Interpersonal skills of recent entrants to the field of - ACHE.org

The Interpersonal Skills of Recent Entrants to

the Field of Healthcare Management:

Final Report

December 2011

Prepared for the American College of Healthcare Executives

by

Diane M. Howard, Ph.D., FACHE

Assistant Professor, Rush University

Douglas Silverstein, MHSA, FACHE

President, NorthShore University HealthSystem – Glenbrook Hospital

Interpersonal Skills of Recent Entrants

to the Field of Healthcare Management

Introduction ................................................................................................................................................. 1 Methods ........................................................................................................................................................ 1 Chapter 1: Background ............................................................................................................................. 3

Intergenerational communication and conflict ...................................................................................... 6 Graduate education and early career experiences .................................................................................. 7 Overall Findings ...................................................................................................................................... 8

Demographics of Responding Senior Executives ................................................................................................. 8 Demographics of recent entrant manager (REM) ............................................................................................... 11

Assessment of the REM ......................................................................................................................... 13 a. Paired Comparisons on Intrapersonal and Interpersonal Attributes ................................................................ 13 b. REMs’ Competencies compared with Evaluators’ Own Competencies at the Same Career Stage ............... 17 c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents .............................................................. 18

Chapter 2: The Impact of Senior Executives’ Generation on How They Evaluated their REM ..... 20 Demographic and Positional Characteristics of Evaluators by Generation ........................................ 20 The Demographic Characteristics of REMs by Evaluator’s Cohort .................................................... 21

a. Paired Comparisons on Intra- and Interpersonal attributes ............................................................................. 21 b. REMs’ Competencies compared with Evaluators’ Own Competencies at the Same Career Stage ................ 21 c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents .............................................................. 22

Chapter 3: The Impact of Senior Executives’ Gender on How They Evaluated the REM ............... 38 a. Paired Comparisons on Intra- and Interpersonal attributes ............................................................ 38 b. REMs’ Competencies Compared with Evaluators’ Own Competencies

at the Same Career Stage ................................................................................................................... 38 c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents ............................................... 39

Chapter 4: The Impact of the REM’s Education on How They Were Evaluated ............................. 49 a. Paired Comparisons on Intra- and Interpersonal attributes ............................................................ 49 b. REMs’ Competencies Compared with Evaluators’ Own Competencies


Chapter 5: The Impact of REMs’ Age on How They Were Evaluated ............................................... 61 a. Paired Comparisons on Intra-and Interpersonal attributes ............................................................. 61 b. REMs’ Competencies compared with Evaluators’ Own Competencies


Chapter 6: The Impact of REMs’ Having Clinical Experience on How They Were Evaluated ...... 71 a. Paired Comparisons on Intra-and Interpersonal attributes ............................................................. 71 b. REMs’ Competencies compared with Evaluators’ Own Competencies


Chapter 7: Identification of “Fast Trackers” and Strategies to

Enhance REM Interpersonal Skills ......................................................................................................... 81 Useful Strategies and Programs That Have Enhanced Interpersonal Skills

of Recent Entrant Managers ................................................................................................................. 81 Conclusion ................................................................................................................................................. 83 Appendix I: Survey Instrument The Interpersonal Skills of Recent Entrants

to the Field of Healthcare Management Survey ..................................................................................... 86 Appendix II: The Impact of the REM’s Education on How They Were Evaluated—

All Degree Categories (Chapter 4) .......................................................................................................... 91

1

Introduction

The generation divide in the workplace has consumed attention in the print and broadcast media.

Workplace professionals comment on the generational differences in how senior executives and

early careerists approach the nature of their jobs. What specifically are the perceptions that

senior executives have about the interpersonal skills of recent entrants to the field of healthcare

management (REM)? To help answer this question, a national survey was conducted to

determine the current state of senior executive perceptions of recent entrants within corporate

headquarters, hospital systems, and freestanding hospitals. The survey was constructed based on

leadership interpersonal competencies and competency-based career development programs. A

total of 676 respondents returned a survey, representing 31 percent of the mailing sample.

The goal of the research was to (1) determine the perceptions that senior executives have about

the interpersonal skills of recent entrants to the field of health care management and (2) identify

best practices for organizational training of recent entrants to the field of health care

management.

Methods

The survey instrument developed was based on the findings of an initial pilot study consisting of

four focus groups, a review of the pertinent literature and was revised based on a pretest of the

initial questionnaire.

The pilot study focus group protocol was based on the leadership framework provided by the

Healthcare Leadership Alliance (Stefl, 2008). The focus groups consisted of graduate students

spanning multiple generations of learners in a large metropolitan area. Five overall management

competencies were considered by the groups: communication and relationship management,

leadership, professionalism, knowledge of the healthcare environment and business skills and

knowledge. Based on surveys completed by the participants, communication and relationship

management competency was the most important for entry level managers to develop (54

percent).

Published research was also consulted. In particular, questions developed by Freshman and

Rubin (2002) Cherlin et al. (2006), Helfand, Cherlin and Bradley (2005), and White and Begun,

(2006) were considered while more conceptual studies required us to operationalize those ideas

for survey administration. (Guo, 2009, George, 2000, Ferris, 2001). Finally, several concepts

from the Bar-On model of emotional intelligence (Stein and Book, 2006) and Goleman’s

framework of emotional competencies were consulted (Goleman, 2001).

The survey was fielded using web-based solicitations for participation. The sample consisted of

2,200 senior executives from the American College of Healthcare Executives membership. The

electronic surveys were distributed along with a cover letter explaining the purpose of the

survey. The survey contained a screener question which inquired if the senior executive could

identify a recent entrant manager (REM) with whom they worked on a regular basis. The REM

was defined as an individual 30 years of age or less who had been a healthcare management

2

professional for five years or less. In three-weeks following the electronic solicitation, 1,301

faxes were directed to non-responders from the initial web-based solicitation. A total of 676

respondents returned a completed survey from the two solicitations which represented 31 percent

of the 2,200 affiliates originally sampled. Of the 676 surveys, 9% (61) did not complete the full

survey. This left 615 completed surveys, or 91% of surveys received.

3

Chapter 1: Background

Howe and Strauss (2000) divide the American workforce into four distinct ‘generations’ in 20-

year cohorts: Traditionalists (born between 1925 and 1945), Baby Boomers (1946 and 1964),

Gen Xers (1965 and 1979), and Gen Yers or Millennials (1980 and 2001). According to Alsop

(2008), each twenty-year cohort has characteristics distinct to the group which stem from events

and cultural factors taking place during key phases of their development, differences that are also

reflected in how each group approaches their work.

In addition to social and economic changes influencing development, healthcare leaders may be

influenced by the nature and climate within which their profession operated at key points during

their career. Table 1.1 (next page) summarizes these generational as well as healthcare-specific

differences, which are described in more depth as follows.

Traditionalists. The Traditionalists were born between 1925 and 1945 and are a population of

38.6 million (Alsop, 2008). The Great Depression, Pearl Harbor, World War II, and the Korean

War were key historical events to this group. Character traits often associated with this

generation include: patriotic, dependable, conformist, respect for authority, rigid, socially and

financially conservative, and individuals with a solid work ethic (Howe & Strauss, 2000). The

Traditionalist cohort has trust in the medical establishment and so prefers to be directed by

professionals with clinical expertise (Gleeson, 2003).

Baby Boomers. The Baby Boomer generation born between 1946 and 1964 followed the

Traditionalists generation and represent 78.3 million in the population (Alsop, 2008). The

Vietnam War, assassination of John and Robert Kennedy and Martin Luther King, Jr., the moon

landing, Kent State student deaths, and the Watergate break-in define this generation. Much has

been written about this cohort because of its size, the economic advantages of the group, and its

ability to define America through its protests around the Vietnam War. Group traits include

being workaholics, idealistic, competitive, loyal, materialistic, seeks personal fulfillment, and

values titles and the corner office (Alsop, 2008). The Boomers want a dialogue with their

healthcare providers and they want to be involved in the decision-making (Gleeson, 2003).

Generation X. Generation X followed the Boomers, a smaller cohort of 62 million born between

1965 and 1979. Key historical events in this cohort include the AIDS epidemic, space shuttle

Challenger, Berlin Wall, Oklahoma City bombing, and Presidential impeachment of Bill Clinton.

Traits associated with this group include being self-reliant, adaptable, cynical, distrustful of

authority, resourceful, entrepreneurial, and technology savvy (Alsop, 2008). The Generation X

wants to be educated and informed about their health, not directed or talked at (Gleeson, 2003).

Table 1.1: Generations and National Events that Shape Perspectives

Generation Year of Birth Age National Events Health Care

Events

Health Care

Perspective

(The health care

perspective was

adapted from

Gleeson (2003)

Managing and

motivating the

generations:

Implications for the

student and the

employee)

Traditionalist 1925-1945

38.6M

65-85 WWI, WWII,

Roaring 20s, New

Deal, GI Bill,

Depression, Korean

War, Television

Polio epidemic,

Bacterial dysentery

care, Flu epidemic,

Clinical trial of

penicillin, Measles

outbreak, Sloan

Kettering planning,

CDC, ADA

Direct me!

Specific direction

& support

Baby Boomers 1946 – 1964

78.3M

46-64 Kennedy and King

Assassinations,

Vietnam, Civil

Rights, Women’s

Rights, Gay

Liberation,

Watergate, Kent

State, Color

Television

Hill Burton, Kinsey

Report, Iron Lung

replaced for polio,

NIMH, ERISA,

AMA position on

national health

insurance,

Medicare, Medicaid

Engage me!

Two-way

interaction;

involved in

decision-making

Generation X 1965 – 1979

62M

31-45 AIDS epidemic,

Challenger, Berlin

Wall, Oklahoma

City, Clinton

impeachment,

Cable TV,

Unemployment

affects health care

access

HMO Act

CON

Educate me!

Healthcare is a

personal

responsibility;

value

independence, not

direction

Millennials 1980 – 2001

92M

9 - 30 Columbine H.S.,

Gulf War, 9/11,

Afghanistan & Iraq,

Hurricane Katrina,

Internet

DRGs

RBRVS

COBRA

Connect me!

Continuous

connection through

Texting, Facebook,

Twitter;

E-mail responses to

questions

6

Millennials. The fourth and youngest group currently in the healthcare management workforce

is the Millennials. Born between 1980 and 2001 and with a total population of 92 million, they

will eventually become the largest of the four cohorts in the workplace. Key historical events

that shaped this age cohort are Columbine High School shootings, September 11 terrorist attacks,

Enron and other corporate scandals, wars in Afghanistan and Iraq, and Hurricane Katrina.

Characteristics associated with this group include: entitled, optimistic, civic minded, close

parental involvement, values work-life balance, impatient, multitasking, and team oriented

(Alsop, 2008). Millennials require instantaneous feedback and prefer the use of technology

when being educated (Gleeson, 2003).

Intergenerational communication and conflict Differences across these generations can present challenges to optimal working relationships and

organizational coherency (Pew Research Center, 2010). Leading healthcare organizations have

begun to recognize these challenges and address them through additional education. For

example, the Mayo Clinic’s website provides strategies to improve the working relationships

between the generational cohorts with the following formula: 1) Beware of the differences; 2)

Appreciate the strengths of each group; and 3) Manage the differences effectively. Strategies to

better communicate between groups are enhanced when the interaction builds upon each cohort’s

unique characteristics.

In terms of generation-to-generation communications, our experience has suggested that

healthcare managers can benefit from guidance about some of the differences in perspectives

described above. As the Mayo Clinic website recommends, Baby Boomer communication with

Generation X should get to the point and address specific points for which the Generation X

requires. On the other hand, Generation X should approach the Boomer with respect and give

the group complete attention. For the Generation Xer addressing the Traditionalist, respect

should also be shown as well as valuing the person’s knowledge and experience.

