LAUSR

OBJECTIVE Leaders of a pediatric trauma team are tasked with managing rapidly changing diagnostic and treatment challenges, while ensuring the entire team functions effectively to produce optimal patient outcomes. An effective trauma team leader is often thought to be self-evident, and there is little formal literature identifying the leadership characteristics and attributes associated with optimal trauma team performance. The purpose of this study was to elicit the trauma team leader traits and characteristics deemed of greatest utility by members of the pediatric trauma team. DESIGN, SETTING, PARTICIPANTS Members of the pediatric trauma team at British Columbia Children's Hospital were asked to participate in a semistructured interview to identify trauma team leader attributes associated with maximal team performance. Using the attributes, we constructed a discrete choice experiment (DCE). DCEs, developed in the economics and market research setting, allow participants to express preferences among finite alternatives, with subsequent statistical analysis that allows quantitative comparison of the utility of selected attributes. RESULTS After interviewing 21 trauma team practitioners, 6 themes were identified as being most important for trauma team leadership. The developed DCE was administered to 64 members of the trauma team. Analysis of the DCE revealed the most important attributes were collaboration, strong communication, and decisiveness. The attribute of least utility was experience. The specific leadership qualities that provided the most utility to the trauma team included "actively involves input for team" (mean utility [MU]: 0.70; standard error [SE]: 0.11) and "concise communication, at times closed-loop" (MU: 0.52; SE: 0.09). "Hesitant and unclear communication" (MU: -0.88; SE: 0.09) and "often indecisive" (MU: -0.68; SE: 0.10) were deemed most detrimental (negative utility) to the team's function. CONCLUSIONS This study is novel in applying a strategy to identify and quantify the relative value of trauma team leader attributes. When designing education initiatives for pediatric trauma care teams, defining trauma team quality metrics, and providing continuing medical education for the team leader, it is essential to incorporate preferred leadership characteristics. Crisis resource management skills benefit greatly from an understanding of the preferred attributes, as defined and evaluated by other trauma team members.