Abstract
Context
Career development is essential and has the potential to assist in building a sustained faculty within academic departments of Anesthesiology. Career development is essential for growth in academic medicine. Close attention to the details involved in career management, goal setting as part of career planning, and professional networking are key elements.
Methods
This article examines the specific educational strategies involved in a 120 minute workshop divided into four 25 minute segments with 20 minutes at the end for discussion for training junior faculty in career development. The teaching methods include 1) brief didactic presentations, 2) pre-workshop completion of two professional development tools, 3) facilitated small group discussion using trained facilitators and 4) use of a commitment to change format. Three major learning tools were utilized in conjunction with the above methods: a professional network survey, a career planning and development form and a commitment to change form.
Results
Forty one participants from 2009 reported 80 projected changes in their practice behaviors in relation to career management: Build or enhance professional network and professional mentoring (36.3%); Set career goals, make a plan, follow though, collaborate, publish (35.1%); Increase visibility locally or nationally (10.0%); Building core skills, such as clinical, teaching, leading (36.3%); Identify the criteria for promotion in own institution (5.0%); Improved methods of documentation (2.5%). Over the past two years, the workshop has been very well received by junior faculty, with over 95% marking each of the following items as excellent or good (presentation, content, audiovisuals and objectives met).
Conclusions
The challenge for continuing development and promotion of academic anesthesiologists lies in the explicit training of faculty for career advancement. Designing workshops using educational tools to promote a reflective process of the faculty member is the one method to meet this challenge. We believe that this national workshop has initiated an increasing awareness of a core of junior faculty nationally having now delivered the material to almost 200 junior faculty and having trained seven facilitators in the usage of these materials.
Background
Anesthesiology with its triple threat of education, research and service is attempting to survive in this millennium. The overall job market for a private practitioner in anesthesiology has markedly improved as the shortage of anesthesiologists has grown over the years1. The quality of academic life has continued to deteriorate as academic departments struggle to cope with decreasing professional fee reimbursement and with maintaining financial security. This has created a problem throughout academic medicine in relation to faculty retention, particularly at the lower ranks. As Lieff noted in October 2009, “loss of new faculty is of particular significance in the new context of medical education.”2 This challenge is particularly acute in Anesthesiology.. In a survey by De Oliveira et. al., published in 2011, faculty retention was reported to cause “large or extreme” stress over the past year for more than 50% of Anesthesiology department chairs, exceeding all other causes of stress3.
Fewer academic faculty members, in a time of increased clinical workload, leaves the remaining faculty with less time for academic endeavors, increasing the challenge of attaining academic success. Wong and Stock reported that over the 20-year time period, from 1985 to 2005, there was a small increase in the number of academic anesthesiologist in every academic rank; however the majority are assistant professors4. As the 2008-09 AAMC salary survey demonstrates 55.5% of all academic anesthesiologists are at the assistant professor level.5 Thus, although anesthesiologists enter into academics, they may depart academic medicine or remain in the same rank throughout their career. It is a constant challenge for department leadership to ensure that junior faculty members do not become disheartened in climbing the academic ladder. Costerino and Deshpande state that one key to our future as a field is investing in education and fostering research through formal training and mentoring6.
Career development is essential for growth in academic medicine. Close attention to the details involved in career management, goal setting as part of career planning, and professional networking are key elements. These, along with developing a clear research agenda and maintenance of productivity, improve the chances of achieving promotion2. There is evidence of a positive impact of supporting career development. The strongest evidence—described in one summary as “substantial and convincing” comes from studies that look at the effect of career development training on attitudes, motivation and learning of career-related skills. These studies show multiple impacts including more positive and confident attitude toward future career options, increased knowledge of education and employment opportunities, increased self-awareness, and increased confidence in decision-making7.
National Workshop
In 2006, one author (JRT) established a two-hour national workshop focusing on career development for junior faculty in academic pediatric anesthesiology. The workshop, offered each spring at an annual Society for Pediatric Anesthesia (SPA) meeting, has since been refined to its present format by Drs. Yanofsky, Voytko and Nyquist. Attendance has averaged 40 participants with almost all being instructors or assistant professors on a clinical track. The workshop goal is to increase faculty awareness of key elements of professional success and thus focuses on three topics – career management, professional networking and career planning. The professional academic development materials used in the workshop were developed at the University of Southern California for usage in the Masters of Academic Medicine program, and prior to that, for usage in the Master of Science in Medical Education degree program within the Division of Medical Education. The materials have been used with more than 300 health professions faculty throughout the United States as parts of the degree programs, fellowship programs and workshops. They were initially developed from examination of the literature on career development and have evolved based on experiences of the senior author (JGN) in mentoring faculty, delivering workshops and participating on an Appointments, Promotion and Tenure Committee within a medical school.8
The learner outcome objectives for the participants were to be able to:
Discuss the elements of career management
Discuss and enhance their professional network
Complete their career development plan
Take a proactive role in managing their career
The workshop takes the junior faculty though a discussion of seven tasks of career management.
