Rosalyn C. Richman

Effective faculty preceptoring and mentoring during reorganization of an academic medical center

The experience and lessons learned in the design, implementation and initial evaluation of a demonstration faculty-to-faculty mentoring program, during a time of major institutional reorganization, are described. The question addressed was: Can a voluntary mentoring program be established with minimal resources and be effective in the context of major organizational change? Key design elements included two-tiered programs (one year preceptoring and multi-year mentoring), voluntary participation, and selection of senior faculty members by the junior faculty members. A total of 20% of junior faculty and 30% of senior faculty participated. Faculty indicated the program was worth the time invested, had a positive impact on their professional life and increased productivity. There was high satisfaction with the mentoring relationship, especially the psychosocial mentoring functions, and a trend toward increased retention of minority faculty. Within two years, the program was institutionalized into the Office for Faculty Affairs, and faculty approved a mentoring policy. It is concluded that voluntary mentoring programs can have a positive impact on junior and senior faculty satisfaction, reinvigorate the collegial culture, and improve productivity and retention even during a time of reorganization and minimal resources.

Evaluating a leadership program: a comparative, longitudinal study to assess the impact of the Executive Leadership in Academic Medicine (ELAM) Program for Women.

Purpose The Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) program provides an external yearlong development program for senior women faculty in U.S. and Canadian medical schools. This study aims to determine the extent to which program participants, compared with women from two comparison groups, aspire to leadership, demonstrate mastery of leadership competencies, and attain leadership positions. Method A pre-/posttest methodology and longitudinal structure were used to evaluate the impact of ELAM participation. Participants from two ELAM cohorts were compared with women who applied but were not accepted into the ELAM program (NON) and women from the Association of American Medical Colleges (AAMC) Faculty Roster. The AAMC group was a baseline for midcareer faculty; the NON group allowed comparison for leadership aspiration. Baseline data were collected in 2002, with follow-up data collected in 2006. Sixteen leadership indicators were considered: administrative leadership attainment (four indicators), full professor academic rank (one), leadership competencies and readiness (eight), and leadership aspirations and education (three). Results For 15 of the indicators, ELAM participants scored higher than AAMC and NON groups, and for one indicator they scored higher than only the AAMC group (aspiration to leadership outside academic health centers). The differences were statistically significant for 12 indicators and were distributed across the categories. These included seven of the leadership competencies, three of the administrative leadership attainment indicators, and two of the leadership aspirations and education indicators. Conclusions These findings support the hypothesis that the ELAM program has a beneficial impact on ELAM fellows in terms of leadership behaviors and career progression.

Advancing Women and Closing the Leadership Gap: The Executive Leadership in Academic Medicine (ELAM) Program Experience

Women are persistently underrepresented in the higher levels of academic administration despite the fact that they have been entering the medical profession in increasing numbers for at least 20 years and now make up a large proportion of the medical student body and fill a similar proportion of entry level positions in medical schools. Although there are no easy remedies for gender inequities in medical schools, strategies have been proposed and implemented both within academic institutions and more broadly to achieve and sustain the advancement of women faculty to senior level positions. Substantial, sustained efforts to increase programs and activities addressing the major obstacles to advancement of women must be put in place so that the contributions of women can be fully realized and their skills fittingly applied in meeting the medical education and healthcare needs of all people in the 21st century.

Medical school deans' perceptions of organizational climate: useful indicators for advancement of women faculty and evaluation of a leadership program's impact.

Purpose and Method The authors surveyed U.S. and Canadian medical school deans regarding organizational climate for faculty, policies affecting faculty, processes deans use for developing faculty leadership, and the impact of the Executive Leadership in Academic Medicine (ELAM) Program for Women. Results The usable response rate was 58% (n = 83/142). Deans perceived gender equity in organizational climate as neutral, improving, or attained on most items and deficient on four. Only three family-friendly policies/benefits were available at more than 68% of medical schools; several policies specifically designed to increase gender equity were available at fewer than 14%. Women deans reported significantly more frequent use than men (P = .032) of practices used to develop faculty leadership. Deans’ impressions regarding the impact of ELAM alumnae on their schools was positive (M = 5.62 out of 7), with those having more fellows reporting greater benefit (P = .01). The deans felt the ELAM program had a very positive influence on its alumnae (M = 6.27) and increased their eligibility for promotion (M = 5.7). Conclusions This study provides a unique window into the perceptions of medical school deans, important policy leaders at their institutions. Their opinion adds to previous studies of organizational climate focused on faculty perceptions. Deans perceive the organizational climate for women to be improving, but they believe that certain interventions are still needed. Women deans seem more proactive in their use of practices to develop leadership. Finally, deans provide an important third-party judgment for program evaluation of the ELAM leadership intervention, reporting a positive impact on its alumnae and their schools.

Effects of participation in the Executive Leadership in Academic Medicine (ELAM) program on women faculty's perceived leadership capabilities.

