Objective: 

This study aimed to assess the relationship between surgeons’ leadership style and team behavior in the hybrid operating room through video coding. Secondly, possible fluctuations in leadership styles and team behavior during operative phases were studied.

Summary/Background-Data: 

Leadership is recognized as a key component to successful team functioning in high-risk industries. The ‘full range of leadership’ theory is commonly used to evaluate leadership, marking transformational, transactional and passive. Few studies have examined the effects of these leadership styles on team behavior in surgery and/or their fluctuations during surgery.

Methods: 

A single-center study included patients planned for routine endovascular procedures. A medical data capture system was used to allow post-hoc video coding through Behavior Anchored Rating Scales. Multilevel statistical analysis was performed to assess possible correlations between leadership style and three team behavior indicators (speaking up, knowledge sharing, collaboration) on an operative phase level.

Results: 

Twenty-two cases were analyzed (47 hours recording). Transformational leadership is positively related to the extent to which team members work together (γ=0.20, P<0.001), share knowledge (γ=0.45, P<0.001) and speak up (γ=0.64, P<0.001). Passive leadership is significantly positively correlated with speaking up (γ=0.29, P=0.004). Leadership style and team behavior clearly fluctuate during a procedure, with similar patterns across different types of endovascular procedures.

Conclusions: 

Consistent with other professional fields, surgeons’ transformational leadership enhances team behavior, especially during the most complex operative phases. This suggests that encouraging surgeons to learn and actively implement a transformational leadership style is meaningful to enhance patient safety and team performance.

中文翻译：

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混合手术室中外科医生的领导风格和团队行为：前瞻性队列研究

客观的： 

本研究旨在通过视频编码评估混合手术室中外科医生的领导风格与团队行为之间的关系。其次，研究了运营阶段领导风格和团队行为可能出现的波动。

摘要/背景数据： 

领导力被认为是高风险行业团队成功运作的关键组成部分。“全方位领导力”理论通常用于评估领导力，标记变革型、交易型和被动型。很少有研究探讨这些领导风格对手术中团队行为和/或手术期间波动的影响。

方法： 

一项单中心研究包括计划进行常规血管内手术的患者。医疗数据采集系统用于通过行为锚定评分量表进行事后视频编码。进行多层次统计分析，以评估领导风格与操作阶段层面的三个团队行为指标（发言、知识共享、协作）之间可能的相关性。

结果： 

分析了 22 个案例（47 小时记录）。变革型领导力与团队成员合作（γ=0.20， P <0.001）、分享知识（γ=0.45，P <0.001）和畅所欲言（γ=0.64，P <0.001）的程度呈正相关。被动领导与直言不讳显着正相关（γ=0.29，P =0.004）。领导风格和团队行为在手术过程中明显波动，不同类型的血管内手术具有相似的模式。

结论： 

与其他专业领域一样，外科医生的变革型领导力可以增强团队行为，尤其是在最复杂的手术阶段。这表明鼓励外科医生学习并积极实施变革型领导风格对于提高患者安全和团队绩效有意义。