The impact of positive and negative intraoperative surgeons' leadership behaviors on surgical team performance☆

Abstract Background The effects of surgeons' leadership on team performance are not well understood. The purpose of this study was to examine the simultaneous effects of transformational, passive, abusive supervision and over-controlling leadership behaviors by surgeons on surgical team performance. Methods Trained observers attended 150 randomly selected operations at a tertiary care teaching hospital. Observers recorded instances of the four leadership behaviors enacted by the surgeon. Postoperatively, team members completed validated questionnaires rating team cohesion and collective efficacy. Multiple regression analyses were computed. Data were analyzed using the complex modeling function in MPlus. Results Surgeons' abusive supervision was negatively associated with psychological safety (unstandardized B  = −0.352, p  B  = −0.237, p  B  = −0.230, p  Conclusions This study is the first to assess the simultaneous effects of surgeons' positive and negative leadership behaviors on intraoperative team performance. Significant effects only surfaced for negative leadership behaviors; transformational leadership did not positively influence team performance.