Leadership and interprofessional team management — formative SAQs

SAQ 1 — Leading a paediatric resuscitation team (10 marks)

A four-year-old arrests on the ward. You arrive first as the senior registrar. There are two nurses, a resident and a pharmacist present, and the parents are at the bedside. Describe how you would lead this team in the first minutes. [4] [11]

Questions

1. Describe your immediate actions to establish team leadership and role allocation in the first 60 seconds. (3 marks) [4]
2. Explain how you would use closed-loop communication and a shared mental model during the resuscitation, and why each matters. (4 marks) [2] [11]
3. State two concrete actions you would take to flatten the authority gradient so a junior can speak up, and what you would do after the event to help the team learn. (3 marks) [4] [14]

Model answer

Establishing leadership and roles (3). I would declare myself team leader out loud ("I am taking the role of team leader"), stand back far enough to see the whole bed space and the monitors but close enough to direct, and allocate roles by name and task: one person on airway, one doing compressions, one on drugs drawing up as I call each dose, and one as scribe and time-keeper. A leader who is also doing compressions has stopped leading; my job is to run the team and think ahead, not to perform the tasks. [4] [11]

Closed-loop communication and shared mental model (4). For every dose and critical task I would use closed-loop communication: I state the message, the receiver reads it back, and I confirm — this guarantees the dose and recipient were heard correctly and prevents a dose being missed or doubled. Every minute or two I would run a structured pause to share the mental model: who the child is, the working diagnosis, the current plan, who is doing what, and the next contingency. A shared mental model keeps five people coordinated as the picture changes; without it each works from a different assumption and tasks are duplicated or omitted. [2] [4]

Flattening the gradient and learning (3). To flatten the authority gradient I would invite speak-up by name ("If anyone sees something wrong, please say it — that includes the student") and respond well the first time someone does, because a poor response silences the team permanently. After the event I would run a short structured debrief — what went well, what we learned, what we will change — and I would check on the team members and the parents, because a clinician harmed by an adverse event (a second victim) needs structured support, not blame. [4] [14]