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.

The Historical Thesaurus and the sentimental language of Robert Burns

This thesis demonstrates a new methodology for the linguistic analysis of literature drawing on the data within The Historical Thesaurus of the Oxford English Dictionary (2009). Developing ideas laid out by Carol McGuirk in her book Robert Burns and the Sentimental Era (1985), this study offers a novel approach to the cultural connections present in the sentimental literature of the eighteenth century, with specific reference to Robert Burns. In doing so, it responds to the need to “stop reading Burns through glossaries and start reading him through dictionaries, thesauruses and histories”, as called for by Murray Pittock (2012). Beginning by situating the methodology in linguistic theory, this thesis goes on firstly to illustrate the ways in which such an approach can be deployed to assess existing literary critical ideas. The first chapter does this testing by examining McGuirk’s book, while simultaneously grounding the study in the necessary contextual background. Secondly, this study investigates, in detail, two aspects of Burns’s sentimental persona construction. Beginning with his open letter ‘The Address of the Scotch Distillers’ and its sentimental use of the language of the Enlightenment, and moving on to one of Burns’s personas in his letters to George Thomson, this section illustrates the importance of persona construction in Burns’s sentimental ethos. Finally, a comprehensive, evidence-based, comparison of linguistic trends examines the extent to which similar sentimental language is used by Burns and Henry Mackenzie, Laurence Sterne, William Shenstone and Samuel Richardson. This thesis shows how this new methodology is a valuable new tool for those involved in literary scholarship. For the first time in any comprehensive way the Historical Thesaurus can be harnessed to make new arguments in literary criticism.

Eighty years 'Owre the Sea': Robert Burns and the early United States of America, c. 1786-1866.

This thesis represents the first extensive critical study of the relationship between Robert Burns and the early United States of America. Spanning literature, history and memory studies, the following chapters take an interdisciplinary approach towards investigating the methods by which Burns and his works rose to prominence and came to be of cultural and literary significance in America. Theoretically, these converging disciplines intersect through a transnational, Atlantic Studies perspective that shifts emphasis from Burns as the 'national poet of Scotland' onto the various socio-cultural connections that facilitated the spread of his work and reputation. In addition to Scottish literary studies, the thesis contributes to the broader fields of Transatlantic, Transnational and American Studies. Previous studies have suggested that Burns's popularity in the early United States might be attributed to his kinship with 'national' American ideals of freedom, egalitarianism and individual liberty. While some of the evidence supports this claim, this thesis argues that it also wrongly assumes a spatiotemporal unity for the nineteenth-century American nation. It concludes by suggesting that future critical studies of the poet must heed the multifarious complexities of 'national' paradigms, pointing the way to further work on the reception and influence of Burns in other 'global' or, indeed, transnational contexts.