2014 Leadership program: Emotional intelligence, mentoring are keys to effective performance

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Mr. Halford

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Meeting attendees interact during the EI portion of the program.

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Dr. Gewertz

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Dr. Pellegrini

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Participants at the Leadership & Advocacy Summit reception.

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Participants at the Leadership & Advocacy Summit reception.

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Dr. Buchmiller

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Dr. González

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Dr. Rombeau

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Dr. Rosen

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Dr. Turner

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Leadership program attendees attend lectures and participate in breakout sessions.

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Participants at the Leadership & Advocacy Summit reception.

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Dr. Rioux

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Leadership program attendees attend lectures and participate in breakout sessions.

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Dr. Nigri (left) and Dr. Malangoni

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Dr. Ferdinand

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Leadership program attendees attend lectures and participate in breakout sessions.

“Leadership is defined as the intentional process by which a person influences others to accomplish a specific goal,” said David B. Hoyt, MD, FACS, Executive Director of the American College of Surgeons (ACS), in his opening remarks at the third annual Leadership & Advocacy Summit, March 29 to April 1, at the JW Marriott, Washington, DC. “The goal of leadership training is to develop better awareness of self and others by focusing on personality and interaction styles,” added Dr. Hoyt, referring to emotional intelligence (EI)—a topic that was a central focus of the leadership program.

Part of a dual meeting held in conjunction with the Advocacy program, the 2014 Leadership program featured presentations on strengthening leadership and mentoring skills, chapter development and success stories, and the practical applications of EI skills to enhance personal and professional relationships.

Patricia L. Turner, MD, FACS, Director, ACS Division of Member Services, said a primary goal of the EI presentation was to give attendees “digestible and evidence-based” information on this emerging topic and how it relates to developing successful leadership skills.

The 2014 Leadership & Advocacy Summit drew a total of 427 attendees—up from 308 attendees last year—from all levels of ACS leadership, including Regents, Governors, Advisory Council members, chapter leaders, and others.

“This meeting provides an opportunity for you to develop a sense of camaraderie with your peers and to meet people who have the same challenges as you do,” said Dr. Turner. “These sessions offer you practical skill sets that you can take back home.”

Successful mentoring

In his presentation, Strategies for Successful Mentoring, John L. Rombeau, MD, FACS, emeritus professor of surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, described the key differences between mentors, teachers, and role models. “All mentors are teachers and role models, but a mentor is personally committed to the educational and professional successes of the mentee,” explained Dr. Rombeau. He suggested that mentors focus on mentee expectations rather than their own, engage in active listening, and work toward consensus and compromise when outlining solutions.

Dr. Rombeau presented what he called “new directions” in mentoring, including the “reverse academic mentoring pyramid” model. Mentoring is typically assigned to junior staff members, such as assistant professors, but he suggested tapping senior surgeons to fill the mentoring role. “I would argue that it is time to bring the gray hairs like me into the picture. We have the most knowledge, and, at this point in our careers, we probably have the most time to work with mentees,” said Dr. Rombeau. He also emphasized the importance of “mosaic mentoring,” which goes beyond the traditional one-on-one model to include non-surgical mentors who can provide guidance on basic business skills, such as negotiating a contract.

Another new direction in mentoring is actually a model that harkens to surgical education practices of the past. “Let’s return to scrub sink mentoring, where we can discuss what operation is being performed, why we are doing it, how we are going to do it, and what evidence there is to support this operative decision,” said Dr. Rombeau.

Jennifer E. Rosen, MD, FACS, chief of endocrine surgery, vice-chair for research, MedStar Washington Hospital Center, Washington, DC, presented an update on the ACS Young Fellows Association (YFA) Mentorship Program. She said the mentorship program has expanded to 20 pairings, including two international pairs, with an expanded range of specialties, including surgical oncology, military plastics, urology, ophthalmology, cardiothoracic, transplant, and critical care.

The program’s primary objective, according to Dr. Rosen, is to strengthen engagement and participation in the ACS for both young surgeons and senior Fellows. “The mentoring program makes the College more accessible,” said Dr. Rosen. “It’s no longer this giant monolith, but rather, it becomes a personal experience with the College.”

The future of the ACS/YFA Mentoring Program will include the development of learning models and training, an expanded mentor base (including more subspecialties), and publication of program results data. Rebecca Britt, MD, FACS, associate professor of surgery and surgical director, Sentara Center for Surgical Education, Eastern Virginia Medical School, Norfolk, will also take over as the director of the program.