Table 1.2: Optimal Generation Communication Strategy

Boomers & Traditionalists Generations X & Y

Generations X & Y

Get to the point

Use e-mail

Give them space

Get over the notion of dues paying

Lighten up; work can be fun

Challenge them

Ask them their opinion

Find them a mentor

Provide timely feedback

Boomers

Show respect

Choose face-to-face conversation

Give them your full attention

Play the game

Learn the corporate history

Traditionalists

Honor the chain of command

Value their experience

Appreciate their dedication

According to Cahill and Sedrak (2009), tension between the generations is particularly acute

between the Boomers and Millennials (Generation Y). Recruiters find Millennials to be overly

demanding when it comes to needing guidance, ongoing feedback, career advancement, and

7

work-life balance, a term that was unheard of for Boomers who gave all to the organization to

secure advancement. Boomers will refer to Millennials as “slackers” because they are perceived

to be much less willing to make personal sacrifices for the good of their employers (Alsop, 2008;

Cahill and Sedrak, 2010). The generational shift to Millennials is exacerbated by the ethnically

and racially diverse nature of the Millennials. In a study of U.S. college freshman trends, UCLA

found that there were jumps in education enrollment for Asians from 0.6% in 1971 to 8.6% in

2006, and Latino students from 0.6% to 7.3%. In addition, the gender shift has become more

pronounced with college and graduate school enrollment at 55% for females (DeAngelo et al,

2009).

Graduate education and early career experiences In recognition of some of the challenges new healthcare managers faced acculturating to the

workplace, the Commission on the Accreditation of Healthcare Management Education

(CAHME, 2013) added Interpersonal Effectiveness and Professionalism to its list of content

areas that accredited programs are required to teach. As a result, professionalism courses are

now taught in many graduate programs of health management. These programs assist students in

developing resumes and cover letters, prepare them for the interview experience through audio

and video recordings, identifies mentors and advises them on salary negotiation, and even

provides dining etiquette instruction. Although all of these are important skills, effectiveness in

communicating across generations and interpersonal skills do not get the attention they should.

The challenges early careerists face in this arena are particularly acute for students who obtain

prestigious administrative fellowships. For a year to two years, these students are able to work

with the president and other senior executives, completing projects that advance their knowledge

in some vital direction that the organization is pursuing. However, at the conclusion of the

fellowship experience, early careerists are relegated to entry level positions. No longer working

directly with senior-level leadership, they can suffer from post-fellowship depression (Salazar,

2006). Like many of their peer Millennials, they can become frustrated and can begin seeking

positions that will allow them to regain some of what they lost at the end of their fellowship

(Alsop, 2008). The Pew Research Center (2010) reported that Millennials are job hoppers and

see their current position as either a steppingstone to a career or just a job to help them get by.

Six-in-ten (61%) expect to be working for someone else while 37% indicate they will never

leave their current employer.

What should organizations do to retain the talent of these Millennials, particularly when there

has been a tremendous organizational investment in them? Who in the organization is

responsible for identifying the problem and investing the resources to retain this young talent? If

the Mayo Clinic (2007) is correct, then listening, challenging their interests, providing mentors,

and giving feedback requires a cultural change in an organization. Senior leaders have to be

convinced that the status quo will not keep talented Millennials in an organization because the

Millennials need to be brought into leadership. Anecdotally, it is often reported that the

organizational hierarchy and norms that retained Baby Boomers on the job will not work with

Millennials. In health care, job satisfaction and being valued are key satisfiers for the

Millennials. Since we don’t know what the generational differences may be long-term, there is

an opportunity to investigate the interpersonal skills of recent entrants to the field of healthcare

management and the strategies to mainstream them into the organization and retain them.

8

Overall Findings

Demographics of Responding Senior Executives

Sixty-nine percent of the respondents are male and 31% percent are female. The race/ethnicity of

the respondent was: Caucasian/White – 86%; African American/Black – 3%; Hispanic – 2%;

and Asian/Pacific Islander – 1%. The degree completed was in the following area: Health

Management (50%); Business – 28%; Clinical/Allied Health – 15%; and Other – 7% (Figure 1)

The self-reported positions of the respondent senior executive population is: CEO – 42%; COO

– 14%; CFO – 3%; CIO – 1%; CMO 1%; CNO – 7%; Senior VP – 6%; and VP – 25%. The

work setting of the senior executive respondents was Freestanding Hospital – 55%; System

Hospital – 32%; and Corporate Headquarters – 13%. The mean age of the respondent was 53.

Forty-seven percent (292) of the respondents reported that they could identify a REM with whom

they worked on a regular basis (Figure 1).

The capacity in which the senior executive interacted with the REM was primarily as an

immediate supervisor (41%); formal mentor (14%); informal mentor (21%); work group

participant (17%); and has an office near the recent entrant manager (7%) (Figure 1).

Figure 1. Demographic and Professional Characteristics of Responding Senior Executives

(Evaluators)

9

10

1. Can you identify a recent entrant

manager, as defined above, with whom

you work on a regular basis?

2. In what capacity do you interact with the recent

entrant manager? (Check all that apply.)

11

Demographics of recent entrant manager (REM)

The mean age of the REM is 29 years of age (Figure 2). Fifty-four percent of the REMs are

female and 46% are male. Of the 297 REMs where the senior executive knew their marital

status, 66% of the REMs are married and 29% are single. Of the 297 REMs, 52% have no

children and 48% have children.

The race/ethnicity of the REM is Caucasian/White – 79%; African-American/Black – 9%;

Hispanic – 5%; and Asian – 5%. The academic major of the REM is Health Management (50%);

Business (23%); Clinical and Allied Health (includes medicine, nursing, and science-related

degree programs) (10%); and Other (includes community health, legal, and public

administration) (1%) (Figure 2). Sixteen percent did not have a graduate degree.

Figure 2. Demographic and Professional Characteristics of Recent Entrant Managers

(REMs)

3. REM’s approximate age: 29

4. REM’s gender: 5. REM’s marital status:

12

6. Does the REM have any children? 7. Which of the following best describes the REM’s

race/ethnicity? (Check all that apply.)

13

8. In which of the following degree programs

did the REM complete graduate work (check

all that apply)?

9. Does the REM have prior clinical

experience?

10. If yes, how many years (estimate)? Less than 5 years 60%

Assessment of the REM

a. Paired Comparisons on Intrapersonal and Interpersonal Attributes

To assess the intrapersonal and interpersonal characteristics of the REM, evaluators were

presented with 26 items derived from suggestions from focus group respondents, a preliminary

survey and the pertinent literature. To assist in interpreting the findings, the 26 questions have

been divided into four categories: (1) intrinsic qualities, (2) self development, (3) outlook, (4)

management skills (Table 1.3).

Respondents were asked to rate their REM on a five point scale where “1” indicates superior

performance or possession of a positive attribute, “2” indicates excellent, or above average

competence, “3” indicates average performance or possession of the attribute, “4” represents fair

or somewhat below average and “5” indicates poor performance or possession of an attribute.

Intrinsic qualities. Four attributes comprised this category: (1) the REM’s personal values being

consistent with the management team values, (2) the REM being honest about mistakes the REM

made, (3) ease for evaluator to trust the REM, and (4) ease for others to trust the REM.

We can evaluate the intrinsic qualities of the four statements by summing the proportion of

REMs that were assessed above average,” (i.e., scores of 1 or 2) and contrast this with the

proportion that rated their REM “below average” (i.e., scores of 4 or 5). Overall, in regard to

these four attributes, evaluators scored their REM positively. Seventy-five percent or more of the

evaluators gave their REMs above average ratings.

14

Only between 7 and 9 percent of REMs were evaluated negatively on their intrinsic qualities.

The average negative score on this dimension was 8. The largest proportion of negative scores (9

percent) was that “others find it easy to trust this manager.” Eight percent stated that their REM’s

personal values were not always consistent with the management team. As many, 8 percent,

stated the manager was below average in being honest about his mistakes. Only seven percent

said they found it difficult to trust their REM.

Self-development. The second dimension, self-development, was comprised of five attributes:

(1) the REM seeks feedback from knowledgeable others; (2) the REM is receptive to

constructive criticism, (3) the REM takes direction well, (4) the REM is open to new ideas and

(5) the REM deals with facts when deciding on issues. Again, as was true for the intrinsic

qualities, evaluators gave their REM high marks on self development. Seventy six percent or

more of the REMs were given scores above average.

Negative evaluations on this dimension ranged from a low of four to a high of 10; the average

negative percentage was 6.2. Of the five questions, ten percent rated their REM negatively

relative to not seeking feedback from others who are more knowledgeable. On the other hand,

only four percent rated their REM negatively on not being open to new ideas.

Outlook. The third dimension evaluated REMs on six qualities that reflect on the perceived

mental state that the REM exhibits. Attributes included in this dimension were: (1) being self

assured, (2) showing respect to superiors, (3) having a positive mental attitude, (4) being in

control of emotions, (5) enjoying the work, and (6) having a good sense of humor.

As was the case for intrinsic and self development dimensions, evaluators gave high marks to

their REMs’ outlook. Seventy-six or more percent rated their REMs as excellent or superior on

the six attributes.

Negative scores on this dimension ranged from a low of two percent to a high of 9 percent. The

average negative percentage was 5.5. Nine percent of evaluators stated their REM was not in

control of his emotions. Only two percent said that their REM does not have a positive mental

attitude.

Management skills. The fourth dimension evaluated REMs on 11 qualities that reflect on the

management skills of the REM. Included here were: (1) handling difficult people or situations

with diplomacy, (2) understanding organizational politics, (3) confronting others about their

mistakes, (4) setting challenging goals for staff, (5) exercising authority easily, (6) reading other

people’s emotions well, (7) working easily with others, (8) being sensitive when communicating

with diverse cultures, (9) using various techniques to influence others, (10) building rapport with

peers and others on the management team, and (11) communicating directly about controversial

issues.

Whereas none of the previous attributes received less than 75 percent above average scores, 7 out

of the 11 attributes on management skills did not reach the 75 percent threshold.

More negative evaluations were given to the following: (1) the REM can read other people’s

emotions well (54 percent above average;14 percent below average scores); (2) the REM

15

understands politics in the organization (60 percent above average and 13 percent below average

scores); (3) the REM uses a variety of techniques to influence others (61 percent above average

and 13 percent below average scores); 4) the manager handles difficult people or situations with

diplomacy (65 above average and 10 percent below average); (5) the REM confronts others

about their mistakes (64 percent above average, nine percent below average); (6) the REM

communicates directly about controversial issues (70 percent above average, eight percent below

average); and (7) the manager exercises authority easily (65 percent above average and 9 percent

below average). Negative scores on this dimension ranged from a low of 5 to a high of 14; the

average negative percentage was 9.2.

Of the four dimensions we identified, the management skills category garnered the highest

proportion of negative evaluations of the REMs. This helps to show the importance of

developing managerial skills and where additional training might be most useful for entry level

managers.

Table 1.3 Senior Executive Evaluations of their REM Using Paired Comparisons on Four

Dimensions – Row Percentages (Survey Instrument Question 11, see Appendix)

1. INTRINSIC QUALITIES Positive Medium Negative

1 2 3 4 5

This manager’s personal

values are always

consistent with the

management team.

126

(38%)

133

(40%)

43

(13%)

24

(7%)

1

(1%)

This manager’s personal

values are not consistent

with the management team.

This manager is honest

about his mistakes. 191

(59%)

84

(26%)

27

(8%)

21

(7%)

2

(1%)

This manager is not always

honest about his mistakes.

I find it easy to trust this

manager.

179

(55%)

91

(28%)

34

(10%)

18

(6%)

4

(1%)

I find it difficult to trust this

manager.

Others find it easy to trust

this manager.

133

(41%)

109

(34%)

51

(16%)

23

(7%)

5

(2%)

Others do not find it easy to

trust this manager.

2. SELF-DEVELOPMENT Positive Medium Negative

1 2 3 4 5

This manager seeks

feedback for projects from

others who are more

knowledgeable.

157

(48%)

106

(33%)

29

(9%)

27

(8%)

5

(2%)

This manager does not seek

feedback from others who

are more knowledgeable.

