Leadership Development in Academic Health Science Centers: Towards a Paradigm Shift.

PROBLEM: In an era of increasing complexity, leadership development is an urgent need for academic health science centers (AHSCs). The Association of American Medical Colleges (AAMC) and others have described the need for a focus on organizational leadership development and more rigorous evaluation of outcomes. Although the business literature notes the importance of evaluating institutional leadership culture, there is sparse conversation in the medical literature about this vital aspect of leadership development. Defining the leadership attributes that best align with and move an AHSC forward must serve as the foundational framework for strategic leadership development. APPROACH: In 2015, the Medical University of South Carolina (MUSC) began a systematic process to approach strategic leadership development for the organization. An interprofessional group completed an inventory of our leadership development programs and identified key drivers of a new institutional strategic plan. A strategic leadership advisory committee designed a series of leadership retreats to evaluate both individual and collective leadership development needs. OUTCOMES: Three key drivers were identified as critical attributes for the success of our institutional strategy. Four specific areas of focus for the growth of the institution's ideal leadership culture were identified, with specific action items or behaviors developed for our leaders to model. As a result of this foundational work, we have now launched the MUSC Leadership Institute. NEXT STEPS: Knowledge of our current leadership culture, key drivers of strategy and our desired collective leadership attributes are the basis for building our institutional leadership development strategy. This will be a longitudinal process that will start with senior leadership engagement, organizational restructuring, new programming and involve significant experimentation. Disciplined, thoughtful evaluation will be required to find the right model. In addition to individual transformation with leadership development, MUSC will measure specifically identified strategic outcomes and performance metrics for the institution.

Using the web to increase access to oral health care for patients with special health care needs in South Carolina: A replicable model.

AIM: To create an accessible web-based resource of providers willing to provide dental services for patients with special health care needs (SCHNs). METHODS: With a grant from The Duke Endowment, surveys were sent to dentists in South Carolina RESULTS: Data showed that the majority of providers expressed willingness to treat patients with one or more mild SHCN, but fewer expressed willingness to treat those with one or more moderate or severe SHCN. Additionally, the data showed that among general practitioners specifically, only one-third were willing to treat mild and moderate/severe manifestations of all categories listed. The number of practitioners willing to treat moderate to severe manifestations of SHCN and accept Medicaid and willing to take new Medicaid patients dropped even further. These results demonstrated a need to increase the number of providers in South Carolina who are willing to treat patients with SHCN, and a need to provide an accessible resource for patients with SHCN to be able to find these providers. Data collected populated the web-based resource for the Special Adult Network of Dentists url:www.sandsc.org1 CONCLUSION: This resource may be used by patients, caregivers, and health care providers and could be replicated in other states or designed as a national resource.

An assessment of promotion and tenure requirements at dental schools.

Tenure and promotion are integral parts of the academic environment; however, in this era of growing shortages of faculty, as the baby boomers retire and the majority of dentists choose private practice, recruitment and retention may be affected by the way institutions handle promotion and tenure. A national survey of U.S. dental schools conducted in 2007 assessed the existence of multiple employment tracks for faculty and examined the requirements for promotion and tenure. All responding schools reported the existence of multiple tracks for academic faculty appointments. Many dental schools reported that they provided opportunity for faculty members to switch from one track to another, thus circumventing the traditional "up-or-out" policy. The number of schools offering non-tenure appointment tracks has also increased. This finding indicates an apparent increase over time in flexibility regarding tracks and tenure. The majority of schools did not report requirements for the number of publications necessary for promotion. Those that did report requirements showed an increase in expected scholarly activity relative to past studies, indicating that it may be more difficult than ever to achieve promotion.

Development and assessment of a cultural competency curriculum.

The recent intense attention given to the existence of racial and ethnic health care disparities in the United States has resulted in an enhanced focus on the problem and a call to integrate cultural competence training into health professions curricula. While most dental schools have formally integrated cultural competence into their curricula, the professional literature contains little information regarding the specific types of curriculum modifications necessary to prepare culturally competent dentists. The purpose of this article is to communicate the process and materials used to develop and present didactic curriculum content incorporating cultural competence and to report early data regarding its effectiveness in improving students' knowledge and self-awareness regarding cultural competence. The preliminary observation of differences between pre-test and post-test scores suggests that the curriculum content may have contributed to developing students' cultural knowledge and self-awareness. Students' reflection papers also provided qualitative evidence that experience with the curriculum modules was transformational for some. Recommendations for future curriculum modifications and follow-up research studies to validate the instrument are discussed.

Strategic partnerships between academic dental institutions and communities: addressing disparities in oral health care.

BACKGROUND: A landmark report from the U.S. surgeon general identified disparities in oral health care as an urgent and high-priority problem. A parallel development in the dental education community is the growing consensus that significant curriculum reform is long overdue. METHODS: The authors performed a literature review and conducted a series of structured interviews with key institutional and community stakeholders from seven geographical regions of the United States. They investigated a wide range of partnerships between community-based dental clinics and academic dental institutions. RESULTS: On the basis of their interviews and literature review, the authors identified common themes and made recommendations to the dental community to improve access to care while enhancing the dental curriculum. CONCLUSIONS: Reducing disparities in access to oral health care and the need for reform of the dental curriculum may be addressed, in part, by a common solution: strategic partnerships between academic dental institutions and communities. Practice Implications. Organized dentistry and individual practitioners, along with other major stakeholders, can play a significant role in supporting reform of the dental curriculum and improving access to care.

Evaluation of web-based dental CE courses.

Various organizations offer online continuing dental education (CDE) courses. While previous investigations focused on objective measures to determine the quality of the courses, this exploratory study evaluates the participants' experience with them. We surveyed 436 past course participants from nine online CDE courses (courses provided by six organizations) regarding their experience with the courses taken. Our analysis of the 169 responses (38.8 percent response rate) focuses on how the participants of online CDE courses can be characterized; whether the participants' expectations were met by the courses; how the participants evaluated the content of the courses; why they enrolled; and the participants' experience of the online environment. The results suggest that online CDE courses partially meet the needs and expectations of dental professionals. The lack of communication with peers and instructors as well as the fact that courses appeared outdated were main reasons for dissatisfaction. Most of the participants accomplished their goals of gaining new knowledge and deepening their understanding of the subject. Based on this evaluation, future courses can be tailored to meet more closely the expectations and needs of dental professionals.