title: Attending Surgeons' Leadership Style in the Operating Room: Comparing Junior Residents' Experiences and Preferences.
abstract: OBJECTIVE
  Recent studies have focused on surgeons' nontechnical skills in the operating room (OR), especially leadership. In an attempt to identify trainee preferences, we explored junior residents' opinions about the OR leadership style of teaching faculty.
  
  
  METHODS
  Overall, 20 interns and 20 mid-level residents completed a previously validated survey on the style of leadership they encountered, the style they preferred to receive, and the style they personally employed in the OR. In all, 4 styles were explored; authoritative: leader makes decisions and communicates them firmly; explanatory: leader makes decisions promptly, but explains them fully; consultative: leader consults with trainees when important decisions are made, and delegative: leader puts the problem before the group and makes decisions by majority opinion. Comparisons were completed using chi-square analysis.
  
  
  RESULTS
  Junior resident preference for leadership style of attending surgeons in the OR differed from what they encountered. Overall, 62% of residents encountered an authoritative leadership style; however, only 9% preferred this (p < 0.001). Instead, residents preferred explanatory (53%) or consultative styles (41%). Preferences differed by postgraduate year. Although 40% of interns preferred a consultative style, 50% of mid-level residents preferred explanatory leadership.
  
  
  CONCLUSIONS
  Junior resident preference of leadership style in the OR differs from what they actually encounter. This has the potential to create unwanted tension and may erode team performance. Awareness of this difference provides an opportunity for an educational intervention directed at both attendings and trainees.
authors.affiliation: Neil and Elise Wallace STRATUS Center for Medical Simulation, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts. Electronic address: nkissane@utmck.edu.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Kissane-Lee
authors.affiliation: Neil and Elise Wallace STRATUS Center for Medical Simulation, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Steven
authors.initials: S
authors.lastname: Yule
authors.affiliation: Neil and Elise Wallace STRATUS Center for Medical Simulation, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Charles N
authors.initials: CN
authors.lastname: Pozner
authors.affiliation: Neil and Elise Wallace STRATUS Center for Medical Simulation, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Smink
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005180:Faculty, Medical; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007857:Leadership; D008297:Male; D008505:Medical Staff, Hospital; D009873:Operating Rooms; D013043:Specialties, Surgical / Q000193:education*
keywords: Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Professionalism; leadership in the operating room; surgical resident education; surgical simulation