Academic health centers are increasingly faced with persistent forces of change. Implementing the change process frequently involves unique skills and strategies by effective leaders willing to transform individuals, organizations and cultures. Many of us in contemporary medical science recognize the importance of influencing change to align both individual and organizational goals. Each of us must develop many leadership roles throughout our careers. Understanding the conceptual and practical aspects of what makes a leader effective helps us maximize opportunities, operations and outcomes. Educational leadership requires attitudes and skills: perspectives, strategies, interpersonal interactions and clear communications. Effective leadership boosts productivity, career success and morale whether in the research, clinical or academic environment. The IAMSE webcast audio seminar is a well-established format for faculty development. This webcast series was organized and conducted in two six-part series (2007) to explore the dynamic interactions of organizations, individuals, behaviors, strategies, cultures and contexts required to develop leadership strategies in academic healthcare settings. Part I (Spring 2007) addressed how we are influenced by the leadership behaviors and styles of those with whom we interact. Likewise, we are affected by the leadership styles we use in turn. Part II (Fall 2007) expanded upon the previous strategies and factors that enhance career development. Concepts in the continuing series included recognizing elements in curriculum change, leading meetings effectively, negotiating for consensus and collaboration, leading multi-disciplinary teams, inspiring a vision and aspiring to positions of leadership in academic health centers. With this in mind, an experienced and dynamic cadre of academic leaders shared their insights and abilities in the realization that everyone can maximize their leadership potential. Part I of the series commenced with:
A Practical Approach to Build Leadership Effectiveness
The webcast series began with Dr. Jeffrey A. Morzinski who presented an organizational framework using metaphors to help us understand complex organizations. Dr. Morzinski initiated the seminar by sharing his academic and administrative background in educational leadership at the Medical College of Wisconsin. He claimed that âleadership is a key skill set in academic medical settingsâ. From early in their careers faculty are expected to perform successfully in leadership roles, such as those encountered on research teams, curriculum planning projects or new initiatives on quality or safety. These expectations exist in highly complex environments where the future can be uncertain. Stakes are high in many leadership situations, with outcomes associated with funding, efficiency, productivity and morale. He offered a practical and well-accepted perspective to best understand the complex role that educational leaders may apply when reframing organizations. Using an organizational framework (Bolman and Deal: 1997), he articulated how each frame guides our thinking and vision to improve administrative performance. The four-part framework (e.g., Structural, Human Resource, Political and Symbolic) provides a lens for diagnosing leadership gaps and for planning leadership actions. He went on to apply the framework to a case example, as participants used a template worksheet to address each of the four frames for action. The session concluded with âlessons from the fieldâ along with selected resources for improving future leadership effectiveness. Several questions and comments reinforced how these frames may help us better understand highly complex organizations, such as academic health centers. To better interpret the organizational frames and their application, view Jeffâs presentation at:
www.iamse.org/development/2007/was-2007-spring.htm
Everyone Can be (must be) an Influential (and effective) Leader
Dr. Lynn Curry, a presenter in an earlier webcast series and proprietor of the CurryCorp, Inc., specified that organizational health and success fundamentally depends on the quality of shared leadership. That means regardless of the title we bear, we have a responsibility to our organization and to our colleagues in that organization to help it be a healthy place to work and to succeed in its organizational mission. Dr. Curry further emphasized that this shared obligation for leadership is particularly acute in the academic health care centers where all faculty members have a permanent responsibility as role models for students and junior faculty. Therefore, we all need to learn to optimize our day-to-day formal and informal leadership opportunities. An important aspect of that skill is to understand the contribution of cognitive style to interpersonal relationships and leadership in general. She provided an overview of the role of cognitive style in formal and informal leadership. A particular example was offered using the Myers Briggs Type Indicator (MBTI) as a reference point for analyzing our unique leadership roles, however many cognitive style formulations have compatible and obvious connections with various leadership roles (e.g., organizers, doers, intuitives, reflectives, etc.). An individual with a Myers-Briggs Type ISTJ (introvert, sensing, thinking, judging attitude) cognitive style for example, would likely excel at leadership tasks that require in-depth advance planning, but not so much in generating the interpersonal enthusiasm to engage participants. In conclusion, Lynn highlighted the need to learn skills at different stages of our academic career in order to perform our evolving leadership roles based upon our cognitive style strengths. To achieve added insight into the relationship between shared leadership and cognitive style, please view Lynnâs in-depth presentation at:
www.iamse.org/development/2007/was-2007-spring.htm
The Impact of Effective Leadership on Faculty Productivity and Career Success
