[The following notes were generated by Andrea Belovich, PhD.]

IAMSE Webinar Series, Fall 2019

Speaker: Darin Latimore, MD
Title: Recruiting, Retaining and Developing a Diverse Faculty
Series: Re-imagining Faculty Development in Health Professions Education

The Fall 2019 IAMSE Web Seminar Series entitled “Re-imagining Faculty Development in Health Professions Education,” is focused on providing participants with practical tips for developing their own skills as well as insight into how to become engaged with and possibly improve the faculty development culture within their institutions. The second installment of this series, entitled, “Recruiting and developing a diverse faculty,” was delivered by Dr. Darin Latimore, the Deputy Dean for and inaugural Chief Officer of Diversity and Inclusion at the Yale School of Medicine. Dr. Latimore holds leading roles in developing a comprehensive plan for furthering diversity, equity, and inclusion at the Yale School of Medicine, including a robust recruitment and retention program for faculty and students from historically underrepresented medical communities. During his talk, Dr. Latimore outlined the need for growing the underrepresented minority (URM) component of the physician workforce, explored best practices for robust recruitment of URM faculty in medicine, and summarized effective strategies medical schools have used to retain URM faculty.

Dr. Latimore first emphasized the need for recruiting and retaining URM faculty, which he defined to include Black/African American, Hispanic/Latinx, and Native American/Pacific Islander faculty. When comparing demographic data between United States medical school faculty1 and the general United States population2, there is a much lower percentage of URMs in faculty (especially in the ranks of associate and full professor1) compared to the general population. In particular, the percentages of faculty from URMs Dr. Latimore identified have not increased by even 1% over the last 15 years across all medical schools.

To underscore the value of diversity in medicine, Dr. Latimore discussed several studies across multiple fields (including business and academia) to show that teams rich in diversity produce higher quality of outcomes3,4,5,6,7. In addition, the patient-physician race concordance is highly relevant for medical care, as patients are more likely to visit physicians with a similar race/ethnicity as themselves8 and tend to perceive physician-patient communication as being poorer when there is a racial/ethnic discordance9. Dr. Latimore stated that URM physicians are also more likely to see underinsured or uninsured patients of all ethnicities, emphasizing the role URM physicians play in addressing healthcare inequity in the United States.

To recruit URM faculty, Dr. Latimore suggested developing learners in the campus “pipeline” by intentionally developing an inclusive culture and allowing URM learners (medical students, residents, and fellows) opportunities to envision themselves (and/or remain) as faculty10. He also discussed examples of such efforts being implemented at Yale School of Medicine, including URM mentorship programs, curriculum revisions to focus on health equity, and mitigation of microaggressions, harassment, and discrimination more proactively when reported. Yale also provides several opportunities for URM learners to network and interact with URM faculty, including a lecture series given by MD, PhD, and resident Yale alumni. Anecdotally, Dr. Latimore discussed that post-exit interviews report that these interventions have led to greater engagement with Yale and the community.

Dr. Latimore next discussed strategies to recruit URM faculty through proactive prospecting. Prior to posting job opportunities, utilize existing faculty networks, NIH-funded grant databases, and conference activities to identify potential candidates10. Unconscious bias training, increasing diversity of search committees and charging search committees to identify candidates of diverse backgrounds can help identify qualified URM faculty candidates11. Contacting diversity subcommittees of organizations can also help when deciding where and how to advertise job postings or locate potential URM candidates. Finally, ensuring the candidate search process and the interview experience are equitable across all demographics is essential to successful recruitment11.

Dr. Latimore also discussed Yale University’s holistic approach to faculty recruitment packages. Rather than offering recruitment packages through individual departments, Yale utilizes a centrally located fund that allows for strategic application and flexibility to adjust funding priorities based on need. The Yale University 50 million Faculty Excellence and Diversity Initiative has facilitated 65 recruitments campus-wide over 3 years, and funds up to 50% of faculty salary (or non-salary requirements) for up to 3 years12.

One of the major challenges to recruiting diverse faculty is the lack of “critical mass” of URM faculty at medical schools to attract other potential candidates13. The cohort recruitment method encourages the recruitment of multiple URM faculty simultaneously to rapidly establish a diverse environment. This method of recruitment has been effective for institutions with very few URM faculty.

