Luanne E. Thorndyke

Functional Mentoring: A Practical Approach With Multilevel Outcomes

Introduction: Mentoring is a central component of professional development. Evaluation of “successful” mentoring programs, however, has been limited and mainly focused on measures of satisfaction with the relationship. In todays environment, mentoring programs must produce tangible outcomes to demonstrate success. To address this issue, the authors advance the framework of functional mentoring combined with measurement of outcomes at multiple levels. Methods: The mentoring program is embedded within an intensive, continuing medical education (CME) accredited faculty development program. Survey methodology is used to collect qualitative and quantitative data at the start, midpoint, and end of the program and longitudinally. Participants in 4 years of the program were surveyed. Results: In 4 years, 165 faculty participated in the program. Respondents were highly satisfied with the pairings: 85% of junior faculty believed their mentor had a significant effect on their projects. Junior faculty reported a significant enhancement of skills related to initiating and negotiating a new mentoring relationship (85%) and stated that their project would have a significant impact on their career (92%) and on the department or institution (86%). Discussion: The success of this mentoring program is demonstrated at multiple levels. The key outcome of functional mentoring is the project. Projects are aligned with professional responsibilities and with institutional missions. The project contributes to the individuals dossier and adds value to the institution. Functional mentoring is a practical approach that allows measurable results at multiple levels.

The essential value of projects in faculty development.

Projects--planned activities with specific goals and outcomes--have been used in faculty development programs to enhance participant learning and development. Projects have been employed most extensively in programs designed to develop faculty as educators. The authors review the literature and report the results of their 2008 study of the impact of projects within the Pennsylvania State University College of Medicine Junior Faculty Development Program, a comprehensive faculty development program. Using a mixed-methods approach, the products of project work, the academic productivity of program graduates, and the impact of projects on career development were analyzed. Faculty who achieved the most progress on their projects reported the highest number of academic products related to their project and the highest number of overall academic achievements. Faculty perceived that their project had three major effects on their professional development: production of a tangible outcome, development of a career focus, and development of relationships with mentors and peers. On the basis of these findings and a review of the literature, the authors conclude that projects are an essential element of a faculty development program. Projects provide a foundation for future academic success by enabling junior faculty to develop and hone knowledge and skills, identify a career focus and gain recognition within their community, generate scholarship, allocate time to academic work, and establish supportive relationships and collaborative networks. A list of best practices to successfully incorporate projects within faculty development programs is provided.

Perspective: Toward a competency framework for faculty.

Today, faculty in academic medicine face challenges in all three mission areas--research, education, and patient care--and require a broad set of competencies to survive in this changing environment. To support faculty and to design assessments that match new expectations, the authors argue that it is essential to capture the full scope of skills, knowledge, and behaviors necessary for a successful faculty member. Thus, it is timely to explore and define competencies for faculty in academic medicine. The authors describe three approaches to identifying faculty competencies. Each reveals diverse but overlapping sets of competency domains, reflecting the breadth of activities expected of todays faculty. To organize these competencies into a coherent framework, the authors propose a model based on a typology of competency. A key feature of the model is the division between occupational competencies, which are largely role-specific, and personal competencies, which are necessary for all faculty. A competency framework also must be developmental, to reflect the growth in skills, knowledge, and behaviors from trainee to expert and to allow for an individuals changing roles over a career. Such a competency framework will inform professional development activities and require assessment of competence. The generation of competencies also will reveal areas of faculty practice that are poorly measured, requiring new tools to be incorporated into existing processes of faculty evaluation. The authors provide general principles to guide the identification of a competency framework for faculty and invite the academic medicine community to engage in further discussion.

Perspective: Recognizing and rewarding clinical scholarship.

Faculty members in medical schools and academic medical centers are in a constant process of generating new knowledge. The cornerstone of academia--and academic medicine--is scholarship. Traditionally, tenure and/or academic promotion in the professorial ranks is awarded to those who meet institutional criteria in the missions of research, teaching, and service, including patient care. In the academic review process, priority is often placed on a record of demonstrated, consistent success in traditional laboratory research, also known as the scholarship of discovery. More recently, there has been greater recognition of other forms of scholarship: education, application, and integration. These forms of scholarship, although less recognized, also result in the generation of new knowledge. In an attempt to understand the breadth and scope of clinical scholarship, the authors searched the extant literature in academic medicine for a definition of clinical scholarship and expanded the search to disciplines outside of medicine. They found that succinct, discrete definitions of clinical scholarship have been published in other disciplines, but not in academic medicine. After reviewing definitions of clinical scholarship from other disciplines, adapting definitions of educational scholarship in academic medicine, and including qualities unique to clinical scholarship, the authors developed a framework for understanding clinical scholarship in academic medicine as a means for opening a dialogue within the academic medical community. This dialogue hopefully will lead to formulating a succinct, discrete definition of clinical scholarship that will allow greater recognition and reward for clinical scholars in the promotion and tenure process.