The series continued with Dr. Patricia S. OâSullivan from the University of California, San Francisco who signified that âleaders have an essential role to enhance productivity and career successâ. Most faculty members have stress about their productivity and what it takes to be successful in their institution. Many define academic success solely in terms of publications and of course they are an important element. However, success as an educator may be related not only to research, but also to other roles, such as curriculum development, assessment, mentoring/advising and administration. Dr. OâSullivan affirms that leadership must be vigilant in providing opportunities for faculty members to be successful in all of these roles. For those faculty in leadership, having a faculty member develop a strategic plan considering these five roles helps leadership in planning for individual success. Creating a community of educators encourages educational scholarship as typified by applying Kotterâs leadership steps, a framework for implementing change (Kotter. Leading Change: 1996). The presumptive leadership steps involve: creating a sense of urgency; creating a guiding coalition; developing a vision and strategy; communicating the vision for change; empowering broad based action; generating short term wins; consolidating gains and producing more change; and anchoring new approaches in the institution. A key feature of this model is a team approach, whereby leaders formulate a research team with tasks and targets to help sustain productivity. By the conclusion of the seminar, Pat was able to describe the elements of a personal strategic plan to help with research productivity and career success. Participant questions and comments reinforced many of these elements in the remaining time. Patâs suggestions for creating an environment that encourages productivity is available in greater detail by reviewing her presentation at:
www.iamse.org/development/2007/was-2007-spring.htm
Leading People within Organizations: Communicating for Performance
Paula Bartholome presented a concise presentation of organizational communications from her background as an organization development consultant with her firm Parallax. Ms. Bartholome started this one-hour webcast by discussing what defines a leader and characteristics of effective leader communication. âThe greatest problem with communication is the illusion it has been accomplishedâ. This quote from George Bernard Shaw illustrates how many organizational leaders are expected to set an organizational vision, chart a course toward it, and coordinate with and through others to get there. Communication is crucial to achieve alignment and movement toward organizational or individual goals and how communication is done is as important â or perhaps more important â than its specific content. She reinforced the leader role from the previous seminar by emphasizing how effective communication supports organizational performance while building and maintaining necessary interpersonal relationships and open environments. Effective communications enhances teamwork, collaboration and mutual respect to support quality performance. She further asserted that effective communications achieves commitment and offers constructive feedback for individual, team and organizational achievement. Lastly, she revealed how storytelling inspires meaning for emotional and rational connections based on the unique qualities of each organization. Paulaâs specific suggested tips and communication strategies for performance are available by viewing her presentation at:
www.iamse.org/development/2007/was-2007-spring.htm
Coaching and Mentoring
Dr. Tom Viggiano, Associate Dean for Faculty Affairs at Mayo Medical School and Director of the Office of Education Scholarship in the Mayo Clinic College of Medicine, characterized one aspect of leadership as âa process that ordinary people use when they are bringing forth the best from themselves and othersâ (Kouzes and Pozner: 2003). The common developmental relationships that comprise academic leadership are advising, mentoring and coaching. Advising, mentoring and coaching involve goal setting, analysis and reflection, providing feedback and directing actions to achieve goals. Advising usually occurs over a limited period of time and the advisor serves as a guide to help the advisee achieve a specified goal. Mentoring involves a sustained and committed relationship from which the mentor and protĂ©gĂ© obtain reciprocal benefits. Coaching is a process that facilitates learning and development of specific skills for the purpose of improving oneâs performance. Dr Viggiano described the characteristics of effective mentoring relationships and the situations in which coaching is most effective. Dr Viggiano summarized the individual, institutional and leadership characteristics of a productive research organization (Bland. Acad Med. 80: 225-237, 2005) and discussed how these characteristics apply to the education enterprise. He then presented a method for documenting advising and mentoring relationships that is recommended by the Association of American Medical Colleges Group on Educational Affairs Scholarship Project. Participants were invited to share their comments, questions and challenges concerning developmental relationships as a leadership activity. This presentation on Coaching and Mentoring may be viewed at:www.iamse.org/development/2007/was-2007-spring.htm
Leading Effectively at the Department or Program Level: People, Priorities, and Politics
