Department of Surgery, Universidad de la Sabana, Chía, Colombia.
Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
J Surg Res. 2021 Sep;265:233-244. doi: 10.1016/j.jss.2021.03.034. Epub 2021 May 3.
Surgeons should transform their residents to take the lead in their jobs and optimize their working conditions, so-called job crafting. We investigated the actions undertaken by surgeons with a transformational leadership style to encourage residents' job crafting, about which there is at present a paucity of information.
We performed a qualitative study based on principles of constructivist grounded theory. In-depth interviews were held with a purposive sample of surgeons who were perceived as transformational leaders by their residents. During data analysis (open, axial, and selective coding), we compared inductive codes with deductive codes drawn from the job demands-resources and transformational leadership theories to reach a consensus on the interpretation of data and identification of the main themes.
Sixteen surgeons participated. Surgeons undertook five actions that enhanced job crafting in residents. They: one) modeled positive behaviors of a good surgeon; two) used a stepwise individual approach toward autonomy; three) connected with the resident as a person; four) supported residents in handling complications and errors; and five) they coached the resident to deal with competing interests. These actions had four consequences for residents. They led to: one) more responsibilities in patient care; two) more constructive relationships in the workplace; three) less pressure from workload and surgical care duties; and four) less personal difficulties and errors in patient care.
The actions undertaken by surgeons with a transformational leadership style have a positive association with the residents' ability to craft their jobs. This knowledge has implications for surgeons' leadership development with a view to workplace education.
外科医生应该转变其住院医师的角色，使其在工作中发挥主导作用，并优化其工作条件，即所谓的工作重塑。我们调查了具有变革型领导风格的外科医生为鼓励住院医师进行工作重塑而采取的行动，而目前关于这方面的信息还很少。
我们进行了一项基于建构主义扎根理论原则的定性研究。对被其住院医师视为变革型领导者的外科医生进行了有针对性的深入访谈。在数据分析（开放式、轴向式和选择性编码）过程中，我们将归纳编码与源自工作需求-资源和变革型领导理论的演绎编码进行了比较，以就数据解释和主要主题的确定达成共识。
16 名外科医生参与了研究。外科医生采取了五项增强住院医师工作重塑的行动。他们：一是树立优秀外科医生的积极行为榜样；二是逐步采取个体化的自主方式；三是与住院医师建立个人联系；四是支持住院医师处理并发症和错误；五是指导住院医师应对利益冲突。这些行动对住院医师有四个后果。它们导致：一是在患者护理方面承担更多的责任；二是在工作场所建立更具建设性的关系；三是减轻工作量和外科护理职责带来的压力；四是减少患者护理方面的个人困难和错误。
具有变革型领导风格的外科医生采取的行动与住院医师工作重塑的能力呈正相关。这一知识对外科医生的领导力发展具有启示意义，有助于进行工作场所教育。