Know yourself (e.g., values, personal story, strengths and weaknesses)
Know your institution and unit (e.g., culture, goals, structure, opportunities)
Network and obtain mentoring (e.g., collaborate on projects, increase visibility, obtain mentoring)
Make career plan and act on it (e.g., long and short term goals, time schedule, action items)
Keep documents up to date (e.g., personal statement, curriculum vitae)
Manage time and balance work and private life
Seek feedback and stretch
The teaching methods include 1) brief didactic presentations, 2) pre-workshop completion of two professional development tools, 3) facilitated small group discussion using trained facilitators and 4) use of a commitment to change format. The 120 twenty minutes of the session were divided into four 25- minute segments with 20 minutes at the end for discussion and conclusions. The 25-minute segments were divided as follows: 1) introduction to the session and to the principles of career management; 2) small group introductions of participants and facilitators and individual completion of the network survey; 3) large group presentation of networking principles and paired discussion of individual network survey results; and 4) large group description of career planning and small group brainstorming in relation to making career development plans for reaching each person’s next career goal. The final 20 minutes were devoted to open discussion and completion of the commitment to change forms.
Workshop Tools
There are three major learning tools woven into this workshop in conjunction with the above methods and content: a professional network survey, a career planning and development form and a commitment to change form. Two of these tools, the network survey and career planning form are used as pre-workshop activities to allow more time for interactive discussion during the workshop.
Network Survey (Appendix 1)
The first tool is a professional network survey. Professional networks are a key element to success as well as to job satisfaction. In their 1995 meta-analysis on professional networking in academia, Hitchcock, et al. reported that productive networks of colleagues relate to improved research, higher research productivity, quicker promotion, distinguished awards, increased income and higher satisfaction with work and career9. In a 2006 report on medical faculty job satisfaction, the Association of American Medical Colleges noted the importance of productive interpersonal relationships with colleagues in job satisfaction10. This was particularly noted for clinician educators, who are the majority of faculty in Departments of Anesthesiology. Mentor-protégé relationships are also particularly important for junior faculty as they enter the field. These relationships affect personal development, career choice and research productivity. Finally, professional academic meetings are important means by which faculty meet and maintain relationships that set the foundation for career development.
The professional network questionnaire was designed based on the findings of the Hitchcock et al meta-analysis to gather data on key elements of the person’s network and is completed as a pre-workshop activity. The questionnaire requires the learner to select their five most important colleagues and to describe key characteristics of each and the relationship with these colleagues. The questionnaire asks for the following data – gender; length of the relationship; how often they are in contact; how they met; location of person; whether they consider the person to be primarily a personal friend, a mentor, peer colleague or protégé; and primary activities (socializing, giving/receiving advice, working on tasks). Hitchcock et al noted that task-oriented colleague relationships related most highly to quantitative measures of success and to job satisfaction9. This questionnaire is reviewed in the large group setting and further reflected upon in dyads, providing a means for learners to process the information in a private setting and discuss how they might further enhance their network.
Career Plan (Appendix 2)
The second tool is a career planning and development form. Developing a career plan has always been important, but its importance is increased in an era of increased longevity and extended career expectations. Career planning begins with a clear understanding of self, including values, strengths and weaknesses11. If the faculty member plans on remaining in their current organization, career planning also requires knowledge of the organization including opportunities, expectations and potential barriers to success. The career plan is intended to guide the junior faculty member in setting priorities and making their professional development plan.
The career planning and development form is comprised of four items. As a pre-activity, the junior faculty member completes the first three items. First, the participants are encouraged to think about their ultimate job, to speak with someone who currently holds that job, and then to briefly describe the activities of that job. Next, they provide a baseline description of their current job. The fourth pre-activity is to list the skills and abilities that might be required for their ultimate job.
During the workshop this fourth item is discussed - the career development planning table for their next promotion. After a large group discussion of the key elements of academic success, the participants work in small groups guided by trained facilitators to generate a list of 1) issues/skills critical to gaining the next promotion (e.g., job challenges, any new skills require) and 2) development action items(activities that can assist them in achieving that near term goal). For example the person may note the need for more publications as an “issue,” and state the need to develop a national network and local collaborative partners, as well as to attend a writing workshop, as the action items.
