical distinctions between concepts” and to “show their semantic relationship to other related constructs” ([1], p. 347). Nowhere is this need more apparent than in the enormous amount of literature on leadership styles [2]. Leadership is one of the most discussed topics in literature across all different industries and sciences.

Three theories of leadership are discussed most in literature. The most discussed model of leadership is the theory of Bass [3] who describes transformational, transactional and laissez-faire leadership in a model. Transforming and transactional leadership were first discussed by Burns [4] and a few years later Bass [3] extended the theory of Burns [4]. Bass [3] introduced the term transformational leadership and combined this leadership style with transactional leadership and laissez-faire leadership.

Transformational leadership consists of four elements according to Bass [3] : individualized consideration, intellectual stimulation, inspirational motivation and idealized influence. Yukl [5] defines transformational leaders as leaders with an appealing vision for their team and they intellectually stimulate others in a way that is demanding and appreciative of the individual needs of the team members, incorporating the four elements of Bass [3] in the definition. Transactional leaders exert influence on followers based on exchanging benefits, this can be internal or external motivators, and respond to their self-interests when they achieve defined goals [3]. Transactional leadership included two components: contingent reward and management-by-extinction [3]. Often the transactional leadership style is contrasted to the transformational leadership style [2]. Transactional leaders are task-oriented. In contrary to transformational and transactional leadership, Bass [3] defined leaders who do not take charge of their leadership as passive or laissez-faire leaders. As the laissez-faire leader believes people are unpredictable and uncontrollable and understanding people is a waste of time, this leader maintains a low profile and works with whatever structure is available without any suggestions or criticism [6] [7] [8].

The leadership model of Bass [3] shows a lot of similarities with two other well-known models of leadership. First of all, the model of Ha-Vikström [9] based on the theory of Blake, Shepard, and Mouton [10] shows three basic paths to think about leadership; relation-oriented or people-oriented leadership, task-oriented or goal-oriented leadership and laissez-faire leadership. And second, the leadership model of Lewin, Lippit and White [11], describes autocratic, democratic and laissez-faire leadership.

Finally, shared leadership can be seen as a meta-theory of leadership, as all leadership is shared leadership, it is simply a matter of degree according to Pearce, Wassenaar and Manz [12]. Shared leadership builds on the philosophical assumption that every person is capable of sharing the burden and responsibility of leading to some extent [13]. Shared leadership encompasses other leadership styles and provides a way of organizing them [12]. An overview of these leadership theories is mentioned in Table 1 .

A lot of research is based on the research done before and many different types of leadership are discussed in literature, as Suddaby [1] stresses. This research aims to bring clarification to the most discussed types of leadership in the past five years. There for the research question is: What types of leadership have been described in scientific literature between March 2013 and March 2018?

Table 1 . Overview three leadership theories.

2. Methodology

This study is an explorative study into the different types of leadership described in literature in the past five years. As the research question is broad, this is an explorative study, which is a starting point from which other research can be build [16].

The research method is a systematic literature review. Systematic literature reviews started in the medical sciences and were developed because of a need to describe objective, generalizable and reliable data from literature on the application of medicine and treatment methods [17]. However, systematic literature research is also widely used in social sciences [18].

“A systematic literature review is the process of systematically locating, valuing and synthesizing research results, obtained with scientific research, to obtain a reliable analysis and overview” ([17], p. 178). The systematic review process generally comprises five steps: the development of a protocol to guide the review, screening or inclusion criteria, quality appraisal, data extraction, and synthesis [19]. In this research it is to get an overview of types of leadership described in literature in the last five years. The studies selected meet the inclusion criteria, but the quality of the articles is not further appraised.

A type of leadership is defined in this research when a definition could be given to clarify what is meant and the noun leadership is combined with an adjective which says something about the noun leadership.

A range of electronic databases was accessed across December 2017 to March 2018 to find the articles as can be seen in Table 2 . The only selection criteria for the articles is that leadership is mentioned in the title. The articles are selected from the first options the catalogue gave and so on. The selection criteria in the search engines is: a time period between March 2013 and March 2018, full text articles and scientific journals. The only search term in de search engines is leadership; no synonyms and the word leadership should be present in the title.