This manager is receptive

to constructive criticism. 134

(41%)

114

(35%)

44

(19%)

27

(5%)

4

(1%)

This manager is not

receptive to constructive

criticism.

16

Positive Medium Negative

1 2 3 4 5 This manager takes

direction well. 169

(52%)

92

(28%)

43

(13%)

19

(6%)

0

(0%)

This manager does not take

direction well.

This manager is open to

new ideas.

184

(57%)

93

(29%)

32

(10%)

12

(4%)

1

(0%)

This manager is not open to

new ideas.

This manager deals with

facts when deciding on

issues.

126

(39%)

131

(41%)

47

(15%)

13

(4%)

3

(1%)

This manager does not deal

with fact when deciding on

issues.

3. OUTLOOK Positive Medium Negative

1 2 3 4 5

This manager is

sufficiently self-assured.

116

(36%)

130

(40%)

56

(17%)

20

(6%)

2

(1%)

This manager is not

sufficiently self-assured.

This manager shows

appropriate

respect to his superiors.

194

(60%)

90

(28%)

25

(8%)

9

(3%)

4

(1%)

This manager does not show

appropriate respect to his

superiors.

This manager has a

positive mental attitude.

201

(62%)

90

(28%)

25

(8%)

7

(2%)

1

(0%)

This manager does not have

a positive mental attitude.

This manager is in control

of his emotions. 140

(43%)

110

(34%)

43

(13%)

27

(8%)

2

(1%)

This manager is not in

control of his emotions.

This manager enjoys his

work.

186

(58%)

105

(32%)

23

(7%)

6

(2%)

0

(0%)

This manager does not enjoy

his work.

This manager has a good

sense of humor.

173

(54%)

109

(34%)

26

(8%)

10

(3%)

2

(1%)

This manager does not have

a good sense of humor

4. MANAGEMENT SKILLS Positive Medium Negative

1 2 3 4 5

This manager sets

challenging goals for his

staff.

134

(42%)

107

(33%)

44

(19%)

27

(5%)

4

(1%)

This manager does not set

challenging goals for his

staff.

This manager exercises

authority easily.

82

(25%)

128

(40%)

84

(26%)

26

(8%)

3

(1%)

This manager does not

exercise authority easily.

This manager can read

other people’s emotions

well.

57

(18%)

116

(36%)

106

(33%)

35

(11%)

11

(3%)

This manager cannot read

other people’s emotions

well.

It is easy for this manager

to work with others. 155

(48%)

100

(31%)

46

(14%)

22

(7%)

1

(0%)

It is not easy for this

manager to work with

others.

17


1 2 3 4 5 This manager is sensitive

to culturally correct

behavior when

communicating with

diverse cultures.

138

(43%)

119

(37%)

51

(16%)

12

(4%)

2

(1%)

This manager is not

sensitive to culturally

correct behavior when

communicating with diverse

cultures.

This manager confronts

others about their mistakes. 72

(22%)

134

(42%)

86

(27%)

26

(8%)

3

(1%)


confront others about their

mistakes.

This manager handles

difficult people or

situations with diplomacy.

91

(28%)

120

(37%)

77

(24%)

29

(9%)

3

(1%)


handle difficult people or

situations with diplomacy.

This manager understands

politics in the organization. 69

(22%)

121

(38%)

86

(27%)

34

(10%)

10

(3%)


understand politics in the

organization.

This manager

communicates directly

about controversial issues.

87

(27%)

138

(43%)

69

(21%)

25

(7%)

3

(1%)

This manager fails to

communicate directly about

controversial issues.

This manager uses a

variety of techniques to

influence others.

62

(20%)

130

(41%)

86

(27%)

32

(10%)

8

(3%)

This manager does not use a

variety of techniques to

influence others.

This manager builds

rapport with peers and

others on the management

team.

127

(39%)

125

(38%)

47

(15%)

20

(6%)

3

(1%)

This manager does not build

rapport with peers and

others on the management

team.

b. REMs’ Competencies compared with Evaluators’ Own Competencies at the Same Career Stage

One way to determine if today’s young managers are up to par is to ask senior executives to

compare their REM’s competence with their own abilities when they entered the profession. As

shown in Table 1.4, six areas of competence were presented. It appears that a sizeable minority

of respondents evaluated their REM negatively compared to themselves at the same career stage.

The table shows that fully 39 percent of REMs were deemed less competent than their evaluators

in developing others. Thirty-seven percent of REMs were deemed less competent in

marketing/strategic planning. Senior executives evaluated their REMs as less competent

compared to themselves in communications (34 percent), problem solving (30 percent) and

interpersonal skills (30 percent). However, far fewer, 15 percent, evaluated REMs as less

competent than themselves with respect to managerial ethics and values. That fully 30 percent of

senior executives evaluate their REMs as less competent in interpersonal skills provides a second

piece of evidence suggesting the importance of our research.

18

Table 1.4 Senior Executives’ Appraisal of their REM’s Competencies in Relation to their

own at the Same Stage of their Career – Row Percentages (Survey Instrument Question 12,

see Appendix)

Competencies Much

worse

Worse

About

the

same

Better

Much

better

a. Managerial ethics & values 2

(1%)

45

(14%)

222

(72%)

36

(12%)

6

(2%)

b. Communication 8

(3%)

97

(31%)

136

(43%)

65

(21%)

9

(3%)

c. Problem solving 6

(2%)

87

(28%)

167

(54%)

44

(14%)

6

(2%)

d. Interpersonal skills 10

(3%)

82

(27%)

153

(50%)

56

(18%)

6

(2%)

e. Developing others 15

(5%)

106

(34%)

156

(50%)

35

(11%)

2

(1%)

f. Marketing/Strategic Planning. 13

(4%)

101

(33%)

117

(38%)

60

(19%)

18

(6%)

c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents

Table 1.5 shows the overall evaluation given by senior executives of the REMs relative to

supervisors, peers, subordinates and physicians. To provide the evaluation, senior executives

gave their REM a score on a scale ranging from 1 (poor) to 10 (excellent). For the purposes of

this research, scores were collapsed into three general categories: below average (scores 1-4),

average (5-7) and above average (8-10).

It can be seen that REMs were evaluated differently depending on who was being discussed. For

example over 60 percent rated the REMs above average in relating to their supervisor or to peers

and fewer than 10 percent rated their REMs below average in dealing with these groups. On the

other hand, about half of evaluators rated their REM above average when dealing with

subordinates or physicians and the proportion rating their REM below average was 13 percent

for subordinates and 11 percent for physicians.

The overall, summary measure of the REMS’ interpersonal skills showed that one third of the

evaluators rated their REMs as average, 59 percent rated their REM above average and 7 percent

rated them below average.

19

Table 1.5 Senior Executives’ Ratings of the Interpersonal Skills of their REM – Row

Percentages (Survey Instrument Question 13, see Appendix)

Percentages (%)

Poor Average Excellent

1 2 3 4 5 6 7 8 9 10

Supervisor

0 1 7

(2%)

9

(3%)

28

(9%)

25

(8%)

38

(13%)

83

(27%)

65

(21%)

48

(16%)

Peers

1 1 5

(2%)

15

(5%)

26

(8%)

30

(10%)

38

(12%)

87

(28%)

63

(20%)

46

(15%)

Subordinates

1 3

(1%)

10

(3%)

28

(9%)

27

(9%)

36

(12%)

47

(15%)

60

(19%)

55

(18%)

44

(14%)

Physicians

0 2

(1%)

14

(5%)

17

(5%)

34

(11%)

32

(10%)

41

(13%)

69

(22%)

53

(17%)

48

(15%)

Overall

0 1 7

(2%)

15

(5%)

28

(9%)

27

(9%)

47

(15%)

80

(26%)

65

(21%)

37

(12%)

20

Chapter 2: The Impact of Senior Executives’ Generation on How They

Evaluated their REM

As noted in the background section, a central objective of this research was to characterize the

different generations of the evaluators to their REM. When the data were analyzed, we

discovered there were only two generations that were sufficiently well represented to

characterize each: Gen X and Baby Boomers. Of the 615 completed surveys, 292 respondents

were able to identify a REM with whom they worked on a regular basis. We received 23

responses from Traditionalist cohort, 238 in the Boomer cohort, and 58 in the Generation X, and

none in Generation Y. Therefore, it became impossible to complete a true cohort analysis with

the data in hand. To capture some of the differences, we decided to divide the Boomer

generation in half and label them Older Boomers (Age 57-66), and Younger Boomers (Age 47-

56). There were sufficient individuals of whom we could apply percentages using this

modification.

The main hypothesis that we will explore in this chapter is whether or not evaluators from

different generations perceive their REM differently. While the formal definition of the

generations has been altered, patterns may nevertheless be detected. We will first describe the

respondents’ demographic characteristics as well as their professional positions (Tables 2.1–2.3).

We will then turn our attention to describing their REMs (Tables 2.4–2.5). We conclude with a

description of the REMs’ interpersonal skills evaluated by the three generations of senior

executives i.e., Gen Xers, Younger Boomer, and Older Boomers (Tables 2.6–2.8).

Demographic and Positional Characteristics of Evaluators by Generation

When we look at the gender distribution of respondents (evaluators) by generation, we see that

about two thirds of Gen X and Older Boomers are male. In contrast, only about 60 percent of

Younger Boomers are male (Table 2.1a).

Examining the education of senior executives by generation shows that for all three groups, a

high proportion majored in Healthcare Management and Policy. The second most common major

for all three groups was Business. There was a significant difference among the generations

relative to their major (Table 2.1b).

Senior executives held positions that varied by generation. Over a third of Gen Xers are in vice

president positions compared to only 17 percent of Older Boomers. Conversely, while 52 percent

of Older Boomers are CEOs, only 30 percent of Gen Xers are CEOs. In fact, there is a

monotonic relationship in the proportion of positions held at the highest and lowest levels in the

organizations’ hierarchy. One interesting finding is that a higher proportion of Younger Boomers

are CNOs when compared to the other two generations. This feature probably accounts for the

higher proportion of women of that generation in this study.

Viewing the type of organization that the senior executives lead, (i.e., corporate headquarters of

systems, system hospitals, or freestanding hospitals) showed no significant differences by

generation (Table 2.1d).

21

Table 2.2 presents a key finding concerning the representativeness of the respondents. It can be

seen that between 40 and 50 percent of each generation could identify a REM with whom they

worked on a regular basis. Thus, as far as generation is concerned, there were no major

differences between those that could complete the survey on their REM and the other

respondents who were unable to do so.

Table 2.3 shows the capacity in which the senior executive evaluator interacted with their REM

by generation. Overall the largest proportion of each generation related to their REM as an

immediate supervisor. However, there were variations in the proportion acting in this capacity by

generation. For example 52 percent of Gen Xers worked with their REM as an immediate

supervisor while only 32 percent of Older Boomers did so. Conversely, a higher proportion of

Older Boomers worked with their REM as part of a work group (22 percent) compared to 6

percent of Gen X respondents.

The Demographic Characteristics of REMs by Evaluator’s Cohort The question explored in this section is whether or not the three generations of evaluators

worked with REMs that were similar or different using demographic and educational background

measures. In brief, the answer is, no. REMs were similar across the generations of evaluators.

The REMS of the three generations were similar in age, gender, marital status, number of

children and race/ethnicity (Table 2.4). Finally, with regard to the REMs’ education, there were

no significant differences among those who were evaluated by Gen Xers, Younger Boomers or

Older Boomers (Table 2.5).

a. Paired Comparisons on Intra- and Interpersonal attributes

The senior executives were asked to assess the REM on 26 interpersonal competencies based on

generational age band which includes Gen X (28 – 46 years); Younger Boomer (47 – 56 years);

and Older Boomer (57 – 66 years). The senior executive respondent age had no impact on their

assessment of the REM with the exception of “this manager confronts others about their

mistakes” In this regard, a higher proportion of evaluators who were members of Gen X (20%)

stated that their REM did not confront others about their mistakes (Table 2.6).

