{"id":{"repo_id":"vt","oai_identifier":"oai:vtechworks.lib.vt.edu:10919/113833"},"canonical_url":"https://search.dev.ndltd.org/etd/vt/oai:vtechworks.lib.vt.edu:10919/113833","repository":{"repo_id":"vt","name":"Virginia Tech","base_url":"https://vtechworks.lib.vt.edu/oai/request"},"display":{"title":"Leadership, Psychological Safety, Team Trust, and Performance: A Study of Surgical Teams","abstract":"Within the growing literature on team leadership, there is a lack of understanding which leadership process may be most reflective of intratsk leadership. In study 1, I explored leadership behaviors throughout the operating team's OR tasks and if a shared leadership approach is related to psycho-social attitudes and performance of the team. I also investigate surgical teams' engagement in safety related behaviors and if these are related to the team's workflow disruptions. As an exemplar environment, I chose to observe these dynamics in the operating theater, which is a high-stakes environment that necessitates the team to use both technical and non-technical skills. In study 2, I investigate whether a brief targeted leadership coaching sessions with residents in a simulated environment results in different (increase or decrease) leadership behaviors at an interval of 6 months. Multiple hypothesized models were tested in Study 1. The results of model 1 show that psychological safety and team trust are significantly correlated to each other (r=.704, p= <.001). The results show that psychological safety (β= -.505 p=.049) is related to performance (time of patient on bypass), while team trust (β= .177 p=.303) does not predict performance. The results of model 2 show that more extensive shared leadership behaviors are not significantly correlated with psychological safety (r=.087 p=.250) and performance (r=-.085, p =.295); however, the results show that there is a significant correlation with shared leadership and team trust (r=.260 p =.023), indicating that a more extensive shared leadership approach is related to higher team trust in a surgical team. The results of model 3 show that the length of the time-out (a safety critical behavior) does not mediate the relationship between perceptions of the usefulness of the time-out and frequency with which the circulating nurse leaves the operating room (OR). However, there is a strong relationship between the perceptions of the time-out and the number of times the circulating nurse leaves the OR (β = -.425, p<.001), indicating that for every unit increase in the perceptions of the usefulness of the time-out, the nurse leaves the OR .45 fewer times. In study 2, a paired sample t-test was conducted to understand if leadership behaviors post-coaching session are more frequent than pre-coaching session. The results show that there is no significant difference in the frequency of leadership behaviors at time 1 (M =.113, SD=.040) and the leadership behaviors at time 2 (M= .127, SD= .041); t (6)= -1.216, p = .270.","abstract_html":"Within the growing literature on team leadership, there is a lack of understanding which leadership process may be most reflective of intratsk leadership. In study 1, I explored leadership behaviors throughout the operating team&#x27;s OR tasks and if a shared leadership approach is related to psycho-social attitudes and performance of the team. I also investigate surgical teams&#x27; engagement in safety related behaviors and if these are related to the team&#x27;s workflow disruptions. As an exemplar environment, I chose to observe these dynamics in the operating theater, which is a high-stakes environment that necessitates the team to use both technical and non-technical skills. In study 2, I investigate whether a brief targeted leadership coaching sessions with residents in a simulated environment results in different (increase or decrease) leadership behaviors at an interval of 6 months. Multiple hypothesized models were tested in Study 1. The results of model 1 show that psychological safety and team trust are significantly correlated to each other (r=.704, p= &lt;.001). The results show that psychological safety (β= -.505 p=.049) is related to performance (time of patient on bypass), while team trust (β= .177 p=.303) does not predict performance. The results of model 2 show that more extensive shared leadership behaviors are not significantly correlated with psychological safety (r=.087 p=.250) and performance (r=-.085, p =.295); however, the results show that there is a significant correlation with shared leadership and team trust (r=.260 p =.023), indicating that a more extensive shared leadership approach is related to higher team trust in a surgical team. The results of model 3 show that the length of the time-out (a safety critical behavior) does not mediate the relationship between perceptions of the usefulness of the time-out and frequency with which the circulating nurse leaves