Interprofessional reconstruction of a policy for academic advancement: The evolution and evaluation of scholarship for today, tomorrow, and beyond.

Within higher education, scholarship is narrowly and inconsistently defined, limiting recognition of evolving faculty expectations, particularly for nursing faculty. At this academic medical center, a campus-wide, multi-school, academic advancement policy was achieved with a broader definition of scholarship that included: peer-reviewed publication of federally funded research, as well as innovation in curriculum development, teaching methodology, community engagement, safety and quality improvement, clinical practice, and health policy that would be applicable to tenure and non-tenure track faculty. The background, process, and outcomes of developing an expanded definition of scholarship that encompasses new and evolving areas of scholarship for a reconstructed academic personnel policy is presented. Beginning with a literature review and surveys of other schools' policies, we describe how a campus-wide working group ensured consensus and acceptance of the new policy. Upon approval of the reconstructed document, guidelines for implementation were widely disseminated through training workshops and discussions, integration into new faculty orientation, and faculty development programs. We share our process, outcomes, and lessons learned believing this information to be useful to other institutions engaged in review and revision of their promotion and tenure processes to align with the increasing expectations of nursing faculty of today and tomorrow.

Defining Scholarship for Today and Tomorrow.

ABSTRACT: Scholarship, required for academic advancement, has traditionally been defined narrowly, not keeping pace with the expansion of faculty academic activities in health professions schools. How can we refine the definition of scholarship so that it better aligns with the scope of current faculty practice within academic health systems? Revision of the academic policies for promotion and tenure at the University of Massachusetts Chan Medical School afforded an opportunity to redefine scholarship such that a broader platform was available for faculty recognition, aligning with current academic standards, yet providing flexibility for the future. The authors describe the historical context of the definition of scholarship and their institution's process to construct a definition of scholarship with three essential elements: advancement of knowledge, dissemination for critical review, and impact on a discipline, practice, or community. Application of this definition to team science and digital scholarship is also described. Following a widespread continuing education initiative, implementation of the new definition within promotion and tenure processes of the medical, nursing, and graduate schools resulted in broad acceptance across the institution. This forum article provides lessons in leading an academic health sciences institution to reassess academic processes and is a resource for advancing the vigorous debate on the evolving meaning and evaluation of scholarship.

Endowed Chairs and Professorships: A New Frontier in Gender Equity.

PURPOSE: Endowed chairs and professorships are prestigious and financially important awards that symbolize individual faculty recognition. However, data about the gender distribution of these positions are lacking. The purpose of this study was to examine the gender distribution of endowed positions at U.S. medical schools and identify strategies that have been used to promote investiture of women into these positions. METHOD: The authors interrogated the websites for all U.S. medical schools for publicly available data. Of 38 schools that listed schoolwide information, they analyzed data from the 30 with at least 10 endowed positions. Then, they conducted interviews with deans of the 10 schools with the highest percentages of women holding endowed positions ("top 10") to understand the strategies they used to increase gender equity in this area. RESULTS: The percentage of endowed positions held by women at the 30 schools analyzed ranged from 10.8% to 34.6%, with a mean of 21.6%. Themes that emerged from interviews with deans included (1) intentionality to identify women candidates in the selection process, (2) monitoring the numbers of women holding endowed positions, (3) inclusion of endowed positions as part of larger institutional goals on gender equity and diversity, (4) use of endowed positions to recruit, retain, and recognize women faculty, (5) purposeful fundraising to increase the number of endowed positions, and (6) institutional investment of resources to develop women faculty. CONCLUSIONS: Analysis of the gender distribution of endowed positions across 30 representative U.S. medical schools revealed a significant gender disparity. Interviews with deans at the top 10 schools revealed strategies that they have used to promote equity in this important area. Implementation of a systematic national reporting process could provide schools with comparative data to gauge their progress.

A Systematic Review of Development Programs Designed to Address Leadership in Academic Health Center Faculty.

