Leadership Beyond the Manual

A Structured Response to “The Leadership Skills Nobody Teaches”

By: Ivan Gowe

Gantt and Holdsworth are exactly right; as I talk to leaders in Sterile Processing (SPD), Infection Prevention (IP), High-Level Disinfection (HLD), and Quality & Patient Safety (QPS), many became leaders "because they were excellent clinicians, technicians, educators, or subject matter experts." I have heard of many a nurse who came into IP because someone said, "You are smart, you could do this (IP) work." Once in, they are overwhelmed by regulatory pressure, human-factor variability, and constant operational urgency; concerns that are invisible to most front-line staff. Experience, smarts, and traditional management training rarely address the acute emotional, cognitive, and system-level demands present in these fields.

In "The Leadership Skills Nobody Teaches," Gantt and Holdsworth discuss this gap, arguing that leaders must possess deeper competencies, including emotional intelligence, facilitation of psychological safety, systems thinking, and the ability to recognize hidden risks before they evolve into patient-safety events. Many of these soft skills are not well covered in education curricula¹. However, they can be taught and evaluated. This response expands the article's core themes and provides some evidence-based ideas for selecting better leaders, showcasing soft skills on resumes, and developing soft skills in a department and organization.

Selecting Leaders for SPD, IP, HLD, and QPS

Leadership selection must evolve beyond the traditional model of promotions based on long tenure or adept clinicians and technicians. Successful leadership in these areas of the patient safety spectrum requires interpersonal, cognitive, and cultural influence skills that are directly tied to safety outcomes. Here are some approaches to address the gaps raised by Gantt and Holdsworth.

Emotional Intelligence (EI)

Gantt and Holdsworth speak about the value of EI to improving patient safety. Peer-reviewed literature identifies EI as an essential component of effective healthcare leadership^2,3. EI influences communication quality, conflict navigation, burnout recognition, and the ability to interpret team behavioral cues. Many problems in SPD/IP/HLD/QPS are not about technique, but about the fear of speaking up regarding impractical processes and conflicting priorities.

The hiring processes should evaluate EI through scenario-based questions and validated assessment tools, such as Emotional & Social Competency Inventory (ESCI), Emotional Quotient Inventory (EQ-I 2.0), and Mayer-Salovey-Caruso Emotional Intelligence Test, 2^nd. Edition (MSCEIT 2), etc.

Personality tests have been misused in the past, so these tools must be implemented carefully, appropriately, and must not facilitate discrimination. Additionally, when these tools are used often enough, people learn the 'right' answers, so this must be part of a multi-modal candidate evaluation process.

Systems Thinking

One internal hire for SPD manager had a lot of experience in the department. They knew all the pain points and hit the ground running with many solutions. However, their solutions worked for an isolated SPD, not one in a busy hospital with upstream and downstream processes affected by their changes. SPD appeared to improve, but at the expense of the patient experience from admission to discharge.

Long tenure may be beneficial for identifying broken parts of a process, but facilitating departmental solutions that add value to the whole organization requires more than technical aptitude. Effective leaders must understand how human factors influence compliance and how systems behave in ideal and adverse situations. Rote policy recitation will come up short when tasked to diagnose recurring workflow bottlenecks, staff fatigue patterns, or process deviations.

Include real-world scenario-based interview questions to help identify leaders who think beyond checklists. Candidates who are fluent in systems thinking tend to ask, "Why is this happening? Who else is affected? How do we add value to the departmental and organizational customer?" instead of "How do we get them to follow the policy?"

Psychological Safety

Facilities and departments where staff are comfortable speaking up, reporting concerns, and discussing mistakes with their leaders will see better outcomes, build better processes, and have more value-added conversations^4,5. Leaders must understand fear-based behaviors and be able to create cultures where concerns are freely voiced. Selecting leaders who will prioritize transparency, openness, and constructive feedback helps reduce silent failures.

An experienced surgical tech can speak to the need for psychological safety in the surgical suite. This is very different from fostering it in practice. The best leaders exhibit their qualities before they are promoted. Look for evidence of psychological safety in a candidate's word choice, seek examples in interviews with candidates, and references.

Showing Soft Skills on Resumes

Soft skills are essential in healthcare leadership, but it is often difficult for candidates to convey them effectively on a resume. Generic descriptors like "excellent communicator" or "team player" lack the weight of evidence. In a metrics-driven industry, "I lead with emotional intelligence and psychological safety" has less impact than "I increased productivity by 20%." Here are some ways that candidates can shore up their soft skills presentation on a resume.

Quantify Contributions

Career and resume experts argue that quantified soft-skill contributions are significantly more persuasive to hiring managers than vague assertions^6,7. Soft skills should be tied to measurable results, such as decreased turnover, improved audit scores, or enhanced safety indicators. For example, instead of "Strong communicator," say, "Facilitated interdepartmental huddles that reduced OR-SPD communication-related defects by 28%."

When exact metrics are unavailable, candidates should provide specific scope (number of staff or stakeholders), frequency (daily or weekly cadence), and concrete outputs (training programs, dashboards, policies authored). Resume experts recommend these approaches to maintain clarity and credibility even without hard data⁷.

Use CAR/STAR

CAR (Context–Action–Result) or STAR (Situation–Task–Action–Result) structures are preferred in leadership resumes because they provide a narrative anchored in outcomes. They maintain narrative clarity while supporting measurable statements. For example:

• Context: SPD audits showed increased documentation errors.
• Action: Redesigned relevant job aids and provided coaching.
• Result: Increased compliance from 72% to 91% over four months.

