Supplement Content 1: Description of Neurosurgery Resident Leadership Program as conducted at the
University of Iowa Hospitals & Clinics
Session 1: Leadership Styles
Purpose of session: to help participants become more familiar with various leadership styles and to explore
their own approach to leading
Instrument: Blake & Mouton Leadership GRID (available from
http://www.nwlink.com/~donclark/leader/matrix.html#Questionnaire
Resources: Explanation of 5 leadership styles http://www.mindtools.com/pages/article/newLDR_73.htm
http://www.lacpa.org.lb/Includes/Images/Docs/TC/TC409.pdf
Articles:
1. Tuso PJ. The Physician as Leader. The Permanente Journal, 2003; 7:68-71.
2. Itani KMF, Liscum K, Brunicardi FC.Physician leadership is a new mandate in surgical training.
Am J Surg, 2004; 187:328-311.
3. Schwartz RW, Pogge C. Physician Leadership: Essential Skills in a Changing Environment. Am
J Surg, 2000; 180:187-192.
Didactic:
Explanation of the five managerial GRID styles of leadership
Discussion questions:
1. What types of leadership styles do we have in the team/group? Do the results surprise you?
2. “…especially surgeons, are the ideal leaders for health care in the 21st century.” Do you believe
this and why/why not?
3. What are the characteristics of an effective neurosurgery leader?
4. Formal vs. informal leaders – do you have them in your team? How do you identify them? What
role do they provide?
5. Any other thoughts on leadership styles?
Session 2: Conflict Management
Purpose of session: to help participants become more familiar with various approaches to managing conflict
and to explore their own approach to dealing with conflict
Instrument: Thomas & Kilmann Conflict Management inventory (available from
http://www.cerritos.edu/anagao/Conflict_Scale.pdf
Resources: Explanation of 5 conflict styles http://foundationcoalition.org/publications/brochures/conflict.pdf
http://www.springerlink.com/content/p3557335253w8243/
Articles:
1. Friedman RA, Tidd ST, Currall SC, Tsai JC. What Goes Around Comes Around: The Impact of
Personal Conflict Style on Work Conflict and Stress. Inter J Conflict Mgmt, 2000; 11:32-55.
2. Harolds J, Wood BP. Conflict Management and Resolution. J Am Coll Radiol, 2006; 3:200206.
Didactic:
Explanation of the five conflict management styles
Discussion questions:
1. Quick review of different leadership styles
2. What types of conflict management styles do we have in the team/group? Do the results
surprise you?
3. In what types of situations are you likely to use each conflict management approach?
4. Would you agree that an effective leader is capable of using all five approaches?
5. What types of conflict do we most often encounter? Which approach would be better suited to
manage these conflicts?
Session 3: Communication & Feedback
Purpose of session: to help participants become more familiar with various communication styles and to
develop a more effective feedback technique
Instrument: Blake & Mouton Leadership GRID (available from
http://www.ctl.calpoly.edu/workshops/fliers/2008_Winter_CommunicationStyles%20Survey001.pdf
Resources: Explanation of 5 communication styles
http://www.ctl.calpoly.edu/workshops/fliers/2008_Winter_CommunicationStyles%20Survey001.pdf
http://www.lacpa.org.lb/Includes/Images/Docs/TC/TC409.pdf
Articles:
1. Rider EA, Keefer CH. Communication skills competencies: definitions and a teaching toolbox.
Med Educ, 2006; 40: 624–629.
2. Mayfield JR, Mayfield MR, Kopf J. The Effects of Leader Motivating Language on Subordinate
Performance and Satisfaction. Human Resource Management, 1998; 37:235–248.
3. Branch WT, Paranjape A. Feedback and Reflection: Teaching Methods for Clinical Settings.
Acad Med, 2002; 77:1185-1188.
Didactic:
Explanation of the five communication styles
Explanation of providing effective feedback
Discussion questions:
1. What types of communication styles do we have in the team/group? Do the results surprise you?
2. Physicians and nurses tend to have communication problems. What style represents physicians?
Nurses? How can we communicate better given these different styles?
3. How important is it to provide feedback? Why?
4. How frequently do you give positive feedback? Negative feedback? Why is it so heavy on the
negative? How can you improve your ability to provide positive feedback?
5. Any other thoughts on communication & feedback?
Session 4: Role of Team Members
Purpose of session: to help participants become more familiar with various types of team members and how
to be a more effective team player
Instrument: Team Player survey (available from www.wmich.edu/engineer/webal/docs/t08-tmplayer-survey.doc
Resources: Explanation of 4 team member styles
http://www.irislearning.com/tvi/2153-L3.pdf
http://www.winstonbrill.com/bril001/html/article_index/articles/101-150/article102_body.html
Articles:
1. Parker GM. Team Players and Teamwork. 1996: Jossey-Bass Publishers.
2. Kirnan JP, Woodruff D. Reliability and Validity Estimates of the Parker Team Player
Survey. Educational and Psychological Measurement 1994; 54:1030-1037.
