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J Surg Res. 2008 Jul;148(1):49-59. doi: 10.1016/j.jss.2008.03.007. Epub 2008 Apr 10.

Transformational, transactional, and passive-avoidant leadership characteristics of a surgical resident cohort: analysis using the multifactor leadership questionnaire and implications for improving surgical education curriculums.

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Department of Management Policy and Community Health, University of Texas School of Public Health, Houston, Texas 77030, USA.



The need for leadership training has become recognized as being highly important to improving medical care, and should be included in surgical resident education curriculums.


Surgical residents (n = 65) completed the 5x-short version of the Multifactor Leadership Questionnaire as a means of identifying leadership areas most in need of training among medical residents. The leadership styles of the residents were measured on 12 leadership scales. Comparisons between gender and postgraduate year (PGY) and comparisons to national norms were conducted.


Of 12 leadership scales, the residents as a whole had significantly higher management by exception active and passive scores than those of the national norm (t = 6.6, P < 0.01, t = 2.8, P < 0.01, respectively), and significantly lower individualized consideration scores than the norm (t = 2.7, P < 0.01). Only one score, management by exception active was statistically different and higher among males than females (t = 2.12, P < 0.05). PGY3-5 had significantly lower laissez-faire scores than PGY1-2 (t = 2.20, P < 0.05). Principal component analysis revealed two leadership factors with eigenvalues over 1.0. Hierarchical regression found evidence of an augmentation effect for transformational leadership.


Areas of resident leadership strengths and weaknesses were identified. The Multifactor Leadership Questionnaire was demonstrated to be a valuable tool for identifying specific areas where leadership training would be most beneficial in the educational curriculum. The future use of this instrument could prove valuable to surgical education training programs.

[Indexed for MEDLINE]

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