Sharon M. Knight

Mentoring faculty in academic medicine. A new paradigm

In this paper, we discuss an alternative structure and a broader vision for mentoring of medical faculty. While there is recognition of the need for mentoring for professional advancement in academic medicine, there is a dearth of research on the process and outcomes of mentoring medical faculty. Supported by the literature and our experience with both formal dyadic and group peer mentoring programs as part of our federally funded National Center of Leadership in Academic Medicine, we assert that a group peer, collaborative mentoring model founded on principles of adult education is one that is likely to be an effective and predictably reliable form of mentoring for both women and men in academic medicine.

Facilitating scholarly writing in academic medicine

Scholarly writing is a critical skill for faculty in academic medicine; however, few faculty receive instruction in the process. We describe the experience of 18 assistant professors who participated in a writing and faculty development program which consisted of 7 monthly 75-minute sessions embedded in a Collaborative Mentoring Program (CMP). Participants identified barriers to writing, developed personal writing strategies, had time to write, and completed monthly writing contracts. Participants provided written responses to open-ended questions about the learning experience, and at the end of the program, participants identified manuscripts submitted for publication, and completed an audiotaped interview. Analysis of qualitative data using data reduction, data display, and conclusion drawing/verification showed that this writing program facilitated the knowledge, skills, and support needed to foster writing productivity. All participants completed at least 1 scholarly manuscript by the end of the CMP. The impact on participants’ future academic productivity requires long-term follow-up.

A study of the relational aspects of the culture of academic medicine

Purpose The impact of medical school culture on medical students has been well studied, but little documentation exists regarding how medical faculty experience the culture in which they work. In an ongoing project, the National Initiative on Gender, Culture and Leadership in Medicine, the authors are investigating how the existing culture of academic medical institutions supports all faculty members’ ability to function at their highest potential. Method The authors conducted a qualitative study of faculty in five disparate U.S. medical schools. Faculty in different career stages and diverse specialties were interviewed regarding their perceptions and experiences in academic medicine. Analysis was inductive and data driven. Results Relational aspects of the culture emerged as a central theme for both genders across all career categories. Positive relationships were most evident with patients and learners. Negative relational attributes among faculty and leadership included disconnection, competitive individualism, undervaluing of humanistic qualities, deprecation, disrespect, and the erosion of trust. Conclusions The data suggest that serious problems exist in the relational culture and that such problems may affect medical faculty vitality, professionalism, and general productivity and are linked to retention. Efforts to create and support trusting relationships in medical schools might enhance all faculty members’ efforts to optimally contribute to the clinical, education, and research missions of academic medicine. Future work will document the outcomes of a five-school collaboration to facilitate change in the culture to support the productivity of all medical faculty.

The Culture of Academic Medicine: Faculty Perceptions of the Lack of Alignment Between Individual and Institutional Values

BACKGROUNDEnergized, talented faculty are essential to achieving the missions of academic medical centers (AMCs) in education, research and health care. The alignment of individuals’ values with workplace experiences are linked to meaningfulness of work and productivity.OBJECTIVETo determine faculty values and their alignment with institutional values.DESIGNA qualitative hypothesis-generating interview study to understand the professional experiences of faculty and organizational approach in five AMCs that were nationally representative in regional and organizational characteristics. Analysis was inductive and data driven.PARTICIPANTSUsing stratified, purposeful sampling, we interviewed 96 male and female faculty at different career stages (early career, plateaued, senior faculty and those who had left academic medicine) and diverse specialties (generalists, medical and surgical subspecialists, and research scientists).APPROACHDominant themes that emerged from the data.RESULTSFaculty described values relating to excellence in clinical care, community service (including care for the underserved and disadvantaged), teaching, intellectual rigor/freedom and discovery, all values that mirror the stated missions of AMCs. However, many faculty also described behaviors that led them to conclude that their AMCs, in practice, undervalued excellence in clinical care, and their social and educational missions. Themes were seen across gender, career stage, race and discipline, except that female leaders appeared more likely than male leaders to identify incongruence of individual values and organizational practices.CONCLUSIONSIn this study of five diverse medical schools, faculty values were well aligned with stated institutional missions; however, many perceived that institutional behaviors were not always aligned with individual faculty values.

Collaboration in academic medicine: Reflections on gender and advancement

Purpose Collaboration in academic medicine is encouraged, yet no one has studied the environment in which faculty collaborate. The authors investigated how faculty experienced collaboration and the institutional atmosphere for collaboration. Method In 2007, as part of a qualitative study of faculty in five disparate U.S. medical schools, the authors interviewed 96 medical faculty at different career stages and in diverse specialties, with an oversampling of women, minorities, and generalists, regarding their perceptions and experiences of collaboration in academic medicine. Data analysis was inductive and driven by the grounded theory tradition. Results Female faculty expressed enthusiasm about the potential and process of collaboration; male faculty were more likely to focus on outcomes. Senior faculty experienced a more collaborative environment than early career faculty, who faced numerous barriers to collaboration: the hierarchy of medical academe, advancement criteria, and the lack of infrastructure supportive of collaboration. Research faculty appreciated shared ideas, knowledge, resources, and the increased productivity that could result from collaboration, but they were acutely aware that advancement requires an independent body of work, which was a major deterrent to collaboration among early career faculty. Conclusions Academic medicine faculty have differing views on the impact and benefits of collaboration. Early career faculty face concerning obstacles to collaboration. Female faculty seemed more appreciative of the process of collaboration, which may be of importance for transitioning to a more collaborative academic environment. A reevaluation of effective benchmarks for promotion of faculty is warranted to address the often exclusive reliance on individualistic achievement.

