Assessing Physician Leadership Styles: Application of the Situational Leadership Model to Transitions in Patient Acuity

Background: The situational leadership model suggests that an effective leader adapts leadership style depending on the followers' level of competency. Purpose: We assessed the applicability and reliability of the situational leadership model when observing residents in simulated hospital floor-based scenarios. Methods: Resident teams engaged in clinical simulated scenarios. Video recordings were divided into clips based on Emergency Severity Index v4 acuity scores. Situational leadership styles were identified in clips by two physicians. Interrater reliability was determined through descriptive statistical data analysis. Results: There were 114 participants recorded in 20 sessions, and 109 clips were reviewed and scored. There was a high level of interrater reliability (weighted kappa r = .81) supporting situational leadership model's applicability to medical teams. A suggestive correlation was found between frequency of changes in leadership style and the ability to effectively lead a medical team. Conclusions: The situational leadership model represents a unique tool to assess medical leadership performance in the context of acuity changes.