Aside from the row percentages and tests of generational effects using the Chi-square statistic,

we also computed the mean scores on each measure and tested their differences to determine if

there were significant differences. As shown in Table 2.6A, there were no significant

generational effects observed.

b. REMs’ Competencies compared with Evaluators’ Own Competencies at the Same Career Stage

When the senior executives assessed the REMs competencies relative to their own competency

at the same career stage, there were no significant generational effects relative to managerial

ethics and values, communication, problem solving interpersonal skills or marketing/strategic

planning. However, more Gen X evaluators (45 percent) than older evaluators said their REM

performed more poorly in developing others than they did at their career stage (Table 2.7).

22

c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents

The interpersonal skills of the REMs as evaluated by the senior executive respondents by age

cohort did not show significant differences. Thus, Gen X, Younger Boomer, and Older Boomers

evaluated their REMs interpersonal skills with supervisors, peers, subordinates, and physicians

quite similarly. Moreover, taking all of the REMs’ interpersonal skills in a summary measure

showed no significant differences by the evaluators’ age cohort (Table 2.8).

23

Table 2.1

Demographic and Position Characteristics of Respondents, by Cohort

a. Gender of Respondents***

Senior

Executives

Senior Executives

Female % Male % Total Chi Sq

P-value

Gen X 28

(25%)

83

(75%)

111 .001***

Younger

Boomer

102

(41%)

148

(59%)

250

Older Boomer 59

(23%)

195

(77%)

254

b. Education*

Senior

Executives Health

Management Business

Clinical/

Allied

Health Other Total

Chi Sq

P-value

Gen X 66

(57%)

35

(30%)

11

(9%)

4

(3%)

116 .019*

Younger

Boomer

114

(45%)

76

(30%)

47

(19%)

15

(6%)

252

Older

Boomer

147

(51%)

71

(25%)

39

(14%)

29

(10%)

286

Does not add to 100% because multiple responses were given

c. Position Held***

Senior

Executives

Senior Executives

CEO COO CFO CIO CMO CNO SVP VP Total Chi Sq

P-value

Gen X 33

(30%)

23

(21%)

6

(5%)

1

(1%)

0 4

(4%)

4

(4%)

40

(36%)

111

.001***

Younger

Boomer

94

(38%)

31

(12%)

6

(2%)

4

(2%)

4

(2%)

26

(10%)

13

(5%)

72

(29%)

250

Older

Boomer

131

(52%)

31

(12%)

9

(4%)

1

5

(2%)

15

(6%)

18

(7%)

44

(17%)

254

24

d. Type of Organization

Senior

Executives

Senior Executives

Freestanding

Hospital

System

Hospital

Corporate

Headquarters Total

Chi Sq

P-value

Gen X 64

(58%)

37

(33%)

10

(9%)

111 .374

Younger

Boomer

134

(54%)

86

(34%)

30

(12%)

250

Older Boomer 139

(55%)

75

(30%)

40

(16%)

254

*** <.001; ** <.01; *<.05

Tables may not add to 100% due to rounding.

25

Table 2.2

Respondent’s Ability to Identify a REM with Whom They Work, by Cohort

Senior

Executives Yes No

Total Chi-Square

P-value

Gen X

(Age 28-46)

45

(41%)

66

(59%)

111 .269

Younger Boomer

(Age 47-56)

123

(49%)

127

(51%)

250

Older Boomer

Age 57-66)

124

(49%)

130

(51%)

254

*** <.001; ** <.01; *<.05


Table 2.3

Capacity in Which Senior Executives Interact with REM, by Cohort

Senior

Executives

Immediate

Supervisor

Formal

Mentor

Informal

Mentor

Work

Group

Office

Nearby

Total

Gen X

(Age 28-46)

35

(52%)

11

(16%)

12

(18%)

4

(6%)

5

(7%)

67

Younger

Boomer

(Age 47-56)

58

(41%)

22

(16%)

31

(22%)

24

(17%)

5

(4%)

140

Older Boomer

Age 57-66)

49

(32%)

19

(12%)

38

(25%)

35

(22%)

14

(9%)

156

Chi-Square

P-value

.043* .777 .325 .003** .536 363

*** <.001; ** <.01; *<.05


26

Table 2.4

Demographic Characteristics of REM, by Senior Executive Cohort

a. Age of REM

Senior Executives Mean Age Chi Square/P-

value

Gen X

(Age 28 – 46)

28.47 .159

Younger Boomer

(Age 47 – 56)

29.64

Older Boomer

(Age 57 – 66)

29.39

b. Gender of REM

Senior Executives Male Female Total Chi Square/P-

value

Gen X

(Age 28 – 46)

33

(55%)

27

(45%)

60 .221

Younger Boomer

(Age 47 – 56)

50

(41%)

71

(59%)

121

Older Boomer

(Age 57 – 66)

59

(46%)

70

(54%)

128

c. Marital Status of REM

Senior Executives MARRIED SINGLE DON’T

KNOW

Total Chi Square/P-

value

Gen X

(Age 28 – 46)

40

(67%)

19

(32%)

1

(8%)

60 .051

Younger Boomer

(Age 47 – 56)

82

(68%)

38

(31%)

1

(8%)

121

Older Boomer

(Age 57 – 66)

84

(66%)

34

(27%)

10

(8%)

128

d. REM Parental Status

Senior Executives WITH

CHILDREN

WITHOUT

CHILDREN

Chi Square/P-

value

Gen X

(Age 28 – 46)

28

(47%)

32

(53%)

.062

Younger Boomer

(Age 47 – 56)

54

(46%)

64

(54%)

Older Boomer

(Age 57 – 66)

62

(52%)

57

(48%)

27

e. REM Ethnicity/Race

Senior Executives American

Indian Asian

Black/

African

American

White/

Caucasian Hispanic Other

Gen X

(Age 28 – 46)

0 3

(19%)

6

(22%)

48

(19%)

2

(13%)

0

Younger Boomer

(Age 47 – 56)

0 8

(50%)

12

(44%)

101

(40%)

3

(20%)

3

(50%)

Older Boomer

(Age 57 – 66)

1

(100%)

5

(31%)

9

(33%)

103

(41%)

10

(67%)

3

(50%)

TOTAL 1 16

27 252 15 6

Chi-Square/

P-value

.479

.661

.729

.962

.103

.471

*** <.001; ** <.01; *<.05


28

Table 2.5

Education and Clinical Experience of REM, by Senior Executive Cohort

Senior

Executives

REM Education and Clinical Experience

Health

Manage-

ment &

policy

Business Public

admini-

stration

Commu-

nity

Health

Nursing Medicine Did not

complete

graduate

study

Other Don’t

know

Gen X (Age

28-46)

31 11 2 4 3 0 10 1 1

(45%) (17%) (3%) (6%) (5%) (16%) (2%) (2%)

Younger

Boomer

(Age 47-56)

51 29 3 7 11 2 16 0 3

(42%) (24%) (2%) (6%) (9%) (2%) (13%) (2%)

Older

Boomer

(Age 57-66)

63 32 3 3 10 1 16 4 3

(43%) (45%) (38%) (21%) (41%) (33%) (38%) (80%) (43%)

Chi Sq

P-value

0.349 0.562 0.935 0.300 0.634 0.554 0.726 0.149 0.938

*** <.001; ** <.01; *<.05


29

Table 2.6

Paired Comparisons on Dimensions of Interpersonal Competency, by Cohort

1. INTRINSIC QUALITIES


1 2 3 4 5 Total Chi Sq

P-value

This manager’s

personal values are

always consistent

with the

management team

Gen X 24

(41%)

25

(42%)

7

(12%)

3

(5%) 0 59 .413 This manager’s

personal values

are not

consistent with

the management

team

Younger

Boomer

47

(40%)

41

(35%)

21

(17%)

10

(8%)

0 119

Older

Boomer

48

(40%)

54

(45%)

10

(26%)

7

(35%)

1

(8%)

120

This manager is

honest about his

mistakes

Gen X

33

(57%)

17

(29%)

5

(9%)

2

(3%)

1

(2%)

58 .536 This manager is

not always

honest about his

mistakes Younger

Boomer

73

(62%)

25

(21%)

12

(10%)

7

(6%)

1

(.8%)

118

Older

Boomer

71

(59%)

33

(28%)

6

(5%)

10

(8%)

0 120

I find it easy to

trust this manager Gen X 32

(55%)

17

(29%)

6

(10%)

3

(5%)

0 58 .269 I find it difficult

to trust this

manager Younger

Boomer

74

(62%)

27

(23%)

11

(9%)

4

(3%)

3

(3%)

119

Older

Boomer

47

(40%)

44

(38%)

15

(13%)

8

(7%)

2

(2%)

116

Others find it easy

to trust this

manager

Gen X 25

(43%)

19

(33%)

10

(17%)

3

(5%)

1

(1%)

58 .984 Others do not

find it easy to

trust this

manager Younger

Boomer

45

(39%)

47

(40%)

19

(16%)

3

(3%)

2

(2%)

118

Older

Boomer

53

(45%)

47

(40%)

13

(11%)

4

(3%)

1

(1%)

116

2. SELF-DEVELOPMENT Positive Medium Negative


P-value

This manager

seeks feedback for

projects from

others who are

more

knowledgeable

Gen X 27

(46%)

19

(33%)

7

(12%)

5

(9%)

0 58 .833 This manager

does not seek

feedback from

others who are

more

knowledgeable

Younger

Boomer

56

(47%)

42

(35%)

9

(8%)

9

(8%)

3

(2%)

119

Older

Boomer

62

(52%)

36

(30%)

9

(8%)

10

(9%)

1

(.8%)

118

This manager is

receptive to

constructive

criticism

Gen X

22

(39%)

20

(35%)

8

(14%)

6

(10%)

1

(2%)


not receptive to

constructive

criticism Younger

Boomer

48

(41%)

45

(38%)

15

(13%)

9

(8%)

1

(.8%)

118

Older

Boomer

57

(48%)

35

(29%)

18

(15%)

8

(7%)

1

(.8%)

119

30

This manager takes

direction well

Gen X

33

(57%)

12

(21%)

7

(12%)

5

(9%)


takes direction

well Younger

Boomer

61

(52%)

30

(26%)

18

(15%)

8

(7%)

0 117

Older

Boomer

64

(53%)

41

(34%)

10

(8%)

5

(4%)

0 120

This manager is

open to new ideas Gen X

32

(55%)

18

(31%)

7

(12%)

1

(2%)

0 58 .398 This manager is

not open to new

ideas Younger

Boomer

67

(58%)

31

(27%)

10

(9%)

8

(7%)

0 116

Older

Boomer

72

(61%)

36

(30%)

8

(7%)

2

(1%)

1

(1%)

119

This manager deals

with facts when

deciding on issues

Gen X 20

(35%)

24

(42%)

7

(12%)

6

(11%)


does not deal

with fact when

deciding on

issues

Younger

Boomer

45

(39%)

47

(40%)

19

(16%)

3

(3%)

2

(2%)

116

Older

Boomer

53

(45%)

47

(40%)

13

(11%)

4

(3%)

1

(1%)

118

3. OUTLOOK Positive Medium Negative


P-value

This manager is

sufficiently self-

assured

Gen X

17

(30%)

24

(42%)

10

(18%)

6

(10%)

0


not sufficiently

self-assured Younger

Boomer

38

(32%)

46

(39%)

23

(20%)

10

(8%)

1

(.8%)

118

Older

Boomer

51

(43%)

48

(40%)

18

(15%)

2

(2%)

1

(.8%)

120

This manager

shows appropriate

respect to his

superiors

Gen X 35

(61%)

17

(30%)

5

(10%)

0 0 57 .840 This manager

does not show

appropriate

respect to his

superiors

Younger

Boomer

70

(59%)

33

(28%)

9

(8%)

4

(3%)

2

(2%)

118

Older

Boomer

75

(64%)

