ASSOCIATION OF AMERICAN MEDICAL COLLEGES

Facilitating the Mentoring and Career Development of Faculty and Residents

6/27/07

Janet Bickel Career Development and Executive Coach Faculty Career & Diversity Consultant

Why Support Faculty Career Development?

• Faculty appointments less attractive• Hard work and native ability no

longer sufficient for success • Facilitation of proactive career

management: *prevents career derailing*garners loyalty *costs less than replacing faculty *increases ROI in faculty

Faculty Development EnvironmentFaculty Development Environment •Relentless pressure to generate revenues.

•Emphases on revenue generation eating into academic goals and spirit of volunteerism.

•Little time to develop new competencies.

•Few forum for faculty learning outside their “silos.”

•Over 20% of faculty report significant levels of depressive symptoms, with higher levels in younger faculty.

•Over 20% reported thinking often of early retirement (Schindler BA, et al. The Impact of the Changing Health Care Environment on the Health and Well-Being of Faculty at Four Medical Schools. Acad Med 2006 81: 27-34).

Maslow's Hierarchy of Needs

5. Actualization

4. Esteem

3. Love/Belonging

2. Safety

1. Physiological

• A department’s strength depends on its success in recruiting, developing and retaining excellent residents and faculty.

• Many faculty re not finding the mentoring they need.

• Everyone can become a more effective mentor.

• Academic medicine needs fresh mentoring and career development strategies

• To be productive, individuals need a collegial environment that fosters development.

PREMISES

What is interfering with creating a more supportive ecology here?

• Competing demands limit faculty availability

• Mentoring not evaluated or rewarded

• Lack of skills in mentoring across differences

• ???

Contemporary Mentoring is:*a continuum: not “all or nothing”

*differs by context and role—task-centered guidance and support.

*collective approach in service of life-long co-learning

*a scaffold for sharing expertise that could otherwise only be attained from experience

See: Pololi, L.H., Knight S. Mentoring faculty in academic medicine. JGIM. 2005; 20:866-70

Activities To Support Mentoring• Offer resources and tools, eg programs,

guides

• Work with new faculty in selecting one (or a small “team”)

• Address in faculty orientation

• Create Peer and Group mentoring opportunities

• Establish Mentoring Awards

• Add mentoring to promotion criteria; return dossiers when inadequate

• Evaluate mentoring skills

• Hold chairs accountable

• Acting as if Mentoring Were a Core Mission, eg CREAM

Mentoring Across Differences

• Use an exploratory survey

• Discuss important influences and acknowledge differences, eg “this approach worked for me but it may not for you”

• Break the ice: Recognize effects of differences in power, gender

• Set goals for the relationship

• Ask for feedback

Exploratory Survey for Advisees• Looking at last year: What are you

proudest of? And what would have done differently?

• What do you want to accomplish in the next 1-2 yrs? 5-10 yrs? What measures of success will you use?

• What relationships outside our discipline and institution do you want to build?

• What if anything is holding you back from reaching your potential?

• What areas of personal and professional growth do you most want to work on now?

MENTORSHIP EFFECTIVENESS SCALE:

My mentor:

• Is accessible and approachable

• Demonstrates expertise in my areas of need

• Motivates me to improve my work

• Provides constructive critiques

• Challenges me to take risks and extend myself

• Suggests appropriate resources

Source: Berk RA et al. Measuring the effectiveness of faculty mentoring relationships. Acad Med. 2005; 80:66-71.

Evaluating Each Other as Mentors• demonstrates respectful attitude

toward my work

• provides timely constructive and feedback

• listens skillfully

• gives counsel on important professional decisions

• communicates without racial or gender bias

• role models the highest professional ethics

U Calif-Davis’s ResponsesU Calif-Davis’s Responses*addressing mentoring needs at many levels

*menu of faculty development options, eg e-learning platforms, series certificates

*each faculty gets bank of “FD credits”

*each dept appoints “Director of FD”

*variety of peer-reviewed awards

*more family leave and ”modified duties” options

* more flexible part-time optionsSource: Howell L, Servis G, Bonham A. Multigenerational Challenges in Academic Medicine: UC Davis’s Responses.” Acad Med. 2005; 80:527-32.

