• authentic leadership;
  • ethical dilemmas;
  • health care;
  • nursing;
  • team-based-simulation

Aim  This study explores nurses’ ethical decision-making in team simulations in order to identify the benefits of these simulations for authentic leadership.

Background  While previous studies have indicated that team simulations may improve ethics in the workplace by reducing the number of errors, those studies focused mainly on clinical aspects and not on nurses’ ethical experiences or on the benefits of authentic leadership.

Methods  Fifty nurses from 10 health institutions in central Israel participated in the study. Data about nurses’ ethical experiences were collected from 10 teams. Qualitative data analysis based on Grounded Theory was applied, using the atlas.ti 5.0 software package.

Findings  Simulation findings suggest four main benefits that reflect the underlying components of authentic leadership: self-awareness, relational transparency, balanced information processing and internalized moral perspective.

Conclusions  Team-based simulation as a training tool may lead to authentic leadership among nurses.

Implications for nursing management  Nursing management should incorporate team simulations into nursing practice to help resolve power conflicts and to develop authentic leadership in nursing. Consequently, errors will decrease, patients’ safety will increase and optimal treatment will be provided.