Childhood Sun Exposure: Parental Knowledge, Attitudes, and Behaviors

Abstract Skin cancer is the most common form of cancer in the United States, accounting for about 700,000 new cases annually or approximately one-third of all new cancer cases. Sun exposure is a serious risk factor for skin cancer, particularly that which results in severe sunburn during childhood. Reducing sun exposure in early childhood, however, is dependent on sun protective behaviors undertaken by parents or caretakers on behalf of their young children. The purpose of this study was to examine the knowledge, attitudes, and behaviors of parents concerning the sun exposure of their young children and the relationship between these variables and the behaviors parents adopt on behalf of their children. A 48-item researcher-developed questionnaire containing demographic items and items assessing knowledge, attitudes, and behaviors relating to sun exposure was completed by 470 parents of young children while waiting to be seen by a pediatrician in a large general pediatric practice in the southeast. Data a...

Designated-driver programs: college students' experiences and opinions

We investigated the experiences and opinions of college students regarding the use of designated drivers. Although using designated drivers appeared to be common, results indicated that in many instances the designated driver did not abstain from drinking alcoholic beverages. The opinions of the participants indicated that the nondrivers in a drinking group may in fact drink more when there is a designated driver. Our findings lead us to question the overall value of currently practiced designated-driver programs for college student drinkers. Developing programs on how to be a designated driver are among our recommendations.

Exploring Practical Knowledge: A Case Study of an Experienced Senior Tennis Performer

The purpose of the study was to explore sport-related practical knowledge through the perceptions and experiences of a senior adult competitive tennis performer. Practical knowledge was defined as goal oriented, experiential knowledge developed within particular physical activity settings. Data were collected through formal interviews and participant observation and analyzed through narrative inquiry and conventional coding techniques. The data suggest that the tennis environment was perceived in terms of the opportunities afforded by that environment. Specifically, the participants practical knowledge centered on performance capabilities and strategic planning that revealed opponent limitations. This knowledge appeared to be developed and expressed within the relationships among individual capabilities, the task, and the situated context of game play.

Gender-Specific Changes in Students' Sexual Behaviors and Attitudes at a Southeastern University between 1973 and 1988

This study investigated the gender-specific, self-reported sexual behaviors and attitudes of never-married college students attending a southeastern university in 1973 and 1988. Data were collected by means of a mailed questionnaire that remained essentially unchanged for both years. The authors found that both men and women reported an increase in heterosexual relationships that included sexual intercourse and a decrease in nonsexual relationships with the other gender. The majority of the students perceived themselves as adequately informed about sexuality and satisfied with their relationships, although the proportion of men who reported being satisfied with their relationships declined over the 15 years. The students indicated that sexuality education should focus primarily on information about AIDS and on preparation for marriage.

The clinical, operational, and financial worlds of neonatal palliative care: A focused ethnography

OBJECTIVE Due to multiple issues, integrated interdisciplinary palliative care teams in a neonatal intensive care unit (NICU) may be difficult to access, sometimes fail to be implemented, or provide inconsistent or poorly coordinated care. When implementing an effective institution-specific neonatal palliative care program, it is critical to include stakeholders from the clinical, operational, and financial worlds of healthcare. In this study, researchers sought to gain a multidisciplinary perspective into issues that may impact the implementation of a formal neonatal palliative care program at a tertiary regional academic medical center. METHOD In this focused ethnography, the primary researcher conducted semistructured interviews that explored the perspectives of healthcare administrators, finance officers, and clinicians about neonatal palliative care. The perspectives of 39 study participants informed the identification of institutional, financial, and clinical issues that impact the implementation of neonatal palliative care services at the medical center and the planning process for a formal palliative care program on behalf of neonates and their families. RESULTS Healthcare professionals described experiences that influenced their views on neonatal palliative care. Key themes included: (a) uniqueness of neonatal palliative care, (b) communication and conflict among providers, (c) policy and protocol discrepancies, and (d) lack of administrative support. SIGNIFICANCE OF RESULTS The present study highlighted several areas that are challenging in the provision of neonatal palliative care. Our findings underscored the importance of recognizing and procuring resources needed simultaneously from the clinical, operational, and financial worlds in order to implement and sustain a successful neonatal palliative care program.