The broad and explorative nature of this study makes the precision of the found articles great. Of the 380 articles analyzed, 370 add adjectives to leadership and there for talk about different types of leadership, the other 10 articles write about leadership in general and not about a specific leadership style, there for these are not included in the research. The precision is 97% [20].

The research synthesis involves the effort to discover patterns, consistencies, differences and explanations for this analysis and overview, with the aim of generalizing [17]. In this study the different types of leadership were collected,

Table 2 . Databases.

showing how often the different types of leadership were mentioned together and how often the types of leadership were mentioned.

A systematic literature review is a time-consuming and work intensive research method and as in all qualitative research processes, subjectivity plays an important role. The literature reviewed can be interpreted differently.

3. Results & Discussion

The journals in which the articles are placed are very diverse. However, a few journals were mentioned more often, namely the “Journal of Business Ethics” (32), “Social Behavior and Personality” (16), and “New Directions for Student Leadership” (8).

Of the authors 524 (58%) are male and 354 (39%) are female, with a total of 22 missing values. Finally, the region in which the authors worked is analyzed. As can be seen in Table 3 most of the articles came from North America, Asia/Pacific and Europe. The reason for this Western focus of the region the authors are located, are assumptions. It for example can be, because in Western countries there are more resources to publish, or there is a greater importance for publishing. Another reason can be that curiosity and the need for knowledge about leadership is greater in the Western countries. What the reason may be, it remains speculation.

Table 3 . Region authors articles.

In total 658 different types of leadership were mentioned in the 380 analyzed articles. Of that, transformational leadership was mentioned 200 times, effective leadership was mentioned 118 times, transactional leadership 110 times, participative leadership was mentioned 89 times and ethical leadership was mentioned 72 times. In the table in Appendix 1 the types of leadership mentioned more than 15 times are described.

Most mentioned type of leadership is transformational leadership, mostly in combination with transactional (104), effective (75), ethical (48), authentic (47), servant (44), laissez-faire leadership (38) and charismatic leadership (35). Transactional leadership is also most often mentioned with transformational leadership (104), effective (50) laissez-faire (36), charismatic (27) and servant leadership (27).

Laissez-faire leadership is also often named with passive (6), avoidant (2) or passive-avoidant leadership (3), which in most articles is discussed as being the same leadership style only with different adjectives. Also, in the models as discussed in the introduction, the names are mixed up depending on the article. So, some articles will talk about laissez-faire leadership as others talk about passive or avoidant leadership.

Transformational leadership is mentioned most often in the literature analyzed, however, there are also synonyms of transformational leadership mentioned, for example the transformative leadership (5) as Burns [4] mentioned it, transforming leadership (2) or transformation leadership (4).

Transformational is also combined with other adjectives to describe leadership, for example creative (1), CEO (1), team (1), shared (1) and transformational school leadership (2).

Shared leadership (37) was most often mentioned in combination with transformational leadership (20), servant leadership (12), distributed leadership (18) and effective leadership (13).

Effective leadership is the type of leadership mentioned most after transformational leadership. This is not so much a leadership style, but more as a desired outcome of leadership. However, Gandolfi and Stone [21] define five key attributes of leadership from the literature of Kouzes and Posner [22] : 1) to model the way, 2) to inspire a shared vision, 3) to challenge the process, 4) to enable others to act, and 5) to encourage the heart [22].

As effective leadership can be seen as a type of leadership one wishes to reach, this is the same for outstanding leadership and successful leadership.

Another notable result is the number of times leadership specific to the educational industry is mentioned, for example school leadership (26), principal leadership (6), university leadership (13), student leadership (17), and teacher leadership (57).

In the articles analyzed, leadership combined with the adjective female was mentioned 22 times and women’s as adjective to leadership was mentioned 12 times, as can be seen in Table 4 . These articles are mostly written by women, especially the ones on women’s leadership, female leadership is more often discussed as well by men, but almost always in the combination with a female author as can be seen in the table below.

As mentioned in the introduction, in the literature there are three major theories on leadership, the theory of Bass [3] with transformational, transactional and laissez-faire leadership, the theory of Ha-Vikström [9] shows three basic paths to think about leadership; relation-oriented or people-oriented leadership, task-oriented or goal-oriented leadership and laissez-faire leadership and the leadership model of Lewin, Lippit and White [11], which describes autocratic, democratic and laissez-faire leadership.

