Effective Behaviors of Leaders During Clinical Emergencies: A Qualitative Study of Followers’ Perspectives

Abstract

BackgroundTo effectively manage a clinical emergency, physicians need well-developed leadership skills, yet there is limited structured leadership training available for critical care trainees. In order to develop an effective curriculum, leadership competencies must first be defined. Research QuestionDuring clinical emergencies, what leadership behaviors do followers value? Study Design and MethodsWe conducted qualitative interviews with members of multidisciplinary critical care teams at a large academic health system, with participants including resident physicians, nurses, and respiratory therapists (N=15). Thematic analysis was used to categorize leadership behaviors that followers perceived to be effective. ResultsWe identified three themes related to leadership during clinical emergencies: “control,” “collaboration,” and “common understanding.” Participants described behaviors they felt resulted in both effective and ineffective leadership. For effective leaders, control, the most dominant theme, included behaviors that clearly established roles for the leader and followers, allowing the leader to guide care during a clinical emergency. Collaboration referenced the ability of a leader to maintain a collegial environment. Finally, common understanding reflected a leader’s ability to manage communication in a way that fostered a shared mental model across team members. InterpretationDuring clinical emergencies, followers value leaders who assert themselves while also maintaining positive team interaction and encouraging an organized flow of information. Our findings provide a potential framework to develop a leadership curriculum for critical care trainees.