Skip to main content

Table 3 Characteristics of included studies

From: Advancing leadership in surgery: a realist review of interventions and strategies to promote evidence-based leadership in healthcare

Study

Country

Study type

Participants (number of surgeons)

Specialty

Setting

Leadership Intervention of interest

Quality

Ahmed 2019 [32]

Pakistan

Mixed methods RCT including non-technical skills scale followed by focus group

28

Obstetrics and gynaecology

Hospital operating theatre

Non-technical skills training

(didactic and practical sessions)

Medium

Al-Jundi 2016 [33]

UK

Mixed methods-survey with open-ended questions and

Non-technical skills scale

76

Not specified

1 teaching and 2 district general hospitals (NHS)

Non-technical skills training

(acceptability of assessments)

Hig

Brindle 2018 [34]

USA

Qualitative–semi-structure interviews

4

Surgical quality improvement implementation leaders

3 large public health systems (20 hospitals) and one army medical centre

Surgical debriefing program

High

Brook 2020 [35]

USA

Quantitative survey

117

Academic orthopaedic surgeons

Academic residency programs

Mentoring

Low

Cochran 2019 [36]

USA

Qualitative interviews

15

Academic surgeons (varying specialties)

Unclear

Mentoring

High

Dominguez 2021 [37]

Colombia

Qualitative-semi structured interviews

16

Surgeons identified as exponents of a transformational leadership style

unclear

‘Job crafting’ from senior surgeons to enhance residents

High

Doumouras 2017 [38]

Canada

Quantitative non-randomised prospective study including non-technical skills scale

23

General surgery residents

McMaster University General Surgery Residency Program

Non-technical skills training

(crisis simulation training with debrief based on crisis resource management principles)

High

Foley 2021 [39]

Australia

Quantitative survey

118

Consultant surgeons (varying specialities)

2 tertiary hospitals

Peer-based coaching

High

Gostlow 2017 [40]

Australia

Quantitative case–control including non-technical skills scale

70

Surgical trainees (40), experienced consultants (30) (varying specialties mainly general surgery)

Unclear

Non-technical skills training

(before and after the introductions of Royal Australasian College of Surgeons Surgical Education and Training (SET) curriculum)

High

Greenberg 2018 [41]

USA

Mixed methods survey, focus groups and interview

12

Varied experience and specialty

Range- academic, private urban and private rural

Video based coaching

Medium

Gregory 2018 [42]

USA

Quantitative retrospective including 360° feedback

12

Orthopaedic surgery service chiefs

urban academic orthopedic surgery department

360° feedback program and coaching

High

Hart 2020 [43]

USA

Quantitative survey

149

Orthopaedic residents

University, community and military-based programs

Mentoring

Low

Hill 2018 [44]

USA

Quantitative survey

17

Junior residents general surgery

University hospital

Leadership development programme

(lectures with discussion)

Medium

Hu J 2020 [45]

USA and Canada

Quantitative non-randomised study

including

360° feedback

547

Variety of specialties—neurosurgery, orthopaedic, obstetrics and gynaecology, cardiothoracic, plastics, urology

Academic and community hospitals

360° feedback programme

(Group 1-Feedback report only

Group 2-Debriefing only

Group 3-Debriefing and coaching)

High

Hu Y 2016 [46]

USA

Quantitative study (video-based observational)

5

General and oncological surgery

Quaternary care hospital

Assessment of leadership styles in the operating room

Medium

Jaffe 2016 [47]

USA

Qualitative interview

24

Academic surgeons (variety of specialities) Many in leadership positions—section and division heads and program directors

University

Views on leadership development programme

High

Jayasuria-Illesinghe 2016 [48]

Sri Lanka

Qualitative interview

15

Junior and senior general surgeons

Teaching hospital

Views on teamwork, team member roles, and team processes

High

Kaderli 2015 [49]

Switzerland

Quantitative survey

512

General surgeons—junior and senior

Mixed-university hospital, referral, and regional hospitals and private practice

Mentoring

Low

Kawase 2016 [50]

Japan, USA, Finland, and Hong Kong

Quantitative survey

225

Women surgeons (varied specialties and career stages)

60% were affiliated with an academic institution, 22% a general hospital, 12% private practice

Views on factors that promote or impede advancement of women as leaders

Medium

Lee SH 2021 [51]

USA

Quantitative prospective pre-post cohort study

36

Orthopaedic surgeons-attending, resident and fellow level

Hospital

Leadership development programme

(communication, lectures, discussion, and grand rounds)

Low

Lee T 2020 [52]

USA

Quantitative survey

52

American College of Surgeons Society of Surgical Chairs

Academic Surgery Departments

Experience of leadership and academic advancement

Medium

Mutabdzic 2015 [53]

Canada

Qualitative interview

14

Staff surgeons -Varied specialties

University affiliated hospitals

Coaching

High

Nicksa 2015 [54]

USA

Quantitative pre- and post-evaluation and survey feedback

37

Junior surgical residents (post-graduate year 1 and 2) on general, vascular and cardiothoracic surgery

San Francisco VA Medical Center

Simulation

High

Nurudeen 2015 [55]

USA

Quantitative feedback survey including

360° feedback

118

Attending surgeons cardiac, thoracic, vascular, orthopedic, plastic, and general surgery departments

8 hospitals including academic medical centers and university affiliated community hospitals with a voluntary medical staff

360° feedback programme

Medium

Pena 2015 [56]

Australia

Quantitative single-blinded, prospective comparative trial including non-technical skills scale

40

Trainees and fellows of Mixed specialty's

Unclear

Simulation

 ± non-technical skills workshop

High

Praderelli 2016 [57]

USA

Qualitative interview

21

Academic surgeons varied specialities—many in leadership positions, e.g. program directors

Large academic institution

Leadership development programme

High

Ramjeeawon 2020 [58]

UK

Quantitative pre-post test study including non-technical skills scale

16

General and vascular surgeons

Unclear

Simulation

 ± non-technical skills workshop

High

Sinclair 2015 [59]

UK and ROI

Mixed methods survey with open-ended questions

565

Trainees of all grades and specialties

National survey varied settings

Mentorship

High

Somasundram 2018 [60]

UK

Mixed methods NOTTS scores and feedback form with open-ended questions

48

Urology trainees

Unclear

Simulation

 + non-technical skills wardrounds

High

Stephens 2018 [61]

USA

Quantitative survey

288

Cardiothoracic surgery residents

Unclear

Mentoring

High

Vitous 2019 [62]

USA

Qualitative interviews

14

Range of clinical areas including general, vascular, plastic, thoracic, and transplant surgery

The University of Michigan

Leadership development programme

High

Vu 2020 [63]

USA

Qualitative- interview

18

General surgery residents

Tertiary care academic institution

Feedback

High

Yule 2015 [64]

USA

Quantitative randomised trial including non-technical skills scale

16

Senior surgical residents

Academic medical center

Simulation

 ± non-technical skills feedback

Medium