Shifting towards the retention of URM faculty, Dr. Latimore discussed two major factors as being important: fostering an inclusive culture at the institutional level and having formal programs geared towards URM professional development and networking at the individual level. Using the University of California San Diego School of Medicine as a case study, Dr. Latimore described a Junior faculty development program (National Center for Leadership in Academic Medicine: NCLAM) with an 87% (13/15) retention rate of participating URM faculty hired in 200514,15. For comparison, USCD has a 58% retention rate of all faculty recruited in 2005, including URM and women faculty subgroups15. This comprehensive program (with funding assistance from a center of excellence grant) provides structured mentorship and sponsorships to junior faculty and is especially proactive in including URM and women junior faculty. The program offers counseling, completion of a professional development project, and several sessions with mentors. Mentors agree to partner with their mentees on projects, critique scholarly work, promote mentees at networking events, advocate for leadership roles for mentees at conference sessions, and encourage invitations to submit manuscripts.

An example of a faculty retention program implemented at Yale is the Minority Organization for Retention and Expansion (M.O.R.E.), a self-run faculty organization supported by Dr. Latimore’s office and the Dean16. The organization offers network/community-building events and open lunches based on topics including appointments and promotion groups, increasing URM presence in leadership, internal and external grant opportunities, and resources to handle bias and discriminatory behavior. In addition to hosting an annual professional development retreat, each department is encouraged to have a junior URM faculty mentorship program run by senior URM faculty. Other initiatives at Yale to promote URM faculty development and retention include a pilot junior faculty coaching program, with a (1-5 year) professional development plan as an outcome, participation in AAMC minority professional development programs for junior and mid-career faculty, and coordinated sessions with media experts to help minority faculty increase career exposure and influence at the national level17.

Dr. Latimore also discussed the importance of developing diverse leaders who will not only mentor URM faculty to encourage individual development but also actively seek and advocate career advancement opportunities for their faculty as a sponsor18. For institutions looking to establish these sponsorship initiatives, it is important to consider the compatibility between mentors and mentees to promote faculty satisfaction with mentorship.

Dr. Latimore concluded by emphasizing the importance of working on institutional climates to promote successful inclusion and retention of URM faculty. Understanding and monitoring the institutional culture is challenging, but focus groups, one-on-one meetings, and exit interviews can help identify areas that need improvement. Since even the most excellent URM faculty may not be able to thrive in a culture of bias hostility or exclusion, inclusive environments are needed, and the environment must be developed as much as the individual faculty.

References (as provided by Dr. Latimore):
1. “Medical School Faculty by Sex and Race/Ethnicity” (2019). Association of American Medical Colleges
2. “United States Census” (2018.) United States Census
3. Hong L., Page SE., 2004
4. Rohner V., Dougan B., 2012
5. Dendon N., Chang MJ., 2019
6. Freeman, R., Huang W., “ Collaborating with People Like Me: Ethnic Coauthor ship within the United States.” J. Labor Economics, Vol. 33 (3) 2015.
7. Campbell L.G., et. al., “Gender-Heterogenous Walking Groups Provide Higher Quality Science.” PLUS-ONE, Vol. 8 (10) 2013.
8. Simon, A.E., et al., “Physician-Patient Race Concordance from the Physician Perspective,” J Natl Med Assoc. 105; 150-156; 2013.
9. Shen, M.J., et al., J. Racial & Ethnic Health Disparities March 2017.
10. Peek M.E., et al., “URM Candidate Are Encouraged to Apply: A national Study to Identify Effective Strategies to Enhance Racial and Ethnic Faculty Diversity in Academic Departments of Medicine”. Acad. Med. ; 88 (3) 405-412, March 2013.
11. Christopher D. Lee. Search Committees: A Comprehensive Guide to Successful Faculty, Staff, and Administrative Searches. 2nd edition. Sterling, VA: Stylus Publishing, 2014.
12. Faculty.yale.edu/faculty-excellence–and-diversity
13. Kaplan, S.E., et al., “Challenges in Recruiting Retaining and Promoting Racially and Ethnically Diverse Faculty,” J Natl Med Assoc, Vol. 110 (1) 58-65, 2018.
14. Assoc, Vol 111 (1) 44-53, 2019.
Daley S., et al., “ Improving the Retention of Underrepresented Minority Faculty in Academic Medicine,” J Natl Med Assoc, Vol 98 (9) 1435-1440, 2006.
15. Wingned D., et al. “ Faculty, Equity, Diversity Culture and Climate Change in Academic Medicine. A Longitudinal Study,” J Natl Med
16. https://medicine.yale.edu/more
17. https://medicine.yale.edu/diversity
18. Raphael J.L., “ The Role of Sponsorship in Achieving Workforce Diversity in Academic Pediatrics.” Pediatrics; 144 (2) 1-4, 2019.

