Wilson Samuel, Rixon Andrew, Hartanto Stephanie, White Peter, Judkins Simon
Department of Management and Marketing, Swinburne University of Technology, Melbourne, Victoria, Australia.
Department of Business Technology and Entrepreneurship, Swinburne University of Technology, Melbourne, Victoria, Australia.
Emerg Med Australas. 2020 Dec;32(6):935-952. doi: 10.1111/1742-6723.13658. Epub 2020 Oct 21.
Emergency medicine (EM) is a discipline with complex leadership demands. However, studies of EM physician leadership and ED leadership are in their infancy. As such, there is a lack of clarity about the forms, antecedents, enablers, barriers and consequences of EM physician leadership. A systematic review of the scientific literature was conducted to reveal the different conceptualisations of EM physician leadership, the activities involved in the practice of leadership, and the knowledge and skills of effective ED leaders. Seven databases were systematically searched for peer-reviewed empirical studies on the topic of EM physicians carrying out a manager or leadership role in an ED setting. Finally, 26 articles were included, and their findings were synthesised and analysed narratively. Two conceptualisations of EM physician leadership were found, reflecting clinical leadership and medical leadership, respectively. Clinical leadership is performed by all EM physicians, often informally, within their daily clinical practice, whereas medical leadership is performed by EM physicians who work at the management level within a hospital, in addition to or instead of their clinical practice. The focus of EM physician leadership and ED leadership research is team leadership, with much less attention given to wider organisation leadership. Consistent with the focus on team leadership, clinical knowledge and skill in orchestrating teams, especially trauma and resuscitation teams, emerged as the most important factors underpinning leadership effectiveness. Future research and training should make better use of existing leadership theory and research designs to illuminate the forms, dynamics, antecedents, moderators and consequences of EM physician leadership.
急诊医学（EM）是一门对领导力要求复杂的学科。然而，对急诊医学医师领导力和急诊科领导力的研究尚处于起步阶段。因此，对于急诊医学医师领导力的形式、前因、促成因素、障碍及后果，目前仍缺乏清晰的认识。本研究对科学文献进行了系统综述，以揭示急诊医学医师领导力的不同概念、领导力实践所涉及的活动，以及高效急诊科领导者所需的知识和技能。我们系统检索了七个数据库，查找关于急诊医学医师在急诊科担任管理或领导角色这一主题的同行评审实证研究。最终纳入了26篇文章，并对其研究结果进行了叙述性综合与分析。研究发现了急诊医学医师领导力的两种概念，分别反映临床领导力和医学领导力。临床领导力由所有急诊医学医师在日常临床实践中通常以非正式方式践行，而医学领导力则由在医院管理层工作的急诊医学医师践行，这是其临床实践之外或替代临床实践的工作。急诊医学医师领导力和急诊科领导力研究的重点是团队领导力，对更广泛的组织领导力关注较少。与对团队领导力的关注一致，协调团队，尤其是创伤和复苏团队的临床知识和技能，成为领导力有效性的最重要支撑因素。未来的研究和培训应更好地利用现有的领导力理论和研究设计，以阐明急诊医学医师领导力的形式、动态、前因、调节因素及后果。
