Deborah Finstad

A theoretical, practical, predictive model of faculty and department research productivity.

Purpose Although numerous characteristics impact faculty research productivity, and although researchers have suggested comprehensive theoretical models to explain the relationship between these characteristics and levels of faculty research productivity, few studies have assessed these models. This study tests the ability of the Bland et al. (2002) model—based on individual, institutional, and leadership variables influencing faculty research productivity—to explain individual and group (department) research productivity within the context of a large medical school. Method This study used data from a University of Minnesota Medical School—Twin Cities vitality survey conducted in 2000 that had a response rate of 76% (n = 465 faculty). A statistical software package was used to conduct t tests, logistic regressions, and multiple regressions on these data. Results The validity of faculty, department, and leadership characteristics identified in the Bland et al. (2002) model were confirmed as necessary for high levels of research productivity. Faculty productivity was influenced more by individual and institutional characteristics; group productivity was more affected by institutional and leadership characteristics. Conclusion The characteristics and groupings (individual, institutional, and leadership) in the Bland et al. (2002) model predict faculty research productivity. Research productivity is influenced by the interaction of the three broad groupings, and it is the dynamic interplay of individual and institutional characteristics, supplemented with effective leadership, that determines the productivity of individuals and departments.

The Impact of Appointment Type on the Productivity and Commitment of Full-Time Faculty in Research and Doctoral Institutions

A paradigm shift in the use of faculty appointment types is occurring in academia. Using National Study of Postsecondary Faculty data, this study examines the influence of appointment type on faculty productivity—research and education—and commitment at Research and Doctoral institutions. All full-time faculty and a subset based on experience comprised the samples.

Organizational climate and family life: how these factors affect the status of women faculty at one medical school.

Purpose To compare men and women faculty’s family situations and perceptions of organizational climate. Method In 2005, the authors sent an electronic survey to full-time faculty at the University of Minnesota Medical School to assess their perceptions of professional relationships, mentoring, obstacles to satisfaction, policies, circumstances that contribute to departure, gender equality, family situations, and work life. Results Of 615 faculty, 354 (57%) responded. Women and men were equally productive and worked similar total hours. Women were less likely to have partners/spouses, were more likely to have partners/spouses who were employed, and devoted more time to household tasks. Compared with men, women reported more experience with obstacles to career success and satisfaction and with circumstances that contribute to departure. More women than men perceived that they were expected to represent the perspective of their gender, that they were constantly under scrutiny by colleagues, that they worked harder than colleagues worked in order to be perceived as legitimate, and that there were “unwritten rules” and bias against women. Few faculty reported overt discrimination; however, more women than men perceived gender discrimination in promotion, salary, space/resources, access to administrative staff, and graduate student/fellow assignment. Conclusions Work–life and family–life factors served as obstacles to satisfaction and retention of the women faculty studied. Many of these factors reflect challenges attributable to subtle gender bias and the intersection of work and family life. The authors provide examples showing that medical schools can implement policy changes that support faculty who must balance work and family responsibilities. Identification and elimination of gender bias in areas such as promotion, salary, and resource allocation is essential.

Menstrual phase effects on smoking relapse.

AIMS To examine if menstrual phase affects relapse in women attempting to quit smoking. DESIGN An intent-to-treat randomized smoking cessation trial where women were assigned to quit smoking in either the follicular (F) or luteal (L) menstrual phase and were followed for up to 26 weeks. They were assessed for relapse by days to relapse and relapse phase to determine if those who begin a quit attempt during the F phase were more successful than those who begin during the L phase. SETTING Tobacco Use Research Center, University of Minnesota, Minneapolis, Minnesota. PARTICIPANTS A total of 202 women. MEASUREMENTS Latency to relapse from continuous and prolonged abstinence, point prevalence, phase of relapse, first slip within the first 3 and 5 days post-quit date, subject completion rates and symptomatology (i.e. withdrawal and craving). FINDINGS The mean days to relapse from continuous abstinence and relapse from prolonged abstinence for the F group were 13.9 and 20.6 days, respectively, and 21.5 and 39.2 days, respectively, for the L group. Using point prevalence analysis at 14 days, 84% of the F group had relapsed compared with 65% of the L group [chi(2)=10.024, P=0.002; odds ratio (OR) = 2.871, 95% confidence interval (CI), 1.474-5.590]. At 30 days, 86% of the F group relapsed, compared with 66% of the L group (chi(2)=11.076, P=0.001; OR=3.178, 95% CI, 1.594-6.334). CONCLUSION Women attempting to quit smoking in the F phase had less favorable outcomes than those attempting to quit in the L phase. This could relate to ovarian hormones, which may play a role in smoking cessation for women.

Recruitment and Retention of Rural Physicians: Outcomes From the Rural Physician Associate Program of Minnesota

CONTEXT Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation. Projects designed to bring value to the community, including an evidence-based practice and community health assessment, are completed. PURPOSE To examine RPAP outcomes in recruiting and retaining rural primary care physicians. METHODS The RPAP database, including moves and current practice settings, was examined using descriptive statistics. FINDINGS On average, 82% of RPAP graduates have chosen primary care, and 68% family medicine. Of those currently in practice, 44% have practiced in a rural setting all of the time, 42% in a metropolitan setting and 14% have chosen both, with more than 50% of their time in rural practice. Rural origin has only a small association with choosing rural practice. CONCLUSION RPAP data suggest that the 9-month longitudinal experience in a rural community increases the number of students choosing primary care practice, especially family medicine, in a rural setting.