INTRODUCTION: To describe Academic Health Center (AHC) faculty leadership development program characteristics and categorize leadership topics into thematic areas suggesting competency domains to guide programmatic curricular development. METHODS: A systematic literature review was conducted (PubMed/MEDLINE, Scopus, Cumulative Index of Nursing and Allied Health Literature [CINAHL], and Journal Storage [JSTOR databases]). Eligible studies described programs with leadership development intent for faculty in AHCs. Information was extracted using a structured data form and process. RESULTS: Six hundred ninety citations were screened; 25 publications describing 22 unique programs were eligible. The majority (73%) were institutionally based; mean class size was 18.5 (SD ± 10.2, range 4.5-48); and mean in-person time commitment was 110 hours (SD ± 101.2, range 16-416), commonly occurring in regular intervals over months to years (n = 10, 45%). Six programs provided per participant costs (mean $7,400, range $1000-$21,000). Didactic teaching was the primary instructional method (99.5%); a majority (68%) included project work. Fourteen thematic content areas were derived from 264 abstracted topics. The majority or near majority incorporated content regarding leadership skills, organizational strategy and alignment, management, self-assessment, and finance/budget. DISCUSSION: Institutions and faculty invest significantly in leadership development programs, addressing perceived needs and with perceived benefit for both. The prevalence of common curricular content indicates that AHCs deem important faculty development in leadership, business, and self-assessment skills.

Advancing Professional Development Through a Community of Practice: the New England Network for Faculty Affairs.

INTRODUCTION: In an era of competing priorities, funding is increasingly restricted for offices of faculty affairs and development. Opportunities for professional staff to grow and network through attendance at national meetings and to share best practices are limited. We sought to describe a community of practice established to enhance the professional development of faculty affairs professionals and to document its impact. METHODS: We outlined the process of formation of the New England Network for Faculty Affairs (NENFA), reviewed the pedagogical approaches to professional development, and surveyed members to evaluate the impact of NENFA on their activities, professional network and their institutions. RESULTS: After a successful 2011 initial meeting, NENFA created an organizing committee and conducted a needs assessment among potential members. NENFA's charter, mission, goals, and structure were based on survey results. NENFA's regional community of practice grew to 31 institutions and held 10 meetings over 5 years. Meetings have examined a faculty development topic in depth using multiple learning formats to engage participants from academic medical centers and allied professions. Results from a 2015 member survey confirmed the value of NENFA. Multiple members documented changes in practice as a result of participating. DISCUSSION: NENFA has been sustained by volunteer leadership, collaboration, and the value that the group has brought to its members. We propose that a "community of practice" offers an effective model for collaborative learning among individuals at different institutions within a competitive health care environment. We recommend that the approach be replicated in other regions.

Meeting the Late-Career Needs of Faculty Transitioning Through Retirement: One Institution's Approach.

PROBLEM: Medical school faculty are aging, but few academic health centers are adequately prepared with policies, programs, and resources (PPR) to assist late-career faculty. The authors sought to examine cultural barriers to successful retirement and create alignment between individual and institutional needs and tasks through PPR that embrace the contributions of senior faculty while enabling retirement transitions at the University of Massachusetts Medical School, 2013-2017. APPROACH: Faculty 50 or older were surveyed, programs at other institutions and from the literature (multiple fields) were reviewed, and senior faculty and leaders, including retired faculty, were engaged to develop and implement PPR. Cultural barriers were found to be significant, and a multipronged, multiyear strategy to address these barriers, which sequentially added PPR to support faculty, was put in place. A comprehensive framework of sequenced PPR was developed to address the needs and tasks of late-career transitions within three distinct phases: pre-retirement, retirement, and post-retirement. OUTCOMES: This sequential introduction approach has led to important outcomes for all three of the retirement phases, including reduction of cultural barriers, a policy that has been useful in assessing viability of proposed phased retirement plans, transparent and realistic discussions about financial issues, and consideration of roles that retired faculty can provide. NEXT STEPS: The authors are tracking the issues mentioned in consultations and efficacy of succession planning, and will be resurveying faculty to further refine their work. This framework approach could serve as a template for other academic health centers to address late-career faculty development.

Grant writing 101.

