Author + information
- Andrew M. Freeman, MDa,
- Rosanne Nelson, MBA, MA/ODb@rosanne_nelson1 and
- Shashank S. Sinha, MD, MScc,d,∗ (, )@ShashankSinhaMD@heartcuredoc
- aDivision of Cardiology, Department of Medicine, National Jewish Health, Denver, Colorado
- bAmerican College of Cardiology, Organization and Leadership Development, Washington, DC
- cDivision of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan
- dInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
- ↵∗Address for correspondence:
Dr. Shashank S. Sinha, Division of Cardiovascular Medicine, Samuel and Jean Frankel Cardiovascular Center, University of Michigan, 1500 East Medical Center Drive, SPC 5853, Ann Arbor, Michigan 48109.
Uncertainties in today’s increasingly complex health care landscape abound (1). These present several challenges for all clinicians, including cardiovascular (CV) fellows-in-training (FITs) and early career professionals (ECPs) (2). Concurrently, a lack of training in nonclinical competencies grows more pronounced (3,4). The title “leader” is no longer reserved for those achieving a certain rank; it is now expected that each physician will lead both independently and collaboratively within a team environment (5). Collectively, FITs and ECPs are intellectually curious, technically sophisticated, and highly accomplished. Yet, it is most often mastery of nonclinical competencies, such as leadership development, that thrusts these individuals further in their career (6).
Institutions within academic medicine and private practice now expect physicians, at all levels, to operate with emotional intelligence, change readiness, and an eagerness to serve as competent and capable leaders, often without formal training or guidance (7–9). Leadership development in medicine remains an important organizational priority across hospitals and persists as the largest “readiness gap” for many organizations (10–12).
Based on data from 2 distinct cohort experiences, comprising 30 FITs/ECPs, the 2-year American College of Cardiology’s (ACC’s) Leadership Academy (LA) programming has demonstrated significant effectiveness for participants both within the College and within participants’ respective institutions. This FIT/EC Page serves to illustrate how leadership development programming shapes and influences the CV practitioner. Specifically, we examine key components of LA programming, delineate the competencies developed during the 2-year curriculum, and share survey data demonstrating self-reported improvements in various nonclinical competencies.
FITs and ECPs are at a critical albeit vulnerable juncture within their career. Prior studies have shown the crucial role of mentorship in cultivating the professional growth and development of these young physicians (13–15). Accordingly, mentorship serves as a linchpin of the ACC’s LA program, and the alignment of a senior mentor to each LA appointee occurs through a manual matching algorithm. This enables ACC’s senior members to play a significant role in guiding CV leaders of the future (16,17). Those at the start of their leadership journey must embrace and address several challenges: assessing change readiness; coaching others; innovating and continuously improving quality; working across generations; and identifying talented individuals to build high-performing organizations (5,6). One cannot coach and develop those within their CV team if one does not have the skills to manage conflict or effectively lead through change. When the investment is constrained and time horizon for return is short, a limited window exists to grow an emerging leader at a phase when skill acquisition and enhancement are indispensable to success.
The ACC Leadership Academy Experience
Professional societies have both an opportunity and an obligation to help FIT and early career members with their leadership development. Launched in 2014, the ACC’s LA is a 2-year leadership development program that addresses various leadership-specific competencies to ensure each FIT and ECP participant is highly qualified to lead their respective organizations.
From the start, the LA curriculum was based on 1 simple question: “What keeps you up at night?” The response from both Cohorts I and II ran the gamut, addressing a strong need for training in such areas as conflict management, team leadership, influencing others, navigating challenging conversations, and how to achieve work-life balance. This input led to a robust curriculum designed to address participants’ unmet needs with respect to key principles of effective leadership. In addition, the program facilitated valuable networking and mentoring opportunities with ACC’s senior members.
