There are many leadership theories that dominate the field of Industrial and Organizational Psychology, however there is a lack of understanding as to which leadership processes may be most appropriate for action teams in high stress environments. Previous research has articulated leadership behaviors, but has largely ignored the temporal processes of leadership, and how it changes throughout the operating team’s tenure. The proposed study investigates two types of leadership, namely shared and autocratic leadership, that take place during critical steps of the perioperative process and relates these leadership behaviors to team dynamics and psychological processes. Specifically, this study builds upon other studies by testing how leadership behaviors are related to levels of psychological safety and the optimization of teamwork and communication among team members. We were also interested in understanding if the surgeon’s perception of past performance of their team has an impact on the amount of trust the leader has in his/her team and if this in turn, has an impact on the type of leadership utilized during the team’s tenure. As an exemplar environment, we explored these dynamics in the operating theater, which is a high stakes environment requiring both technical and non-technical skills, such as leadership, communication, and teamwork. Results show that the correlation between the surgeon’s perceived past performance of the team and the trust the surgeon has in his/her team and the relationship between team’s trust and teamwork and communication were significant at the alpha =.1 level. All other relationships were non-significant.