Exploring value-creating contexts in the capacity building of nursing managers: a reflective thematic analysis

Building leadership capacity among nursing managers is essential for improving healthcare quality and organizational performance. Although value creation has been widely discussed as an organizational outcome within value-based healthcare, its role as a developmental process underlying capacity building remains poorly understood. This study explored how nursing managers develop leadership capacity through value-creating experiences across personal, social, and professional contexts. A qualitative study was conducted using Braun and Clarke’s reflexive thematic analysis. Twenty-six nursing managers from Birjand University of Medical Sciences, Iran, were purposively recruited between April and July 2025. Data were collected through semi-structured, in-depth interviews, transcribed verbatim, and analyzed concurrently using MAXQDA 2020. Analysis continued until sufficient richness had been achieved to construct coherent interpretive themes. Analysis generated the overarching theme of “Value-Creating Context as a Developmental Process for Management Capacity Building,” comprising three interrelated themes: family value-creating experiences, community-based developmental factors, and facilitating conditions for value realization in nursing practice. Rather than representing independent contextual factors, these themes described a continuous developmental process in which family experiences established foundational values and self-confidence, community interactions fostered social learning and professional identity, and workplace environments translated these capacities into effective leadership through collaboration, reflective learning, knowledge sharing, and continuous professional development. Together, these findings illustrate how value creation contributes to the progressive development of nursing management capacity. This study proposes a new interpretive understanding of nursing management capacity building by conceptualizing value creation as the developmental mechanism through which leadership capacity evolves across multiple life contexts. The findings suggest that effective leadership development requires organizational strategies extending beyond competency-based training to cultivate value-generating environments that support reflective learning, mentorship, professional identity formation, and continuous leadership development. This perspective offers a broader conceptual foundation for designing sustainable leadership development programs in nursing management.