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Leadership Models Teachable and Useful to Surgeons
and Clinicians
Progress has been made in understanding two basic ingredients of leadership behav-
ior: task behavior and relational behavior. Task behavior refers to a leader’s words
and actions used to accomplish the goals, for example:
- Guiding or teaching people how to perform tasks
- Reviewing roles and responsibilities
- Instructing people about goals
- Offering instruction about how to meet deadlines and performance standards
Task behavior occurs when a leader focuses attention on obtaining goals, over-
coming constraints and barriers, and general problem solving.
Relational behavior refers to a leader’s words and actions used to make personal
connections, for example:
- Expressing appreciation for good work
- Listening to understand people’s points of view
- Creating a safe space for people to express opinions
- Listening to people’s ideas and concerns
- Maintaining the group’s self-esteem
- Treating people fairly and with respect
Relational behavior occurs when a leader focuses attention on listening, praising,
recognizing, respecting, and building self-efficacy (or collective efficacy) [ 3 , 4 ].^22
If we put these two elements on a horizontal and vertical axis, we get a two-by-
two table (see Fig. 20.1). By segmenting the two-by-two table into four quadrants,
we can combine these two ingredients and obtain high and low task behavior and
high and low relational behavior.
Now we can define a surgeon (or anyone’s) leadership style. Style is the pattern
of a leader’s behavior in terms of the proportion of task versus relational behavior
as perceived by the people working with that leader. Leadership styles are malleable
and may be altered according to the demands of a situation, resulting in alternative
solutions to various situations.
Figure 20.2 is a visualization of these four quadrants, and represents in more
detail, the four alternative attention structures and styles of leading:
- High task/low relational behavior, a very directive style, called the “teacher.”
- High task/high relational behavior, a persuading and clarifying style with two-
way communication, called the “hub at the center.”
(^22) Professionals may be self-confident, but in some situations, they may feel insecure. Self-efficacy
is a belief in one’s ability to succeed in a specific situation when it involves a task, activity, assign-
ment, or challenging goal. Collective efficacy is also situational; it refers to a group’s belief that
together they have the resources and capabilities to undertake a challenge and to achieve and per-
form (Bandura [ 3 ]; 2010).
J.A. Chilingerian