Contraceptive requirements for clinical research.

Objective To survey the type and frequency of use of contraceptive requirements for entry into clinical trials. Methods We reviewed 410 protocols submitted between January 1994 and January 1997 to one Institutional Review Board. Results Contraception or sterility for women was required in 171 (41.7%) protocols without explanation and 146 (35.6%) based on study drug. Eight and one half percent had no exclusions. Signature certification of contraceptive use was required in 138 protocols; 230 required certification of understanding requirements; and 101 required two signatures. Signature certification documenting no pregnancy at enrollment was required in 234 protocols. There were no requirements for signatures from male subjects. Celibacy or sexual orientation were not recognized as reasons for waiver from signature requirements. Conclusion The broad application of contraceptive requirements potentially creates disproportionate burdens and access by gender to participation in clinical research. Careful elucidation of methods, timing, and the consent process in order to avoid potential fetal risk and encourage inclusion of hormonally intact women will improve research and access.

Restoring Faculty Vitality in Academic Medicine When Burnout Threatens

Increasing rates of burnout—with accompanying stress and lack of engagement—among faculty, residents, students, and practicing physicians have caused alarm in academic medicine. Central to the debate among academic medicine’s stakeholders are oft-competing issues of social accountability; cost containment; effectiveness of academic medicine’s institutions; faculty recruitment, retention, and satisfaction; increasing expectations for faculty; and mission-based productivity. The authors propose that understanding and fostering what contributes to faculty and institutional vitality is central to preventing burnout during times of change. They first look at faculty vitality and how it is threatened by burnout, to provide a framework for a greater understanding of faculty well-being. Then they draw on higher education literature to determine how vitality is defined in academic settings and what factors affect faculty vitality within the context of academic medicine. Next, they propose a model to explain and examine faculty vitality in academic medicine, followed by a discussion of the need for a greater understanding of faculty vitality. Finally, the authors offer conclusions and propose future directions to promote faculty vitality. The authors encourage institutional decision makers and other stakeholders to focus particular attention on the evolving expectations for faculty, the risk of extensive faculty burnout, and the opportunity to reduce burnout by improving the vitality and resilience of these talented and crucial contributors. Faculty vitality, as defined by the institution, has a critical role in ensuring future institutional successes and the capacity for faculty to thrive in a complex health care economy.

Meeting the Late-Career Needs of Faculty Transitioning Through Retirement: One Institution's Approach

PROBLEM Medical school faculty are aging, but few academic health centers are adequately prepared with policies, programs, and resources (PPR) to assist late-career faculty. The authors sought to examine cultural barriers to successful retirement and create alignment between individual and institutional needs and tasks through PPR that embrace the contributions of senior faculty while enabling retirement transitions at the University of Massachusetts Medical School, 2013-2017. APPROACH Faculty 50 or older were surveyed, programs at other institutions and from the literature (multiple fields) were reviewed, and senior faculty and leaders, including retired faculty, were engaged to develop and implement PPR. Cultural barriers were found to be significant, and a multipronged, multiyear strategy to address these barriers, which sequentially added PPR to support faculty, was put in place. A comprehensive framework of sequenced PPR was developed to address the needs and tasks of late-career transitions within three distinct phases: pre-retirement, retirement, and post-retirement. OUTCOMES This sequential introduction approach has led to important outcomes for all three of the retirement phases, including reduction of cultural barriers, a policy that has been useful in assessing viability of proposed phased retirement plans, transparent and realistic discussions about financial issues, and consideration of roles that retired faculty can provide. NEXT STEPS The authors are tracking the issues mentioned in consultations and efficacy of succession planning, and will be resurveying faculty to further refine their work. This framework approach could serve as a template for other academic health centers to address late-career faculty development.