33

(28%)

6

(5%)

3

(3%)

1

(.8%)

118

This manager has a

positive mental

attitude

Gen X

32

(57%)

18

(32%)

4

(7%)

2

(4%)


does not have a

positive mental

attitude Younger

Boomer

75

(63%)

33

(28%)

8

(7%)

2

(2%)

1

(.8%)

119

Older

Boomer

62

(65%)

34

(28%)

15

(6%)

8

(2%)

0 119

This manager is in

control of his

emotions

Gen X

26

(45%)

19

(33%)

6

(10%)

6

(10%)

1

(2%)


not in control of

his emotions Younger

Boomer

50

(42%)

42

(36%)

13

(11%)

12

(10%)

1

(1%)

118

Older

Boomer

55

(46%)

40

(35%)

14

(12%)

8

(7%)

0

117

31

This manager

enjoys his work Gen X

31

(54%)

22

(38%)

3

(5%)

2

(3%)


enjoys his work

Younger

Boomer

70

(60%)

37

(32%)

8

(7%)

1

(1%)

0 116

Older

Boomer

72

(61%)

35

(30%)

7

(6%)

3

(3%)

0 117

This manager has a

good sense of

humor

Gen X

31

(54%)

20

(35%)

5

(9%)

1

(2%)


does not have a

good sense of

humor Younger

Boomer

65

(55%)

41

(35%)

8

(7%)

3

(3%)

0 117

Older

Boomer

65

(56%)

37

(32%)

10

(8%)

4

(3%)

1

(1%)

117

4. MANAGEMENT SKILLS



P-value

This manager sets

challenging goals

for his staff

Gen X

25

(43%)

16

(28%)

14

(24%)

3

(20%)


does not set

challenging

goals for his staff Younger

Boomer

48

(41%)

35

(30%)

23

(20%)

8

(7%)

2

(2%)

116

Older

Boomer

52

(44%)

40

(34%)

22

(19%)

4

(27%)

0

118

This manager

exercises authority

easily

Gen X

11

(19%)

23

(40%)

16

(28%)

6

(11%)

1

(2%)

57 .794 This manager

does not exercise

authority easily Younger

Boomer

34

(29%)

43

(36%)

29

(25%)

11

(9%)

1

(.8%)

118

Older

Boomer

28

(24%)

54

(45%)

29

(24%)

7

(6%)

1

(.8%)

119

The manager can

read other people’s

emotions well

Gen X

8

(14%)

21

(36%)

22

(38%)

6

(10%)

1

(2%)

58 .972 The manager

cannot read other

people’s

emotions well Younger

Boomer

22

(19%)

42

(35%)

38

(32%)

11

(9%)

6

(5%)

119

Older

Boomer

23

(19%)

44

(37%)

37

(31%)

12

(10%)

3

(3%)

119

It is easy for this

manager to work

with others

Gen X 27

(47%)

21

(36%)

7

(12%)

2

(3%)

1

(2%)

58 .532 It is not easy for

this manager to

work with others Younger

Boomer

57

(48%)

34

(29%)

19

(16%)

9

(8%)

0 119

Older

Boomer

67

(52%)

34

(29%)

15

(13%)

8

(7%)

0 119

This manager is

sensitive to

culturally correct

behavior when

communicating

with diverse

cultures

Gen X 23

(40%)

23

(40%)

10

(17%)

2

(3%)

0 58 .636 This manger is

not sensitive to

culturally correct

behavior when

communicating

with diverse

cultures

Younger

Boomer

47

(40%)

51

(44%)

15

(13%)

3

(3%)

1

(1%)

117

Older

Boomer

57

(48%)

35

(30%)

20

(17%)

5

(4%)

1

(1%)

118

32

This manager

confronts others

about their

mistakes*

Gen X

12

(21%)

25

(45%)

8

(14%)

11

(20%)

0 56 .043* This manager

does not

confront others

about their

mistakes

Younger

Boomer

26

(22%)

46

(39%)

36

(30%)

8

(7%)

2

(2%)

118

Older

Boomer

25

(21%)

50

(42%)

36

(31%)

6

(5%)

1

(1%)

118

This manager

handles difficult

people or situations

with diplomacy

Gen X

15

(26%)

20

(18%)

16

(28%)

6

(11%)


does not handle

difficult people

or situations with

diplomacy

Younger

Boomer

36

(30%)

43

(36%)

27

(23%)

11

(9%)

1

(1%)

118

Older

Boomer

33

(28%)

46

(39%)

28

(24%)

10

(9%)

0 117

This manager

understands

politics in the

organization

Gen X

14

(24%)

23

(40%)

16

(28%)

4

(7%)

1

(2%)


understands

politics in the

organization Younger

Boomer

24

(20%)

46

(40%)

24

(21%)

18

(15%)

5

(4%)

117

Older

Boomer

26

(22%)

42

(36%)

37

(32%)

8

(7%)

3

(3%)

116

This manager

communicates

directly about

controversial issues

Gen X

12

(21%)

27

(47%)

13

(22%)

6

(10%)


fails to

communicate

directly about

controversial

issues

Younger

Boomer

35

(30%)

44

(38%)

24

(21%)

12

(10%)

2

(1%)

117

Older

Boomer

33

(28%)

54

(46%)

24

(20%)

6

(5%)

1

(1%)

118

This manager uses

a variety of

techniques to

influence others

Gen X 11

(19%)

21

(38%)

17

(30%)

5

(9%)

2

(4%)


does not use a

variety of

techniques to

influence others

Younger

Boomers

21

(18%)

47

(40%)

31

(27%)

14

(12%)

3

(3%)

116

Older

Boomers

26

(22%)

51

(44%)

29

(25%)

8

(7%)

3

(3%)

117

This manager

builds rapport with

peers and others on

the management

team

Gen X 24

(41%)

23

(40%)

8

(14%)

3

(5%)


does not build

rapport with

peers and others

on the

management

team

Younger

Boomers

46

(39%)

44

(38%)

19

(16%)

6

(5%)

2

(2%)

117

Older

Boomers

49

(41%)

48

(41%)

13

(11%)

7

(6%)

1

(1%)

118

33

Table 2.6A

Paired Comparison in Four Major Groupings

Dependent

Variables Cohort

Mean

Difference Std Error Sig.

Intrinsic

Qualities

Gen X Younger

Boomer -.03922 .12365 .946

Older Boomer -.00995 .12282 .996

Younger

Boomer Gen X .03922 .12365 .946

Older Boomer .02927 .10022 .954

Older Boomer Gen X .00995 .12282 .996

Younger

Boomer -.02927 .10022 .954

Self-

Development

Gen X Younger

Boomer .01209 .12039 .994

Older Boomer .12299 .11958 .559

Younger

Boomer Gen X -.01209 .12039 .994

Older Boomer .11090 .09703 .488

Older Boomer Gen X -.12299 .11958 .559

Younger

Boomer -.11090 .09703 .488

Intrapersonal

Mindset

Gen X Younger

Boomer .01209 .12039 .994

Older Boomer .12299 .11958 .559

Younger

Boomer Gen X -.01209 .12039 .994

Older Boomer .11090 .09703 .488

Older Boomer Gen X -.12299 .11958 .559

Younger

Boomer -.11090 .09703 .488

Interpersonal

Skills

Gen X Younger

Boomer .00538 .11086 .999

Older Boomer .10367 .11011 .614

Younger

Boomer Gen X -.00538 .11086 .999

Older Boomer .09829 .08934 .515

Older

Boomer Gen X -.10367 .11011 .614

Younger

Boomer -.09829 .08934 .515

34

Table 2.7

Recent REMs Competencies Compared with Senior Executives Views of Their Own

Competency at the Same Career Stage, by Cohort

a. REM Managerial ethics and values

Senior

Executives

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Gen X 0 8

(14%)

41

(72%)

6

(11%)

2

(3%)

57

.859

Younger

Boomers

1

(1%)

17

(15%)

85

(74%)

10

(9%)

2

(2%)

115

Older

Boomers

1

(1%)

16

(14%)

78

(68%)

18

(16%)

2

(2%)

115

b. REM Communication

Senior

Executives

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Gen X 0

20

(36%)

25

(45%)

11

(20%)

0 56

.107

Younger

Boomers

5

(4%)

32

(28%)

51

(44%)

26

(23%)

1

(1%)

115

Older

Boomers

2

(1%)

35

(30%)

52

(43%)

23

(19%)

8

(7%)

120

c. REM Problem solving

Senior

Executives

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Gen X 1

(1%)

19

(34%)

25

(45%)

11

(20%)

0 56

.523

Younger

Boomers

3

(3%)

31

(28%)

62

(56%)

13

(12%)

2

(2%)

111

Older

Boomers

1

(1%)

28

(24%)

70

(59%)

17

(14%)

3

(3%)

119

d. REM Interpersonal skills

Senior

Executives

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Gen X 0 15

(28%)

33

(61%)

6

(11%)

0 54

.116

Younger

Boomers

4

(4%)

30

(27%)

60

(54%)

16

(14%)

2

(2%)

112

Older

Boomers

5

(4%)

29

(24%)

51

(43%)

30

(25%)

4

(3%)

119

35

e. REM Developing others*

Senior

Executives

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Gen X 0

26

(45%)

30

(52%)

2

(3%)

0 58

.036*

Younger

Boomers

9

(8%)

36

(32%)

53

(46%)

14

(12%)

2

(2%)

114

Older

Boomers

5

(4%)

35

(30%)

59

(50%)

19

(16%)

0 118

f. REM Marketing/Strategic planning

Senior

Executives

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Gen X 2

(3%)

22

(39%)

23

(41%)

7

(13%)

2

(3%)

56

.472

Younger

Boomers

5

(4%)

37

(33%)

40

(35%)

26

(23%)

5

(4%)

113

Older

Boomers

2

(2%)

34

(29%)

48

(40%)

25

(21%)

10

(8%)

119

*** <.001; ** <.01; *<.05


36

Table 2.8

The Interpersonal Skills of REMs as Evaluated by Senior Executive Respondents,

by Cohort as They Relate to:

a. Supervisors

Senior

Executives

REM Interpersonal Skills

Fair to Poor

(1-4)

Average

(5-7)

Good to Excellent

(8-10) Total

Chi Sq

P-value

Gen X 5

(9%)

14

(25%)

38

(67%)

57

.428

Younger

Boomers

4

(4%)

39

(35%)

69

(62%)

112

Older Boomers 6

(5%)

31

(28%)

75

(67%)

112

b. Peers

Senior

Executives


Fair to Poor

(1-4)

Average

(5-7)

Good to Excellent

(8-10) Total

Chi Sq

P-value

Gen X 3

(5%)

22

(39%)

32

(56%)

57

.438

Younger

Boomers

8

(7%)

33

(29%)

73

(64%)

114

Older Boomers 6

(5%)

30

(25%)

82

(69%)

118

c. Subordinates

Senior

Executives


Fair to Poor

(1-4)

Average

(5-7)

Good to Excellent

(8-10) Total

Chi Sq

P-value

Gen X 6

(11%)

26

(46%)

25

(44%)

57

.377

Younger

Boomers

16

(14%)

38

(33%)

61

(53%)

115

Older Boomers 12

(10%)

37

(32%)

66

(57%)

115

d. Physicians

Senior

Executives


Fair to Poor

(1-4)

Average

(5-7)

Good to Excellent

(8-10) Total

Chi Sq

P-value

Gen X 5

(9%)

22

(39%)

29

(52%)

56

.563

Younger

Boomers

11

(10%)

42

(37%)

60

(53%)

113

Older Boomers 13

(11%)

33

(28%)

71

(61%)

117

37

e. Overall

Senior

Executives


Fair to Poor

(1-4)

Average

(5-7)

Good to Excellent

(8-10) Total

Chi Sq

P-value

Gen X 4

(7%)

20

(34%)

34

(59%)

58

.970

Younger

Boomers

7

(6%)

38

(35%)

65

(59%)

110

Older Boomers 8

(7%)

35

(30%)

72

(63%)

115

*** <.001; ** <.01; *<.05


38

Chapter 3: The Impact of Senior Executives’ Gender on How They Evaluated

their REM

When the study was initiated, the main interest was in showing the relationship of REM evaluation

outcomes and the generational effects of their evaluators. But after the generational effects of the

study were analyzed, we took the opportunity to study the impact of the REM’s gender on how they

were evaluated. That is the objective in this chapter.

