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.

Blaxploitation! A Video Essay

Video essay on the history of Blaxploitation, included as an extra on the Blu-ray "Coffy", produced for Arrow Films

Panoramic Sea Happening (After Kantor): Video Installation

Panoramic Sea Happening (After Kantor) is a 7 minute durational film that reimagines part of Tadeusz Kantor's original sea happenings from 1967 in a landscape in which the sea has retreated. The conductor of Kantor’s original performance is replaced with a sound object cast adrift on a beach in Dungeness (UK). The object plays back the sound of the sea into the landscape, which was performed live and then filmed from three distinct angles. The first angle mimics the position of the conductor in Kantor’s original happening, facing outwards into the horizon of the beach and recalls the image in Kantor’s work of a human figure undertaking the absurd task of orchestrating the sound of a gigantic expanse of water. The second angle exposes the machine itself and the large cone that amplifies the sound, reinforcing the isolation of the object. The third angle reveals a decommissioned nuclear power station and sound objects used as a warning system for the power plant. Dungeness is a location where the sea has been retreating from the land, leaving traces of human activity through the disused boat winches, abandoned cabins and the decommissioned nuclear buildings. It is a place in which the footprint of the anthropocene is keenly felt. The sound object is intended to act as an anthropomorphic figure, ghosting the original conductor and offering the sound of the sea back into the landscape through a wide mouthpiece, echoing Kantor’s own load hailer in the original sequence of sea happenings. It speculates on Kantor's theory of the bio-object, which proposed a symbiotic relationship between the human and the nonhuman object in performance, as a possible instrument to access a form of geologic imagination. In this configuration, the human itself is absent, but is evoked through the objects left behind. The sound object, helpless in a red dingy, might be thought of as a co-conspirator with the viewer, enabling a looking back to the past in a landscape of an inevitable future. The work was originally commissioned by the University of Kent in collaboration with the Polish Cultural Institute for the Symposium Kantorbury Kantorbury in Canterbury (UK) to mark the 100 years since Tadeusz Kantor’s birth (15 - 19 September 2015). It should be projected and requires stereo speakers.