Part I of the seminar series concluded with a departmental leader perspective, as expressed by Dr. Michael Lumpkin from Georgetown University. Dr. Lumpkin started with a practical approach to leadership at the medical science departmental level. At the onset he pointed out that formal and informal leaders need to balance the importance of people, priorities and political influences within their respective academic departments or programs. Effective departments and programs need to recognize and promote faculty members who contribute to the creative and innovative purposes of the organization. He provided a practical focus on performing effectively in the department or program leadership position â abbreviated version of the faculty development course. Specific applications were offered for managing change appropriate for program or departmental basic scientist leadership. Insights were drawn from his experiences including an example of curriculum change led by a Dean who applied many of the salient leadership aspects delineated in the previous series presentations. Most notably, he recommended treating staff with respect, including them in routine communications, advocating for their success and publicly acknowledging their work. He concluded with an assertion to treat everyone equitably and avoid favoritism. Finally, the leader needs to be the first to step forward finding a solution to problems. Problems are often discrepancies between what ought to be and what is. The leaderâs ability to solve problems contributes to satisfying individual and team needs. Please go to this link and listen Michaelâs presentation and review its content for practical tips on leading at the departmental level:
www.iamse.org/development/2007/was-2007-spring.htm
Part II
Leadership and the Complexity of Change
Part II in the series began in the fall of 2007 with Dr. Nehad El-Sawi (Associate Dean at the KCUMB Institute for Medical Innovation), acknowledging that innovation and change are ever-present in academic health sciences educational environments (e.g., curriculum re-organization, teaching/learning methods, technology, accreditation expectations, etc.). Various models of leadership for change are available and considerable evidence is in the literature regarding specific strategies and practical approaches to facilitating an organizational context that is conducive to change and long-lasting success. Dr. El-Sawi focused on common characteristics of facilitative and proactive-strategic leaders, models of change, and examples of correspondingly practical application and strategies. During this session she focused specifically on impetus, issues, and challenges for curriculum change. A more current version of Kotterâs (2006) leadership model exemplified the essential facilitating factors she advocates for transforming organizations. In addition, effective strategies were offered in how to effectively initiate curriculum change, engage stakeholders, and facilitate positive stages of curriculum change. You may educe greater awareness of the facilitating factors described in Nehadâs seminar by reviewing her presentation at:
www.iamse.org/development/2007/was-2007-spring.htm
Effective Committees and Meetings
Organizing and managing meetings is an often overlooked skill of effective leaders. Dr. Franklin Medio shared his practical suggestions from his extensive graduate medical education experience. He provided recommendations that augmented Dr. El-Sawiâs earlier directive on transformative leadership, namely to facilitate effective communications that build team consensus. His five elements of successful meetings offers guidance to leaders concerned about challenges for balancing valuable time and individual participation. Planning the meeting entails purposeful decisions on specific items worthy of discussion. A well-constructed agenda ranks items by their level of importance and urgency. It is valuable to select participants who are empowered to contribute the most quality. Furthermore, leaders need to design a purposeful agenda with specific, achievable goals, initiate meetings with clearly established ground rules or expectations, manage time to keep everyone on time and on task, and close the meeting by reflecting on what worked and clarity for further actions. Keeping participants actively involved in meeting activities builds consensus and group cohesion while enhancing their accountability. These are important qualities for academic leaders at all levels. In closing, Franklin presented a useful template to plan and conduct meetings. Giving appropriate structure to your meetings improves efficient use of time and models qualities of effective leadership. As is often true in our teaching role, we tend to forget what we do not apply. Opportunities abound to put these ideas into practice â as soon as your next meeting. More specific recommendations for structure and control of your meetings may be found in Franklinâs presentation at:
www.iamse.org/development/2007/was-2007-spring.htm
Negotiations and Conflict Management
Dr. Medio was followed by Dr. Elza Mylona, Associate Dean of Educational Development and Evaluation at Stony Brook University. Dr. Mylonaâs session offered key concepts for listening and meeting individual needs and interests in a mutually satisfying manner. Often it is important to recognize that disagreements or disputes exist, explore functional options or agreeable courses of action to achieve consensus (âwin-winâ) outcomes. Specific negotiation skills were considered in meeting organizational and individual goals. All leaders at all levels encounter the complex features of negotiation and conflict management, especially shaping new curriculum. It is vital to recognize that negotiation is interpersonal communication designed to reach agreement, especially when both parties have some shared interests. She presented several aspects of the negotiation process including âseeing things from the other point of view while being aware of the consequences if your idea/proposal is not acceptedâ. Furthermore, Elza proclaimed that âa well thought out BATNA (Best Alternative to a Negotiated Agreement) gives you more power or leverageâ. We are to focus on interests using objective criteria to make decisions and above all listen actively and reflectively. A truly win-win outcome is a compromise where we close the gap between our wants and are real needs. She concluded with a few pearls to consider, namely that most negotiations are as much about emotions as they are about money or resources and that negotiations with high expectations generally do better. A more in-depth understanding of the negotiation process and models of conflict management in Elzaâs seminar are available for your review at:
www.iamse.org/development/2007/was-2007-spring.htm
Leadership in a Changing Environment: Inspiring a Shared Vision
Leadership is a dynamic process where leaders inspire and communicate their vision for change. Ms. Lintner, a staff developer at the University of Texas Medical Branch, proclaimed that âleaders mobilize others with passion to achieve a defined and aspired goalâ. Those of us in medical science education may easily recognize an abundance of leadership opportunities such as those involving: curriculum, courses, promotion & tenure, clinical science assessment and research. Our success as leaders is predicated on the unique style we apply in this dynamic process. Alison several leadership styles: coercive, authoritative, affiliative, democratic, pacesetting, and coaching. The qualities of each are described in her presentation along with a self-assessment ranking. She suggests that authoritative, affiliative, democratic and coaching styles have the highest correlations in medical science. In addition, she presented a few case studies to query participants on which style might be most effective in resolving the student progress case or the team-work case. To interject a degree of interactive learning, the series director/moderator acted as a proxy for all participants. Finally, Kotterâs (1996) leadership step for developing a vision for change was expounded upon. Alison described the benefits of a vision statement and a template for creating a vision for an educational unit. In this way, participants learned how to create and communicate a vision for change. Details on crafting a vision statement are available at this link
www.iamse.org/development/2007/was-2007-spring.htm
Multi-disciplinary Team Building
This session by Dr. Stephen Bogdewic (Executive Dean for Faculty Affairs and Professional Development; Indiana University, School of Medicine) offered participants a general overview of the team development process; characteristics of effective teams; common challenges at each development stage; and practical applications (e.g., when are teams needed, how to sustain teams when people move on, how to reduce conflict in oral and written communications, etc.). Dr. Bogdewicâs long-standing role in academic medicine provides a distinct vantage point to recognize the complex and unique challenges as well as organizational and leadership characteristics that faculty must possess. He placed emphasis upon strategies that overcome dysfunctional aspects of multi-disciplinary teams in academic health centers. Increasingly, patient care âis not delivered by individuals but by a systemâ. Inherent in this system are high performing, multi-disciplinary teams often with diverse skills that cross lines of specialization. He demonstrated a set of useful teambuilding stages and strategies often used in developing workplace teams (e.g., forming, storming, norming and performing). In particular, he discussed a set of proactive interventions that facilitate well-managed problem solving groups. Of interest, were the five dysfunctions of a team (e.g., absence of trust, fear of conflict, lack of commitment, avoidance of accountability and inattention to results). He further asserts that âteams go through predictable stages of development and the role of the leader needs to change as the team evolvesâ. Leading multi-disciplinary and diverse teams of key stakeholders requires leaders who enhances equity, gains trust and sustains shared authority when achieving specific goals or tasks. Stephenâs descriptive models and extensive references on team management are beyond the scope of this report but may be accessed at:
www.iamse.org/development/2007/was-2007-spring.htm
Aspiring to a Leadership Position
The two-part seminar series came to a close with an admonition that we all need to aspire to be effective leaders in academic medicine. Series presentations have given us a variety of concepts and practices that will assist us in this task. In this final session Dr. Tom Schmidt (Assistant Dean at the Carver College of Medicine, University of Iowa) shared his personal insights, experiences and decisions in his academic career that prepared him for his leadership position. As a professor in the Department of Physiology and Biophysics, Dr. Schmidt highlighted significant leadership accomplishments in research, teaching and administration. He humbly declared that âsome self-promotion is necessaryâ and we must seize opportunities to excel (i.e., Harvard Macy Institute, IAMSE involvement, teaching award submissions, etc.). He examined key features for professional development and advancement that associate with evidence of educational scholarship. Among these features are career goal-setting, communicating with key individuals for input and advice regarding strategies, making decisions about where to focus professional efforts, saying no effectively when necessary, seizing opportunities, strategies for monitoring oneâs progress up the career ladder and how to make mid-course adjustments when needed. His personal reflections and self-awareness offer valuable insights that we can all draw from to help guide our own pathway to career success. In conclusion, he exhorted us to develop our reputation as a dedicated and enthusiastic educator. These features and other perspectives for aspiring to a leadership position are available in Tomâs presentation at:
www.iamse.org/development/2007/was-2007-spring.htm
Dr. Scott served as Director and Moderator for the Webcast Audio Seminar series, Part I and Part II that broadcast in the spring and fall of 2007.