the operating room (OR). However, there is a strong relationship between the perceptions of the time-out and the number of times the circulating nurse leaves the OR (β = -.425, p&lt;.001), indicating that for every unit increase in the perceptions of the usefulness of the time-out, the nurse leaves the OR .45 fewer times. In study 2, a paired sample t-test was conducted to understand if leadership behaviors post-coaching session are more frequent than pre-coaching session. The results show that there is no significant difference in the frequency of leadership behaviors at time 1 (M =.113, SD=.040) and the leadership behaviors at time 2 (M= .127, SD= .041); t (6)= -1.216, p = .270.","abstract_has_math":false,"creators":["Zagarese, Vivian Joy"],"institution":"Virginia Tech","degree_name":"Doctor of Philosophy","degree_level":"doctoral","degree_discipline":"Psychology","degree_department":"Psychology","school":null,"contributors":[],"advisors":[],"committee_chairs":["Foti, Roseanne J.","Parker, Sarah H."],"committee_members":["Hauenstein, Neil M. A.","Hernandez, Jorge Ivan"],"year":2023,"date_issued":"2023-02-14","date_published":"2023-02-14","updated_at":"2026-07-22T22:19:22Z","subjects":["shared leadership","psychological safety","team trust","surgical teams"],"languages":["en"],"rights":["In Copyright"],"rights_urls":["http://rightsstatements.org/vocab/InC/1.0/"],"identifier_entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["vt_gsexam:36281"],"render_values":[{"text":"vt_gsexam:36281","href":null,"code":true}]}]},"links":{"outbound_url":"http://hdl.handle.net/10919/113833","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.committeechair","label":"Committee Chair","values":["Foti, Roseanne J.","Parker, Sarah H."]},{"key":"dc:contributor.committeemember","label":"Committee Member","values":["Hauenstein, Neil M. A.","Hernandez, Jorge Ivan"]},{"key":"dc:contributor.department","label":"Department","values":["Psychology"]},{"key":"dc:creator","label":"Author","values":["Zagarese, Vivian Joy"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2023-02-15T09:00:34Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2023-02-15T09:00:34Z"]},{"key":"dc:date.issued","label":"Date","values":["2023-02-14"]},{"key":"dc:publisher","label":"Institution","values":["Virginia Tech"]},{"key":"dc:type","label":"Dc Type","values":["Dissertation"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Psychology"]},{"key":"thesis:degree_level","label":"Degree Level","values":["doctoral"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Philosophy"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["Virginia Polytechnic Institute and State University"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["shared leadership","psychological safety","team trust","surgical teams"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["In Copyright"]},{"key":"dc:rights.uri","label":"Rights URI","values":["http://rightsstatements.org/vocab/InC/1.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["vt_gsexam:36281"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/10919/113833"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Within the growing literature on team leadership, there is a lack of understanding which leadership process may be most reflective of intratsk leadership. In study 1, I explored leadership behaviors throughout the operating team's OR tasks and if a shared leadership approach is related to psycho-social attitudes and performance of the team. I also investigate surgical teams' engagement in safety related behaviors and if these are related to the team's workflow disruptions. As an exemplar environment, I chose to observe these dynamics in the operating theater, which is a high-stakes environment that necessitates the team to use both technical and non-technical skills. In study 2, I investigate whether a brief targeted leadership coaching sessions with residents in a simulated environment results in different (increase or decrease) leadership behaviors at an interval of 6 months. Multiple hypothesized models were tested in Study 1. The results of model 1 show that psychological safety and team trust are significantly correlated to each other (r=.704, p= <.001). The results show that psychological safety (β= -.505 p=.049) is related to performance (time of patient on bypass), while team trust (β= .177 p=.303) does not predict performance. The results of model 2 show that more extensive shared leadership behaviors are not significantly correlated with psychological safety (r=.087 p=.250) and performance (r=-.085, p =.295); however, the results show that there is a significant correlation with shared leadership and team trust (r=.260 p =.023), indicating that a more extensive shared leadership approach is related to higher team trust in a surgical team. The results of model 3 show that the length of the time-out (a safety critical behavior) does not