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Coleadership in Maternity Teams, a Randomized, Counterbalanced, Crossover Trial in Simulation
Sarah Janssens1, Sharon Clipperton, Robert Simon
1From the Mater Misericordiae Ltd (S.J., M.B.), Australia; Monash University, Department of Anaesthesia and Perioperative Medicine (S.J., S.M.), Melbourne, Australia; University of Queensland, School of Medicine (S.J.), Brisbane, Australia; Mater Education Ltd. (S.C.), Australia; Massachusetts General Hospital and Harvard Medical School (retired) (R.S.); Gold Coast University Hospital (B.L.), Southport, Australia; Bond University (B.L.), Southport, Australia; QIMR Berghofer Medical Research Institute (A.G.), Brisbane, Australia; Mater Research (M.B.), University of Queensland, Brisbane Australia; and University of Melbourne, Department of Critical Care (S.M.), Melbourne, Australia.
Objective:
This study aimed to measure the effect of a coleadership model on team performance compared with singular leadership model in simulated maternity emergencies.
Methods:
A randomized, counterbalanced, crossover trial was performed at 2 tertiary maternity hospitals. Teams of obstetric physicians and nurse/midwives responded to 2 simulated maternity emergencies in either a singular or coleadership model. The primary outcome measure was teamwork rated with the Auckland Team Behavior tool. Secondary outcome measures included clinical performance (completion of critical tasks, time to critical intervention, documentation), self-rated teamwork (TEAM tool) and workload. Participants also answered a survey assessing their views on the coleadership model. Paired t tests and mixed-effects linear regression considering team as a random effect were used to estimate the unadjusted and adjusted associations between leadership model and the outcomes of interest.
Results:
There was no difference between leadership models for the primary outcome of teamwork (5.3 vs. 5.3, P = 0.91). Clinical outcome measures and self-rated teamwork scores were also similar. Team leaders reported higher workload than other team members, but these were not different between the leadership models. Participants viewed coleadership positively despite no measured objective evidence of benefit.
Conclusions:
A coleadership model did not lead to a difference in team performance within simulated maternity emergencies. Despite this, participants viewed coleadership positively.
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