Previous research on the impact of the gender of “raters,” is comprised of two types of studies,

those conducted in a laboratory and those conducted in the field. Bartol (1999) conducted a

literature review of both types of studies and concluded that “there was little or no impact of rater

gender on performance evaluations.” Citing one of few field studies reported in the literature, she

indicated that when the official ratings of more than 8,000 first term Army enlisted personnel were

examined, females gave higher ratings than males. On the other hand, two other field studies

showed no rater gender effects. She concluded that prior field studies had focused mostly on ratings

of non-managers and this paucity of research argued for more studies that address the ratings of

incumbents in managerial positions.

On the other hand, when assessing the performance of females and males, Eagly and Karau’s (1991)

meta-analysis on the emergence of leaders finds that men emerge more frequently on measures of

leadership as well as task oriented leadership. Women, on the other hand, emerge more frequently

than men on measures of social leadership (Eagly and Karau, 1991).

a. Paired Comparisons on Intra- and Interpersonal attributes When the 26 interpersonal competencies were assessed by the senior executives between REM

males and females, there was a difference between the genders in four areas (Table 3.1):

Dealing with facts when deciding on issues

Being sensitive to culturally correct behavior when communicating with diverse cultures

Understanding politics in the organization

Using a variety of techniques to influence others

In each instance, men evaluated the REM more favorably than did women.

b. REMs’ Competencies Compared with Evaluators’ Own Competencies at the Same Career Stage Senior executives were asked to assess the REM compared to their own competency at that career

stage. Again, the six areas that REMs were evaluated on included: managerial ethics and values,

communication, problem solving, interpersonal skills, developing others and marketing/strategic

planning. Differences in men’s and women’s evaluations were not significant on any of these

dimensions (Table 3.2).

39

c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents The interpersonal skills of REMs as they relate to supervisors, peers, subordinates, and physicians

showed no difference between the responding evaluators. Moreover, there was no important

difference in the evaluators’ assessment of the REMs interpersonal skills overall (Table 3.3).

40

Table 3.1

Paired Comparisons of Interpersonal Skills, by Gender


This manager’s personal values are always consistent with the management team

Gender Positive Medium Negative

Total Chi Sq

P-value 1 2 3 4 5

Female 43

(37%)

45

(39%)

18

(16%)

8

(7%)

1

(1%)

115 .597

Male 82

(39%)

86

(41%)

25

(12%)

16

(8%)

0 209

This manager is honest about his mistakes


Total Chi Sq

P-value 1 2 3 4 5

Female 73

(63%)

26

(23%)

7

(6%)

8

(7%)

1

(1%)

115 .621

Male 116

(56%)

58

28%)

19

(9%)

13

(6%)

1

207

I find it easy to trust this manager


Total Chi Sq

P-value 1 2 3 4 5

Female 56

(49%)

36

(31%)

14

(12%)

7

(6%)

2

(2%)

115 .566

Male 121

(58%)

55

(26%)

19

(9%)

11

(5%)

2

(1%)

208

Others find it easy to trust this manager


Total Chi Sq

P-value 1 2 3 4 5

Female 41

(36%)

39

(35%)

20

(18%)

11

(10%)

2

(2%)

113 .474

Male 91

(44%)

69

(34%)

31

(15%)

11

(5%)

3

(1%)

205

41

2. SELF-DEVELOPMENT

This manager seeks feedback for projects from others who are more knowledgeable


Total Chi Sq

P-value 1 2 3 4 5

Female 53

(46%)

34

(30%)

11

(10%)

14

(12%)

3

(3%)

115 .270

Male 104

(50%)

70

(34%)

17

(8%)

13

(6%)

2

(1%)

206

This manager is receptive to constructive criticism


Total Chi Sq

P-value 1 2 3 4 5

Female 37

(33%)

48

(42%)

16

(14%)

12

(11%)

0 113 .063

Male 95

(46%)

66

(32%)

28

(14%)

14

(7%)

4

(2%)

207

This manager takes direction well


Total Chi Sq

P-value 1 2 3 4 5

Female 51

(44%)

36

(31%)

19

(17%)

9

(8%)

0 115 .159

Male 116

(57%)

56

(27%)

23

(11%)

10

(5%)

0 205

This manager is open to new ideas


Total Chi Sq

P-value 1 2 3 4 5

Female 58

(51%)

37

(32%)

13

(12%)

5

(4%)

1

(1%)

114 .366

Male 124

(60%)

55

(27%)

19

(9%)

7

(3%)

0 205

This manager deals with facts when deciding on issues*


Total Chi Sq

P-value 1 2 3 4 5

Female 39

(35%)

42

(38%)

23

(21%)

5

(4%)

3

(3%)

112 .029*

Male 87

(42%)

86

(42%)

24

(12%)

8

(4%)

0 205

42

3. OUTLOOK

This manager is sufficiently self-assured


Total Chi Sq

P-value 1 2 3 4 5

Female 38

(33%)

42

(37%)

23

(20%)

10

(9%)

1

(1%)

114 .394

Male 77

(37%)

88

(43%)

31

(15%)

10

(5%)

1

207

This manager shows appropriate respect to his superiors


Total Chi Sq

P-value 1 2 3 4 5

Female 57

(51%)

41

(37%)

7

(6%)

5

(4%)

2

(2%)

112 .056

Male 135

(65%)

49

(24%)

17

(8%)

4

(2%)

2

(1%)

207

This manager has a positive mental attitude


Total Chi Sq

P-value 1 2 3 4 5

Female 69

(60%)

33

(29%)

8

(7%)

4

(3%)

1

(1%)

115 .496

Male 130

(63%)

57

(28%)

16

(8%)

3

(1%)

0 206

This manager is in control of his emotions


Total Chi Sq

P-value 1 2 3 4 5

Female 41

(36%)

42

(37%)

17

(15%)

13

(11%)

1

(1%)

114 .275

Male 98

(48%)

67

(33%)

25

(12%)

14

(7%)

1

205

This manager enjoys his work


Total Chi Sq

P-value 1 2 3 4 5

Female 61

(54%)

42

(37%)

8

(7%)

3

(3%)

0 114 .596

Male 123

(61%)

63

(31%)

14

(7%)

3

(1%)

0 203

43

This manager has a good sense of humor


Total Chi Sq

P-value 1 2 3 4 5

Female 63

(55%)

40

(35%)

5

(4%)

4

(4%)

2

(2%)

114 .166

Male 108

(53%)

69

(34%)

20

(10%)

6

(3%)

0 203


This manager sets challenging goals for his staff


Total Chi Sq

P-value 1 2 3 4 5

Female 47

(42%)

30

(27%)

26

(23%)

8

(7%)

2

(2%)

113 .154

Male 86

(42%)

75

(37%)

36

(18%)

7

(3%)

1

205

This manager exercises authority easily


Total Chi Sq

P-value 1 2 3 4 5

Female 34

(30%)

35

(31%)

30

(27%)

12

(11%)

2

(2%)

113 .119

Male 47

(23%)

91

(44%)

54

(26%)

14

(7%)

1

207

This manager can read other people’s emotions well


Total Chi Sq

P-value 1 2 3 4 5

Female 17

(15%)

38

(33%)

35

(31%)

17

(15%)

7

(6%)

114 .107

Male 39

(19%)

78

(38%)

69

(33%)

18

(9%)

4

(2%)

208

It is easy for this manager to work with others


Total Chi Sq

P-value 1 2 3 4 5

Female 52

(46%)

35

(31%)

17

(15%)

10

(9%)

0

114 .710

Male 102

(49%)

64

(31%)

29

(14%)

11

(5%)

1

207

44

This manager is sensitive to culturally correct behavior when communicating with diverse

cultures*


Total Chi Sq

P-value 1 2 3 4 5

Female 40

(35%)

42

(37%)

25

(22%)

4

(4%)

2

(2%)

113 .038*

Male 97

(47%)

75

(36%)

26

(13%)

8

(4%)

0 206

This manager confronts others about their mistakes


Total Chi Sq

P-value 1 2 3 4 5

Female 24

(21%)

49

(43%)

33

(29%)

5

(4%)

2

(2%)

113 .306

Male 47

(23%)

83

(40%)

53

(26%)

21

(10%)

1

205

This manager handles difficult people or situations with diplomacy


Total Chi Sq

P-value 1 2 3 4 5

Female 34

(30%)

36

(31%)

28

(25%)

12

(11%)

3

(3%)

113 .101

Male 56

(27%)

83

(41%)

49

(24%)

16

(8%)

0 204

This manager understands politics in the organization*


Total Chi Sq

P-value 1 2 3 4 5

Female 20

(18%)

39

(35%)

35

(31%)

10

(9%)

8

(7%)

112 .017*

Male 48

(23%)

81

(40%)

50

(24%)

24

(12%)

2

(1%)

205

This manager communicates directly about controversial issues


Total Chi Sq

P-value 1 2 3 4 5

Female 33

(29%)

44

(39%)

23

(20%)

12

(11%)

2

(1%)

114 .401

Male 53

(26%)

93

(45%)

45

(22%)

13

(6%)

1 205

45

This manager uses a variety of techniques to influence others*


Total Chi Sq

P-value 1 2 3 4 5

Female 22

(20%)

36

(32%)

31

(28%)

17

(15%)

5

(5%)

111 .033*

Male 39

(19%)

94

(46%)

53

(26%)

15

(7%)

3

(1%)

204

This manager builds rapport with peers and others on the management team


Total Chi Sq

P-value 1 2 3 4 5

Female 45

(39%)

38

(33%)

19

(17%)

11

(10%)

1

(1%)

114 .205

Male 81

(40%)

86

(42%)

28

(14%)

8

(4%)

2

(1%)

205

*** <.001; ** <.01; *<.05


46

Table 3.2



a. Managerial ethics & values

Gender

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Female 1

(1%)

16

(14%)

76

(68%)

17

(15%)

1

(1%)

111 .513

Male 1

(1%)

29

(15%)

143

(73%)

19

(10%)

5

(3%)

197

b. Communication

Gender

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Female 4

(4%)

32

(29%)

54

(48%)

18

(16%)

4

(4%)

112 .435

Male 4

(2%)

65

(33%)

81

(41%)

45

(23%)

5

(3%)

200

c. Problem solving

Gender

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Female 5

(5%)

27

(25%)

59

(54%)

18

(16%)

1

(1%)

110 .082

Male 1

(1%)

59

(30%)

107

(54%)

25

(13%)

5

(3%)

197

d. Interpersonal skills

Gender

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Female 5

(5%)

28

(26%)

57

(52%)

19

(17%)

0 109 .342

Male 5

(3%)

53

(27%)

95

(49%)

36

(18%)

6

(3%)

195

47

e. Developing others

Gender

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Female 9

(8%)

35

(32%)

54

(50%)

11

(10%)

0 109 .238

Male 6

(3%)

70

(35%)

100

(50%)

24

(12%)

2

(1%)

202

f. Marketing/Strategic planning

Gender

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Female 7

(6%)

31

(28%)

40

(37%)

24

(22%)

7

(6%)

109 .460

Male 6

(3%)

69

(35%)

76

(39%)

35

(18%)

11

(6%)

197

*** <.001; ** <.01; *<.05


48

Table 3.3



a. Supervisors

Gender

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Female 5

(5%)

33

(31%)

68

(64%)

106

.925

Male 11

(6%)

58

(30%)

126

(65%)

195

b. Peers

Gender

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Female 6

(6%)

35

(32%)

68

(62%)

109 .750

Male 15

(8%)

59

(30%)

126

(63%)

200

c. Subordinates

Gender

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Female 20

(18%)

33

(30%)

57

(52%)

110 .134

Male 22

(11%)

76

(38%)

100

(51%)

198

d. Physicians

Gender

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Female 15

(14%)

32

(29%)

62

(57%)

109 .237

Male 18

(9%)

74

(37%)

106

(54%)

198

e. Overall

Gender

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Female 8

(7%)

37

(34%)

65

(59%)

110 .986

Male 15

(8%)

64

(33%)

115

(59%)

194

*** <.001; ** <.01; *<.05


49

Chapter 4: The Impact of the REM’s Education on How They Were Evaluated

In Chapter 4, we examine whether or not the graduate educational preparation of REMs was related

to their evaluation. We compare REMs with degrees in health care management and those with

degrees in general business which are the two most prevalent categories among our respondents

(Tables 4.1 to 4.3). In Appendix II, we present the graduate degrees obtained by all respondents

including health care management, general business, clinical and allied health (includes medicine,

nursing, and science related degree programs), other degrees (includes community and health

science, legal, and public administration), as well as those with no graduate degree.

