Magali Fassiotto

Organizations as Fonts of Entrepreneurship

Most entrepreneurs emanate from established organizations, yet systematic theorizing about the ways in which organizations shape the entrepreneurial process has only recently begun to emerge. We provide a framework for organizing this emerging literature. We focus on four different metaphors in the literature for how organizations matter in the entrepreneurial process and suggest promising avenues for future research.

Reducing Implicit Gender Leadership Bias in Academic Medicine With an Educational Intervention

Purpose One challenge academic health centers face is to advance female faculty to leadership positions and retain them there in numbers equal to men, especially given the equal representation of women and men among graduates of medicine and biological sciences over the last 10 years. The purpose of this study is to investigate the explicit and implicit biases favoring men as leaders, among both men and women faculty, and to assess whether these attitudes change following an educational intervention. Method The authors used a standardized, 20-minute educational intervention to educate faculty about implicit biases and strategies for overcoming them. Next, they assessed the effect of this intervention. From March 2012 through April 2013, 281 faculty members participated in the intervention across 13 of 18 clinical departments. Results The study assessed faculty members’ perceptions of bias as well as their explicit and implicit attitudes toward gender and leadership. Results indicated that the intervention significantly changed all faculty members’ perceptions of bias (P < .05 across all eight measures). Although, as expected, explicit biases did not change following the intervention, the intervention did have a small but significant positive effect on the implicit biases surrounding women and leadership of all participants regardless of age or gender (P = .008). Conclusions These results suggest that providing education on bias and strategies for reducing it can serve as an important step toward reducing gender bias in academic medicine and, ultimately, promoting institutional change, specifically the promoting of women to higher ranks.

Category Signaling and Reputation

We propose that category membership can operate as a collective market signal for quality when low-quality producers face higher costs of gaining membership. The strength of membership as a collective signal increases with the sharpness of the category boundary, that is, contrast. Our empirical study focuses on biodynamic and organic viticulture in Alsace.

Women in Academic Medicine: Measuring Stereotype Threat Among Junior Faculty

BACKGROUND Gender stereotypes in science impede supportive environments for women. Research suggests that womens perceptions of these environments are influenced by stereotype threat (ST): anxiety faced in situations where one may be evaluated using negative stereotypes. This study developed and tested ST metrics for first time use with junior faculty in academic medicine. METHODS Under a 2012 National Institutes of Health Pathfinder Award, Stanford School of Medicines Office of Diversity and Leadership, working with experienced clinicians, social scientists, and epidemiologists, developed and administered ST measures to a representative group of junior faculty. RESULTS 174 School of Medicine junior faculty were recruited (62% women, 38% men; 75% assistant professors, 25% instructors; 50% white, 40% Asian, 10% underrepresented minority). Women reported greater susceptibility to ST than did men across all items including ST vulnerability (p < 0.001); rejection sensitivity (p = 0.001); gender identification (p < 0.001); perceptions of relative potential (p = 0.048); and, sense of belonging (p = 0.049). Results of career-related consequences of ST were more nuanced. Compared with men, women reported lower beliefs in advancement (p = 0.021); however, they had similar career interest and identification, felt just as connected to colleagues, and were equally likely to pursue careers outside academia (all p > 0.42). CONCLUSIONS Innovative ST metrics can provide a more complete picture of academic medical center environments. While junior women faculty are susceptible to ST, they may not yet experience all of its consequences in their early careers. As such, ST metrics offer a tool for evaluating institutional initiatives to increase supportive environments for women in academic medicine.

Occupational Radiation Exposure during Pregnancy: A Survey of Attitudes and Practices among Interventional Radiologists

PURPOSE To assess attitudes of interventional radiologists toward occupational ionizing radiation exposure in pregnancy and to survey practice patterns and outcomes. MATERIALS AND METHODS A 34-question anonymous online survey on attitudes and work practices toward interventional radiologists who worked during pregnancy was sent to active SIR members, including 582 women. RESULTS There were 534 (10%) respondents, including 142 women and 363 men. Among respondents, men were statistically older than women (P < .001) and had practiced interventional radiology (IR) longer (P < .001). Of female interventional radiologists, 55% had worked during pregnancy and reported no specific mutagenic events in their offspring. Spontaneous abortions (11%) and use of reproductive technology (17%) matched that of women with similar age and socioeconomic background. Although more women changed their work practice because of concerns of occupational exposure than men (23% vs 13%), this change was largely limited to the duration of a pregnancy. Among pregnant interventional radiologists, 4 (6%) completely abstained from performing fluoroscopically guided interventions (FGIs), whereas 31 (46%) continued to spend > 80% of their work week doing FGIs with additional protection. Perceptions of impact of pregnancy on daytime work redistribution varied significantly with gender (P < .001); however, perceptions regarding impact of pregnancy on on-call hours, distribution of complex cases, and need to hire for temporary coverage were similar between the genders. CONCLUSIONS Most pregnant interventional radiologists continue to practice IR while pregnant. Pregnancy and fetal outcomes parallel that of the general population when matched for demographics. However, perceptions of impact of pregnancy on work lives of colleagues vary notably.