Didactic:
Explanation of the team member styles
Discussion questions:
1. What types of team member styles do we have in the team/group? Do the results surprise you?
2. What happens to the team if all the members have the same style?
3. Which of the styles is most important for an effective team? How do we identify this style when
we interview prospective candidates for residency?
4. What are the current strengths of our team’s members? What are the challenges?
5. Any other thoughts on team players and team members?
Session 5: Team Leader
Purpose of session: to help participants become more familiar with various roles of team leaders and their
attitudes toward health care teams
Instrument: Attitudes Toward Health Care Teams Scale (available from Heinemann GD, Schmitt MH, Farrell
MP, Brallier SA. Development of an Attitudes Toward Health Care Teams Scale. Evaluation & The
Health Professions, 1999; 22:123-142.
Resources: Explanation of Health Care Teams Scale
Heinemann GD, Schmitt MH, Farrell MP, Brallier SA. Development of an Attitudes Toward Health
Care Teams Scale. Evaluation & The Health Professions, 1999; 22:123-142.
Articles:
1. Hyer K, Fairchild S, Abraham I, Mezey M, Fulmer T. Measuring attitudes
related to interdisciplinary training: revisiting the Heinemann, Schmitt and
Farrell `attitudes toward health care teams’ scale. J Interprof Care, 2000; 14:249258.
2. Zaccaro SJ, Rittman AL, Marks MA. Team leadership. The Leadership Quarterly, 2001; 12:451483.
Didactic:
Explanation of the Attitudes Toward Health Care Teams Scale
Discussion questions:
1. What were the responses to item #13 (working in teams unnecessarily complicates things most of
the time)?
2. What were the responses to item #15 (a team’s primary purpose is to assist physicians in
achieving treatment goals for patients)?
3. What were the responses to item #18 (physicians are natural team leaders)?
4. What were the responses to item #20 (physicians, as a rule, are team players)?
5. Any other thoughts on team leadership?
Session 6: Motivation
Purpose of session: to help participants become more familiar with theories related to motivation and
techniques used to motivate others
Instrument: Attitudes Toward Health Care Teams Scale (available from
http://www.businessballs.com/mcgregor.htm
Resources: Explanation of Health Care Teams Scale
http://www.netmba.com/mgmt/ob/motivation/mcgregor/
http://www.referenceforbusiness.com/management/Str-Ti/Theory-X-and-Theory-Y.html
Articles:
1. Gallagher WE, Einhorn HJ. Motivation Theory and Job Design. The Journal of Business, 1976;
49:358-373.
2. Douglas McGregor – Theory X and Y http://www.bola.biz/motivation/mcgregor.html
Didactic:
Explanation of the Theory X and Y properties and performance is a function of ability and motivation
Discussion questions:
1. What types of x/y styles do we have in the team/group? Do the results surprise you?
2. As a chief resident, you noticed that a junior resident just doesn’t seem to be motivated.
A. What clues lead you to this assumption?
B. What can you do to overcome these clues?
3. If performance is a function of ability and motivation, how do you know is someone has the
ability? If they don’t, how do you develop it?
4. How do the members of your team like to be recognized? Some prefer one-on-one; others like
it in front of the group. The only way to find out is to ask each team member.
5. Any other thoughts on motivation and performance?
Session 7: Moving From Peer to Leader
Purpose of session: to help participants changes that occur in the transition from peer to chief resident
Instrument: Leadership Self-Assessment Activity (available from
http://www.nwlink.com/~donclark/leader/survlead.html
Resources: instrument is self-explanatory
Articles:
1. Raviglione MC. Machiavelli and the Chief Resident. Acad Med, 1990; 65:361-362.
2. Goffee R, Jones G. Why Should Anyone Be Led by You? HBR, 2000; 78:63-70.
Didactic:
Discussion of human dynamics and transition from peer to leader and challenges of 1st time
managers
Discussion questions:
1. For the current chiefs, what changes did you see occur when you took over as chiefs? Where
there any surprises?
2. A major challenge for new leaders is that you have been their peer for several years and now
you have power and responsibility over them. Are you able to provide tough feedback or does it
feel like it’s not your job?
3. For the rest of the team, what do you expect from your chiefs?
4. For the new chiefs, what do you expect from your team?
Session 8: Review of Leadership Program
Purpose of session: to review topics covered and information presented during the program
Instrument: Review of all instruments used throughout the program
Resources: as identified with each session
Articles:
1. Souba WW. Building Our Future: A Plea for Leadership. World J Surg, 2004; 28:445-450.
2. Kouzes JM, Posner BZ. Ten Commitments of Leadership. The Leadership Challenge. 1995:
Jossey-Bass.
Didactic:
Review of all sessions and how they are integrated to developing effective leaders
Discussion questions:
1. Looking back over the many sessions, what have you learned about yourself and leadership?
2. What components of leadership were most helpful to you? Which components needed more
development?
3. As we go into the future, what types of sessions/topics would you like to cover?