There is ongoing debate about which degree program best prepares students to be successful in the

field of health care management. The American College of Healthcare Executives describes the

advantages of various master’s degree programs (ACHE, 2011). Hogan and Blake (1996) report

that a person’s major and overall interests have an effect on how that person relates to other people.

Interests may also have a predictive expectation on how one chooses their own major, activity, and

occupation (Hogan and Blake, 1990). Niles and Bowlsbey (2009) report that there is congruence

between career and overall interests and behavior type in employment situations. Holland,

Gottfredson, and Baker (1990) state that there are person-environment assumptions related to work

skills and that people search for environments that will let them exercise their skills and abilities

and that a person’s behavior is determined by an interaction between their personality and

characteristics of their environment.

Griffith (2007) found that master’s education is the most common entry portal to senior

management in healthcare. Regardless of academic degree completed, he recommended a model

whereby continuous improvement of education practices was implemented. Dorgan, Layton,

Bloom, Homkes, Sadun and Van Reenen (2011) reported that graduate education is linked to better

management. Better-managed companies employ more educated managers and workers (Bloom,

Homkes, Sadun, and Van Reenen, 2011). While MBA and MHA graduate programs subscribe to

this educational logic, the program curricula emphasize different management competencies.

Bennis (2005) accused business schools of failing to impart useful skills, failing to prepare leaders,

failing to instill norms of ethical behavior, and failing to lead graduates to good corporate jobs.

However, there was an absolute increase in salaries for those that obtained an MBA (Inderrieden,

Holtom, and Bies, 2006). The same commentary is directed at the MHA with the caveat that the

graduate is restricted to the healthcare environment and may not have the opportunity to cross into

other industries comparable to the generalist MBA (Student-Doctor Network, 2007).

a. Paired Comparisons on Intra- and Interpersonal attributes When the 26 interpersonal competencies were assessed by the senior executives based on the

education program of the REM, there was no statistical difference among the REMs holding

degrees in healthcare management and those holding degrees in general Business (Table 4.1).

50

b. REMs’ Competencies Compared with Evaluators’ Own Competencies at the Same Career Stage When senior executives were asked to assess the REM compared with senior executive views of

their own competency at the same career stage, there was no statistical difference in the assessment

of the REM as it relates to managerial ethics and values, communication, problem solving,

interpersonal skills, and developing others (Table 4.2).

c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents The interpersonal skills of REMs as they relate to supervisors, peers, subordinates, and physicians

showed no statistical difference based on the REM’s education (Table 4.3).

51

Table 4.1

Paired Comparisons on Dimensions of Interpersonal Competency,

by Health Management and Business Degrees



REM Education Positive Medium Negative Chi Sq

P-value 1 2 3 4 5 Total

Health Policy &

Management

65

(44%)

58

(39%)

20

(13%)

6

(4%)

0 149 .060

Business 26

(45%)

16

(28%)

8

(14%)

8

(14%)

0 58




Health Policy &

Management

88

(59%)

40

(27%)

12

(8%)

9

(6%)

0 148 .564

Business 36

(62%)

13

(22%)

5

(9%)

3

(5%)

1

(2%)

58




Health Policy &

Management

86

(58%)

39

(26%)

15

(10%)

7

(5%)

1

(1%)

148 .608

Business 30

(52%)

20

(34%)

6

(10%)

1

(2%)

1

(2%)

58




Health Policy &

Management

62

(42%)

52

(36%)

23

(16%)

8

(5%)

1

(1%)

146 .869

Business 21

(36%)

22

(38%)

11

(19%)

4

(7%)

0

58

52

2. SELF-DEVELOPMENT




Health Policy &

Management

80

(54%)

41

(28%)

13

(9%)

13

(9%)

1

(1%)

148 .718

Business 25

(45%)

18

(32%)

7

(13%)

5

(9%)

1

(2%)

56

The manger is receptive to constructive criticism



Health Policy &

Management

63

(43%)

54

(37%)

18

(12%)

11

(8%)

0 146 .231

Business 20

(34%)

22

(38%)

12

(21%)

3

(5%)

1

(2%)

58




Health Policy &

Management

86

(59%)

40

(27%)

10

(7%)

11

(7%)

0 147 .177

Business 25

(44%)

20

(35%)

8

(14%)

4

(7%)

0 57




Health Policy &

Management

96

(65%)

32

(22%)

16

(11%)

3

(2%)

0 147 .079

Business 29

(50%)

23

(40%)

5

(9%)

1

(2%)

0 58

This manager deals with facts when deciding on issues



Health Policy &

Management

62

(42%)

62

(42%)

17

(12%)

4

(3%)

1

(1%)

146 .827

Business 22

(38%)

26

(45%)

6

(10%)

3

(5%)

1

(2%)

58

53

3. OUTLOOK




Health Policy &

Management

57

(39%)

58

(39%)

21

(14%)

11

(7%)

1

(1%)

148 .918

Business 25

(43%)

22

(38%)

8

(14%)

3

(5%)

0 58




Health Policy &

Management

91

(63%)

37

(26%)

11

(8%)

3

(2%)

3

(2%)

145 .599

Business 32

(55%)

19

(33%)

5

(9%)

2

(3%)

0 58




Health Policy &

Management

99

(68%)

38

(26%)

8

(5%)

1

(1%)

0 146 .203

Business 32

(55%)

22

(38%)

3

(5%)

0 1

(2%)

58




Health Policy &

Management

71

(49%)

54

(37%)

12

(8%)

9

(6%)

0 146 .173

Business 25

(43%)

18

(31%)

10

(17%)

4

(7%)

1

(2%)

58




Health Policy &

Management

86

(59%)

50

(34%)

7

(5%)

2

(1%)

0 145 .838

Business 34

(59%)

21

(36%)

3

(5%)

0 0 58

54




Health Policy &

Management

78

(54%)

51

(35%)

12

(8%)

3

(2%)

1

(1%)

145 .962

Business 31

(53%)

22

(38%)

4

(7%)

1

(2%)

0 58





Health Policy &

Management

63

(43%)

48

(33%)

29

(20%)

6

(4%)

0 146 .458

Business 28

(48%)

17

(29%)

11

(19%)

1

(2%)

1

(2%)

58




Health Policy &

Management

36

(24%)

51

(35%)

47

(32%)

10

(7%)

3

(2%)

147 .406

Business 19

(33%)

23

(40%)

13

(22%)

3

(5%)

0 58




Health Policy &

Management

26

(18%)

60

(41%)

41

(28%)

18

(12%)

3

(2%)

148 .063

Business 10

(17%)

18

(31%)

22

(38%)

3

(5%)

5

(9%)

58




Health Policy &

Management

79

(54%)

41

(28%)

19

(13%)

8

(5%)

0 147 .511

Business 25

(43%)

19

(33%)

11

(19%)

3

(5%)

0 58

55


cultures



Health Policy &

Management

67

(46%)

53

(36%)

21

(14%)

5

(3%)

0 146 .997

Business 26

(45%)

21

(36%)

9

(16%)

2

(3%)

0 58


REM Education 1 2 3 4 5 Total Chi Sq

P-value

Health Policy &

Management

29

(20%)

59

(41%)

43

(30%)

12

(8%)

2

(1%)

145 .254

Business 19

(33%)

22

(38%)

15

(26%)

2

(3%)

0 58




Health Policy &

Management

42

(29%)

60

(41%)

31

(21%)

12

(8%)

0 145 .497

Business 17

(29%)

18

(31%)

17

(29%)

4

(7%)

2

(3%)

58

This manager understands politics in the organization



Health Policy &

Management

30

(21%)

58

(40%)

41

(28%)

16

(11%)

1

(1%)

146 .182

Business 19

(33%)

20

(34%)

13

(22%)

4

(7%)

2

(3%)

58




Health Policy &

Management

39

(27%)

62

(42%)

33

(23%)

10

(7%)

2

(1%)

146 .564

Business 20

(34%)

21

(36%)

11

(19%)

6

(10%)

0 58

56

This manager uses a variety of techniques to influence others



Health Policy &

Management

25

(17%)

64

(45%)

36

(25%)

15

(10%)

3

(2%)

143 .803

Business 10

(17%)

27

(47%)

17

(29%)

3

(5%)

1

(2%)

58




Health Policy &

Management

61

(42%)

58

(40%)

15

(10%)

10

(7%)

2

(1%)

146 .396

Business 24

(41%)

20

(34%)

13

(22%)

1

(2%)

0 58

*** <.001; ** <.01; *<.05


57

Table 4.2




REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

0 14

(10%)

99

(72%)

19

(14%)

5

(4%)

137 .060

Business 0 9

(16%)

45

(80%)

2

(4%)

0 56

b. Communication

REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

2

(1%)

43

(31%)

61

(44%)

27

(19%)

7

(5%)

140 .658

Business 2

(4%)

20

(35%)

25

(44%)

9

(16%)

1

(2%)

57

c. Problem solving

REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value e

Health

Management

1

(1%)

37

(26%)

72

(51%)

28

(20%)

3

(2%)

141 .687

Business 1

(2%)

15

(26%)

32

(56%)

7

(12%)

2

(4%)

57


REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

2

(1%)

41

(29%)

71

(51%)

23

(16%)

3

(2%)

140 .563

Business 3

(6%)

17

(31%)

24

(44%)

9

(17%)

1

(2%)

54


REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

7

(5%)

49

(35%)

66

(47%)

16

(11%)

2

(1%)

140 .688

Business 3

(5%)

19

(33%)

32

(55%)

4

(7%)

0 58

58


REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

2

(1%)

37

(27%)

54

(40%)

30

(22%)

13

(10%)

136 .698

Business 1

(2%)

18

(32%)

22

(39%)

13

(23%)

2

(4%)

56

*** <.001; ** <.01; *<.05


59

Table 4.3



a. Supervisors

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

9

(7%)

34

(25%)

93

(68%)

136 .436

Business 1

(2%)

21

(38%)

33

(60%)

55

b. Peers

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

9

(6%)

35

(25%)

96

(69%)

140 .136

Business 4

(7%)

24

(43%)

28

(50%)

56

c. Subordinates

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

20

(14%)

45

(32%)

74

(53%)

139 .409

Business 6

(11%)

25

(45%)

24

(44%)

55

d. Physicians

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

16

(12%)

47

(34%)

74

(54%)

137 .618

Business 3

(5%)

20

(36%)

33

(59%)

56

60

e. Overall

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

11

(8%)

40

(29%)

88

(63%)

139 .468

Business 4

(7%)

23

(42%)

28

(51%)

55

*** <.001; ** <.01; *<.05


61

Chapter 5: The Impact of REMs’ Age on How They Were Evaluated

It should be noted that although respondents were asked to identify a REM that was 30 years of age

or younger, full 53 of 320 individuals that were able to identify a REM with whom they worked

stated that their REM was over age 30. Because there were interesting differences observed between

younger and older REMs’ evaluations, we elected to include these 53 responses and display them in

this section of the report.

