Does Team Leader Gender Matter? A Bayesian Reconciliation of Leadership and Patient Care During Trauma Resuscitations

OBJECTIVE: Team leadership facilitates teamwork and is important to patient care. It is unknown whether physician gender-based differences in team leadership exist. The objective of this study was to assess and compare team leadership and patient care in trauma resuscitations led by male and female physicians. METHODS: We performed a secondary analysis of data from a larger randomized controlled trial using video recordings of emergency department trauma resuscitations at a Level 1 trauma center from April 2016 to December 2017. Subjects included emergency medicine and surgery residents functioning as trauma team leaders. Eligible resuscitations included adult patients meeting institutional trauma activation criteria. Two video-recorded observations for each participant were coded for team leadership quality and patient care by 2 sets of raters. Raters were balanced with regard to gender and were blinded to study hypotheses. We used Bayesian regression to determine whether our data supported gender-based advantages in team leadership. RESULTS: A total of 60 participants and 120 video recorded observations were included. The modal relationship between gender and team leadership (β = 0.94, 95% highest density interval [HDI], -.68 to 2.52) and gender and patient care (β = 2.42, 95% HDI, -2.03 to 6.78) revealed a weak positive effect for female leaders on both outcomes. Gender-based advantages to team leadership and clinical care were not conclusively supported or refuted, with the exception of rejecting a strong male advantage to team leadership. CONCLUSIONS: We prospectively measured team leadership and clinical care during patient care. Our findings do not support differences in trauma resuscitation team leadership or clinical care based on the gender of the team leader

Targeted Simulation-based Leadership Training for Trauma Team Leaders

Introduction: Effective team leadership is linked to better teamwork, which in turn is believed to improve patientcare. Simulation-based training provides a mechanism to develop effective leadership behaviors. Traditionally, healthcare curricula have included leadership as a small component of broader teamwork training, with very few examples of leadership-focused curricula. The objective of this work is to describe a novel simulation-basedteam leadership curriculum that easily adapts to individual learners.Methods: We created a simulation-based team leadership training for trauma team leaders in graduatemedical education. Participants included second- and third-year emergency medicine and surgery residents. Training consisted of a single, four-hour session and included facilitated discussion of trauma leadership skills,a brief didactic session integrating leadership behaviors into Advanced Trauma Life Support®, and a seriesof simulations and debriefing sessions. The simulations contained adaptable components that facilitated individualized learning while delivering set curricular content. A survey evaluation was administered 7-24 months following the training to assess self-reported implementation of trained material.Results: A total of 36 residents participated in the training and 23 (64%) responded to the survey. The majority of respondents (n = 22, 96%) felt the training was a valuable component of their residency education and allrespondents reported ongoing use of at least one behavior learned during the training. The most commonly cited skills for ongoing use included the pre-arrival brief (n = 21, 91%) and prioritization (n = 21, 91%).Conclusion: We delivered a leadership-focused, simulation-based training that 1) adapted to learners’individual needs, and 2) was perceived to impact practice up to 24 months post-training. More work is needed tounderstand the impact of this training on learner knowledge and behavior, as well as patient outcomes.

Targeted Simulation-based Leadership Training for Trauma Team Leaders

Introduction: Effective team leadership is linked to better teamwork, which in turn is believed to improve patient care. Simulation-based training provides a mechanism to develop effective leadership behaviors. Traditionally, healthcare curricula have included leadership as a small component of broader teamwork training, with very few examples of leadership-focused curricula. The objective of this work is to describe a novel simulation-based team leadership curriculum that easily adapts to individual learners. Methods: We created a simulation-based team leadership training for trauma team leaders in graduate medical education. Participants included second- and third-year emergency medicine and surgery residents. Training consisted of a single, four-hour session and included facilitated discussion of trauma leadership skills, a brief didactic session integrating leadership behaviors into Advanced Trauma Life Support®, and a series of simulations and debriefing sessions. The simulations contained adaptable components that facilitated individualized learning while delivering set curricular content. A survey evaluation was administered 7–24 months following the training to assess self-reported implementation of trained material. Results: A total of 36 residents participated in the training and 23 (64%) responded to the survey. The majority of respondents (n = 22, 96%) felt the training was a valuable component of their residency education and all respondents reported ongoing use of at least one behavior learned during the training. The most commonly cited skills for ongoing use included the pre-arrival brief (n = 21, 91%) and prioritization (n = 21, 91%). Conclusion: We delivered a leadership-focused, simulation-based training that 1) adapted to learners’ individual needs, and 2) was perceived to impact practice up to 24 months post-training. More work is needed to understand the impact of this training on learner knowledge and behavior, as well as patient outcomes

Qualitative Study of Emergency Medicine Residents’ Perspectives of Trauma Leadership Development

Background: Trauma team leadership is a core skill for the practice of emergency medicine (EM). In this study our goal was to explore EM residents’ perception of their trauma leadership skill development through formal and informal processes and to understand factors that may impact the development and implementation of trauma leadership skills.Methods: Using qualitative semi-structured interviews, we explored the leadership experiences of 10 EM residents ranging from second to fourth postgraduate year. Interviews were conducted between July 26–October 31, 2019 and were audio-recorded, transcribed, and de-identified. We analyzed data using qualitative content analysis.Results: Residents discussed three main themes: 1) sources of leadership development; 2) challenges with simultaneously assuming a dual leader-learner role; and 3) contextual factors that impact their ability to assume the leadership role, including the professional hierarchy in the clinical environment, limitations in the physical environment, and gender bias.Conclusion: This study describes the complex factors and experiences that contribute to the development and implementation of trauma team leadership skills in EM residents. This includes three primary sources of leadership development, the dual role of leader and learner, and various contextual factors. Research is needed to understand how these factors and experiences can be leveraged or mitigated to improve resident leadership training outcomes