Designing a physician leadership development program based on effective models of physician education

Background: Because of modern challenges in quality, safety, patient centeredness, and cost, health care is evolving to adopt leadership practices of highly effective organizations. Traditional physician training includes little focus on developing leadership skills, which necessitates further training to achieve the potential of collaborative management. Purpose: The aim of this study was to design a leadership program using established models for continuing medical education and to assess its impact on participants’ knowledge, skills, attitudes, and performance. Methodology/Approach: The program, delivered over 9 months, addressed leadership topics and was designed around a framework based on how physicians learn new clinical skills, using multiple experiential learning methods, including a leadership active learning project. The program was evaluated using Kirkpatrick’s assessment levels: reaction to the program, learning, changes in behavior, and results. Four cohorts are evaluated (2008–2011). Results: Reaction: The program was rated highly by participants (mean = 4.5 of 5). Learning: Significant improvements were reported in knowledge, skills, and attitudes surrounding leadership competencies. Behavior: The majority (80%–100%) of participants reported plans to use learned leadership skills in their work. Improved team leadership behaviors were shown by increased engagement of project team members. Results: All participants completed a team project during the program, adding value to the institution. Conclusion: Results support the hypothesis that learning approaches known to be effective for other types of physician education are successful when applied to leadership development training. Across all four assessment levels, the program was effective in improving leadership competencies essential to meeting the complex needs of the changing health care system. Practice implications: Developing in-house programs that fit the framework established for continuing medical education can increase physician leadership competencies and add value to health care institutions. Active learning projects provide opportunities to practice leadership skills addressing real word problems.

Reasons for faculty departures from an academic medical center: a survey and comparison across faculty lines

BackgroundFaculty departure can present significant intellectual costs to an institution. The authors sought to identify the reasons for clinical and non-clinical faculty departures at one academic medical center (AMC).MethodIn May and June 2010, the authors surveyed 137 faculty members who left a west coast School of Medicine (SOM) between 1999 and 2009. In May and June 2015, the same survey was sent to 40 faculty members who left the SOM between 2010-2014, for a total sample size of 177 former faculty members. The survey probed work history and experience, reasons for departure, and satisfaction at the SOM versus their current workplace. Statistical analyses included Pearson’s chi-square test of independence and independent sample t-tests to understand quantitative differences between clinical and non-clinical respondents, as well as coding of qualitative open-ended responses.ResultsEighty-eight faculty members responded (50%), including three who had since returned to the SOM. Overall, professional and advancement opportunities, salary concerns, and personal/family reasons were the three most cited factors for leaving. The average length of time at this SOM was shorter for faculty in clinical roles, who expressed lower workplace satisfaction and were more likely to perceive incongruence and inaccuracy in institutional expectations for their success than those in non-clinical roles. Clinical faculty respondents noted difficulty in balancing competing demands and navigating institutional expectations for advancement as reasons for leaving.ConclusionsAMCs may not be meeting faculty needs, especially those in clinical roles who balance multiple missions as clinicians, researchers, and educators. Institutions should address the challenges these faculty face in order to best recruit, retain, and advance faculty.

LOUD AND CLEAR: THE EFFECT OF PROTEST SIGNALS ON CONGRESSIONAL ATTENTION*

We examine the effect of public protest on policy by considering how protests may matter to lawmakers. Research on this topic suggests that protest signals information to lawmakers about citizen preferences. Empirical work finds that the strength of the signal sent by protest can influence its effectiveness in achieving desired policy goals. We build on this insight by arguing that signal clarity is also important. Public protests sending focused and clear messages to lawmakers are more likely to impact policy than protests with unfocused messages. Using data on womens protests from 1961–1995, we confirm past findings on the importance of signal strength and find support for our new argument about the importance of signal clarity.

Pulled in Too Many Directions: The Causes and Consequences of Work-Work Conflict:

Previous research has documented the influence of overwork and inflexible hours on work-life conflict for working professionals. In this paper, we build on this literature and explore the novel theoretical concept of work-work conflict, a form of inter-role conflict analogous to work-life conflict. Drawing on 48 in-depth interviews with 42 physicians and survey data of 60 faculty at a prominent west-coast academic medical center, we find that work-work conflict is fueled by institutional structural characteristics. Institutional incentives, the extent of recognition for various work activities, and financial rewards are misaligned, causing physicians to experience competing demands across multiple organizational missions (research, teaching, clinical care, and administration/service). Other industries may face similar conditions leading to work-work conflict. We conclude that work-life interventions are necessary but not sufficient to increase employee satisfaction, and that mechanisms to alleviate work-work conflict must be incorporated in practical solutions to address burnout.

A long-term follow-up of a physician leadership program

Purpose Physician leadership programs serve to develop individual capabilities and to affect organizational outcomes. Evaluations of such programs often focus solely on short-term increases in individual capabilities. The purpose of this paper is to assess long-term individual and organizational outcomes of the Stanford Leadership Development Program. Design/methodology/approach There are three data sources for this mixed-methods study: a follow-up survey in 2013-2014 of program participants ( n=131) and matched (control) non-participants ( n=82) from the 2006 to 2011 program years; promotion and retention data; and qualitative in-person interview data. The authors analyzed survey data across leadership knowledge, skills, and attitudes as well as leadership titles held, following program participation using Pearsons χ2 test of independence. Using logistic regression, the authors analyzed promotion and retention among participants and non-participants. Finally, the authors applied both a grounded theory approach and qualitative content analysis to analyze interview data. Findings Program participants rated higher than non-participants across 25 of 30 items measuring leadership knowledge, skills, and attitudes, and were more likely to hold regional/national leadership titles and to have gained in leadership since program participation. Asian program participants were significantly more likely than Asian non-participants to have been promoted, and women participants were less likely to have left the institution than non-participants. Finally, qualitative interviews revealed the long-term impact of leadership learning and networking, as well as the enduring, sustained impact on the organization of projects undertaken during the program. Originality/value This study is unique in its long-term and comprehensive mixed-methods nature of evaluation to assess individual and organizational impact of a physician leadership program.