Purpose. This study measured the impact of participation by women academics in the Executive Leadership in Academic Medicine (ELAM) program as part of a robust evaluation agenda. Method. The design is a classic pre/post, within-group, self-report study. The survey elicits self-perception about leadership in ten constructs: knowledge of leadership, management, and organizational theory; environmental scanning; financial management; communication; networking and coalition building; conflict management; general leadership; assessment of strengths and weaknesses; acceptance of leadership demands; and career advancement sophistication. The post surveys inquire additionally about perceived program usefulness. Data were collected from 79 participants (1997–98, 1998–99, and 2000–01 classes). Response rates were nearly 100% (pre) and 69% to 76% (post). Results. Statistically significant increases (p < .01) in perceived leadership capabilities were identified across all ten leadership constructs. Gains were large in knowledge of leadership and organizational theory, environmental scanning, financial management, and general leadership. Gains in career building knowledge were large to moderate. More modest were gains in communication, networking, and conflict management. There were significant correlations between each leadership construct and perceived usefulness of the program. Conclusions. Significant improvements were reported on all leadership constructs, even when participants viewed themselves as already skilled. While it cannot be concluded that participation in ELAM directly and solely caused all improvements, it seems unlikely that midcareer women faculty would improve on all ten constructs in 11 months after program completion by natural maturation alone. Future research will investigate whether the changes are due to ELAM or other factors, and assess whether participants show more rapid advancement into leadership than comparable women not participating in ELAM.

The Leadership Continuum: A Framework for Organizational and Individual Assessment Relative to the Advancement of Women Physicians and Scientists

BACKGROUND In the United States, women have attained near gender equity at the entry stages in academic medicine; however, progress has been much slower at senior leadership levels. The paucity of women leaders inhibits the ability of academic medicine to adequately meet the needs of an increasingly diverse body of students, faculty, staff, and patients. Research indicates that until a critical mass of women with sustained success as leaders is achieved, it is unlikely that this deficit will be corrected. METHODS To promote the attainment of a critical mass of women leaders, the authors integrate two approaches to advancing women--the concept of a leadership continuum and a framework of practical approaches for moving toward gender equity at all ranks. RESULTS An institutional guide is presented that can be used to promote dialogue about gender equity, noting areas of success and opportunities for additional improvement as well as an assessment of progress. A corresponding checklist has been developed that women faculty can use as a reflection guide for their career planning and to assess their position and progress along the leadership continuum. CONCLUSIONS Proactive, ongoing use of these frameworks can promote reflective dialogue and provide direction and accountability for institutions working to advance women into leadership positions.

Advancing Women Faculty to Senior Leadership in U.S. Academic Health Centers: Fifteen Years of History in the Making

In 1993 the Hedwig van Ameringen Executive Leadership in Q1 Academic Medicine (ELAM) program was developed in response to concerns regarding the organizational climate and leadership opportunities available to faculty women within academic health centers. Since that time the ELAM program has garnered a reputation as the premier leadership program for women in academic medicine, dentistry, and public health in the United States and Canada. This article details the design of the program and its curricular components as well as the conceptual framework and strategies that underlie it. The success of the program is demonstrated by demographic data on participants and their institutions; pre and postsurvey research on participants’ and comparison groups’ knowledge and skills; surveys of medical and dental school deans regarding their perceptions of program impact; the leadership career trajectory of ELAM fellows; and the development of leadership programs and numerous consultations based on the ELAM model.

New challenges facing interinstitutional social science and educational program evaluation research at academic health centers: a case study from the ELAM program.

Since the mid-1990s, the protection of human subjects through institutional review boards (IRBs) has progressively broadened in scope. In this case study, the authors describe their challenges in effectively handling IRB processes to conduct educational and social sciences research within academic health centers, particularly (1) complications in conducting longitudinal interinstitutional research that involves multiple IRBs, each with different procedures that changed over ten years; and (2) factors affecting consent form and survey response rates when applying the biomedical IRB process to obtain the consent of human subjects for participation in social and educational research. The authors had a unique opportunity to follow the effect of changes in consent forms (from no form to a one-page form to a three-page form requiring signature of a witness), ways of administration (in person or by mail), and time of administration (at the time of the program or years later) on consent form and survey response rates among medical and dental school faculty members. The authors explore the extended timelines required for data collection and increased costs in dealing with these issues, as well as the effects on response rates of consent form language and administration procedures. The authors recommend strategies to lessen adverse effects of dealing with multiple IRBs at different institutions for social science and educational research, and discuss policy implications for funders, institutions and investigators.

A Window Into the Culture of Leadership Within Higher Education Through the Leadership Definitions of Women Faculty: A Case Study of ELAM Women Faculty Alumnae

This article proposes a thematic framework that can serve as a window for understanding the leadership definitions of women academics, and through these how leadership is articulated, understood, and enacted within the culture of leadership in higher education. Th e framework was generated from analysis of 283 available leadership definitions from classes 1996–2004 provided by Fellows in the Hedwig van Ameringen Executive Leadership in Academic Medicine Program for Women. Definitions were analyzed using Atlas. Ti software by coders and discussants in an iterative process that generated, applied, and challenged findings. Beginning with Rost’s (1991) framework, the project went beyond this to develop a framework derived from the voices of the women that includes: leadership as activities, relationship to followers, envisioning and strategy, traits, communication, infl uence, and transformation. The article closes with application to various groups, notes for future research, and conclusions.