Collaborative Mentoring ProgramCollaborative Mentoring Program• Facilitated peer mentoring

• One-day/month sessions for 6 months

• Learning outcomes included:

*identification of values-based career goals

*development of close collaborative relationships

*improved job satisfaction

*skills developed in areas key to advancement

Source: Pololi, L.H., Knight S. Mentoring faculty in academic medicine. JGIM. 2005; 20:866-70.

9 Habits of Highly Effective Mentors• Identify “Coachable Moments” and select

best coaching method• Create enough safety for learning• Together set goals for the relationship• Listen actively, avoiding assumptions• Ask reflective Questions, eg “how do you

think you did?”• Give specific, constructive, timely

feedback• Support transition to independence• Respect confidentiality• Continuously develop mentoring skills

Mentoring – bringing ourselves

fully into the moment.

– giving full attention to other person

– letting the other know that he or she is heard and respected

– listening with curiosity ONE MOUTH

TWO EARS

Skillful Inquiry involves…..• a genuine wish to understand someone else’s

thinking. • inviting elaboration and clarification, asking non-

leading questions that invite the other person to reflect and piece together the elements of their own thinking, eg “Tell me more about that,” “How did you come to hold this value?”

• temporarily putting aside our own ideas, letting the other person talk without interruption

• silencing the inner voice in us that is formulating a response or comparing/disagreeing/interpreting

• refraining from asking questions intended to lead the other person towards a particular point

Gender and Ethnicity:

When Heterogeneity

meets Homogeneity

ASSOCIATION OF AMERICAN MEDICAL COLLEGES

Disadvantages Minorities Sometimes Experience in Obtaining Mentoring

• relationships occur most naturally between “like” individuals

• different cultural norms can be confusing

• face higher hurdles to prove selves to potential mentors

• the accents of some ethnic minorities interfere with communication

Women’s Disadvantages in Obtaining Mentoring

•less likely to view mentor as a role model

•allowed a narrower band of “assertive behaviors”

•leadership potential underestimated

•work an invisible “2nd shift” at home

•miss out on hallway conversations and “golf”

•paucity of senior woman role models

•may be “dropped” if mentor threatened by her increasing expertise

Nine Circles of Mentee Hell

underestimate of potential

failure to respectprotégé’s goals

failure to promoteindependence

taking credit for protégé’s work

conflicts avoidedinappropriate

praise orcriticism

expecting protégé To defer

ethicalviolations

physical intimacy(or appearance of)

Senior Faculty say:• “I don’t think kids these days want to

work as hard.”

• “They act like they’re entitled to privileges I had to earn.”

• “They just don’t make ‘em like they used to.”

• “There is a tremendous gap between what the younger generation wants and what the older generation expects.”

• “Junior faculty seem to want a lot of handholding.”

Gen X and Y say:• “I just don’t buy the values of many senior

faculty ‘success stories’.”

• “When I’ve made different choices than my mentors would, they treat me as if I were failing them.”

• “I thought my chair was looking out for me. Turned out I was just gullible.”

• “My mentor wants me to remain ‘monogamous’—but I’m ready to date!”

• “Every time someone said they would mentor me, they simply gave me more work. But no one’s helping me seeing how my work fits into the larger picture.”

• “How do I get help in creating a plan for my future, including milestones and choice-points?”

Mentoring Gen X and YExamples of productive questions:• What qualities does excellent clinical

judgment encompass?• How will you develop the necessary

expertise?• What are your goals and timelines?• What is your plan for assuring that ..?• How will you evaluate your progress? • Let’s agree about the desired

outcome, then discuss methods.

Mentoring is critical…• To attract, retain and engage high performers• To maximize “return on investment” in faculty• To nurture the academic aspirations of

residents and junior faculty• To swiftly acculturate new members• To foster a collaborative environment• To increase stability and productivity• To promote diversity• To develop leadership talent• Being a mentor is the most effective way of

extending one’s professional contributions• Everyone can become a better mentor.