[The following notes were generated by Andrea Belovich, PhD.]

IAMSE Webinar Series, Fall 2019

Speaker: Alice Fornari, EdD
Title: The Current Landscape of Faculty Development: Challenges and Opportunities
Series: Re-imagining Faculty Development in Health Professions Education

The Fall 2019 IAMSE Web Seminar Series entitled “Re-imagining Faculty Development in Health Professions Education,” is focused on providing participants with practical tips for developing their own skills as well as insight into how to become engaged with and possibly improve the faculty development culture within their institutions.

Presenter: Dr. Alice Fornari is the Associate Dean of Educational Skills Development at the Barbara & Donald Zucker School of Medicine (SOM) at Hofstra/Northwell, and serves as the is the Vice President of Faculty Development for the 23 hospitals of the Northwell Health organization.

Dr. Fornari’s talk, “The Current Landscape of Faculty Development: Challenges and Opportunities,” provided a literature-rich overview of the field of faculty development (FD). This review addressed three major considerations, including reasons why FD has grown substantially in the last ten years, factors that either work well or need to be strengthened in current FD programs, and an examination of the future directions, challenges, and opportunities that must be considered by faculty developers and future FD programming over the next ten years. Throughout the talk, Dr. Fornari outlined several resources, ideas, approaches for faculty and faculty developers to consider.

As a field, FD has grown substantially due to its importance in promoting educational excellence and success and contributing to faculty vitality, job satisfaction, and retention. While investment in the growth and development of faculty skills are necessary to promote innovation, one of the most important aspects of FD to recognize as a faculty developer is that FD shapes and supports identity formation for faculty (Steinert et al, 2016; Irby et al, 2016). As such, FD should aim to support the integration of the role of educator into all other areas of faculty responsibilities.

As it exists today, FD is an essential component of Professional Development in healthcare education, which includes all learning activities needed for health professionals to fulfill their roles in healthcare and learning environments. FD and faculty developers influence growth of faculty skills and behaviors in the domains of teaching effectiveness, leadership and management, research capacity building, academic and career (identity) development, and organizational change (Steinert, 2014). Important stakeholders of faculty development include not only current faculty and administrators but also students and learners who will become future educators. Dr. Fornari also emphasized the importance of developing the developers—recognizing that peers and colleagues who are or are becoming faculty developers also need support and development.

Delivery systems for FD that contribute particular value include longitudinal programs, pedagogical consultation, and objective structured teaching encounters (OSTEs). Similar to the Objective Structured Clinical Encounter (OSCE), the OSTE provides the educator with an opportunity to practice teaching skills and to receive feedback. With an eye towards the year 2030 and beyond, Dr. Fornari believes that technological methods (including infographics, podcasts, and social media) will be extremely important in delivering FD programs to audiences, although these methods present their own challenges in terms of creating interactive, group experiences and fostering relationships between faculty.

Key features of successful FD programs include (a) application of situational and experiential learning (active learning principles), (b) application of the “Science of Learning,” (c) support of effective peer and colleague relationships, (d) well-designed interventions, (e) programmatic systems of evaluation, (e) advanced education for faculty developers as role models, and (e) dissemination of faculty development as scholarship.

An excellent and effective strategy/learning environment for implementing FD is the Community of Practice, or CoP (Buckley et al, 2019). The CoP is defined as a group of people who share a craft or profession (Wenger, 1998).  Serving as a psychologically safe, social space where learning is inherent to membership, a healthy CoP builds relationships between members over time, facilitates work on common passions, and allows sharing of resources between members (Buckley et al, 2019; Smith, 2003). CoP’s are valued for facilitating mentorship relationships, promoting collaborative innovations, serving as a mechanism for knowledge management/enhancement (including tacit knowledge) and best practices, and for being a venue to share resources and social capital to achieve common goals. Furthermore, the CoP allows effective FD even when the faculty developer cannot claim competence in all practices of the diverse membership (Buckley et al, 2019). Finally, the CoP and the faculty developers who promote it contribute to faculty resilience, engagement, and ability to find meaning and joy in the workplace. Dr. Fornari outlined 12 practical tips for implementing a community of practice in FD, as developed by Marco Antonio de Carvalho-Filho and colleagues (2019).

