Abstract 190: Does Gender Matter? Addressing the Question of Gender Superiority in Resuscitation Leadership

Abstract

Introduction: Effective team leadership is linked to better patient care during resuscitations. Several studies suggest a relationship between team leader gender and the quality of resuscitation leadership and clinical care. However, these studies have been either (1) retrospective investigations that do not capture clinical care processes or (2) simulation-based research involving novice medical student subjects. The objective of this study is to compare the quality of team leadership and clinical care between male- and female-led trauma resuscitation teams. Hypothesis: We hypothesize that team leader gender is not associated with differences in trauma team leadership and clinical care Methods: We performed a secondary analysis of prospectively acquired data by analyzing video recordings of trauma resuscitations at a Level 1 trauma center. Subjects (n=60) included 2 nd and 3 rd year emergency medicine and surgery residents functioning in the team leader role. Two video recorded observations for each participant (n=120) were coded for team leadership and clinical care by two sets of raters balanced with regard to gender and blinded to study hypothesis. Duplicate coding was performed on 10% of the observations. We analyzed data using random coefficient modeling (RCM), controlling for patient injury severity score and subject postgraduate training year. Results: We found no significant difference between men and women on team leadership behavior (p=.43; Men: M=7.63, SE = 0.54; Women: M = 8.67, SE = 0.74) nor on clinical care (p=.39; Men: M = 62.32, SE = 1.50; Women: M = 64.87, SE = 2.57). Effect sizes were modest in favor of women and nonsignificant for both team leadership behavior ( d = .26) and clinical care ( d =.21). Conclusion: Our prospective evaluation of team leadership quality and clinical care during trauma resuscitations does not support a male performance advantage, contradicting previous simulation-based work. Focusing on effective team leadership behaviors, not inherent traits and leadership styles, will allow resuscitation leaders to optimize their individual and team performance, irrespective of gender. Further work is needed to develop training and cognitive aids capable of supporting team leadership during complex resuscitative care.