Formal wellness training of academic radiology leaders improves work-life conflict.

OBJECTIVE: To investigate the effect of formal leadership training of academic radiology leaders within an academic center on their own burnout and professional fulfillment. METHODS: The study cohort was academic radiology leaders within one of the largest academic organizations of academic radiologists within the United States. All academic radiology leaders within the organization were electronically mailed a weblink to a confidential IRB-approved survey in April 2021. The survey included validated questions from the Stanford Professional Fulfillment Index (PFI), values alignment, teamwork, overload, and work-family conflict. Academic leaders were invited in May 2021 to participate in instructor-led formal training on leading wellness focusing on 5 core leadership skills - emotional intelligence, self-care, resilience support, demonstrating care, and managing burnout. An identical follow-up survey was electronically mailed 6 months after initial training in November 2021. RESULTS: The overall response rate of academic radiology leaders was 59% (19/32). For both measures, there was acceptable internal consistency (Cronbach's α = 0.63 for work exhaustion and α = 0.90 for fulfillment). There was a statistically significant improvement in work-family conflict (3.32 vs 2.86; p = 0.04). No statistically significant differences were identified for fulfillment, work exhaustion, alignment, work overload, and teamwork scores after training. CONCLUSION: Formal instruction in leading wellness improved work-life conflict for academic radiology leaders. There was no significant change in burnout, fulfillment nor organizational alignment of the leaders. CLINICAL RELEVANCE STATEMENT: Formal instruction in leading wellness raised awareness and improved work-life conflict in academic radiology leaders.

Inclusivity in Leader Selection: An 8-Step Process to Promote Representation of Women and Racial/Ethnic Minorities in Leadership.

At a systemic level, organizations need to take intentional steps to build inclusion, equity, and diversity at all levels. In accordance with this need, organizations have been catalyzed by national conversations surrounding gender and racial/ethnic discrimination to generate sustainable change that addresses the disenfranchisement of women and racial/ethnic minorities. Although progress toward addressing the systemic issues that perpetuate these inequities has been made in recent years, research indicates that underrepresentation at the leadership level persists in academic medicine. Further, those in more senior roles are more likely to select, sponsor, and/or mentor individuals like themselves, thereby depriving minority populations of experiences directly correlated with career development and advancement. Hence, the authors posit a focus on the characteristics and competencies of a leader along with a structured selection process is an effective intervention to reduce bias and support inclusion by recalibrating the representation of leadership within academic medical centers. To this end, the authors developed a sequential 8-step leader selection process informed by their model of leadership characteristics and competencies. This process includes a policy update, selection of interview panels, training of panelists, screening the candidate pool, structured interview guides, final candidate slates, assessments of final candidates, and development of newly selected leaders. By following this process, the authors' organization has seen an increase in the representation of women and racial/ethnic minority leaders, an increase in employees' favorable perceptions specific to representation, and data indicative of developing and maintaining an internal diverse leadership candidate pipeline. Ultimately, inclusion makes stronger and more resilient organizations. By following a standardized process grounded in leadership characteristics and competencies, academic medical centers can see changes in their leadership that mirror the populations they lead and serve. Using such processes can lead to the kind of systemic change needed to create inclusive environments.

Is Beauty in the Eye of the Beholder? Differences in Residency Training Program Preferences Among Women and Minorities.

INTRODUCTION: Training programs are now more than ever seeking ways to promote recruitment and retention of a diverse resident workforce. The goal of this study was to examine how gender and ethnic identities affect applicant attraction to surgery training programs. METHODS: Applicants to general surgery residency in 2018 to 2019 completed a 31-item assessment measuring preferences for training program characteristics and attributes. Differences in preferences across candidate gender and ethnicity were investigated. Factor analyses and analysis of variance (ANOVA) were used to explore these differences. RESULTS: 1491 unique applicants to 7 residency programs completed the assessment, representing 67% of all applicants to general surgery during the 2018 to 2019 season. Women preferred training programs that had high levels of social support (p < 0.001), were less traditional (p < 0.001), and with less turbulence (p < 0.05). Non-white candidates reported greater preference for programs with higher levels of established academics (p < 0.001), clinical experiences (p < 0.001), social support (p < 0.05), traditionalism (p < 0.001), flexibility (p < 0.001), and innovation (p < 0.001). CONCLUSIONS: Organizational efforts to attract and retain a diverse workforce may benefit from considering the aspects of work that align with female and underrepresented minority preferences.

