Leading with Impact: Transformational Leadership Among Women Surgeons - A Qualitative Study.

Purpose: We explored the interdependence of contextual influences and transformational leadership by examining how women surgeons in leadership enact transformational leadership, navigate gender-related challenges, and influence surgical teams. The study further sought to propose key transformational leadership competencies among women surgeons. Patients and Methods: We conducted eight in-depth interviews with women surgeons in leadership positions. Data was analyzed by a sequential combination of thematic analysis and directed content analysis. An inductive approach and interpretation of themes at the semantic level guided thematic analysis. In a second step, transformational leadership served as the underlying theoretical framework for directed content analysis. Results: Participants acknowledge that "gendered perceptions of behavior", the "surgical culture", the "degree of congruence between inclusive policies and their implementation", "endorsement of competence" and the need to "balance private and professional roles" influence how they reach, retain, and shape leadership roles. For women surgeons, transformational leadership competencies significantly shape their leadership style. They emphasize different competencies according to cultural, institutional, or individual context. Conclusion: The way women surgeons conceptualize and shape leadership practices corresponds to the four dimensions of transformational leadership. Organizational dynamics and cultural constructs are key influences on how women surgeons emphasize various competencies of transformational leadership behavior. We propose a transformational leadership competency profile based on these findings.