EMS Leadership Part 5: Idealized Influence Transformational Leadership in EMS

Supportive mentoring and empowering leadership ensure organizational success

This is the fifth in a series of columns on EMS leadership. Dr. Breaux will cover leadership applications such as behavioral, managerial, situational, path-goal, leader-member exchange, full-range transformational and transactional leadership. Other areas like conflict management, effective communications and organization structure will also be addressed.

EMS dispatches ambulance 104 to a major vehicle accident at Post Road and Sinclair Street, with two injured at the scene. Responding time is logged at 1840 hours. EMS Director Linda Thomas in Medic 1 reports to dispatch that she is also responding to the scene. Dispatch replies that her responding time is 1841 hours.

Both ambulance 104 and Medic 1 arrive at the accident scene within five minutes, and Thomas requests law enforcement at the scene for safety and fire to assist in extricating the injured. The two injured were in the same vehicle, which had gone off the road and hit a power pole. Thomas asks the ambulance team, Betty and Jim, to perform initial patient assessment, including spinal stabilization, oxygen and IV treatments, while she manages scene safety. Betty and Jim do not hesitate to perform their duties because they have full trust in Thomas from their previous experience with her on similar EMS calls. They know her objectives are ambulance crew and patient safety; she consistently shares vital operational and environmental risk information with them as needed; she applies appropriate and positive moral and ethical standards and expects the same from other EMS staff, and she is not a power-hungry leader who ignores their personal and professional interests. Thomas is always there for her crews, patients and their families.

Thomas directs traffic until law enforcement arrives, then provides a brief but comprehensive summary of the extrication requirements needed to on-scene fire department personnel. The injured are extricated responsively and safely from the vehicle, stabilized and transported effectively and efficiently to the nearest trauma center while Thomas provides the center with patient-related vital signs and injury assessment obtained from the medics and works with law enforcement to secure the patients' personal property.

Patient outcome was positive and the trauma center staff thanked the ambulance team for their outstanding patient care, which directly influenced patient treatment success. Both Betty and Jim related to hospital staff that they should also thank Linda Thomas for her supportive leadership and effective scene management skills and expertise that she always shares with her EMS staff. Like others in their EMS organization, they believe strongly that supportive, mentoring and empowering leadership is needed to ensure organizational success, as well the success of patient care and providing positive community service support. This is known as "idealized influence" leadership.

Idealized influence is considered an important part of the full-range or transformational leadership model espoused by Bass, Burns and Avolio in 1978. The full-range leadership model includes four leadership factors, also known as the four Is. Transformational leaders, regardless of their organizational position, should apply "individualized consideration," "intellectual stimulation," "inspirational motivation" and "idealized influence" to influence and motivate others from a distance.1

According to Bass and Avolio, transformational leadership is seen when leaders:


  • Stimulate interest among colleagues and followers to view their work from new perspectives
  • Generate awareness of the mission or vision of the team and organization
  • Develop colleagues and followers to higher levels of ability and potential
  • Motivate colleagues and followers to look beyond their own interests toward those that will benefit the group.


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