Commitment Form (Appendix 3)
The third tool was a Commitment to Change Form. The form is used to extend the impact of the session from the classroom into the work/clinical setting and to increase the chances that participants will accomplish a positive change12. It encourages physicians to apply the skills gained in the workshop when they get back to their home institution. Participants were asked to write down their primary take home message and one or more changes they will make as a result of what they have learned during the session. In 2009 a duplicate format was used with one copy for the participant and one copy for the authors. The participants (n-41) listed 54 take home messages that sorted into the following categories:
| Understood the need to establish career goals, make a plan and“do it” (35.2%) | 19/54 |
| Appreciate the need for developing a professional colleague network and for networking (22.2%) | 12/54 |
| Recognize that I am responsible for my own career success and must be proactive (13.0%) | 7/54 |
| Recognize the need for collaborative partners and/or mentors (13.0%) | 7/54 |
| Understand the steps of career advancement: (9.3%) | 5/54 |
| Realized that I am not alone; other have the same issues and fears (7.4%) | 4/54 |
Some of changes that faculty have projected include improving professional networking, developing a career plan and carrying it out, increasing visibility locally and nationally, participating in faculty development activities in my hospital, and learning more about my school’s promotion requirements.
Example results for 2009: In 2009, the 41 participants reported 80 projected changes in their practice behaviors in relation to career management as follows:
| Build or enhance professional network and professional mentoring | 29/80 (36.3%) |
| Set career goals, make a plan, follow though, collaborate, publish | 28/80 (35.1%) |
| Increase visibility locally or nationally | 8/80 (10.0% |
| Building core skills (clinical, teaching, leading) | 5/80 (6.3%) |
| Identify the criteria for promotion in own institution | 4/80 (5.0%) |
| Improved methods of documentation | 2/80 (2.5%) |
The Faculty Development Workshop has been made available to almost 200 junior faculty and 7 facilitators have been trained in the usage of these materials. Over the past two years (2008-2009), the workshop has been very well received by junior faculty, with over 95% marking each of the following items as excellent or good (presentation, content, audiovisuals and objectives met). The authors intend to follow-up with the 41 participants in 2011 with an online survey to ask each participant to mark which of a possible set of follow-up activities they were able to complete and to specifically note any barriers to their completion. This data will help refine future workshops.
Summary
In conclusion, the challenge for continuing development and promotion of academic anesthesiologists lies in the explicit training of faculty for career advancement. Designing workshops and other educational programs using educational tools to promote a reflective process for the faculty member is the one method to meet this challenge. Having now delivered the material to almost 200 junior faculty, we believe that this national workshop has made a good start in increasing awareness of a core of junior faculty nationally . SPA has indicated its intention to continue offering the workshop each year since there continues to be strong interest (i.e., the workshop has filled each year). One of the authors (SY) intends to present this workshop as an option for SEA and ASA as well and potentially to take it to the program directors for anesthesiology for possible usage with their senior residents and fellows.
Acknowledgments
Institutional support from each author’s academic division was provided for this project. No external funding sources were used.
Appendix 1
Professional Network Questionnaire
Your Name: Today’s Date:
Directions: In the table below please list the 5 colleagues most important to you today. Please read the instructions below to fill out this questionnaire. All information provided will be kept confidential:
| A. | B. | C. | D. | E. | F. | G. | H | |
|---|---|---|---|---|---|---|---|---|
| Name (Last name, First initial) * All names kept confidential |
Male/Female (Circle one) | How (1-9) | Length (# of Years) | Relationship (1-4) | Affiliation (1-4) | Contact (1-6) | Focus (1-3) | |
| 1 | M F | |||||||
| 2 | M F | |||||||
| 3 | M F | |||||||
| 4 | M F | |||||||
| 5 | M F |
Name - In column A list the names of up to five (5) of your most important colleagues.
Male/Female - In column B, please circle whether the individual is male or female.
-
How - In column C indicate how you met each of the individual (select one only):
-
(1)
Is/Was my teacher, program director or supervisor.
-
(2)
Is/Was my student.
-
(3)
Met at a professional meeting/national conferences.
-
(4)
Met on the job (happened circumstantially).
-
(5)
Met on the job (sought this person out intentionally).
-
(6)
Met on committee/peer review panel.
-
(7)
Met during training/my classmate.