mediate the relationship between perceptions of the usefulness of the time-out and frequency with which the circulating nurse leaves the operating room (OR). However, there is a strong relationship between the perceptions of the time-out and the number of times the circulating nurse leaves the OR (β = -.425, p<.001), indicating that for every unit increase in the perceptions of the usefulness of the time-out, the nurse leaves the OR .45 fewer times. In study 2, a paired sample t-test was conducted to understand if leadership behaviors post-coaching session are more frequent than pre-coaching session. The results show that there is no significant difference in the frequency of leadership behaviors at time 1 (M =.113, SD=.040) and the leadership behaviors at time 2 (M= .127, SD= .041); t (6)= -1.216, p = .270."]},{"key":"dc:description.abstractgeneral","label":"General Abstract","values":["Within the growing literature on team leadership, there is a lack of understanding which leadership process may be most reflective of intratsk leadership. In study 1, I explored leadership behaviors throughout the operating team's OR tasks and if a shared leadership approach is related to psycho-social attitudes and performance of the team. I also investigate surgical teams' engagement in safety related behaviors and if these are related to the team's workflow disruptions. As an exemplar environment, I chose to observe these dynamics in the operating theater, which is a high-stakes environment that necessitates the team to use both technical and non-technical skills. In study 2, I investigate whether a brief targeted leadership coaching sessions with residents in a simulated environment results in different (increase or decrease) leadership behaviors at an interval of 6 months. Multiple hypothesized models were tested in Study 1. The results of model 1 show that psychological safety and team trust are significantly correlated to each other. The results show that psychological safety is related to performance (time of patient on bypass), while team trust does not predict performance. The results of model 2 show that more extensive shared leadership behaviors are not significantly correlated with psychological safety and performance; however, the results show that there is a significant correlation with shared leadership and team trust, indicating that a more extensive shared leadership approach is related to higher team trust in a surgical team. The results of model 3 show that the length of the time-out (a safety critical behavior) does not mediate the relationship between perceptions of the usefulness of the time-out and frequency with which the circulating nurse leaves the operating room (OR). However, there is a strong relationship between the perceptions of the usefulness of the time-out and the number of times the circulating nurse leaves the OR, indicating that for every unit increase in the perceptions of the usefulness of the time-out, the nurse leaves the OR .45 fewer times. In study 2, a paired sample t-test was conducted to understand if leadership behaviors post-coaching session are more frequent than pre-coaching session. The results show that there is no significant difference in the frequency of leadership behaviors at time 1 and the leadership behaviors at time 2."]},{"key":"dc:description.degree","label":"Dc Description Degree","values":["Doctor of Philosophy"]},{"key":"dc:format.medium","label":"Dc Format Medium","values":["ETD"]},{"key":"dc:title","label":"Title","values":["Leadership, Psychological Safety, Team Trust, and Performance: A Study of Surgical Teams"]}]}],"canonical_facts":{"dc:contributor.committeechair":["Foti, Roseanne J.","Parker, Sarah H."],"dc:contributor.committeemember":["Hauenstein, Neil M. A.","Hernandez, Jorge Ivan"],"dc:contributor.department":["Psychology"],"dc:creator":["Zagarese, Vivian Joy"],"dc:date.accessioned":["2023-02-15T09:00:34Z"],"dc:date.available":["2023-02-15T09:00:34Z"],"dc:date.issued":["2023-02-14"],"dc:description.abstract":["Within the growing literature on team leadership, there is a lack of understanding which leadership process may be most reflective of intratsk leadership. In study 1, I explored leadership behaviors throughout the operating team's OR tasks and if a shared leadership approach is related to psycho-social attitudes and performance of the team. I also investigate surgical teams' engagement in safety related behaviors and if these are related to the team's workflow disruptions. As an exemplar environment, I chose to observe these dynamics in the operating theater, which is a high-stakes environment that necessitates the team to use both technical and non-technical skills. In study 2, I investigate whether a brief targeted leadership coaching sessions with residents in a simulated environment results in different (increase or decrease) leadership behaviors at an interval of 6 months. Multiple