Background: As the nominated or self –appointed leader of the surgical team, surgeons must demonstrate leadership along with technical excellence, in order to optimize performance and maximize patient safety in the operating room (OR). Method: A total of ten operating room discipline-specific focus groups from three hospitals in Scotland discussed intraoperative leadership. Surgeons’ leadership behaviors were extracted from the focus groups and used to develop a preliminary taxonomy which was independently checked by six surgeons for accuracy and face validity. It was then used to code video recordings (n = 5) of live operations, to test interrater reliability of the leadership taxonomy. Results: Eight categories of surgeons’ intraoperative leadership were identified from the focus groups. Overall interrater reliability was acceptable (kappa = .7). Discussion: The taxonomy is empirically grounded in focus group data as well as both the psychological and surgical leadership literature. The reliability of the system is acceptable. Future research should test the taxonomy to evaluate intraoperative leadership, in order to design a tool for training surgeons in intraoperative leadership.
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