Leadership and Teamwork in Trauma and Resuscitation
Introduction: Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly d...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2016-09-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/0jr3k73t |
| _version_ | 1830518266833928192 |
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| author | Michael Menchine Elizabeth Burner Sanjay Arora Kenji Inaba Demetrios Demetriades Bertrand Yersin |
| author_facet | Michael Menchine Elizabeth Burner Sanjay Arora Kenji Inaba Demetrios Demetriades Bertrand Yersin |
| author_sort | Michael Menchine |
| collection | DOAJ |
| description | Introduction: Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders.
Methods: We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders.
Results: We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching followed by simulations. Although programs differed in length, intensity, and training level of participants, all programs demonstrated improved team performance.
Conclusion: Despite the relative paucity of literature on leadership in resuscitations, this review found leadership improves processes of care in trauma and can be enhanced through dedicated training. Future research is needed to validate leadership assessment scales, develop optimal training mechanisms, and demonstrate leadership’s effect on patient-level outcome. |
| first_indexed | 2024-12-22T04:16:50Z |
| format | Article |
| id | doaj.art-0f223bb595634fbda861b88f8ddf2cc2 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-22T04:16:50Z |
| publishDate | 2016-09-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-0f223bb595634fbda861b88f8ddf2cc22022-12-21T18:39:23ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182016-09-0117554955610.5811/westjem.2016.7.29812Leadership and Teamwork in Trauma and ResuscitationMichael Menchine0Elizabeth Burner1Sanjay Arora2Kenji Inaba3Demetrios Demetriades4Bertrand Yersin5Keck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles, CaliforniaKeck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles, CaliforniaKeck School of Medicine of the University of Southern California, Department of Emergency Medicine, Los Angeles, CaliforniaKeck School of Medicine of the University of Southern California, Department of Surgery, Los Angeles, CaliforniaKeck School of Medicine of the University of Southern California, Department of Surgery, Los Angeles, CaliforniaUniversity of Lausanne, Department of Medicine, Lausanne, Switzerland Introduction: Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. Methods: We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. Results: We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching followed by simulations. Although programs differed in length, intensity, and training level of participants, all programs demonstrated improved team performance. Conclusion: Despite the relative paucity of literature on leadership in resuscitations, this review found leadership improves processes of care in trauma and can be enhanced through dedicated training. Future research is needed to validate leadership assessment scales, develop optimal training mechanisms, and demonstrate leadership’s effect on patient-level outcome.http://escholarship.org/uc/item/0jr3k73tLeadershipTraumaResuscitation |
| spellingShingle | Michael Menchine Elizabeth Burner Sanjay Arora Kenji Inaba Demetrios Demetriades Bertrand Yersin Leadership and Teamwork in Trauma and Resuscitation Western Journal of Emergency Medicine Leadership Trauma Resuscitation |
| title | Leadership and Teamwork in Trauma and Resuscitation |
| title_full | Leadership and Teamwork in Trauma and Resuscitation |
| title_fullStr | Leadership and Teamwork in Trauma and Resuscitation |
| title_full_unstemmed | Leadership and Teamwork in Trauma and Resuscitation |
| title_short | Leadership and Teamwork in Trauma and Resuscitation |
| title_sort | leadership and teamwork in trauma and resuscitation |
| topic | Leadership Trauma Resuscitation |
| url | http://escholarship.org/uc/item/0jr3k73t |
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