We performed a survey in June 2017 to assess the early outcomes of the LA program. Following the progression of the LA’s first 2 cohorts (30 members), we observed significant trends. The survey response rate was 77% (23 of 30). Overall, the data suggest a positive impact to each participant, as he or she navigates from the silo of an “individual practitioner” into the complex milieu of team-based CV care. Specifically, data supported a measurable increase in the primary domains of emotional intelligence: self-awareness, self-regulation, relationship management, and social awareness (18,19). When effectively leveraged, these skills empower FITs and ECPs to transition into leadership roles early within their careers and achieve success within such roles. The following themes emerged from our analysis and illustrate the potential impact of LA programming within the early stage of participants’ careers:
• Participants reported increased confidence in key areas required for effective leadership:
○ 96% of the respondents reported increased confidence in authentic leadership, emotional intelligence, and conflict management.
○ 91% of the respondents reported increased confidence in anticipating, leveraging and managing change.
○ 82% of the respondents reported increased confidence in influencing others.
• Participants believed LA programming enhanced opportunities for and acquisitions of new leadership role(s):
○ 80% of respondents reported that participating in ACC’s LA programming had an impact on the acquisition of a new leadership role(s). Note, this does not imply causality. The LA programming brought forth new opportunities.
• Participants reported a positive impact on success within their newly acquired leadership role(s):
○ Of those that acquired a new leadership opportunity, 100% of respondents reported who participating in LA programming had an impact on their success within the newly acquired leadership role(s).
• Participants stated that LA programming had a significant influence on their strategic approach to leadership:
○ In contrast to their pre-program perspective, >95% of respondents reported a proactive approach to leadership within their role(s).
Growing the Next Generation of Cardiovascular Leaders
Per the standard trajectory for career advancement, those with increasingly complex accomplishments—as gifted clinicians, master educators, or prolific investigators—are poised to ascend to the top of the organization. However, an unintended consequence of that progression leads many organizations to find their senior-most leaders as recipients of a “double loss,” defined as removal of a competent physician from clinical or research roles accompanied by the concomitant promotion of a manager unprepared to lead effectively (20). This phenomenon may occur due to several reasons. First, leadership development programming in medical school, residency, or fellowship training continues to be rare (20–22). Second, design principles for building institutional or departmental faculty leadership development programs, such as 360° feedback and executive coaching to develop a personalized improvement plan, are only recently being implemented (23,24). Last, senior leaders must adapt to a complex, rapidly evolving landscape to keep their clinical teams engaged and committed. Consequently, transitioning from a technically strong subject matter expert to a leader within that space may be extremely challenging for those who have not received proper leadership development. Leadership development programs for members within a professional society are gradually emerging to address this unmet need (25). In this regard, the LA is positioned to serve its FIT and ECP members and may serve as a model for other professional organizations aspiring to develop their own specialty-specific leadership programs.
Effective leadership within complex organizations is both an honor and an obligation. To deliver high-quality care at the patient level, CV professionals need the requisite tools and experiences to lead at a team- or systems-based level. A seed that the ACC planted on behalf of its FIT and ECP members in 2014 now reaps the reward of application within the College, and at dozens of hospital systems, academic institutions, and private practice settings across the country. The data within this paper support evidence of significant self-reported improvement amongst LA participants across several key domains of nonclinical competency development. The data also suggest a strong impact on the growth and development of LA’s first 2 cohorts of participants. These are but a few of the reasons professional societies such as the ACC should continue their seminal role supporting FIT and early career leadership development. Our profession desires it; our health systems demand it; and our patients deserve it.
The authors thank Dr. Robert Harrington for his critical review of an earlier version of the manuscript, as well as support and mentorship; the inaugural LA Cohort I participants and their successors in Cohorts II and III; the distinguished LA mentors; and Marthea Wilson, Carissa Gaine, and the entire ACC staff for their partnership, ongoing support, and committed leadership.
The authors have received financial support and patronage of the Leadership Academy by the American College of Cardiology, Dr. Michael Wolk, and The Michael Wolk Heart Foundation. Dr. Freeman is a social media editor for the Journal; and has conducted nonpromotional speaking for Boehringer Ingelheim. Dr. Sinha is a section editor of the Fellows-in-Training and Early Career Page of the Journal.
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