Taxonomy of Trauma Leadership Skills: A Framework for Leadership Training and Assessment.
OBJECTIVE
Good leadership is essential for optimal trauma team performance, and targeted training of leadership skills is necessary to achieve such leadership proficiency. To address the need for a taxonomy of leadership skills that specifies the skill components to be learned and the behaviors by which they can be assessed across the five phases of trauma care, the authors developed the Taxonomy of Trauma Leadership Skills (TTLS).


METHODS
Critical incident interviews were conducted with trauma team leaders and members from different specialties-emergency physicians, trauma surgeons, anesthesiologists, and emergency ward nurses-at three teaching hospitals in the Netherlands during January-June 2013. Data were iteratively analyzed for examples of excellent leadership skills at each phase of trauma care. Using the grounded theory approach, elements of excellent leadership skills were identified and classified. Elements and behavioral markers were sorted and categorized using multiple raters. In a two-round verification process in late 2013, the taxonomy was reviewed and rated by trauma team leaders and members from the multiple specialties for its coverage of essential items.


RESULTS
Data were gathered from 28 interviews and 14 raters. The TTLS details 5 skill categories (information coordination, decision making, action coordination, communication management, and coaching and team development) and 37 skill elements. The skill elements are captured by 67 behavioral markers. The three-level taxonomy is presented according to five phases of trauma care.


CONCLUSIONS
The TTLS provides a framework for teaching, learning, and assessing team leadership skills in trauma care and other complex, acute care situations.
N.F. Leenstra is psychologist, Department of Traumatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. O.C. Jung is staff anesthesiologist, Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. A. Johnson is professor, Department of Psychology, University of Groningen, Groningen, the Netherlands. K.W. Wendt is chief, Department of Traumatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. J.E. Tulleken is professor and staff intensivist, Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Nico F
NF
Leenstra
Oliver C
OC
Jung
Addie
A
Johnson
Klaus W
KW
Wendt
Jaap E
JE
Tulleken
D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000592:standards*; D004521:Educational Measurement / Q000706:statistics & numerical data*; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D009426:Netherlands; D010348:Patient Care Team / Q000458:organization & administration*; D010820:Physicians / Q000592:standards*; D014193:Trauma Centers