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Chapter 1: Leadership

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The fundamental principles of leadership are

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A. Vision and willingness

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B. Command and control

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C. Time management and mentoring

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D. Coaching, pacesetting, and democratic

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Answer: A

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Vision and willingness are the two fundamental principles of leadership. Command and control is a colloquial term for the previously predominant style of leadership in surgery based on fear and intimidation. Time management and mentorship are key leadership skills. Coaching, pacesetting, and democratic are leadership styles. (See Schwartz 10th ed., p. 3.)

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Effective communication is a key component of leadership, given that miscommunication is a leading cause of medical errors. Which of the following statements is FALSE regarding communication?

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A. To Err Is Human, a publication by the US Institute of Medicine, identified medical errors as the eighth leading cause of death in the United States, causing 100,000 deaths annually.

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B. Effective communication that ensures all team members understand daily goals of care for an ICU patient can significantly decrease patient’s length of stay in the ICU.

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C. Communication errors are often simply due to negligence and failure to transmit information.

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D. Information transfer and communication errors cause delays in patient care and can cause serious adverse events.

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E. Improved communication in OR among the cardiac surgery patients is associated with decreased adverse outcomes.

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Answer: C

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Communication errors are often caused by miscommunication due to hierarchical differences, concerns with upward influence, conflicting roles and role ambiguity, and interpersonal conflict. (See Schwartz 10th ed., p. 6.)

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Daniel Goleman of the Harvard Business Review described six key leadership styles. Which of the following statements is FALSE regarding leadership styles?

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A. The coercive style of leadership is antiquated and is no longer effective in surgery.

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B. Democratic leadership is useful for building team consensus and minimizing conflict, but may frustrate team members if there is no clear, unifying vision.

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C. The pacesetter leads by example and sets high standards for his team, but typically takes over the tasks of something falling behind instead of building them up.

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D. The authoritative leader is often the most effective, and focuses on directing the team toward a common vision, allowing team members to give room for innovation and experimentation, and supporting their efforts.

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