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How are Leadership Skills Currently Assessed in Surgery: A Scoping Review
Chai Wei Tong1, Mia Langnier2, Christian Meletis2
1Department of surgery, Westmead Hospital, Westmead, New South Wales, Australia; Sydney Medical School, The University of Sydney Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
Objective:
Leadership is a key competency skill in surgery, where teams work under time-sensitive, and high-pressure conditions. Surgical teams are dynamic, requiring strong leadership to ensure patient safety. Despite its recognized importance, leadership in surgery remains inconsistently defined, and measured. While some leadership tools exist, few are designed to address the unique needs of surgical leadership. This scoping review aims to outline available assessment tools for surgical leadership, examine how leadership is devised, and implemented within these tools, and identify gaps and future directions for their application in surgical training and practice.
Design:
A scoping review was conducted in October 2023 following PRISMA guidelines. MEDLINE, EMBASE, Scopus, and Web of Science were searched using terms related to leadership, non-technical skills, and surgery. Studies were included if they described tools assessing surgeons' leadership using a scoring system. Data were extracted on tool characteristics, leadership behaviors, scoring methods, assessors, and context.
Setting:
A total of 16 articles were included. The earliest article included was published in 2004.
Results:
This review identified 16 leadership assessment tools in surgery: 5 original and 11 modified. All tools assessed leadership as part of a broader non-technical skills, such as communication, and teamwork. Most were used in the intraoperative setting and required trained assessors, such as psychologists. Definitions and observable behaviors of leadership varied across tools.
Conclusion:
Leadership assessment tools in surgery predominantly focus on the operative setting and vary in structure and applicability. Current tools lack a clear distinction from other non-technical skills. Given the importance of leadership skills in surgery, further research is needed to validate existing tools and develop practical assessments for leadership across surgical settings and career stages.
