1. First and Foremost a Leader: How to Encourage a Leadership Identity for Physicians Joann Farrell Quinn, PhD, MBA Director of SELECT Competency Assessment USF Health Morsani College of Medicine

2. Disclosure Statement of Financial Interest I, Joann Farrell Quinn, DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.

3. Disclosure Statement of Unapproved/Investigative Use I, Joann Farrell Quinn, DO NOT anticipate discussing the unapproved/investigative use of a commercial product/device during this activity or presentation.

4. The Importance of the Topic Professionals are often promoted into leadership roles based upon technical expertise, and do not necessarily have the skills needed to become effective leaders. Within healthcare specifically, there is a need for physician leaders who are able to serve as bridges across different professional groups. It is essential to understand the nature of physician leadership, as it is constructed and accepted by the individual to encourage increased participation by these leaders

5. “What am I? Vice- something…” THE NATURE OF PHYSICIAN LEADERSHIP Autonomous Primary professional identity as a physician Unique organizational structure Part time and temporary roles Physician Leadership IS and SHOULD be different from traditional leadership. Physicians should not be clones of traditional business leaders. The nature of physician leadership is noble in purpose and should combine the primary physician identity with a secondary leadership identity.

6. We are informed by Social identity is based upon the individual’s perception of themself a member of a group of persons, which is formed from the categorization of members and influenced by the distinction and prestige of the identity group. (Tajfel 1972, Ashforth and Mael 1989, Hogg 2001) Beyond selected cognitive intelligence competencies, emotional and social competencies are the incremental difference that increase leadership effectiveness. (Boyatzis 1982, Spencer and Spencer 1993, Goleman 1998)

7. We are informed by An understanding of psychological climate is imperative as the individual’s perceptions and valuations of the environment are what mediate the individual’s behavioral responses. (James and Jones 1974) And positive emotions allow for more openness in people’s thought processes and behavior responses. (Boyatzis 2008, Keyes, Fredrickson and Park 2012)

8. From QUAL to QUANT From QUAL to QUANT Discovering the Nature of Physician Leadership Qualitative Exploration Quantitative Confirmation Quantitative Clarification What is the nature of physician leadership? What are the mediating affects of positive psychological climate on the relationship of role factors to participation? What is the mediating affect of both role endorsement and positive psychological climate upon participation?

9. Triangulation Integration of Findings from QUAL, QUANT & QUANT Qualitative Data Collection and Analysis Quantitative Data Analysis Quantitative Data Collection and Analysis Semi-Structured InterviewsCodes, Themes, Theory Quant 1 informed and clarified Quant 2 Qual informed Quant 1 Quant results confirm Qual results

10. Key Findings- Study 1 Physicians who are full time administrators perceive their leadership roles to be positively recognized by others and to be organizationally endorsed, however physicians who were part time leaders do not. This endorsement occurs through the individual’s acceptance of their leadership role at the individual, relational and organizational level.

11. Key Findings- Study 2 Aspects of positive psychological climate (vision and compassion) mediate the relationship of role factors, both positive and negative, to participation. The largest effect found in the model was the impact of role endorsement to vision, which I believe speaks to the importance of an individual being endorsed in their role by both their peers and organization, in addition to their own certainty in their authority.

12. Key Findings- Study 3 The double mediation of positive organizational climate upon role endorsement and participation provides insight as to the importance that positive climate plays in a physician leader’s acceptance of a secondary identity as a leader, which then influences a higher level of professional participation. Although it is an important element, positive psychological climate alone is not enough to influence participation.

13. Conclusions A relational construction of identity is the process by which a physician leader accepts their leadership role. We now know that physicians who adopt a secondary identity have a higher level of professional participation in their leadership role. Positive psychological climate has an important impact upon role endorsement, as well as participation. o Although full time physician leaders are more likely to embrace a leadership identity and role, their understanding of climate is of an even higher level of importance.

14. Key Findings- Study 1

15. Second Study Results

16. Third Study Results