# The red hat — designating leadership using visual and verbal cues: a mixed-methods study

## TL;DR

This study explores how using a red surgical hat helps identify leaders during emergencies in labor and delivery simulations.

## Contribution

The study introduces the red surgical bouffant hat as an effective visual cue for leadership designation in obstetric emergencies.

## Key findings

- Participants were more likely to use the red hat as a visual cue for leadership than to declare it verbally.
- Using the red hat improved perceptions of team communication during simulated obstetric critical events.

## Abstract

During a critical event in the labor and delivery operating room, it is crucial for team members responding to the situation to be aware of the designated leaders. Visual and verbal cues have been utilized to designate leadership in various healthcare settings; however, previous research has indicated mixed results using visual cues for role designation.

The purpose of this study was to explore the use of the red surgical hat as a visual cue of leadership during obstetric emergency simulation training. We used a mixed-methods design to analyze simulation-based education video and debriefing transcripts.

There was a statistically significant difference in the proportion of participants who declared leadership vs. those who donned the red hat. Participants were more likely to visually declare leadership utilizing a red surgical bouffant hat than to verbally declare leadership. Most participants indicated that observing the red hat to detect leadership in the operating room was more effective than when leaders used a verbal declaration to inform others who was leading.

Our findings suggest that utilizing a visual cue of leadership with the red surgical bouffant hat improves participant perceptions of communication of the surgical team during an obstetrical critical event in a simulation environment.