In the results the model of Bass [3] is mentioned the most by far. The developed scale of Bass [3], the Multifactor Leadership Questionnaire, is also an often-used scale to measure leadership.

Even though Bass [3] is mentioned often in the literature, the model of Lewin, Lippit and White [11], which describes autocratic (18), democratic (26) and laissez-faire leadership (36) is mentioned less often. Of the 18 times autocratic leadership is mentioned, 15 times it is mentioned in combination with democratic leadership and 10 times in combination with laissez-faire leadership. Democratic leadership is mentioned 15 times in combination with laissez-faire leadership of the total of 26 times it is mentioned. This also shows the model is not often discussed as a complete model in the articles, but more often as separate types of leadership.

The same goes for the leadership model of Ha-Vikström [9] and the model of Lewin, Lippit and White [11] are not mentioned that often. The three basic paths

Table 4 . Female and women’s leadership and the gender of the authors.

of Ha-Vikström [9] also know a lot of variations, but relation-oriented (11) or people-oriented leadership (8), task-oriented (17) or goal-oriented leadership (2) and laissez-faire leadership (36) are not mentioned that often for a well-known leadership theory. Task-oriented leadership and people-oriented leadership are mentioned 7 times together, task-oriented leadership and laissez-faire leadership are mentioned 5 times together and people-oriented leadership and laissez-faire leadership are mentioned 3 times together. This shows the model is not often discussed as a complete model in the articles, but more often as separate types of leadership. There is a large overlap in the different leadership styles, as can be seen from the model of Ha-Vikström [9] with for example people-oriented or relation-oriented leadership, also mentioned as employee-oriented leadership. The same goes for shared and distributed leadership, which share a lot of common points in their definitions. Or the different leadership styles that can be mentioned as part of the transformational leadership style, for example charismatic, motivational or visionary leadership.

4. Conclusions

In total 658 different types of leadership were mentioned in the 380 analyzed articles. Transformational, effective, transactional, participative and ethical leadership is the most discussed type of leadership in the literature analyzed. The model of Bass [3] is the most discussed theory in the leadership literature in the past five years. Next the model of Lewin, Lippit and White [11] is also mentioned often, however, it does not come close to the popularity of the model of Bass [3].

Effective leadership is the type of leadership mentioned most after transformational leadership. However, it can be discussed if this really is a style of leadership or more a desired outcome of the leadership process. In the articles analyzed female leadership was mentioned 22 times and women’s leadership was mentioned 12 times. These articles are mostly written by women, especially the ones on women’s leadership.

As in total 658 different types of leadership are discussed in only half of the articles, it is safe to say that Suddaby [1] and Anderson and Sun [2] have a fair point. The extensive overlap and the wide diversity in the types of leadership discussed ask for more focus and precision in defining different types of leadership. Further research on leadership should therefore be focused less on explorative research and more on developmental research of a new full range scientific leadership model including the different leadership styles discussed most often. As for example the model of Bass [3] leaves shared leadership or servant leadership aside, these are leadership styles often discussed in the literature in the past five years. This shows the need for an updated and transformed model.

One of the characteristics of the study is that it is explorative and a large range of articles have been included in the study. Therefore the selection was broad and inclusive. For further research it is advisable to narrow this down and be more focused, for example on specific journals, the journal of leadership studies of the university of Phoenix. The journals can for example also be selected because they are known to include either empirical studies or literature surveys, and to be used as sources for other systematic literature reviews related to leadership. Also, the search process and assessment of quality of the articles should be more precise and defined in further research.

Another limitation is that the correlation between the different leadership styles does not say that much. As leadership styles mean (almost) the same, it can be that both styles will be mentioned and only one will remain to be mentioned in the article, for example with laissez-faire leadership and passive leadership. It can also be that only one of the types of leadership is mentioned, in this case the different types of leadership discussed will be not mentioned together in articles, where other articles would do so, for example with people-oriented and relation-oriented leadership.

*The choice of 15 times resides in the extensiveness of the types of leadership mentioned in the literature and to protect the readability of the table and article. However, this leads to the exclusion of the other leadership styles, for example emerging leadership styles or leadership styles with a very specific focus or a specific industry the leadership style focuses on.

Conflicts of Interest

The authors declare no conflicts of interest.

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