Power and conflict: the effect of a superior's interpersonal behaviour on trainees' ability to challenge authority during a simulated airway emergency.
In this simulation study, residents were exposed to a standardized attending anesthesiologist making incorrect decisions. The communication style of the attending was scripted to either be more hierarchical or more inclusive in order to examine whether the leader's communication style contributed to the likelihood of residents speaking up. The authors found no significant differences in residents' likelihood of speaking up based on communication style, suggesting that other interventions are needed to address this aspect of safety culture.