Moderated Poster

Poster, Podium & Video Sessions

MP96-01: Surgeon Leadership in the OR: The Effects of Positive and Negative Behaviors on Surgical Team Performance

Tuesday, May 16
9:30 AM - 11:30 AM
Location: BCEC: Room 153

Presentation Authors: Julian Barling, Amy Akers, Michael Di Lena, Darren Beiko*, Kingston, Canada

Introduction: Leadership in the operating room has been widely studied, yet the effects of surgeons' leadership on team performance are not well understood. The purpose of this study was to examine the simultaneous effects of transformational, passive, abusive supervision and over-controlling leadership behaviors by surgeons on surgical team performance. We hypothesized that transformational leadership and the three negative leadership behaviors would positively and negatively influence surgical team performance, respectively.

Methods: Trained observers attended 150 randomly selected operations at a tertiary care teaching hospital, including 20 urology cases. Observers recorded instances of the four leadership behaviors enacted by the surgeon. Postoperatively, team members (nurses, anesthetists, surgeons and their trainees) completed validated questionnaires rating team cohesion and collective efficacy. To test our hypotheses, multiple regression analyses were computed with psychological safety and collective efficacy as separate outcome variables. Data were analyzed using the complex modeling function in MPlus.

Results: Surgeons' abusive supervision was negatively associated with psychological safety (unstandardized b = -.352, p < .01). There were no significant associations between the other 3 leadership types and psychological safety (p > .05). Both surgeons' abusive supervision (unstandardized b = -.237, p < .01), and over-controlling leadership (unstandardized b = -.230, p < .05) were negatively associated with collective efficacy. Neither transformational leadership nor passive leadership were linked with collective effective.

Conclusions: This study is the first to assess the simultaneous effects of surgeons' positive and negative leadership behaviors on intraoperative team performance. Significant effects only surfaced for negative leadership behaviors; transformational leadership did not positively influence team performance. Surgeons' intraoperative negative leadership behaviors appear to suppress the effects of transformational leadership behaviors. Educating surgeons about both positive and negative leadership behaviors offers the opportunity to enhance intraoperative team performance.

Source Of Funding: none

Darren Beiko, MD, MBA, FRCSC

Queen's University

Darren Beiko, MD, MBA, FRCSC
Darren Beiko is an Associate Professor of Urology at Queen’s University and works at Kingston General Hospital, where he specializes in endourologic surgery. His research focuses on the development of an ambulatory approach to percutaneous renal surgery and on the study of leadership in the operating room. Darren graduated from the Canadian Leadership Institute for Medical Education (CLIME) in 2013 and graduated from the American Urological Association Leadership Program in 2015. Darren is currently Vice-Chair of the Royal College of Physicians and Surgeons of Canada’s Urology Examination Executive Committee and Co-Chair of the Kuwait Institute of Medical Specialization’s Urology Examination Committee.

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