Nurse leaders’ perspectives on a feasibility randomized controlled trial evaluating an online training program to improve evidence-based leadership: a qualitative descriptive study

BACKGROUND: Qualitative evaluation is crucial for leadership feasibility RCTs, as it deepens the interpretation of findings and informs definitive trial design. Yet, such evaluations are lacking. This study describes nurse leaders' perspectives on a feasibility RCT evaluating an online training program to improve evidence-based leadership. METHODS: This qualitative descriptive study followed a feasibility RCT. Using purposive sampling, we recruited nurse leaders from the intervention group. From August 15 to August 24, 2023, we conducted five focus group interviews with 25 participants. Data were analyzed using content analysis, focusing on four feasibility categories: (1) intervention content and delivery, (2) trial design, conduct, and processes, (3) outcomes, and (4) measures. The reporting of the study was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS: Participants valued the training but found its complex content challenging to understand and apply in daily practice; this led to specific suggestions for refinement (Category 1). They emphasized the need for leadership training to be accessible to all nurses, recommending either entry requirements or multi-level training tailored to different competency levels (Category 2). For outcome evaluation, they proposed replacing "self-efficacy" with "evidence-based leadership efficacy" (Category 3), developing targeted assessment tools for evidence-based leadership, and incorporating qualitative methods to assess the intention to leave their professional role or workplace (Category 4). CONCLUSION: This study pioneers the qualitative evaluation of a feasibility RCT focused on leadership training, providing participant-informed insights across key feasibility domains. The findings yield valuable insights for enhancing the feasibility and effectiveness of future evidence-based leadership training programs utilizing RCT designs. Furthermore, they offer practical guidance for developing leadership interventions in comparable contexts. TRIAL REGISTRATION: This trial was prospectively registered at ClinicalTrials.gov (NCT05244499) on February 7, 2022. The protocol and feasibility RCT are published in peerreviewed journals.