This study examines the association between job rotation, clinical leadership, and clinical decision-making among nurses in Jordanian hospitals. Drawing on experiential learning and competency development perspectives, the research explores whether exposure to multiple clinical environments contributes to the development of leadership competencies and clinical reasoning skills.
A cross-sectional correlational study was conducted among 579 registered nurses working in three major public hospitals in Jordan. Data were collected using validated instruments: the Clinical Leadership Scale (CLS), the Clinical Decision-Making in Nursing Scale (CDMNS), and a Job Rotation Questionnaire measuring rotation experience, frequency, and perceived developmental value. Descriptive statistics, Pearson correlations, and multiple regression analyses were performed using SPSS version 26.
Significant positive associations were found among job rotation, clinical leadership, and clinical decision-making. Clinical leadership showed the strongest association with decision-making performance (B = 0.314, SE = 0.036, t = 8.72, p < 0.001, 95% CI [0.242–0.385]), while job rotation demonstrated a smaller but significant relationship (B = 0.117, SE = 0.033, t = 3.55, p < 0.001, 95% CI [0.053–0.182]). Nurses reporting more diverse rotation experiences also demonstrated higher leadership competency scores. However, evidence-based decision-making behaviors and accountability-focused leadership practices were less developed compared with relational leadership behaviors.
The use of a cross-sectional design restricted the ability to infer causality among the variables studied. Longitudinal studies would be needed to establish how these variables evolve over time and whether job rotation actively causes improvements in professional competencies. All measures relied on self-reported questionnaires, which are inherently subject to response bias, including social desirability and recall bias. Nurses may have overstated their use of leadership behaviors or decision-making strategies to align with perceived professional norms. The absence of observational or objective performance assessments may limit the validity of the reported behaviors. The findings may not be generalizable to all healthcare institutions across the country—particularly rural clinics, private hospitals, or specialty centers not included in the sampling frame. Organizational culture, rotation policies, and staffing patterns may differ significantly across other settings, affecting the applicability of the findings. Several important factors that could influence the primary variables were not measured, such as workload intensity, nurse-patient ratios, mentorship availability, burnout levels, and prior leadership training. These confounding variables may have influenced the outcomes independently of job rotation, potentially affecting the interpretation of the findings. Although the study assessed rotation frequency and type, it did not capture the quality, duration, or specific content of the rotation programs.
Structured job rotation programs can enhance clinical exposure, interdisciplinary collaboration, and leadership development. Integrating mentorship, reflective practices, and evaluation mechanisms is essential to maximize learning outcomes and minimize transition challenges.
This study provides empirical evidence from a Middle Eastern context, highlighting job rotation as a practical mechanism for strengthening clinical leadership and decision-making in resource-constrained healthcare systems.