“Both mentors and mentees have responsibilities to reach out and stay in touch,” said Dr. Rosen, highlighting lessons learned from the program. “And stated goals are rarely the actual goals,” she said, emphasizing flexibility and open communication as keys to fostering a productive mentor/mentee relationship.

Mark A. Malangoni, MD, FACS, associate executive director, American Board of Surgery, Philadelphia, PA, and a member of the ACS Board of Regents, presented The Mentor’s Perspective, in which he provided what he called “pearls” or guiding principles that surgical mentors should keep in mind when working with mentees, including the importance of a good match, and the ability to function in a relationship that can be, at times, unpredictable.

“Understand what you don’t control,” advised Dr. Malangoni. “It’s important to recognize that there are many uncontrollable factors in the lives of mentees. Be patient, and be a good, active listener. You are not there to tell someone what to do, you are there to listen and to provide guidance.”

Providing insights on his experience as a mentee, Giuseppe R. Nigri, MD, PhD, FACS, assistant professor of surgery, Sapienza University in Rome, Italy, said the ACS/YFA Mentoring Program helped him “understand the dynamics of the ACS.” Carlos Pellegrini, MD, FACS, FRCSI(Hon), then-Chair of the Board of Regents and current ACS President, became a mentor to Dr. Nigri, as did Chad Rubin, MD, FACS, Chair of the ACS General Surgery Coding and Reimbursement Committee. Today, Dr. Nigri, a former ACS International Guest Scholar, is the Italy Chapter Treasurer and a member of the International Relations Committee.

Chapter leadership

“The committees are your chapters’ lifeblood, and strong committee chairs are essential as they are often the driving force for success in their particular area of expertise,” said John P. Rioux, MD, FACS, a member of the Board of Governors, Chair of the Chapter Activities Domestic Workgroup, and Vice-President of the Florida Chapter, speaking on Leading Your ACS Chapter. Dr. Rioux emphasized that chapter committee structure is usually specified in the chapter bylaws and will vary with chapter size, geography, and strategic plan. In his presentation, Dr. Rioux discussed the fundamental role of many key committees, including those focused on residents and associates, young Fellows, women in surgery, finance/audit, nominating, advocacy and health policy, continuing medical education, membership, and the ACS National Surgical Quality Improvement Program (ACS NSQIP®).

Dr. Rioux also underscored the importance of analyzing chapter metrics by using tools such as the College’s Chapter Performance Dashboard. “There are some tools that can help chapter leaders determine whether or not the chapter is meeting the needs of its members,” said Dr. Rioux. The dashboard is designed for individual chapters to evaluate their effectiveness, improve recruitment and retention, and help the ACS determine which areas of the College can assist in making the chapters more successful, such as through additional training.

Successful chapters, at their core, share five fundamental goals, according to Dr. Rioux: sustain membership, involve and recruit young surgeons, develop member enthusiasm, build strong administrative leadership,  and promote ACS programs.

Chapter success stories

A new session at the Leadership program this year focused on chapter success stories. Officers representing three ACS chapters shared notable achievements over the last year—several of which were conceived at the 2013 Leadership program. Dr. Turner emphasized the fact that there were many chapter success stories over the last year, but due to time and schedule constraints, only a small number of chapters would be highlighted during this portion of the meeting. “At each Leadership program, we will aim to share success stories to highlight chapters and to provide ideas for other chapters to implement,” said Dr. Turner.

Massachusetts Chapter

Terry L. Buchmiller, MD, FACS, President of the Massachusetts Chapter, noted several accomplishments over the last year, including enhancements to the annual meeting and a theme-based state house advocacy day.

Recent additions to their annual meeting, now in its 60th year, include continuing medical education (CME) and Maintenance of Certification self-assessment, an online post-meeting survey, afternoon resident Top-Gun competitions (eight teams this past year), and the establishment of the Joseph Murray, MD, FACS, award for outstanding resident scientific talk. The late Dr. Murray was a member of the chapter and received the Nobel Prize for Medicine in 1990.

The theme for the 2013 State House Advocacy Day was inspired by the Boston Marathon bombing, with a focus on post-event assessment and enhanced infrastructure coordination, said Dr. Buchmiller. “Last year, during the Leadership Summit, all of our cell phones were going off with news of the Boston Marathon Bombing,” recalled Dr. Buchmiller, who noted the event was a call to action for surgeons in her state to advocate for improved trauma response policy. The chapter’s “ask” to state policymakers, according to Dr. Buchmiller, was for “state funding for a 1.5 full-time equivalent epidemiologist/ statistician through the Department of Health for trauma data assessment.”

