Category: Education, Simulation & Virtual Reality
Introduction & Objective : Despite an increasing awareness amongst medical professionals that a shared leadership model would be optimal, and evidence of the positive effects of of shared leadership from research across many sectors in the business world, the effects of shared leadership in the operating room are not well understood. The objective of this study was to assess for shared leadership among nurses, anesthesiologists and surgeons in a high stakes operating room environment by comparing the frequency of their respective positive and negative leadership behaviors.
Methods : Pairs of trained observers attended 150 randomly selected operations at a tertiary care teaching hospital. Observers recorded all instances of one positive leadership behavior (transformational), and three negative forms of leadership behaviors (passive, over-controlling and abusive supervision) enacted by nurses, anesthesiologists and surgeons. The data were expressed as the number of leadership acts performed per hour and compared across the three types of leaders using a one-way analysis of variance as implemented in SPSS23.
Results : Surgeons enacted significantly more transformational leadership behaviors than anesthesiologists and nurses (2.35 vs. 1.29 vs. 0.53 acts/hour; F = 69.18, p < .05). However, surgeons also enacted more laissez-faire (0.079 vs. 0.028 vs. 0.019 acts/hour; F = 3.66, p < .05), over-controlling (0.144 vs. 0.012 vs. 0.019 acts/hour; F = 15.25, p < .05) and abusive supervision (0.044 vs. 0.006 vs. 0.005 acts/hour; F = 3.52, p < .05) leadership behaviors than anesthesiologists and nurses.
Conclusions : This study is the first to quantify the frequency of positive and negative leadership behaviors enacted by nurses, anesthesiologists and surgeons in the operating room. The data demonstrated an uneven distribution of leadership behaviors, with surgeons enacting both positive and negative leadership behaviors more frequently than nurses and anesthesiologists. We have therefore not yet attained a truly shared model of leadership in the operating room.