TY - JOUR
T1 - SAVE 2.0
T2 - Identifying and strengthening resident leadership skills through simulation based team training
AU - Onufer, Emily Jean
AU - Andrade, Erin
AU - Caldwell, Katharine E.
AU - Cullinan, Darren
AU - Vallar, Kelly
AU - Turnbull, Isaiah R.
AU - Schuerer, Douglas
AU - Wise, Paul E.
AU - Klingensmith, Mary E.
AU - Punch, Laurie
N1 - Publisher Copyright:
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - BACKGROUND: The “Surgery for Abdomino-thoracic ViolencE (SAVE)” animate lab engages surgical residents in the management of penetrating injuries in a team setting. Senior residents, representing postgraduate year (PGY) 3–5, assume the role of team leader and facilitate the junior residents, PGY1–2, in operative management of simulated penetrating wounds. Residents completed five scenarios with increasing level of difficulty within set time limits. Senior residents were evaluated on their team’s ability to “SAVE” their patient within the time allotted, as well as their communication and leadership skills. METHODS: General, vascular, urology, and plastic surgery residents (n = 79) were divided into 25 teams of three to four residents by “resident scores” (R scores, the sum of the team members’ PGY) to create balanced teams with comparable years of clinical experience. Residents completed assessments of their senior resident’s leadership ability and style. RESULTS: Evaluation of a resident’s desired learning style changed across PGY with junior residents preferring more hands-on guidance compared with senior residents preferring only verbal correction. Resident leadership evaluations demonstrated that team leaders of varied resident years achieved the highest scores. Greater differences in the mismatch between autonomy provided to and desired by junior residents correlated to greater junior resident discomfort in expressing their opinion, confidence, and leadership ratings of senior residents. However, greater autonomy mismatch also correlated to more rapid time to task completion. CONCLUSION: Different from our expectations, clinical experience alone did not define team leader success. Leadership is a powerful influence on the outcome of team performance and may be a skill, which can transcend overall clinical experience. A match between desired and provided resident autonomy and team cohesion may demonstrate a stronger effect on team success in stressful operative situations, such as trauma resuscitation. Enhancement of leadership skills early in residency training may represent an important focus for trauma surgery education.
AB - BACKGROUND: The “Surgery for Abdomino-thoracic ViolencE (SAVE)” animate lab engages surgical residents in the management of penetrating injuries in a team setting. Senior residents, representing postgraduate year (PGY) 3–5, assume the role of team leader and facilitate the junior residents, PGY1–2, in operative management of simulated penetrating wounds. Residents completed five scenarios with increasing level of difficulty within set time limits. Senior residents were evaluated on their team’s ability to “SAVE” their patient within the time allotted, as well as their communication and leadership skills. METHODS: General, vascular, urology, and plastic surgery residents (n = 79) were divided into 25 teams of three to four residents by “resident scores” (R scores, the sum of the team members’ PGY) to create balanced teams with comparable years of clinical experience. Residents completed assessments of their senior resident’s leadership ability and style. RESULTS: Evaluation of a resident’s desired learning style changed across PGY with junior residents preferring more hands-on guidance compared with senior residents preferring only verbal correction. Resident leadership evaluations demonstrated that team leaders of varied resident years achieved the highest scores. Greater differences in the mismatch between autonomy provided to and desired by junior residents correlated to greater junior resident discomfort in expressing their opinion, confidence, and leadership ratings of senior residents. However, greater autonomy mismatch also correlated to more rapid time to task completion. CONCLUSION: Different from our expectations, clinical experience alone did not define team leader success. Leadership is a powerful influence on the outcome of team performance and may be a skill, which can transcend overall clinical experience. A match between desired and provided resident autonomy and team cohesion may demonstrate a stronger effect on team success in stressful operative situations, such as trauma resuscitation. Enhancement of leadership skills early in residency training may represent an important focus for trauma surgery education.
KW - Team learning
KW - curriculum
KW - leadership training
KW - resident education
KW - surgery simulation
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=85102216461&partnerID=8YFLogxK
U2 - 10.1097/TA.0000000000003037
DO - 10.1097/TA.0000000000003037
M3 - Article
C2 - 33492109
AN - SCOPUS:85102216461
SN - 2163-0755
VL - 90
SP - 582
EP - 588
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 3
ER -