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 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 : 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 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 options Source: Howell L, Servis G, Bonham A. Multigenerational Challenges in Academic Medicine: UC Davis’s Responses.” Acad Med. 2005; 80:

Collaborative 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:

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 respect protégé’s goals failure to promote independence taking credit for protégé’s work conflicts avoided inappropriate praise or criticism expecting protégé To defer ethical violations 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 Y Examples 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.