Writing a grant is a hefty undertaking. Start by surrounding yourself with a successful mentor and accompanying team with a good track record. Get organized, select clear goals and objectives to your project. Once the foundation for the grant is set, begin by generating a robust hypothesis. Once your hypothesis is clearly defined, you should contact the project officer of the specific grant for which you are applying; they can help identify if the proposal meets an area of need. The basic components of a grant include the following: the face page, which highlights the key contributors; followed by table of contents; abstract; biographical sketches, which are minicurriculum vitae; budget; research plan, which is composed mostly of background, significance, and specific aims; and lastly, references cited. Be sure to follow specific formatting. Use resources including the internet to find an appropriate grant. Finally, given the confines of a busy surgical practice and the significant amount of work necessary to complete a grant, it is essential that the work begins early and well in advance of the proposed deadline.

Perspective: Toward a competency framework for faculty.

Today, faculty in academic medicine face challenges in all three mission areas--research, education, and patient care--and require a broad set of competencies to survive in this changing environment. To support faculty and to design assessments that match new expectations, the authors argue that it is essential to capture the full scope of skills, knowledge, and behaviors necessary for a successful faculty member. Thus, it is timely to explore and define competencies for faculty in academic medicine. The authors describe three approaches to identifying faculty competencies. Each reveals diverse but overlapping sets of competency domains, reflecting the breadth of activities expected of today's faculty. To organize these competencies into a coherent framework, the authors propose a model based on a typology of competency. A key feature of the model is the division between occupational competencies, which are largely role-specific, and personal competencies, which are necessary for all faculty. A competency framework also must be developmental, to reflect the growth in skills, knowledge, and behaviors from trainee to expert and to allow for an individual's changing roles over a career. Such a competency framework will inform professional development activities and require assessment of competence. The generation of competencies also will reveal areas of faculty practice that are poorly measured, requiring new tools to be incorporated into existing processes of faculty evaluation. The authors provide general principles to guide the identification of a competency framework for faculty and invite the academic medicine community to engage in further discussion.

The essential value of projects in faculty development.

Projects--planned activities with specific goals and outcomes--have been used in faculty development programs to enhance participant learning and development. Projects have been employed most extensively in programs designed to develop faculty as educators. The authors review the literature and report the results of their 2008 study of the impact of projects within the Pennsylvania State University College of Medicine Junior Faculty Development Program, a comprehensive faculty development program. Using a mixed-methods approach, the products of project work, the academic productivity of program graduates, and the impact of projects on career development were analyzed. Faculty who achieved the most progress on their projects reported the highest number of academic products related to their project and the highest number of overall academic achievements. Faculty perceived that their project had three major effects on their professional development: production of a tangible outcome, development of a career focus, and development of relationships with mentors and peers. On the basis of these findings and a review of the literature, the authors conclude that projects are an essential element of a faculty development program. Projects provide a foundation for future academic success by enabling junior faculty to develop and hone knowledge and skills, identify a career focus and gain recognition within their community, generate scholarship, allocate time to academic work, and establish supportive relationships and collaborative networks. A list of best practices to successfully incorporate projects within faculty development programs is provided.

Functional mentoring: a practical approach with multilevel outcomes.

INTRODUCTION: Mentoring is a central component of professional development. Evaluation of "successful" mentoring programs, however, has been limited and mainly focused on measures of satisfaction with the relationship. In today's environment, mentoring programs must produce tangible outcomes to demonstrate success. To address this issue, the authors advance the framework of functional mentoring combined with measurement of outcomes at multiple levels. METHODS: The mentoring program is embedded within an intensive, continuing medical education (CME) accredited faculty development program. Survey methodology is used to collect qualitative and quantitative data at the start, midpoint, and end of the program and longitudinally. Participants in 4 years of the program were surveyed. RESULTS: In 4 years, 165 faculty participated in the program. Respondents were highly satisfied with the pairings: 85% of junior faculty believed their mentor had a significant effect on their projects. Junior faculty reported a significant enhancement of skills related to initiating and negotiating a new mentoring relationship (85%) and stated that their project would have a significant impact on their career (92%) and on the department or institution (86%). DISCUSSION: The success of this mentoring program is demonstrated at multiple levels. The key outcome of functional mentoring is the project. Projects are aligned with professional responsibilities and with institutional missions. The project contributes to the individual's dossier and adds value to the institution. Functional mentoring is a practical approach that allows measurable results at multiple levels.