Dr. Fornari next identified several opportunities and challenges for disseminating FD as scholarship. FD research should not only focus on individual faculty members and FD community, but also on the workplace communities of faculty in alignment with the CoP model of scholarship (O’Sullivan and Irby, 2011). Researching the effectiveness of FD programming should focus on process, outcomes, and relationships within the program and the participants’ workplace(s), with a focus on improving the workplace environment in a collaborative manner (O’Sullivan and Irby, 2011). Other opportunities include developing humanistic mentors to younger learners (students, residents, junior faculty) (Fornari et al, 2018), and creating entrustable professional activities for faculty. Other opportunities include re-conceptualizing FD as identity development and promoting renewal and reflection on personal and professional growth to allow space for faculty to develop identity, resilience and well-being. Teachers also need to be rewarded as master educators and innovators to allow for career development and advancement through scholarship.

Challenges to scholarship include institutional support (financial and cultural), lack of protected time and resources, identifying and assessing short- and long-term outcomes and impact on multiple stakeholders, assessing the durability of change, and justifying educational outcomes. Strong advocacy by faculty developers and a culture of change (i.e., developing institutional policies that support and reward excellence, innovation, and scholarship) can help to overcome these challenges (Irby and O’Sullivan, 2018).

Programmatic features that lead to creating successful FD initiatives include (i) evidence-informed educational design and measurement of outcomes, (ii) relevant content to faculty, (iii) experiential learning and opportunities for practice and application, (iv) opportunities for feedback and reflection, (v) collaborative educational projects as an outcome, (vi) intentional community building, (vii) longitudinal program design, and (viii) institutional support at all levels. Longitudinal programs are recognized as important but are challenging to implement and assess.

Showing support of joy and engagement in faculty work, using evidence-based evaluation criteria to assess behavior changes and larger societal impact (including end receivers of faculty development), and workplace learning provide benefits to the institution as a whole. Dr. Fornari finished by discussing the financial benefits of FD programming to academic medical centers, including increased job satisfaction of faculty (and reduced turnover), increasing retention of minority and female faculty members, generating increased internal/external grant funding and publications, and the benefit of improving communication with patients, and ultimately improving patient care (Topor and Roberts, 2016). Demonstrating to an administration that there are benefits to FD through scholarship and data will help communicate the importance of FD to senior stakeholders who have the budgetary authority to mitigate the cost. Ultimately, the true value of FD lies in educational excellence, faculty well-being, and increased quality of care to the ultimate stakeholders of FD: patients and general society.

References (as provided by Dr. Fornari):

• Cruess RL, Cruess SR, Steinert Y. Medicine as a Community of Practice: Implications for Medical Education. Acad Med. 2017.
• Lave J, Wenger E. Situated Learning. Legitimate peripheral participation. Cambridge: University of Cambridge Press; 1991.
• Schreurs M-L, Huveneers W, Dolmans D. Communities of teaching practice in the workplace: Evaluation of a faculty development program. Med Teach. 2015; 38 (8):808-14.
• Smith, M. K. (2003) ‘Communities of practice’, the encyclopedia of informal education. www.infed.org/biblio/communities_of_practice.htm
• Steinert Y. Faculty development: From workshops to communities of practice. Med Teach. 2010; 32: 425–428.
• Buckley H, Steinert Y, Regehr G, Nimmon L. When I say . . . community of practice. Medical Education 2019.
• Steinert Y. Faculty Development in the Health Professions: A Focus on Research and Practice. NY: Springer, 2014; p.4.
• Wenger E. Communities of Practice: Learning, Meaning, and Identity. New York: Cambridge University Press; 1998.
• Yvonne Steinert, Karen Mann, Brownell Anderson, Bonnie Maureen Barnett, Angel Centeno, Laura Naismith, David Prideaux, John Spencer, Ellen Tullo, Thomas Viggiano, Helena Ward & Diana Dolmans (2016) A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40, Medical Teacher, 38:8, 769-786
• Marco Antonio de Carvalho-Filho, René A. Tio & Yvonne Steinert (2019): Twelve tips for implementing a community of practice for faculty development, Medical Teacher,
• Irby D, O’Sullivan P. Developing and rewarding teachers as educators and scholars: remarkable progress and daunting challenges. Medical Education (2018) 52: 58–67
• Topor D, Roberts D. Faculty Development Programming at Academic Medical Centers: Identifying Financial Benefits and Value. Med.Sci.Educ. (2016) 26:417–419
• O’Sullivan P, Irby D. Reframing Research on Faculty Development. Acad Med. April 2011
• O’Sullivan P. What Questions Guide Investing in our Faculty? Acad Med. Published ahead of print