Research Article| Volume 215, ISSUE 1, P14-18, January 2018

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



      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.


      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.


      Surgeons' abusive supervision was negatively associated with psychological safety (unstandardized B = −0.352, p < 0.01). Both surgeons' abusive supervision (unstandardized B = −0.237, p < 0.01), and over-controlling leadership (unstandardized B = −0.230, p < 0.05) were negatively associated with collective efficacy.


      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.



      OR (operating room)
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