Empowering junior faculty: Penn State's faculty development and mentoring program.

Empowerment of faculty is essential for academic success. The Junior Faculty Development Program (JFDP), sponsored by the Office of Professional Development of the Penn State College of Medicine, was established in 2003 with the goal of promoting the development and advancement of junior faculty so they can achieve success in their academic careers. The program consists of two components: a curriculum in research, education, clinical practice, and career development, and an individual project completed under the guidance of a senior faculty mentor. The curriculum provides faculty with knowledge, skills, and resources. Mentoring provides relationships and support. Together, these elements combine to empower junior faculty to better manage their careers. The effectiveness of the program has been demonstrated by several measures: participants evaluated the program highly, demonstrated increases in their perceptions of their own abilities, and completed tasks important to the advancement of their careers. Participants stated they were better prepared to advance their academic careers and that the individual projects would contribute to their career advancement. On the basis of this experience, the authors suggest that faculty development programs should empower faculty so that they can more effectively chart a successful career in academic medicine. This report describes an empowerment model, and the design, implementation, and evaluation of the Junior Faculty Development Program in 2003-04 and 2004-05. The authors offer this program as a model for the benefit of other institutions and for one of their most valuable assets: junior faculty.

Seven cDNAs enriched following hippocampal lesion: possible roles in neuronal responses to injury.

Synaptic plasticity is important for formation of long-term memories and in re-establishment of function following injury. Seven cDNAs enriched following lesion in the hippocampus of the rat have been isolated using a PCR-based cDNA suppression subtraction hybridization. Sequence analysis resulted in the identification of two genes with known roles in synaptic development and neuronal activities: astrotactin and calcineurin. These two neuron-specific genes have established roles in development or synaptogenesis. Sequence analysis of the other five additional genes shows that two are likely to be involved in G-protein signaling pathways, one is a WD repeat protein, and the remaining two are entirely novel. All seven candidates are expressed in the hippocampus and, in some cases, cortical layers of adult brains. RT-PCR data show that expression increases following synaptogenic lesion. Immunocytochemical analysis in primary hippocampal neurons showed that Calcineurin immunoreactivity was redistributed in neurons during 2 weeks in culture. This redistribution suggests that Calcineurin's role changes during neurite outgrowth immediately prior to synapse formation in vitro. In addition, inhibiting Calcineurin activity with cyclosporin A enhanced neurite outgrowth, suggesting that Calcineurin has a regulatory role in axon sprouting. The discovery of previously unknown genes involved in the response to neurodegeneration will contribute to our understanding of neural development, responses to CNS trauma, and neurodegenerative diseases.

Differential expression of protein tyrosine kinase genes during microglial activation.

Protein tyrosine kinase (PTK) activity is abundant in microglia, but the PTKs that participate in their activation have not been identified. For these studies, we used three paradigms to characterize PTK expression during microglial activation: resting and activated microglia were bulk fractionated from the adult brain, cultured newborn microglia were treated with lipopolysaccharide (LPS) to model the transition from activated toward phagocytic microglia, and PTK expression was examined in activated microglia in situ after facial nerve axotomy. Two PCR-based strategies were used to show that 21 different PTK genes are expressed by rat brain microglia: 5 receptor PTKs, 10 nonreceptor PTKs, and 6 members of the src family. Seven of the 21 PTKs were examined in greater detail. Five PTK mRNAs (fgr, hck, fak, jak-2, and flk-1) increased expression across all three models of activation. We conclude that they represent key components in the cascades that participate in microglial activation. In contrast, expression of fes and fms correlated with stimuli that affect microglial proliferation. Four of the PTKs (hck, fgr, fes, and fms) are believed to be myeloid cell specific and were not expressed by cultured astrocytes. HCK and FAK protein were also not expressed in lysates of immature astrocytes and oligodendrocytes. Because of their putative specificity, these kinases represent potential targets for inhibitors of microglial activation. Because reactive microglia can exacerbate the severity of neurological diseases, the identification of specific kinases that participate in microglial activation represents an important advance toward the development of new therapeutics.