Succar Bahaa, Hazime Alaa, Johnston Michael, Daniel William, Holroyd Ashley F, Dumas Ryan P
From the Division of Burn, Trauma, Acute and Critical Care Surgery (B.S., A.H., M.J., W.D., A.F.H.), UT Southwestern Medical Center, Dallas; and Division of Trauma, Bariatric and Acute Care Surgery (R.P.D.), Baylor College of Medicine, Houston, Texas.
J Trauma Acute Care Surg. 2025 Jul 1;99(1):89-95. doi: 10.1097/TA.0000000000004635. Epub 2025 May 6.
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.
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).
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).
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.
Prognostic and Epidemiological; Level IV.
在高敏锐度情况下，领导力是团队成功运作的关键要素。然而，关于创伤复苏期间领导风格对团队成员潜在影响的文献却很匮乏。我们旨在通过视频回顾评估创伤病房实习生中领导类型与团队复原力之间的联系，并假设变革型领导将占主导地位且与团队成员行为呈正相关。
我们对在我院一级创伤中心就诊的成年患者（14岁及以上）进行了单中心横断面研究。通过对捕获的创伤复苏进行事后视听回顾，使用行为锚定评级量表评估实习生的表现。进行统计分析以探索领导风格（变革型、交易型和被动型）与三种团队复原力行为（直言不讳、知识共享和合作）之间的可能相关性。
共分析了118次一级和二级创伤激活事件。平均年龄为34[26 - 47]岁，23%（n = 27）为穿透性损伤，平均损伤严重程度评分为12.5[5 - 23.5]。创伤组长在被动领导方面得分最高（M = 2.96，SD = 1.16），其次是交易型（M = 2.67，SD = 1.29）和变革型（M = 2.33，SD = 1.19）。团队成员在知识共享方面得分最高（M = 3.67，SD = 0.78），但在合作方面得分较低（M = 3.10，SD = 0.70），在直言不讳方面得分也较低（M = 3.10，SD = 1.17）。变革型和交易型领导均与团队成员的合作能力呈正相关（分别为r = 0.53，p < 0.001和r = 0.53，p < 0.001）、知识共享能力呈正相关（分别为r = 0.47，p < 0.001和r = 0.47，p < 0.001）以及直言不讳能力呈正相关（分别为r = 0.52，p < 0.001和r = 0.49，p < 0.001）。被动领导与所有三种创伤团队行为均呈负相关（p < 0.001）。
在创伤复苏期间，交易型和变革型领导均与团队复原力行为呈正相关。实习生中存在改进机会，这表明应采用积极而非被动的领导风格来提升团队绩效。
预后和流行病学；四级。