Core conditions of team effectiveness: Development of a survey measuring Hackman's framework.

Leaders and team development practitioners working toward increasing interprofessional team effectiveness frequently need to quickly and accurately determine the extent to which a team possesses the most essential and foundational components required for effective teamwork. While there is no shortage of team theories, there are few freely available, practical, short, and well-developed surveys to measure team functioning across a variety of team types. We developed a 9-item team assessment to fill this gap in the literature, measuring the most fundamental criteria for optimising team functioning, based on Hackman's widely used framework of the foundational conditions for team effectiveness. Reliability and validity of the assessment were investigated through multiple methods, including confirmatory factor analysis and bivariate correlations. Initial psychometric work would appear to support the use of this assessment to measure the three core conditions of team effectiveness. This assessment can be completed by interprofessional team members and their responses can be used to help leaders and team development practitioners focus resources on the most relevant conditions to increase the likelihood of team effectiveness.

Dissecting a department of surgery: Exploring organizational culture and competency expectations.

INTRODUCTION: In order to recruit high-potential trainees, surgery residency and fellowship programs must first understand what competencies and attributes are required for success in their respective programs. This study performed a systematic analysis to define organizational culture and competency expectations across training programs within one academic surgery department. METHODS: Subject matter experts rated the importance and frequency of 22 competencies and completed a 44-item organizational culture inventory along 1 to 5 Likert-type scales. RESULTS: Importance and frequency attributions of competencies varied significantly among programs (p < .05 by ANOVA), but there was substantial agreement on organizational culture; self-directed (x̄ = 3.8), perfectionist (x̄ = 3.7) and social (x̄ = 3.7) attributes were most representative of the program, while oppositional (x̄ = 1.8), competitive (x̄ = 2.5) and hierarchical (x̄ = 2.7) characteristics were least representative. CONCLUSIONS: Residency and fellowship programs within the same department have shared perceptions of the culture and values of their institution, but seek different competencies among entering trainees.

An Examination of Burnout Predictors: Understanding the Influence of Job Attitudes and Environment.

Burnout amongst healthcare employees is considered an epidemic; prior research indicates a host of associated negative consequences, though more research is needed to understand the predictors of burnout across healthcare employees. All employees in a cancer-focused academic healthcare institution were invited to participate in a bi-annual online confidential employee survey. A 72% response rate yielded 9979 complete responses. Participants completed demographic items, a validated single-item measure of burnout, and items measuring eight employee job attitudes toward their jobs and organization (agility, development, alignment, leadership, trust, resources, safety, and teamwork). Department-level characteristics, turnover, and vacancy were calculated for group level analyses. A univariate F test revealed differences in burnout level by department type (F (3, 9827) = 54.35, p < 0.05) and post hoc Scheffe's tests showed employees in clinical departments reported more burnout than other departments. Hierarchical multiple regression revealed that employee demographic and job-related variables (including department type) explained 8% of the variance of burnout (F (19, 7880) = 37.95, p < 0.001), and employee job attitudes explained an additional 27% of the variance of burnout (F (8, 7872) = 393.18, p < 0.001). Relative weights analysis at the group level showed that, of the constructs measured, alignment is the strongest predictor of burnout, followed by trust and leadership. The relationships are inverse in nature, such that more alignment is related to less burnout. Turnover and vacancy rates did not predict group level burnout. The results reported here provide evidence supporting a shift in the focus of research and practice from detection to prevention of employee burnout and from individual-focused interventions to organization-wide interventions to prevent burnout.

Can Better Selection Tools Help Us Achieve Our Diversity Goals in Postgraduate Medical Education? Comparing Use of USMLE Step 1 Scores and Situational Judgment Tests at 7 Surgical Residencies.