hypothesized models were tested in Study 1. The results of model 1 show that psychological safety and team trust are significantly correlated to each other (r=.704, p= <.001). The results show that psychological safety (β= -.505 p=.049) is related to performance (time of patient on bypass), while team trust (β= .177 p=.303) does not predict performance. The results of model 2 show that more extensive shared leadership behaviors are not significantly correlated with psychological safety (r=.087 p=.250) and performance (r=-.085, p =.295); however, the results show that there is a significant correlation with shared leadership and team trust (r=.260 p =.023), indicating that a more extensive shared leadership approach is related to higher team trust in a surgical team. The results of model 3 show that the length of the time-out (a safety critical behavior) does not mediate the relationship between perceptions of the usefulness of the time-out and frequency with which the circulating nurse leaves the operating room (OR). However, there is a strong relationship between the perceptions of the time-out and the number of times the circulating nurse leaves the OR (β = -.425, p<.001), indicating that for every unit increase in the perceptions of the usefulness of the time-out, the nurse leaves the OR .45 fewer times. In study 2, a paired sample t-test was conducted to understand if leadership behaviors post-coaching session are more frequent than pre-coaching session. The results show that there is no significant difference in the frequency of leadership behaviors at time 1 (M =.113, SD=.040) and the leadership behaviors at time 2 (M= .127, SD= .041); t (6)= -1.216, p = .270."],"dc:description.abstractgeneral":["Within the growing literature on team leadership, there is a lack of understanding which leadership process may be most reflective of intratsk leadership. In study 1, I explored leadership behaviors throughout the operating team's OR tasks and if a shared leadership approach is related to psycho-social attitudes and performance of the team. I also investigate surgical teams' engagement in safety related behaviors and if these are related to the team's workflow disruptions. As an exemplar environment, I chose to observe these dynamics in the operating theater, which is a high-stakes environment that necessitates the team to use both technical and non-technical skills. In study 2, I investigate whether a brief targeted leadership coaching sessions with residents in a simulated environment results in different (increase or decrease) leadership behaviors at an interval of 6 months. Multiple hypothesized models were tested in Study 1. The results of model 1 show that psychological safety and team trust are significantly correlated to each other. The results show that psychological safety is related to performance (time of patient on bypass), while team trust does not predict performance. The results of model 2 show that more extensive shared leadership behaviors are not significantly correlated with psychological safety and performance; however, the results show that there is a significant correlation with shared leadership and team trust, indicating that a more extensive shared leadership approach is related to higher team trust in a surgical team. The results of model 3 show that the length of the time-out (a safety critical behavior) does not mediate the relationship between perceptions of the usefulness of the time-out and frequency with which the circulating nurse leaves the operating room (OR). However, there is a strong relationship between the perceptions of the usefulness of the time-out and the number of times the circulating nurse leaves the OR, indicating that for every unit increase in the perceptions of the usefulness of the time-out, the nurse leaves the OR .45 fewer times. In study 2, a paired sample t-test was conducted to understand if leadership behaviors post-coaching session are more frequent than pre-coaching session. The results show that there is no significant difference in the frequency of leadership behaviors at time 1 and the leadership behaviors at time 2."],"dc:description.degree":["Doctor of Philosophy"],"dc:format.medium":["ETD"],"dc:identifier.other":["vt_gsexam:36281"],"dc:identifier.uri":["http://hdl.handle.net/10919/113833"],"dc:language.iso":["en"],"dc:publisher":["Virginia Tech"],"dc:rights":["In Copyright"],"dc:rights.uri":["http://rightsstatements.org/vocab/InC/1.0/"],"dc:subject":["shared leadership","psychological safety","team trust","surgical teams"],"dc:title":["Leadership, Psychological Safety, Team Trust, and Performance: A Study of Surgical Teams"],"dc:type":["Dissertation"],"thesis:degree_discipline":["Psychology"],"thesis:degree_level":["doctoral"],"thesis:degree_name":["Doctor of Philosophy"],"thesis:institution_name":["Virginia Polytechnic Institute and State University"]},"updated_at":"2026-07-22T22:19:22Z"}