Evaluation of a Competency-Based Health Policy Training Program

https://digitalcommons.unmc.edu/coph_policy_reports/1009/thumbnail.jp

Evaluation of a Competency-Based Health Policy Training Program

An academic and practice partnership was formed to create and implement a competency-based training program for local health departments in health policy. We evaluated if the training program improved the policy knowledge and competency of participants. Participants exhibited significant increases for self-assessed policy competency, including substantial improvements in “Critique the feasibility and expected outcomes of potential policy options”, “Identify and assess the strengths and motivations of key stakeholders and potential resistors”, and “Recommend a specific policy change”. The policy competency instrument developed in this report could be used to measure policy knowledge and competency in future training implementations.https://digitalcommons.unmc.edu/coph_policy_reports/1000/thumbnail.jp

Implementing measurable goals for diversity, equity, and inclusion in Clinical and Translational Science Awards leadership

Charting a benchmarking strategy is recommended to measure improvements in equal leadership opportunities for minorities and women in the Clinical Translational Science Awards Consortium (CTSAs). Academic institutions that support diversity, equity, and inclusion (DEI) initiatives should demonstrate a willingness to track their progress with established metrics. In the fall of 2020, the CTSAs convened a virtual conference, which started a dialogue on developing measurable objectives to ensure accountability for DEI goals. Using qualitative and quantitative data from breakout sessions, the authors analyze participant responses to the following recommendation, “develop a common metric and dashboard with regular reporting on diversity in CTSA leadership, with an emphasis on increasing female and Black Indigenous, People Of Color (BIPOC) representation to 30% each,” to understand the impact and challenges associated with implementing metrics within CTSAs. Thematic analysis revealed that white supremacist culture and demographic composition are obstacles to establishing metrics. Participants expressed uncertainty about the perception of token roles. Additionally, participants believed that DEI targets can increase diversity in perspectives and approaches to translational science. Implications for CTSAs include establishing CTSA-wide benchmarks for DEI initiatives, which includes a baseline of the existing DEI climate to assess institutional norms and measurable objectives to track progress

Improving the equity landscape at U.S. academic institutions: 10 strategies to lead change

In the United States, disparities with respect to race, ethnicity, and gender are common across academic institutions, particularly those that are large and have health research-oriented missions. Disparity-affected issues include leadership roles, funding, tenure, and salary. This paper presents a review of the current literature describing those disparities, with a focus on health professions serving major universities in the United States, and proposes approaches to create greater diversity, equity, inclusion and belonging (DEIB) within them. While many organizations nationally are working to address DEIB disparities, academic institutions can benefit from implementing structured approaches and training to nurture their cultures, foster DEIB, and promote psychological safety. We present a literature-based 10-component approach institutions can adopt with relative ease and thus positively support advancing their DEIB engagement. These 10 strategies include the following: Clearly stating DEI values; Conducting gap analyses to identify issues; Using incentives to propel change; Removing bias from recruiting processes; Implementing blind applications processes; Diversifying selection committees; Creating inter-institutional partnerships that truly represent shared power; Developing people and the pipeline; Formalizing mentorship and sponsorship programs; and instituting anti-bias training. Easily implementable strategies can both foster change and build the will and confidence to pursue larger DEIB goals in the future

Leadership Development to Advance Health Equity: An Equity-Centered Leadership Framework

Enduring questions about equity are front and center at this watershed moment in health care and public health. Inequities that became evident in the COVID-19 pandemic in 2020 have highlighted long-standing disparities in health by race and ethnicity. Current crises require examining and reorienting the systems that have, for decades, produced these health inequities; yet, public health and health care leaders are inadequately prepared to respond. The authors offer an equity-centered leadership framework to support the development of visionary leaders for tomorrow. This framework for leadership development programs interweaves traditional leadership and equity, diversity, and inclusion domains in both conceptual knowledge and skills-based teaching for health care and public health leaders, grouping competencies and skills into four domains: personal, interpersonal, organizational, and community and systems. A framework such as this will equip leaders with the mindset and skillset to challenge the paradigms that lead to inequity and health disparities

Clinical Scholars: Making Equity, Diversity and Inclusion Learning an Integral Part of Leadership Development

The plethora of persistent and pervasive health inequities in the United States is a Wicked Problem which threatens the health and wellbeing of all people. To dismantle them is no easy task, and requires a health care workforce practiced in leadership skill sets embracing a deep focus on areas of equity, diversity and inclusion (EDI). This chapter describes how the core competencies and curriculum of the Clinical Scholars Program have been designed to offer this set of skills. To start, the program’s foundational set of 25 competencies cover four domains (Personal, Interpersonal, Organizational, and Community & Systems) and include both more traditional leadership competencies as well as contemporary competencies focused on equity, diversity, and inclusion. The curriculum takes the set of 25 leadership and EDI competencies and breaks them down into learning sessions where participants listen, practice, and apply the ideas, behaviors, and mindsets. The leadership core and the EDI core of the curriculum exist both in tandem and in unison to provide the full Clinical Scholars experience. At times, sessions focus on one core or the other, and at times, both leadership and EDI are present in the learning of a session. Example learning sessions for each core and the weaving of the cores together are provided. Four challenges to creating an equity-centered leadership program are identified: 1. The personalized nature of the journey of self-development; 2. Shifting Mindsets and Skill Sets; 3. Piloting an evidence-based curriculum on EDI; and 4. Maintaining engagement with participants over time and across distance. A set of top recommendations for weaving EDI and Leadership learning are also offered. The chapter details the importance of meaningfully focusing on EDI when tackling modern, wicked problems