Other notable chapter accomplishments over the last year include the ongoing development of the Massachusetts Surgical Quality Improvement Collaborative, as well as the state’s pilot grassroots advocacy program.

Dr. Buchmiller said the chapter plans to implement new recruitment strategies over the upcoming year, including attendance at intern orientation programs across the state, and development of young surgeon practice management seminars.

Metropolitan Philadelphia Chapter

Francis D. Ferdinand, MD, FRCS, FACS, FACC, Past-President of the Metropolitan Philadelphia Chapter and an ACS Governor-at-Large, described several goals met by chapter leaders and members over the past year, including increased attendance at the chapter’s annual event, the development of a citywide mock oral boards program that more than 50 residents attended, and a renewed effort to encourage chapter leaders and members to foster statewide collaboration and communication.

To boost attendance at the annual dinner meeting, chapter leaders engaged in the “selection of non-specialty-specific national speakers and efficient partnering with industry to achieve an attendance of 135 surgeons from our chapter—and surrounding chapters—for our annual dinner meeting,” said Dr. Ferdinand. Chapter leaders also increased meeting attendance by holding applicant interviews immediately before the annual event. “This allowed potential Fellows to see and experience the College at the local level and offered networking opportunities [for the applicants] as well,” he said. “This [initiative] led to an increase in meeting attendance by as many as 30 individuals, based on the number of applicants.”

Dr. Ferdinand also cited this year’s and last year’s Leadership program as a conduit for improved communication with other state chapters, including the Keystone Chapter, the Northwestern Pennsylvania Chapter, and the Southwestern Pennsylvania Chapter.

Puerto Rico Chapter

Carlos González MD, FACS, President of the Puerto Rico Chapter, summarized key chapter achievements from the last year, including promoting ACS NSQIP adoption in regional hospitals; organizing the 64th annual chapter meeting; and supporting ACS initiatives and committees. The annual meeting featured 16 guest speakers and included visiting professor grand rounds at the University of Puerto Rico, medical sciences campus, San Juan, with more than 200 medical students, residents, and faculty in attendance, said Dr. González.

Referring to one of the chapter’s primary goals, Dr. González said that in early 2014 Hospital HIMA San Pablo Caguas received a three-year ACS Commission on Cancer accreditation as a comprehensive community cancer center—the third hospital in Puerto Rico to receive this accreditation.

The power of EI

Understanding emotional intelligence and how it can be used to foster successful relationships with individuals at all levels of an organization was the focus of a presentation by Scott Halford, CSP, an Emmy Award-winning writer and producer and longtime consultant to Fortune 500 executive teams.

EI is defined as a set of “non-cognitive capabilities, competencies, and skills that influence one’s ability to succeed in coping with environment demands and pressures,” explained Mr. Halford.

“Humans can’t fly or swim, and we’re generally not fast runners, so how do we survive? We survive, in part, by how we interact with each other,” said Mr. Halford. What separates humans from other mammals, according to Mr. Halford, is the prefrontal cortex, which he calls the “executive” or “moneymaker” part of the brain that regulates emotions and thought.

“EI is about inclusion and relatedness,” added Mr. Halford. “When we feel included, we perform at higher levels. EI is not fixed like IQ is. And EI, on average, peaks when people are in their 60s, because it grows with life experiences,” he said.

Emotions are a key component of the workplace for the following reasons:

  • Essential to making our brains’ biochemistry work
  • Give weight to ideas
  • Help us discern what is true or false
  • Focus and direct our attention
  • Make it possible to make decisions

EI, in particular, is vital to successful, productive work environments because it “enlarges others rather than makes them feel diminished. EI is what people feel about you when you walk into a room,” he said.

For surgeons, realizing how they are perceived by those around them is essential in developing strong EI. When giving feedback, structure your body language, tone of voice, and other interpersonal cues so that it is received in a positive way and so that it accomplishes what it’s intended to do—improve quality of care.

Emotionally intelligent people are aware of how they come across to others, according to Mr. Halford, and make adjustments accordingly. “A good IQ might get you in the door of professional schools and can help you get hired—but EI is why some people do well in life, while others fail,” he said.

Mr. Halford also described the role that oxytocin, a neurohormone, can play in fostering EI among members of surgical teams. Oxytocin, also known as the bonding hormone or the trust hormone, reduces threat states in the brain and allows people to connect. Laughter is a proven “activator” of oxytocin, according to Mr. Halford, as is the act of collaboration and working toward a goal as a team.