-
(8)
Met through consulting
-
(9)
Met at a social event.
-
(1)
Length - In column D indicate how long you have known this individual. State your answer in years.
-
Relationship - In column E, please state how you would characterize the primary relationship you have presently with each individual (select one only).
-
(1)
Mentor - Person of greater experience/higher rank who takes a personal interest in your career development.
-
(2)
Protégé - Person of lesser experience/lower rank whom you mentor.
-
(3)
Peer Colleague – Person at approximately the same level.
-
(4)
Personal Friend - A social-oriented relationship.
-
(1)
-
Affiliation - In column F indicate whether each individual listed in column A is (select one only)
-
(1)
Personal Friend - No connection to your current professional work.
-
(2)
Department Colleague - In your department.
-
(3)
University Colleague - Outside your department but within your university/research or training center.
-
(4)
National Colleague - Outside your university/medical center.
-
(1)
-
Contact - In column G indicate over the past year how frequently you have been in contact with each individual listed:
-
(1)
Few times per year (1-2 times).
-
(2)
Approximately once every other month (3-6 times per year)
-
(3)
Approximately once per month (7-12 times).
-
(4)
Approximately once every other week (13-26 times)
-
(5)
About once per week (27 - 52 times).
-
(6)
More than once a week or daily (> 52 times per year).
-
(1)
-
Focus - In column H indicate the primary focus of your contact with each individual listed in column A (select one only).
-
(1)
Mentor/protégé (give/receive advice on promotion; office politics; professional goals, etc.)
-
(2)
Socially oriented (exchanging confidences; exchanging solicited, constructive criticism)
-
(3)
Task oriented (co-authoring a paper, co-teaching, making joint presentations, exchanging research ideas, consulting about a student or client/patient)
-
(1)
USC Division of Medical Education
Appendix 2
Career Planning and Development Document
Society for Pediatric Anesthesiology
Introduction: What is your ultimate career goal? Dean? Department Chair? Division Chief? Director of an institute, curricular unit or training program? Professor? President of a national organization? Teacher? Based on your ultimate goal, you will begin to select the types of materials to keep in your curriculum vitae and teaching portfolio, as well as begin to make a professional development plan.
Directions: To develop a career plan, begin by describing your ultimate professional goal. Then calculate how many years from today that you will reach that goal (or ultimate position). Be specific. List the activities you will be engaged in, how will your time be spent and what skills will you use? Next describe your current position in the same type of detail.
If possible, talk to someone who holds your ultimate job prior to completing this form. You can tell them that you are doing this as part of your preparation for attending the SPA session. This interview should focus on the skills and abilities needed for the job and will help you complete the workshop activities. You might also ask them how they prepared for the job, and things that they wish they had done in preparation that they did not do, etc.
-
Describe Ultimate Professional Goal or Position:
Calculate the number of years it will take to reach that goal. _____
-
Describe your current position:
Directions: Now that you have your ultimate goal and your current job described, it is time to conduct the needs assessment. Complete the chart below.
Conduct a personal needs assessment using whatever means most logical to you (e.g., reading articles, phoning a mentor, discussion with peers). Identify five (5) skills/issues that will be critical to success in reaching your ultimate professional position. After attending the workshop, you may wish to complete column 2, listing developmental action for each.
| Issues/Skills Critical to Meeting My Ultimate Career Goal (Personality type, specific experiences or new skills required, etc.) | Development Action Items (Complete after workshop) | |
|---|---|---|
| 1 | ||
| 2 | ||
| 3 | ||
| 4 | ||
| 5 | ||
To be Completed at the Workshop
4. Identify five (5) skills/issues that will be critical to success in gaining your next promotion. In right had column, begin to brainstorm about what specific actions you might take (action items) this next year to begin to meet your needs.
| Issues/Skills Critical to Gaining My Next Promotion (Personality type, gaps in CV, job challenges, missing skills, etc.) | Development Action Items | |
|---|---|---|
| 1 | ||
| 2 | ||
| 3 | ||
| 4 | ||
| 5 | ||
Appendix 3
Commitment to Change Form
Directions: Please reflect for a few minutes on what you have learned in this workshop and what you plan to do differently in your work life based on what you have learned. The session objectives are provided below as a reminder.
Session Objectives: By the end of the workshop you should be able to:
Discuss the elements of career management
Discuss and enhance your professional network
Complete your career development plan
Take a proactive role in managing your career
Describe the primary lesson you learned in this session:
List two things that you will do differently in your professional life based on what you learned in this session:
1.
2.
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