Effect of leadership styles on employee experience among healthcare professionals: A systematic review with implications for Saudi Arabia's Vision 2030

Abstract

Leadership styles significantly influence the employee experience among healthcare professionals, affecting job satisfaction, engagement, wellbeing, burnout, and retention. In the context of Saudi Arabia’s Vision 2030 health sector transformation, understanding these relationships is critical for building sustainable, high-performing healthcare organizations. This systematic review aimed to synthesize evidence on the effects of different leadership styles on the employee experience of healthcare professionals working in hospital settings. Following PRISMA guidelines, PubMed, Web of Science, and Scopus were searched from January 2012 to May 2023. Only English-language cross-sectional and cohort studies conducted in hospital settings that examined the association between leadership styles and employee experience outcomes (job satisfaction, engagement, wellbeing, burnout, intent to leave, etc.) among healthcare professionals were included. Quality was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Eleven cross-sectional studies from eight countries (total N > 11,000 participants, predominantly nurses) met the inclusion criteria and were of satisfactory-to-good methodological quality. Transformational leadership consistently showed the strongest positive association with employee experience, including higher job satisfaction, work engagement, wellbeing, and lower burnout and turnover intention. Resonant (relationship-oriented) leadership also demonstrated positive effects on engagement and satisfaction. Transactional leadership had mixed results, with some benefits in specific contexts (e.g., clear reward systems), but generally weaker long-term impact than transformational styles. Transformational and resonant leadership styles are most strongly linked to positive employee experience among healthcare professionals. Empowering, supportive, and relationship-focused leadership fosters satisfaction, engagement, and retention, which are essential for achieving Vision 2030 goals of an efficient, integrated, and people-centered health system in Saudi Arabia. Policy makers should prioritize developing and appointing leaders with transformational and resonant competencies.