J Trauma Acute Care Surg. 2025 May 6. doi: 10.1097/TA.0000000000004635. Online ahead of print.
ABSTRACT
BACKGROUND: Leadership is a crucial component to successful team functioning in high-acuity scenarios. However, literature addressing the potential impact of leadership style on team members during trauma resuscitations is scarce. We aim to assess the link between leadership type and team resilience among trainees in the trauma bay through video review and hypothesize that transformational leadership would be predominant and positively linked with team member behaviors.
METHODS: We performed a single-center cross-sectional study of adult patients (14 years or older) presenting at our Level I trauma center. Trainee performance was evaluated with Behavior Anchored Rating Scales through post hoc audiovisual review of captured trauma resuscitations. Statistical analysis was performed to explore possible correlations between leadership style (transformational, transactional, and passive) and three team resilience behaviors (speaking up, knowledge sharing, and cooperation).
RESULTS: A total of 118 Level I and II trauma activations were analyzed. The average age was 34 [26-47] years, with 23% (n = 27) penetrating injuries, and an average Injury Severity Score of 12.5 [5-23.5]. Trauma leads scored highest on passive leadership (M = 2.96, SD = 1.16), followed by transactional (M = 2.67, SD = 1.29) and transformational (M = 2.33, SD = 1.19). Team members scored highest on knowledge sharing (M = 3.67, SD = 0.78) but lower on cooperation (M = 3.10, SD = 0.70) and speaking up (M = 3.10, SD = 1.17). Transformational and transactional leaderships were both positively correlated to the capacity in which team members cooperate (r = 0.53, p < 0.001 and r = 0.53, p < 0.001, respectively), share knowledge (r = 0.47, p < 0.001 and r = 0.47, p < 0.001, respectively), and speak up (r = 0.52, p < 0.001 and r = 0.49, p < 0.001, respectively). Passive leadership was negatively correlated with all three trauma team behaviors (p < 0.001).
CONCLUSION: Both transactional and transformational leaderships were positively associated with team resilience behaviors during trauma resuscitations. Opportunities for improvement among trainees suggest adopting an active rather than passive leadership style to promote team performance.
LEVEL OF EVIDENCE: Single-Center Prospective Observational Study; Level IV.
PMID:40327368 | DOI:10.1097/TA.0000000000004635
