New study examines leadership programs in academic medical centers

April 22, 2013, St. Michael's Hospital

Academic medical centres invest considerable time, money and other resources in leadership training programs, yet there is no evidence such programs work, a new study has found.

In particular, researchers led by Dr. Sharon Straus at St. Michael's Hospital said they could not determine whether participation in these programs addresses the "paucity of women leaders" in faculty positions at teaching hospitals or which components of leadership training are most effective for women.

Her findings were published online in the journal Academic Medicine.

Dr. Straus said that while the business world had supported leadership training for decades, academic medical centres embraced the concept only within the last 10 years or so. Their programs range from sessions on coaching strategies to sending clinicians to MBA courses.

Dr. Straus reviewed existing research on leadership training programs to examine which types of programs are most effective and what are their outcomes.

"Teaching hospitals are developing such programs and investing significant resources, including faculty time and money, yet we found a remarkable paucity of literature that presents the benefits of such leadership training," said Dr. Straus, a geriatrician and director of knowledge translation at the hospital's Li Ka Shing Knowledge Institute.

"We found that leadership programs have modest at best effects on the yardsticks that matter most to , including advancement in leadership ranks and ability to publish papers in peer-reviewed journals. We have no measurable evidence it's better to have leadership programs or do nothing."

One of their main findings was that more work needed to be done to evaluate which programs work and why.

"In these times of increasing demands on AMCs to manage complex care in a constrained economic environment, effective leaders are essential," Dr. Straus said. "It is likely that leadership programs will continue to be developed and implemented at significant cost to the institutions and individuals participating. High-quality studies will allow the medical community to share best practices and hone interventions to make them maximally effective."

Dr. Straus noted that many academic medical centres have lacked women in senior leadership roles. In 2000, only three women served as the chair of a department of medicine at a U.S. or Canadian medical school, and she said not much has changed since. One of the paper's co-authors, Dr. Wendy Levinson, has been chair of the Department of Medicine at the University of Toronto since 2004. Dr. Catharine Whiteside has been dean of the U of T's Faculty of Medicine since 2005.

A report last year by the Council of Canadian Academies highlighted the underrepresentation of women in the highest ranks of academic research careers in all fields.

"The paucity of women in leadership positions makes it difficult for other women to envision themselves as leaders," the council said in its report. "The paucity of women in leadership positions can also make it difficult for women to become leaders. The higher in the ranks one looks, the fewer women are present in comparison to men in positions such as full professors and presidents of universities, leaders of government agencies, and CEOs of private sector companies. Mentorship and sponsorship initiatives provide with role models who defy gendered expectations and offer advice and support."

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