important aspects of the pre-op time out is when everyone introduces
themselves, especially in facilities where team makeup is a constant
variable. That step gives everyone in the room an identity and confirms
that they have a place on the team and a role in the case.
Transformational leaders further support this idea by encouraging their
team members to take ownership in the care of the patient and to
speak up if it's appropriate.
Learning to manage
Surgeons are supposed to be the captains of the ship in the OR. In
many ways that's appropriate. But the OR is a complex environment
with many moving parts, and it's critically important that surgeons
have the leadership skills needed to manage those variables.
All too often, we aren't trained to be leaders, because there's no
standardized part of surgical training that teaches management skills.
In other fields, the effect of leadership on team performance is a
well-researched and well-understood phenomenon. That hasn't trans-
lated to surgery, because there's a hidden curriculum about how you
should act and how you should lead your team.
Although no one knows definitively why some surgeons inspire oth-
ers and some do not, becoming a transformational leader is possible
with training. Surgeons ultimately have to be interested in becoming a
transformational leader in order to commit the time and energy need-
ed to improve these skills. Our study hopefully helps to convince
them that they should make that commitment, and that their leader-
ship styles generate real responses from the surgical team, both posi-
tive and negative.
OSM
Dr. Hu (yhu@connecticutchildrens.org) is a surgical trainee at the
Connecticut Children's Medical Center in Hartford.
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