The top five EI attributes for successful surgeon leaders include the following:

  • Independence
  • Stress tolerance
  • Empathy
  • Impulse control
  • Flexibility

Mr. Halford urged surgeons to shift their focus from themselves to others. “It will boomerang back to you.”

EI: A different way of being smart

“Emotional intelligence really makes a difference because it sustains effective leadership, maintains friendships, and fosters collegiality,” said Bruce Gewertz, MD, FACS, surgeon-in-chief, vice-dean of academic affairs, and vice-president, interventional services, Cedars-Sinai Medical Center, Los Angeles, CA, in Emotional Intelligence: Can It Enhance Your Professional and Personal Life? “Emotional intelligence is a different way of being smart,” he said, describing five ways EI can be used to achieve success:

  • Use insight into feelings/emotions to make good decisions
  • Remain hopeful and optimistic despite setbacks
  • Manage moods and control impulses
  • Know what people around you are feeling
  • Persuade and lead others

According to Dr. Gewertz, one of the ultimate goals of fostering EI is to achieve “flow,” a concept developed by Hungarian psychologist Mihaly Csikszentmihalyi, PhD. Flow is similar to what sports psychologists sometimes call the “zone”; it is a state where emotions, feelings, thoughts, and actions are fully synchronized, allowing the individual to focus exclusively on completing a task or goal.

Developing EI and achieving flow are essential for effective leadership in surgery. Dr. Gerwertz suggested that summit attendees strive to “manage their own emotional triggers and reactions to stressors” and to “understand how their actions are viewed by others” to enhance communication, and ultimately, improve outcomes.

The holy grail of leadership

In his lunchtime presentation, Dr. Pellegrini focused on understanding leadership as it has evolved today and provided practical applications for the practice of leadership. “I propose to you that leadership is something that all human beings have an opportunity to exercise,” said Dr. Pellegrini. “Lead from the soul—establishing and developing the moral center is the holy grail of leadership.”

The modern concept of leadership, according to Dr. Pellegrini, is “servant leadership”—a model that is defined by the following characteristics: courage, integrity, selflessness, empathy, collaboration, and humility. “Real leaders—and people of strong character—generate and sustain trust,” explained Dr. Pellegrini. “I can’t overemphasize the importance of [leaders] encouraging openness, and even dissent. Leaders must be candid in their communications and show that they care.”

Leaders must be viewed as trustworthy, and Dr. Pellegrini outlined several ways to build other people’s confidence, including engaging in “deep listening,” which he called “the powerful dynamic of human interaction. Listening doesn’t mean agreeing, but it does mean having the empathic reach to understand another,” he said. He also encouraged surgical leaders to build trust by expressing confidence in followers, by acting with reliability and consistency, and by remembering the “wisdom of the crowds.”

“In the past, when I taught leadership, the concept was ‘follow the leader,’ follow the bird in front because he or she will lead you to food and water and shelter,” Dr. Pellegrini noted. “But now, the bird turns around and taps the talents of his or her followers, and then creates a vision plan.”

In addition to developing trust and supporting the contributions of others, the mark of a good leader is someone who can accept and manage missteps appropriately.

“One has to be comfortable with failure; if you are not comfortable with failure you cannot lead,” asserted Dr. Pellegrini.

He encouraged surgeon leaders to be “talent magnets” rather than “empire builders.” “See what is native in the individual,” said Dr. Pellegrini. “Find their talent and what motivates them, and you will increase the output of the entire organization.” He also highlighted the importance of “removing the blockers,” those who hoard resources or underutilize talent. “Get rid of the prima donnas,” he said.

“The heart is more important than the brain. The way you reach followers is through the heart,” said Dr. Pellegrini.

State/regional meetings

Leadership program attendees convened again this year by geographic location, allowing group participants to identify areas for synergistic and unified efforts. Before adjourning for the day, a representative from each chapter and/or region gave a short report on how the chapter would move forward in the coming year, suggesting initiatives or ways that they could work together with chapters in neighboring states and/or regions.

Several common goals emerged from this year’s breakout session reports, including:

  • Enhance collaboration with neighboring chapters (to develop CME, for example)
  • Reverse mentoring programs to help more senior surgeons embrace technologies
  • Increase marketing of chapter activities
  • Create a committee to promote chapter engagement
  • Develop a formal mentoring program
  • Improve access to quality metrics
  • Develop an advocacy program

Member Services staff are compiling the information presented in the breakout session reports and will provide a summary of these presentations later this year.

The next ACS Leadership & Advocacy Summit will take place April 18–21, 2015, in Washington, DC.

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