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Updated: Oct 2, 2026

Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Transactional techniques required, transformational techniques preferred: The interplay of leadership methods among
Joseph C L'Huillier1, Christie Buonpane2, Ryan Shabahang3
1University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Department of Surgery, Buffalo, NY, USA.
Background:
Transformational techniques empower others to create change while transactional techniques utilize rewards and punishments to modify behavior. We sought to understand the use of these leadership techniques by surgical department chairs.
Methods:
Semi-structured interviews were conducted with 17 Chairs of Surgery and analyzed using reflexive thematic analysis.
Results:
Transformational techniques are effective and require an aligned vision that is associated with change, growth, and empowerment. Transactional techniques are necessary but can damage intrinsic motivation and the sense of collective accomplishment if overutilized. Transformational techniques are preferable yet require more effort.
Conclusions:
Transactional techniques are required for day-to-day operations but transformational techniques are ideal to drive lasting, meaningful change for surgeon leaders. However, tying transactions to the mission makes them more transformational. Deconstructing the techniques and impacts of high-level surgical leaders will help refine optimal leadership practices in the surgical space.
