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The Leadership Perception Gap in Spanish Anesthesiology Departments: A National Cross-Sectional Survey Comparing
Rodrigo Poves-Álvarez1,2,3,4,5, Esther Gómez-Sánchez1,2,3,4,5, Beatriz Martínez-Rafael1,2,4,5
1Department of Anaesthesiology, Clinical University Hospital of Valladolid, Valladolid, Spain.
Purpose:
The alignment between leaders' self-perception and their teams' experience remains unexplored in Spanish anesthesiology. This study aimed to quantify the "perception gap" between Department Heads (DH) and staff anesthesiologists and to identify prevailing leadership profiles.
Patients And Methods:
A nationwide cross-sectional survey was conducted using a multidisciplinary ad hoc instrument. Anonymous responses were collected from DH and staff anesthesiologists. Due to the study design, analysis focused on comparing cohorts rather than matched dyads. Discrepancies in competency ratings and the association between meeting frequency and leadership scores were analyzed. Leadership typologies were identified using hierarchical cluster analysis.
Results:
Responses were obtained from 32 DH and 588 staff. A significant perception gap was evident, DH consistently rated their competencies higher than the staff rated them (mean overall score 4.35 vs 3.25; recommendation 7.88 vs 5.16 on a 0-10 scale; both p < 0.001). Daily team meetings were strongly associated with higher staff satisfaction ratings across all domains. Logistic regression showed decision making, communication, teamwork, and research and innovation were the strongest predictors of recommending a department head (AUC 0.97-0.98), with relational and communication-oriented competencies showing the greatest influence on endorsement. Cluster analysis identified four profiles: High-Performance (22.3%), High-Potential (28.7%), Passive (16.3%), and Dysfunctional (32.7%), with the latter characterized by minimal interaction and critical deficits in communication and fairness.
Conclusion:
A systematic disconnect exists between the self-concept of Anesthesiology leaders in Spain and the reality perceived by their teams. The prevalence of passive and dysfunctional leadership styles highlights an urgent need for management training and the implementation of 360-degree feedback mechanisms to bridge this gap.
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