HHS Public Access Author manuscript Author Manuscript
J Am Coll Surg. Author manuscript; available in PMC 2017 January 01. Published in final edited form as: J Am Coll Surg. 2016 January ; 222(1): 41–51. doi:10.1016/j.jamcollsurg.2015.09.013.
Surgeons' Leadership Styles and Team Behavior in the Operating Room Yue-Yung Hu, MD, MPH1,2,*, Sarah Henrickson Parker, PhD3, Stuart R Lipsitz, ScD1, Alexander F Arriaga, MD, MPH, ScD1,4,5, Sarah E Peyre, EdD1,6,7, Katherine A Corso, MPH1, Emilie M Roth, PhD8, Steven J Yule, PhD1,6, and Caprice C Greenberg, MD, MPH, FACS1,9 1Center
for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA
Author Manuscript
2Department
of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215
3National
Center for Human Factors Engineering in Healthcare, MedStar Institute for Innovation, MedStar Health, Washington, DC
4Department
of Anesthesiology, Brigham and Women's Hospital, Boston, MA
5Department
of Anesthesiology and Critical Care, University of Pennsylvania Health System, Philadelphia, PA
6STRATUS
Center for Medical Simulation, Department of Surgery, Brigham & Women's Hospital,
Boston, MA 7Department
Author Manuscript
8Roth
of Surgery, University of Rochester, Rochester, NY
Cognitive Engineering, Stanford, CA
9Wisconsin
Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin Hospitals & Clinics, Madison, WI
Abstract Background—The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a wellcharacterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards, whereas transformational (team-oriented) leaders inspire performance beyond expectations.
Author Manuscript
Study Design—We video-recorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a
Correspondence address: Yue-Yung Hu, MD, MPH, Connecticut Children's Medical Center Department of Surgery, 282 Washington Street, Hartford, CT 06106, Phone: 860-545-9520, Fax: 860-837-6261, [email protected]. Abstract presented at the American College of Surgeons 101st Annual Clinical Congress, Scientific Forum, Chicago, IL, October 2015. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Hu et al.
Page 2
Author Manuscript
surgeon-researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information-sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (MLQ) was correlated with surgeon behavior (SLI) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. Results—All surgeons scored similarly on transactional leadership (2.38-2.69), but varied more widely on transformational leadership (1.98-3.60). Each 1-point increase in transformational score corresponded to 3× more information-sharing behaviors (p
J Am Coll Surg. Author manuscript; available in PMC 2017 January 01. Published in final edited form as: J Am Coll Surg. 2016 January ; 222(1): 41–51. doi:10.1016/j.jamcollsurg.2015.09.013.
Surgeons' Leadership Styles and Team Behavior in the Operating Room Yue-Yung Hu, MD, MPH1,2,*, Sarah Henrickson Parker, PhD3, Stuart R Lipsitz, ScD1, Alexander F Arriaga, MD, MPH, ScD1,4,5, Sarah E Peyre, EdD1,6,7, Katherine A Corso, MPH1, Emilie M Roth, PhD8, Steven J Yule, PhD1,6, and Caprice C Greenberg, MD, MPH, FACS1,9 1Center
for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA
Author Manuscript
2Department
of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215
3National
Center for Human Factors Engineering in Healthcare, MedStar Institute for Innovation, MedStar Health, Washington, DC
4Department
of Anesthesiology, Brigham and Women's Hospital, Boston, MA
5Department
of Anesthesiology and Critical Care, University of Pennsylvania Health System, Philadelphia, PA
6STRATUS
Center for Medical Simulation, Department of Surgery, Brigham & Women's Hospital,
Boston, MA 7Department
Author Manuscript
8Roth
of Surgery, University of Rochester, Rochester, NY
Cognitive Engineering, Stanford, CA
9Wisconsin
Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin Hospitals & Clinics, Madison, WI
Abstract Background—The importance of leadership is recognized in surgery, but the specific impact of leadership style on team behavior is not well understood. In other industries, leadership is a wellcharacterized construct. One dominant theory proposes that transactional (task-focused) leaders achieve minimum standards, whereas transformational (team-oriented) leaders inspire performance beyond expectations.
Author Manuscript
Study Design—We video-recorded 5 surgeons performing complex operations. Each surgeon was scored on the Multifactor Leadership Questionnaire, a validated method for scoring transformational and transactional leadership style, by an organizational psychologist and a
Correspondence address: Yue-Yung Hu, MD, MPH, Connecticut Children's Medical Center Department of Surgery, 282 Washington Street, Hartford, CT 06106, Phone: 860-545-9520, Fax: 860-837-6261, [email protected]. Abstract presented at the American College of Surgeons 101st Annual Clinical Congress, Scientific Forum, Chicago, IL, October 2015. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Hu et al.
Page 2
Author Manuscript
surgeon-researcher. Independent coders assessed surgeons' leadership behaviors according to the Surgical Leadership Inventory and team behaviors (information-sharing, cooperative, and voice behaviors). All coders were blinded. Leadership style (MLQ) was correlated with surgeon behavior (SLI) and team behavior using Poisson regression, controlling for time and the total number of behaviors, respectively. Results—All surgeons scored similarly on transactional leadership (2.38-2.69), but varied more widely on transformational leadership (1.98-3.60). Each 1-point increase in transformational score corresponded to 3× more information-sharing behaviors (p
