Leadership and Teamwork in Trauma and Resuscitation
Open accessAbstract
INTRODUCTION: Leadership skills are described by the American College of Surgeons' Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. METHODS: We searched the PubMed database using the keywords "leadership" and then either "trauma" or "resuscitation" as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. RESULTS: We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching followed by simulations. Although programs differed in length, intensity, and training level of participants, all programs demonstrated improved team performance. CONCLUSION: Despite the relative paucity of literature on leadership in resuscitations, this review found leadership improves processes of care in trauma and can be enhanced through dedicated training. Future research is needed to validate leadership assessment scales, develop optimal training mechanisms, and demonstrate leadership's effect on patient-level outcome.
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During medical emergencies, fast-response teams frequently include physicians from different specialties.
“During medical emergencies, fast-response teams frequently include physicians from different specialties [26].”
From To Recommend or Not to Recommend: Designing and Evaluating AI-Enabled Decision Support for Time-Critical Medical Events (2025) · cites this paper as [26]
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- [1]Advanced trauma life support (ATLS(R)): the ninth edition J Trauma Acute Care Surg 2013 74 5 1363 6 23609291
- [5]Hoff WS Reilly PM Rotondo MF The importance of the command-physician in trauma resuscitation J Trauma 1997 43 5 772 7 9390488
- [6]Lubbert PH Kaasschieter EG Hoorntje LE Video registration of trauma team performance in the emergency department: the results of a 2-year analysis in a Level 1 trauma center J Trauma 2009 67 6 1412 20 20009695
- [7]Capella J Smith S Philp A Teamwork training improves the clinical care of trauma patients J Surg Educ 2010 67 6 439 43 21156305
- [8]Steinemann S Berg B Skinner A In situ, multidisciplinary, simulation-based teamwork training improves early trauma care J Surg Educ 2011 68 6 472 7 22000533
- [9]Cooper S Wakelam A Leadership of resuscitation teams: “Lighthouse Leadership” Resuscitation 1999 42 1 27 45 10524729
- [10]Marsch SC Muller C Marquardt K Human factors affect the quality of cardiopulmonary resuscitation in simulated cardiac arrests Resuscitation 2004 60 1 51 6 14987784
- [11]Hunziker S Tschan F Semmer NK Hands-on time during cardiopulmonary resuscitation is affected by the process of teambuilding: a prospective randomised simulator-based trial BMC Emerg Med 2009 9 3 19216796 PMC2656452
- [12]Hunziker S Buhlmann C Tschan F Brief leadership instructions improve cardiopulmonary resuscitation in a high-fidelity simulation: a randomized controlled trial Crit Care Med 2010 38 4 1086 91 20124886
- [13]Yeung JH Ong GJ Davies RP Factors affecting team leadership skills and their relationship with quality of cardiopulmonary resuscitation Crit Care Med 2012 40 9 2617 21 22732290
- [14]Yun S Contingent Leadership and Effectiveness of Trauma Resuscitaiton Teams J Appl Psychol 2005 90 6 1288 96 16316282
- [15]Sarcevic A Marsic I Waterhouse LJ Leadership structures in emergency care settings: a study of two trauma centers Int J Med Inform 2011 80 4 227 38 21306940
- [16]Holcomb JB Dumire RD Crommett JW Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training J Trauma 2002 52 6 1078 85 discussion 85–6 12045633
- [18]Sakran JV Finneman B Maxwell C Trauma leadership: does perception drive reality? J Surg Educ 2012 69 2 236 40 22365872
- [20]Ziesmann MT Widder S Park J S.T.A.R.T.T.: development of a national, multidisciplinary trauma crisis resource management curriculum-results from the pilot course Trauma Acute Care Surg 2013 75 5 753 8 24158191
- [21]Fernandez R Pearce M Grand JA Evaluation of a computer-based educational intervention to improve medical teamwork and performance during simulated patient resuscitations Crit Care Med 2013 41 11 2551 62 23949473
- [22]Johnson NB Hayes LD Brown K CDC National Health Report: Leading Causes of Morbidity and Mortality and Associated Behavioral Risk and Protective Factors-United States, 2005–2013 MMWR Surveill Summ (Washington, DC: 2002) 2014 63 3 27 25356673
- [23]Corso P Finkelstein E Miller T Incidence and lifetime costs of injuries in the United States Inj Prev 2006 12 4 212 8 16887941 PMC2586784
- [24]Stelfox HT SS Nathens A Bobranska-Artiuch B Evidence for quality indicators to evaluate adult trauma care: a systematic review Crit Care Med 2011 39 846 59 21317653
- [25]Shafi S Compliance with recommended care at trauma centers: association with patient outcomes JACS 2014 219 189 98 25038959
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Mastrianni, A., Kim, M. S., Sullivan, T. M., Sippel, G. J., Burd, R. S., Gajos, K. Z., & Sarcevic, A. (2025) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3757512 · Cited by 6 · see citing works
“Although providing AI information and recommendations improved diagnostic accuracy in our experiment, our findings also highlighted two socio-technical barriers to implementing AI recommendations in time-critical medical events.”
- Authors
- Ford, K., Menchine, M., Burner, E., Arora, S., Inaba, K., Demetriades, D., & Yersin, B.
- Affiliations
- University of Southern California (US)
- Corresponding author
- Ford, Kelsey
- Venue
- Western Journal of Emergency Medicine
- Publisher
- California Digital Library (CDL)
- Published
- 2016-09-01
- Volume
- 17
- Issue
- 5
- Pages
- 549-556
- ISSN
- 1936-900X (ISSN-L)
- 1936-9018
- PMC
- PMC5017838
- OpenAlex
- W2516354978
- Cited by
- 163
- References
- 0
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 28 · 2023: 13 · 2022: 21 · 2021: 11 · 2020: 22 · 2019: 13 · 2018: 17 · 2017: 6
- FWCI
- 10.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Western Journal of Emergency Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, other-oa)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- IRIS (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- University of Southern California
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Keywords
- leadership, teamwork, trauma resuscitation, Advanced Trauma Life Support, leadership styles, directive leadership, empowering leadership, Injury Severity Score, leadership training, simulation-based training, team performance, process of care
- MeSH terms
- Clinical Competence, Cooperative Behavior, Health Personnel, Humans, Leadership, Quality of Health Care, Surveys and Questionnaires, Resuscitation, Wounds and Injuries
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