A Video Analysis of Intra- and Inter-professional Leadership Behaviours Within “The Burns Suite”: Identifying Key Leadership Models

Objective Leadership is particularly important in complex highly interprofessional health care contexts involving a number of staff, some from the same specialty (intraprofessional), and others from different specialties (interprofessional). The authors recently published the concept of “The Burns Suite” (TBS) as a novel simulation tool to deliver interprofessional and teamwork training. It is unclear which leadership behaviors are the most important in an interprofessional burns resuscitation scenario, and whether they can be modeled on to current leadership theory. The purpose of this study was to perform a comprehensive video analysis of leadership behaviors within TBS. Methods A total of 3 burns resuscitation simulations within TBS were recorded. The video analysis was grounded-theory inspired. Using predefined criteria, actions/interactions deemed as leadership behaviors were identified. Using an inductive iterative process, 8 main leadership behaviors were identified. Cohen’s κ coefficient was used to measure inter-rater agreement and calculated as κ = 0.7 (substantial agreement). Each video was watched 4 times, focusing on 1 of the 4 team members per viewing (senior surgeon, senior nurse, trainee surgeon, and trainee nurse). The frequency and types of leadership behavior of each of the 4 team members were recorded. Statistical significance to assess any differences was assessed using analysis of variance, whereby a p < 0.05 was taken to be significant. Leadership behaviors were triangulated with verbal cues and actions from the videos. Results All 3 scenarios were successfully completed. The mean scenario length was 22 minutes. A total of 362 leadership behaviors were recorded from the 12 participants. The most evident leadership behaviors of all team members were adhering to guidelines (which effectively equates to following Advanced Trauma and Life Support/Emergency Management of Severe Burns resuscitation guidelines and hence “maintaining standards”), followed by making decisions. Although in terms of total frequency the senior surgeon engaged in more leadership behaviors compared with the entire team, statistically there was no significant difference between all 4 members within the 8 leadership categories. This analysis highlights that “distributed leadership” was predominant, whereby leadership was “distributed” or “shared” among team members. The leadership behaviors within TBS also seemed to fall in line with the “direction, alignment, and commitment” ontology. Conclusions Effective leadership is essential for successful functioning of work teams and accomplishment of task goals. As the resuscitation of a patient with major burns is a dynamic event, team leaders require flexibility in their leadership behaviors to effectively adapt to changing situations. Understanding leadership behaviors of different team members within an authentic simulation can identify important behaviors required to optimize nontechnical skills in a major resuscitation. Furthermore, attempting to map these behaviors on to leadership models can help further our understanding of leadership theory. Collectively this can aid the development of refined simulation scenarios for team members, and can be extrapolated into other areas of simulation-based team training and interprofessional education.

Combinative Aspects of Leadership Style and Emotional Intelligence

Purpose – The purpose of this paper is to examine whether the leader’s emotional intelligence influences the leader’s preferences for different ways of combining leadership behaviors (i.e. combinative aspects of leadership style). Design/methodology/approach – The authors used a hybrid design to collect the data to avoid common-method biases. The authors described a high-stress workplace in a vignette and asked participants to rank four styles of combining a task-oriented leadership (i.e. Pressure) statement and a socio-emotional leadership (i.e. Support) statement. The authors then asked participants to complete a Likert-scale based questionnaire on emotional intelligence. Findings – The authors found that leaders who prefer to provide Support immediately before Pressure have higher levels of emotional intelligence than do leaders who prefer the three other combinative styles. Leaders who prefer to provide Pressure and Support separately (i.e. provide Pressure 30 minutes after Support) have the lowest levels of emotional intelligence. Research limitations/implications – A key implicit assumption in the work is that leaders do not want to evoke negative emotions in followers. The authors did not take into account factors that influence leadership style which participating managers would be likely to encounter on a daily basis such as the relationship with the follower, the follower’s level of performance and work experience, the gender of the leader and the gender of the follower, the hierarchical levels of the leader and follower, and the followers’ preferred combinative style. The nature of the sample and the use of a hypothetical scenario are other limitations of the study. Practical implications – Providing leadership behaviors that are regarded as effective is necessary but not enough because the emotional impact of leadership behaviors appears to also depend on how the behaviors are configured. Originality/value – This is the first study to show that the emotional intelligence of leaders is related to their preferences for the manner in which they combine task and social leadership statements. Furthermore, two-factor theories of leadership propose that the effects of task and social leadership are additive. However, the findings show that the effects are interactive.