PURPOSE: Use of the United States Medical Licensing Examination (USMLE) for residency selection has been criticized for its inability to predict clinical performance and potential bias against underrepresented minorities (URMs). This study explored the impact of altering traditional USMLE cutoffs and adopting more evidence-based applicant screening tools on inclusion of URMs in the surgical residency selection process. METHOD: Multimethod job analyses were conducted at 7 U.S. general surgical residency programs during the 2018-2019 application cycle to gather validity evidence for developing selection assessments. Unique situational judgment tests (SJTs) and scoring algorithms were created to assess applicant competencies and fit. Programs lowered their traditional USMLE Step 1 cutoffs and invited candidates to take their unique SJT. URM status (woman, racial/ethnic minority) of candidates who would have been considered for interview using traditional USMLE Step 1 cutoffs was compared with the candidate pool considered based on SJT performance. RESULTS: A total of 2,742 general surgery applicants were invited to take an online SJT by at least 1 of the 7 programs. Approximately 35% of applicants who were invited to take the SJT would not have met traditional USMLE Step 1 cutoffs. Comparison of USMLE-driven versus SJT-driven assessment results demonstrated statistically different percentages of URMs recommended, and including the SJT allowed an average of 8% more URMs offered an interview invitation (P < .01). CONCLUSIONS: Reliance on USMLE Step 1 as a primary screening tool precludes URMs from being considered for residency positions at higher rate than non-URMs. Developing screening tools to measure a wider array of candidate competencies can help create a more equitable surgical workforce.

Great Expectations? Future Competency Requirements Among Candidates Entering Surgery Training.

INTRODUCTION: We describe a multimethod, multi-institutional approach documenting future competencies required for entry into surgery training. METHODS: Five residency programs involved in a statewide collaborative each provided 12 to 15 subject matter experts (SMEs) to participate. These SMEs participated in a 1-hour semistructured interview with organizational psychologists to discuss program culture and expectations, and rated the importance of 20 core competencies derived from the literature for candidates entering general surgery training within the next 3 to 5 years (1 = importance decreases significantly; 3 = importance stays the same; 5 = importance increases significantly). RESULTS: Seventy-three SMEs across 5 programs were interviewed (77% faculty; 23% resident). All competencies were rated to be more important in the next 3 to 5 years, with team orientation (3.87 ± 0.81), communication (3.82 ± 0.79), team leadership (3.81 ± 0.82), feedback receptivity (3.79 ± 0.76), and professionalism (3.76 ± 0.89) rated most highly. CONCLUSIONS: These findings suggest that the competencies desired and required among future surgery residents are likely to change in the near future.

If You Build It, Will They Come? Candidate Completion of Preinterview Screening Assessments.

INTRODUCTION: Residency applicant screening practices are inefficient and costly. However, programs may not consider using alternative assessments for fear that candidates will be "turned off" by additional hurdles in the application process. This study explores the relationship between candidate completion of preinterview screening assessments, applicant examination scores, and program factors. METHODS: Applicants to any of 7 general surgery residency programs were invited to take a preinterview online assessment. Program characteristics and applicant United States Medical Licensing Exams scores were considered in relation to each program's assessment completion rate. RESULTS: A total of 2960 applicants were invited to take the assessment and 97% (2870/2960) completed it. Program completion rates ranged from 95% to 98%. There was no correlation between program characteristics and applicant completion rates. Candidates who did not complete the assessment had significantly lower United States Medical Licensing Exams scores. CONCLUSIONS: Incorporating preinterview assessments to objectively measure candidate competencies and fit will not detract applicants from a general surgery program.

A primer on theory-driven web scraping: Automatic extraction of big data from the Internet for use in psychological research.

The term big data encompasses a wide range of approaches of collecting and analyzing data in ways that were not possible before the era of modern personal computing. One approach to big data of great potential to psychologists is web scraping, which involves the automated collection of information from webpages. Although web scraping can create massive big datasets with tens of thousands of variables, it can also be used to create modestly sized, more manageable datasets with tens of variables but hundreds of thousands of cases, well within the skillset of most psychologists to analyze, in a matter of hours. In this article, we demystify web scraping methods as currently used to examine research questions of interest to psychologists. First, we introduce an approach called theory-driven web scraping in which the choice to use web-based big data must follow substantive theory. Second, we introduce data source theories, a term used to describe the assumptions a researcher must make about a prospective big data source in order to meaningfully scrape data from it. Critically, researchers must derive specific hypotheses to be tested based upon their data source theory, and if these hypotheses are not empirically supported, plans to use that data source should be changed or eliminated. Third, we provide a case study and sample code in Python demonstrating how web scraping can be conducted to collect big data along with links to a web tutorial designed for psychologists. Fourth, we describe a 4-step process to be followed in web scraping projects. Fifth and finally, we discuss legal, practical and ethical concerns faced when conducting web scraping projects. (PsycINFO Database Record