en Medical Education Medical Education Original Research Original Research <p> <strong> Background </strong>:Effective leadership is of prime importance in any organization and it goes through changes based on accepted health promotion and behavior change theory. Although there are many leadership styles, transformational leadership, which emphasizes supportive leadership behaviors, seems to be an appropriate style in many settings particularly in the health care and educational sectors which are pressured by high turnover and safety demands. Iran has been moving rapidly forward and its authorities have understood and recognized the importance of matching leadership styles with effective and competent care for success in health care organizations. This study aimed to develop the Supportive Leadership Behaviors Scale based on accepted health and educational theories and to psychometrically test it in the Iranian context. </p><p> <strong> Methods </strong>: The instrument was based on items from established questionnaires. A pilot study validated the instrument which was also cross-validated via re-translation. After validation, 731 participants answered the questionnaire. </p><p> <strong> Results </strong>: The instrument was finalized and resulted in a 20-item questionnaire using the exploratory factor analysis, which yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors (all above 0.6). Mapping these four measures of leadership behaviors can be beneficial to determine whether effective leadership could support innovation and improvements in medical education and health care organizations on the national level. The reliability measured as Cronbach’s alpha was 0.84. </p><p> <strong> Conclusion </strong>: This new instrument yielded four factors of support for development, integrity, sincerity and recognition and explaining the supportive leadership behaviors which are applicable in health and educational settings and are helpful in improving self –efficacy among health and academic staff. </p> Contextualization, Socio- cognitive Theory, Standardization, Supportive Leadership Behavior Questionnaire. 829 838 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1569-7&slc_lang=en&sid=1 Mandana Shirazi Mandana.shirazi@ki.se 200319475328460013839 200319475328460013839 Yes Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran & Affiliated Assistant Professor of LIME and Clinical Education Science Departments, Karolinska Institute, Sweden. Amir Hosein Emami ami@yahoo.com 200319475328460013840 200319475328460013840 No Faculty of Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran. Seyed Jamal Mirmoosavi sjmirmoosavi@yahoo.com 200319475328460013841 200319475328460013841 No Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran. Seyed Mohammad Alavinia alavinia@health.gov.ir 200319475328460013842 200319475328460013842 No Faculty of Medicine, Bojnord University, Bojnord, Iran. Hadi Zamanian zamanian@razi.tums.ac.ir 200319475328460013843 200319475328460013843 No Qom University of Medical Sciences, Iran. Faezeh Fathollahbeigi f-fbeigi@razi.tums.ac.ir 200319475328460013844 200319475328460013844 No Nursing in Critical Care Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran. Italo Masiello talo.Masiello@ki.se 200319475328460013845 200319475328460013845 No Soder Hospital, Karolinska Institute, Sweden.