Clinical Scholars: Effective Approaches to Leadership Development

The Clinical Scholars (CS) National Leadership Institute (CSNLI) equips interprofessional teams of health care professionals through equity-centered leadership training, preparing them to be change leaders working to advance health equity in communities across the US and its territories. At the time of this writing, four cohorts consisting of 131 Fellows from 14 different disciplines, participating in 36 different teams of two to five members are working on “Wicked Problem Impact Projects”, an implementation science-based approach to action learning projects. This chapter reports on the design of the 3-year CS experience, the onsite and distance-based training support, and the subsequent learning responses of 98 participants, 30 of whom had completed the 3-year training (Cohort 1), 34 of whom had completed 2-years of the training (Cohort 2), and 34 who had completed 1-year of the training (Cohort 3). The training program is guided by 25 competencies that weave leadership and equity throughout, which are divided into four families: Personal, Interpersonal, Organizational, and Community & Systems. Learning outcomes indicated that Fellows are highly satisfied, with all participants rating their experience at 6.10-6.77 on a 7-point scale across all sessions, all years. Retrospective pre-and post-tests assessed learning gains on the competencies, indicating statistically significant changes from baseline to midpoint in participant knowledge, attitude, use, and self-efficacy in each of the 25 competencies and large and significant gains by competency family. The Clinical Scholars Program presents an in-depth, longitudinal, state-of-the-art approach to promoting the cultivation and development of a large and sophisticated set of skills that intentionally integrate leadership competencies with a focus on health equity. Taken together, these outcomes show how a logical and structured process, using widely available tools, can contribute to both learning and implementation of skills that lead to real world impacts in communities. Given the results reported at the close of their Clinical Scholars experience, the data suggest that investing in robust, intensive leadership development of interprofessional teams is a smart decision for impacting the culture of health in communities nationwide

Training "Pivots" from the Pandemic: Lessons Learned Transitioning from In-Person to Virtual Synchronous Training in the Clinical Scholars Leadership Program

Introduction: Since the inception of distance-based teaching modalities, a debate has ensued over the quality of online versus in-person instruction. Due to the COVID-19 pandemic, a number of teaching environments-including leadership development trainings for post-graduate learners-have been thrust into exploring the virtual learning environment more thoroughly. One three-year leadership development program for interdisciplinary healthcare professionals transitioned three simultaneous leadership intensives from in-person to online in the spring of 2020. Methods: Documented changes in overall training length, session length, and session format are described. Further, evaluative data were collected from participants at both retreats via post-session surveys. Ninety-three participants attended the 2019 retreat, and 92 participants attended the 2020 virtual retreat. Quantitative data of three rating questions per session are reported: 1) overall session satisfaction, 2) participants' reported knowledge gain, and 3) participants' reported ability gain. Qualitative data were obtained via two open-ended feedback questions per session. Results: In comparing pre/post scores for knowledge and ability, participants had meaningful (and in some cases higher) self-reported gains in knowledge and ability measures in the online environment, as compared to the in-person environment. Participants reported statistically significant gains in all sessions for both knowledge and ability. Qualitative data of participant feedback identified a number of positive themes similar across the in-person and virtual settings. Negative or constructive feedback of the virtual setting included time constraint issues (eg too much content in one session, a desire for more sessions overall), technical difficulties, and the loss of social connection and networking with fellow participants as compared to in-person trainings. Discussion: While meaningful shifts in knowledge and ability ratings indicate that the transition to successful online learning is possible, several disadvantages remain. The preparation time for both faculty and participants was considerable, there is a need to reduce overall content in each session due to time restraints, and participants indicated feeling the loss of one-on-one connections with their peers in the training. Lessons learned of transitioning leadership training from in-person to an online experience are highlighted

When the Crisis is Personal: Understanding the Lived Experiences of High-Level Leaders Amid Personal Crisis

A CEO’s child is diagnosed with autism spectrum disorder. An executive director learns they have stage 2 thyroid cancer. The chancellor’s divorce takes an ugly turn. The department chair’s partner undergoes a second round of treatment for ovarian cancer. The director of programs experiences a stillbirth. Crisis and profound loss are a part of the human experience, and therefore, are part of the workplace experience.This dissertation explores the intersection of personal crisis and senior leadership in an organizational context. What is it like to live at the crossroads of leading a team, division, or organization while simultaneously experiencing personal trauma (e.g., the death of a loved one, significant illness of a loved one, diagnosis of a life-changing personal illness, the dissolution of a relationship)? Existing literature describes aspects of the return-to-work process following a personal crisis and extensively looks at work-to-family and family-to-work conflict. However, this literature heavily emphasizes the psychological elements of the experience as opposed to leadership-focused elements. Additionally, it considers employees at all levels of the organization, virtually ignoring specific impacts on high-level leaders in the organization. High-level leaders have a degree of responsibility, accountability, and burden to the organization that varies from employees at other levels. It is critical to understand the experiences of high-level leaders from a leadership and organizational context to understand their ultimate needs and to avoid organizational suffering and turnover.This exploratory research highlights two qualitative studies on leaders\u27 lived experiences at the intersection of personal crisis and leadership, and provides a literature review of what we know about this phenomenon. The final discussion focuses on the results and identifies areas of future research