title: Leading teams during simulated pediatric emergencies: a pilot study.
abstract: OBJECTIVE
  Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies.
  
  
  METHODS
  We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory.
  
  
  RESULTS
  The coaching style (mean 54.5%, SD 7.8) is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1). This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content.
  
  
  CONCLUSIONS
  The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency.
authors.affiliation: Department of Pediatric Surgery, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Ester H
authors.initials: EH
authors.lastname: Coolen
authors.affiliation: Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Jos M
authors.initials: JM
authors.lastname: Draaisma
authors.affiliation: Department of Communication Science, Radboud University, Nijmegen, the Netherlands.
authors.forename: Sabien
authors.initials: S
authors.lastname: den Hamer
authors.affiliation: Department of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Jan L
authors.initials: JL
authors.lastname: Loeffen
keywords: emergencies; leadership; medical education; residency; simulation