Efforts to graduate more primary care physicians and physicians who will practice in rural areas: Examining outcomes from the university of Minnesota-Duluth and the rural physician associate program

Purpose To compare practice choices (primary care or specialty) and practice locations (rural or metropolitan) of medical students at the Duluth and Twin Cities (Minneapolis and St. Paul; TC) campuses of the University of Minnesota (UMN). In the early 1970s, Minnesota created two medical education programs at UMN to increase the number of rural and primary care physicians: the first two years of medical school at UMN–Duluth, where the program focuses on recruiting students who will be rural family physicians, and the Rural Physician Associate Program (RPAP) elective, a nine-month, longitudinal immersion experience with a preceptor in a rural community. Method In 2008, the authors analyzed outcomes for four student groups: (1) UMN–Duluth and (2) UMN–TC medical students who participated in RPAP and (3) UMN–Duluth and (4) UMN–TC students who did not participate in RPAP. UMN medical students complete their first two years on either campus; they can apply to RPAP for their third year. Non-RPAP students spend most of their third- and fourth-year rotations in the Twin Cities metropolitan area. Results The UMN–Duluth and RPAP students were most likely to select a rural location and primary care practice. UMN–TC, non-RPAP students followed national trends, choosing predominantly metropolitan and specialty practices. Conclusions RPAP and UMN–Duluth provide significant, complementary educational programs that lead more graduates to choose rural and primary care practices. Efforts across the nation to address the crisis in rural primary care should build on these successful efforts.

Relating mentor type and mentoring behaviors to academic medicine faculty satisfaction and productivity at one medical school.

Purpose To examine relationships among having formal and informal mentors, mentoring behaviors, and satisfaction and productivity for academic medicine faculty. Method In 2005, the authors surveyed full-time faculty at the University of Minnesota Medical School to assess their perceptions of variables associated with job satisfaction and productivity. This analysis focused on perceptions of mentoring as related to satisfaction with current position and productivity (articles published in peer-reviewed journals [article production] and role as a primary investigator [PI] or a co-PI on a grant/contract). Results Of 615 faculty, 354 (58%) responded. Satisfied faculty were not necessarily productive, and vice versa. Outcomes differed somewhat for mentor types: Informal mentoring was more important for satisfaction, and formal mentoring was more important for productivity. Regardless of mentor type, the 14 mentoring behaviors examined related more to satisfaction than productivity. Only one behavior—serves as a role model—was significantly, positively related to article production. Although participants reported that formal and informal mentors performed the same mentoring behaviors, mentees were more satisfied or productive when some behaviors were performed by formal mentors. Conclusions The results emphasize the importance of having both formal and informal mentors who perform mentoring behaviors associated with satisfaction and productivity. The results provide a preliminary indication that mentor types and specific mentoring behaviors may have different effects on satisfaction and productivity. Despite the differences found for some behaviors, it seems that it is more essential that mentoring behaviors be performed by any mentor than by a specific type of mentor.

An adaptive approach to facilitating research productivity in a primary care clinical department.

Efforts to foster the growth of a department’s or school’s research mission can be informed by known correlates of research productivity, but the specific strategies to be adopted will be highly context-dependent, influenced by local, national, and discipline-specific needs and resources. The authors describe a multifaceted approach—informed by a working model of organizational research productivity—by which the University of Minnesota Department of Family Medicine and Community Health (Twin Cities campus) successfully increased its collective research productivity during a 10-year period (1997–2007) and maintained these increases over time. Facing barriers to recruitment of faculty investigators, the department focused instead on nurturing high-potential investigators among their current faculty via a new, centrally coordinated research program, with provision of training, protected time, technical resources, mentoring, and a scholarly culture to support faculty research productivity. Success of these initiatives is documented by the following: substantial increases in the department’s external research funding, rise to a sustained top-five ranking based on National Institutes of Health funding to U.S. family medicine departments, later-stage growth in the faculty’s publishing record, increased research capacity among the faculty, and a definitive maturation of the department’s research mission. The authors offer their perspectives on three apparent drivers of success with broad applicability—namely, effective leadership, systemic culture change, and the self-awareness to adapt to changes in the local, institutional, and national research environment.

Recruitment and Retention of Rural Physicians of Rural Physicians: Outcomes From the Rural Physician Associate Program of Minnesota

CONTEXT Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation. Projects designed to bring value to the community, including an evidence-based practice and community health assessment, are completed. PURPOSE To examine RPAP outcomes in recruiting and retaining rural primary care physicians. METHODS The RPAP database, including moves and current practice settings, was examined using descriptive statistics. FINDINGS On average, 82% of RPAP graduates have chosen primary care, and 68% family medicine. Of those currently in practice, 44% have practiced in a rural setting all of the time, 42% in a metropolitan setting and 14% have chosen both, with more than 50% of their time in rural practice. Rural origin has only a small association with choosing rural practice. CONCLUSION RPAP data suggest that the 9-month longitudinal experience in a rural community increases the number of students choosing primary care practice, especially family medicine, in a rural setting.

Recruitment and retention of rural physicians

CONTEXT Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation. Projects designed to bring value to the community, including an evidence-based practice and community health assessment, are completed. PURPOSE To examine RPAP outcomes in recruiting and retaining rural primary care physicians. METHODS The RPAP database, including moves and current practice settings, was examined using descriptive statistics. FINDINGS On average, 82% of RPAP graduates have chosen primary care, and 68% family medicine. Of those currently in practice, 44% have practiced in a rural setting all of the time, 42% in a metropolitan setting and 14% have chosen both, with more than 50% of their time in rural practice. Rural origin has only a small association with choosing rural practice. CONCLUSION RPAP data suggest that the 9-month longitudinal experience in a rural community increases the number of students choosing primary care practice, especially family medicine, in a rural setting.