Developing Leadership Soft Skills Using Evidence-Based Methods

Some soft skills can be developed through structured training, assessment tools, and real-world practice. The following evidence-based methods can be implemented on a personal and corporate level.

Emotional Intelligence Training

A systematic review and meta-analysis of EI interventions across healthcare workers demonstrated that all included studies found increased EI following training⁸. The effect of education is likely falsely magnified by the limitations of the included studies; however, the evidence clearly supports EI training as an effective developmental strategy.

EI programs commonly include self-reflection, group interaction, coaching, and scenario-based practice. Ideally, such training must be required of all staff, and classes should include multiple departments. This provides an opportunity to simulate the multidisciplinary environment of healthcare; what better opportunity is there for a housekeeping tech to practice speaking up to a senior leader? When all staff attend the same class, it creates a common language so that accountability is built into the program. Such training is more approachable when it is provided by expertly trained facility staff. It is easier to buy into a program presented by a fellow employee who knows the organizational pain points, whose livelihood is affected by the success or failure of this program, versus shiny outside vendors who 'know very little about us'.

Using Validated Soft-Skill Assessment Tools

Validated tools help individuals understand soft-skill strengths and development needs. The Emotional and Social Competency Inventory (ESCI) and the Multiple Soft Skills Assessment Tool (MSSAT) provide structured measurement of competencies such as conflict management, interpersonal communication, decision-making style, and moral integrity⁹. These tools can be integrated into leadership development programs, coaching frameworks, and performance reviews. It is prudent for the organization to ensure non-discriminatory use of such tools.

Experiential Learning and Real-World Practice

Training is most effective when paired with real-world application. Leaders and staff in technical healthcare areas benefit from:

• Bi-directional shadowing – leaders shadow frontline workers, and frontline workers (especially those with leadership aspirations) shadow leaders.
• All members of a department should regularly participate in interdisciplinary huddles and lead department-specific huddles.
• Practicing conflict resolution with guided facilitation
• Engaging in reflective debriefs after critical events.

These experiences build the knowledge essential for navigating complex, people-dependent workflows. Including leaders and staff in such training teaches empathy, increases understanding of the shortcomings of the system, and builds up aspiring leaders.

After training, skills must be practiced consistently to reinforce learned behaviors and develop an organizational culture. This is facilitated by using consistent language, coaching, feedback, and transparency. When soft-skill development is culturally expected rather than optional, aspiring leaders grow more quickly, and teams respond with greater engagement, safety, and consistency.

Conclusion

Leadership in SPD, IP, HLD, and QPS demands advanced soft skills that traditional leadership programs rarely teach. Selecting leaders with strong EI and systems thinking who foster psychological safety improves outcomes and process effectiveness and reduces hidden risk. Demonstrating soft skills on resumes requires measurable evidence tied to outcomes. Developing soft skills relies on structured EI training, validated assessments, coaching, and real-world practice. These competencies influence patient safety, regulatory readiness, staff well-being, and operational consistency. As healthcare grows more complex, organizations must elevate leadership expectations, ensuring leaders understand people as deeply as they understand processes.

Guest Author, Ivan Gowe (Go-weh) has a Bachelor of Science in Medical Technology from Concord University in Athens, WV. He is a certified Medical Lab Scientist through the American Society for Clinical Pathology. He worked in a hospital lab for 4 years before joining the IP team. While in IP, he earned a Master of Science in Integrated Science and Technology from James Madison University in Harrisonburg, VA and was certified in Infection Prevention and Control through CBIC. He is a Certified Professional of Healthcare Quality through NAHQ and is a Fellow of APIC. When Ivan is not working, he enjoys running in the woods, lifting heavy things, and putting them down again in his garage gym, riding his motorcycle when the pollen count is low, cooking, and playing video games with his wife. He is attempting to become a donut connoisseur who runs ultra-marathons.

*Disclaimer: The information shared in this article is that of the author(s) and should be reviewed by the consumer as that written by an independent party to CS Medical or in conjunction with CS Medical staff. The article may or may not directly represent any employer, company, or third party, and are solely that of the individual(s) or contributors themselves.

Reference List

1. Villegas C. A systematic review of research on soft skills for employability. Advanced Education. 2024;25. doi:10.20535/2410-8286.314064


2. Mintz LJ, Stoller JK. A systematic review of physician leadership and emotional intelligence. J Grad Med Educ. 2014;6(1):21-31.


3. Sharma N, Amirthalingam B, Joshi P. The emerging role of emotional intelligence in healthcare leadership: a scoping review. Leadership in Health Services. 2026;39(3):459-482.


4. Montgomery A, Chalili V, Lainidi O, Mouratidis C, Maliousis I, Paitaridou K, et al. Psychological safety and patient safety: a systematic and narrative review. PLoS One. 2025;20(4):e0322215.


5. McCartney J. Psychological safety in the OR improves outcomes and performance. Bull Am Coll Surg. 2024;109(5). 3


6. Smith J. How to quantify soft-skill impact with real-world data. Resumly.ai. Published October 25, 2025. Accessed 2026.


7. Chen A. Quantifying the unquantifiable: how to turn soft skills into resume metrics. CV4Me. Published January 13, 2026. Accessed 2026.


8. Powell C, Brown T, Yap Y, Hallam K, Takac M, Quinlivan T, Xenos S, Karimi L. Emotional intelligence training among the healthcare workforce: a systematic review and meta-analysis. Front Psychol. 2024;15:1437035.


9. Colledani D, Robusto E, Anselmi P. Assessing key soft skills in organizational contexts: development and validation of the multiple soft skills assessment tool (MSSAT). Front Psychol. 2024;15:1405822.