Age heterogeneity can negatively affect productivity in the work environment (Backes-Gellner and

Veen, 2009). Different age cohorts, each with varying socialization processes behind them, regard

their environment against the backdrop of very different cultural and normative attitudes, which

heightens the likelihood of value conflicts (Backes-Gellner and Veen, 2009). This lessens the

degree of social integration and ultimately diminishes productivity (Jackson and Joshi, 2004). It has

been shown that productivity-diminishing conflicts are frequent in the presence of “generation

gaps” and demographic fault lines (Lau and Murnighan, 2005)

a. Paired Comparisons on Intra-and Interpersonal attributes When the 26 interpersonal competencies were assessed by the senior executives based on the REM

being 30 years old or less versus being 31 or older, there were nine differences in how the senior

executive assessed their REM (Table 5.1).

A higher proportion of evaluators with younger REMs rated the following competencies more

highly than those evaluating older REMs:

Setting challenging goals for staff

Taking direction well

Having a positive mental attitude

Working easily with others

Finding it easy to trust this manager

Others finding it easy to trust this manager

Dealing with facts when deciding on issues

Being open to new ideas

Enjoying his work

b. REMs’ Competencies compared with Evaluators’ Own Competencies at the Same Career Stage When senior executives were asked to assess the REM compared with senior executive views of

their own competency at the same career stage, there was no difference in the assessment of the

REM based on the REMs’ age (Table 5.2).

c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents The interpersonal skills of REMs as evaluated by senior executive respondents by age as they relate

to supervisors, peers, subordinates, and physicians showed no difference based on the REMs’ age

(Table 5.3).

62

Table 5.1


by Over and Under 30 Years of Age



REM Age Positive Medium Negative Chi Sq


30 and under 106

(39%)

113

(42%)

33

(12%)

17

(6%)

1

270 .399

31 and over 19

(36%)

18

(34%)

10

(19%)

6

(11%)

0 53




30 and under 162

(60%)

72

(27%)

17

(6%)

15

(6%)

2

(1%)

268 .094

31 and over 27

(51%)

12

(23%)

8

(15%)

6

(11%)

0 53

I find it easy to trust this manager***



30 and under 156

(58%)

70

(26%)

30

(11%)

10

(4%)

3

(1%)

269 .001***

31 and over 21

(40%)

21

(40%)

3

(6%)

8

(15%)

0 53

Others find it easy to trust this manager**



30 and under 118

(45%)

82

(31%)

47

(18%)

15

(6%)

3

(1%)

265 .005**

31 and over 14

(27%)

26

(50%)

4

(8%)

6

(12%)

2

(4%)

52

63

2. SELF-DEVELOPMENT




30 and under 138

(51%)

82

(30%)

23

(9%)

23

(9%)

3

(1%)

269 .382

31 and over 19

(37%)

22

(43%)

5

(10%)

4

(8%)

1

(2%)

51




30 and under 99

(37%)

109

(41%)

44

(16%)

13

(5%)

2

(1%)

267 .180

31 and over 16

(30%)

21

(40%)

9

(17%)

7

(13%)

0 53

This manager takes direction well**



30 and under 63

(24%)

110

(41%)

70

(26%)

20

(8%)

3

(1%)

266 .003**

31 and over 17

(32%)

16

(30%)

14

(26%)

6

(11%)

0 53

This manager is open to new ideas***



30 and under 165

(62%)

65

(24%)

27

(10%)

9

(3%)

0 266 .001***

31 and over 17

(33%)

27

(52%)

5

(10%)

2

(4%)

1

(2%)

52

This manager deals with facts when deciding on issues*



30 and under 111

(42%)

106

(40%)

38

(14%)

8

(3%)

1

264

.017*

31 and over 15

(29%)

22

(42%)

8

(15%)

5

(10%)

2

(4%)

52

64

3. OUTLOOK




30 and under 99

(37%)

109

(41%)

44

(16%)

13

(5%)

2

(1%)

267 .205

31 and over 16

(30%)

21

(40%)

9

(17%)

7

(13%)

0 53




30 and under 163

(61%)

75

(28%)

19

(7%)

7

(3%)

2

(1%)

266 .838

31 and over 29

(56%)

15

(29%)

5

(10%)

2

(4%)

1

(2%)

52

This manager has a positive mental attitude**



30 and under 175

(66%)

71

(27%)

16

(6%)

5

(2%)

0 267 .010**

31 and over 24

(45%)

19

(36%)

7

(13%)

2

(4%)

1

(2%)

53




30 and under 122

(46%)

90

(34%)

29

(11%)

22

(8%)

2

(1%)

265 .127

31 and over 17

(32%)

19

(36%)

12

(23%)

5

(9%)

0 53

This manager enjoys his work*



30 and under 161

(61%)

83

(32%)

15

(6%)

4

(2%)

0 263 .046*

31 and over 23

(43%)

21

(40%)

7

(13%)

2

(4%)

0 53

65




30 and under 145

(55%)

91

(35%)

19

(7%)

6

(2%)

2

(1%)

263 .491

31 and over 26

(49%)

18

(34%)

6

(11%)

3

(6%)

0 53


This manager sets challenging goals for his staff*



30 and under 118

(44%)

90

(34%)

35

(13%)

21

(8%)

2

(1%)

266 .018*

31 and over 14

(26%)

24

(45%)

9

(17%)

5

(9%)

1

(2%)

53




30 and under 111

(42%)

85

(32%)

57

(22%)

10

(4%)

1

264 .404

31 and over 22

(42%)

19

(36%)

5

(9%)

5

(9%)

2

(4%)

53




30 and under 149

(56%)

72

(27%)

29

(11%)

17

(6%)

0 267 .734

31 and over 18

(35%)

20

(38%)

13

(25%)

1

(2%)

0 52

It is easy for this manager to work with others*



30 and under 138

(52%)

77

(29%)

35

(13%)

17

(6%)

0 267 .013*

31 and over 16

(30%)

22

(42%)

10

(19%)

4

(8%)

1

(2%)

53

66


cultures



30 and under 122

(46%)

91

(34%)

42

(16%)

9

(3%)

1

265

.090

31 and over 15

(28%)

26

(49%)

8

(15%)

3

(6%)

1

(2%)

53




30 and under 56

(21%)

113

(43%)

71

(27%)

21

(8%)

3

(1%)

264 .631

31 and over 15

(28%)

18

(34%)

15

(28%)

5

(9%)

0 53




30 and under 78

(30%)

99

(38%)

60

(23%)

25

(9%)

2

(1%)

264 .844

31 and over 12

(23%)

20

(38%)

16

(31%)

3

(6%)

1

(2%)

52




30 and under 52

(20%)

104

(40%)

73

(28%)

28

(11%)

6

(2%)

263 .091

31 and over 16

(30%)

15

(28%)

12

(23%)

6

(11%)

4

(8%)

53




30 and under 74

(28%)

114

(43%)

56

(21%)

19

(7%)

3

(1%)

266 .844

31 and over 12

(23%)

23

(44%)

12

(23%)

5

(10%)

0 52

67




30 and under 51

(20%)

107

(41%)

73

(28%)

26

(10%)

4

(2%)

261 .100

31 and over 10

(19%)

23

(43%)

10

(19%)

6

(11%)

4

(8%)

53




30 and under 111

(42%)

99

(37%)

39

(15%)

14

(5%)

2

(1%)

265 .278

31 and over 15

(28%)

25

(47%)

7

(13%)

5

(9%)

1

(2%)

53

*** <.001; ** <.01; *<.05


68

Table 5.2




REM

Age

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Under 30

1

37

(15%)

183

(72%)

30

(12%)

4

(2%)

255 .596

Over 31

1

(2%)

7

(13%)

36

(69%)

6

(12%)

2

(4%)

52

b. Communication

REM

Age

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Under 30

7

(3%)

76

(29%)

116

(45%)

53

(21%)

6

(2%)

258 .336

Over 31

1

(2%)

21

(40%)

18

(34%)

10

(19%)

3

(6%)

53

c. Problem solving

REM

Age

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Under 30

4

(2%)

73

(29%)

135

(53%)

39

(15%)

5

(2%)

256 .434

Over 31

2

(4%)

12

(24%)

31

(62%)

4

(8%)

1

(2%)

50


REM

Age

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Under 30

7

(3%)

71

(28%)

123

(49%)

45

(18%)

4

(2%)

250 .441

Over 31

3

(6%)

10

(19%)

28

(53%)

10

(19%)

2

(4%)

53


REM

Age

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Under 30

14

(5%)

89

(35%)

129

(50%)

24

(9%)

1

257 .084

Over 31

1

(2%)

16

(30%)

24

(45%)

11

(21%)

1

(2%)

53

69


REM

Age

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Under 30

10

(4%)

84

(33%)

97

(38%)

49

(19%)

15

(6%)

255 .969

Over 31

3

(6%)

15

(30%)

19

(38%)

10

(20%)

3

(6%)

50

*** <.001; ** <.01; *<.05


70

Table 5.3



a. Supervisors

REM

Age

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Under 30 12

(5%)

72

(29%)

166

(66%)

250 .372

Over 31 3

(6%)

19

(38%)

28

(56%)

50

b. Peers

REM

Age

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Under 30 14

(5%)

77

(30%)

166

(65%)

257 .085

Over 31 7

(14%)

16

(31%)

28

(55%)

51

c. Subordinates

REM

Age

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Under 30 35

(14%)

87

(34%)

133

(52%)

255 .674

Over 31 7

(13%)

21

(40%)

24

(46%)

52

d. Physicians

REM

Age

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Under 30 26

(10%)

89

(35%)

139

(55%)

254 .721

Over 31 7

(13%)

16

(31%)

29

(56%)

52

e. Overall

REM

Age

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Under 30 17

(7%)

87

(35%)

148

(59%)

252 .276

Over 31 6

(12%)

13

(25%)

32

(63%)

51

*** <.001; ** <.01; *<.05


71

Chapter 6: The Impact of REMs’ Having Clinical Experience on

How They Were Evaluated

In Chapter 6, we are interested in determining if REMs with clinical experience had a

competitive advantage in how they were perceived by senior executives. We wanted to know if

they had more advanced interpersonal skills relating to non-clinicians and other clinicians.

Yarbrough and Baumgardner (2007) report that having a clinical degree or a particular type of

degree (i.e.,MHA) did not impact a manager’s career progression.

However, other studies suggest that positive career outcomes are related to networking ability,

demonstration of sincerity, an ability to influence others interpersonally, and being socially

astute (Ferris, Perrewe, and Douglas, 2002). In addressing the clinical professions, clinical

supervision influences nurse development of a professional identity, it enhances their decision-

making ability, and personal growth which highlights the need for on-going professional

development (Severinsson, 2010). Davis and Nicholaou (1992) illustrated the positive effects of

formal curricular change that has focused on interpersonal aspects of communication for medical

students. The emphasis on competency training in clinical and non-clinical academic programs

has a positive connection to career outcomes (Todd, Harris, Harris, and Wheeler, 2009).

a. Paired Comparisons on Intra-and Interpersonal attributes When the 26 interpersonal competencies were assessed by the senior executives, there was no

difference in how the senior executive assessed the REM based on their REMs having or not

having clinical experience (Table 6.1):

b. REMs’ Competencies compared with Evaluators’ Own Competencies at the Same Career Stage When senior executives were asked to assess the REM compared with senior executive views of

their own competency at the same career stage, there was a difference in the assessment of the

REM based on marketing/strategic planning skills (Table 6.2). Specifically, no differences in

having had clinical experience were evident in regard to managerial ethics and values,

communication, problem solving, interpersonal skills or developing others. However, REMs that

did not have clinical experience were rated more highly than those with such experience in the

area of marketing/strategic planning.

c. Rating of REMS’ Interpersonal Skills with Other Role Incumbents The interpersonal skills of REMs in working with others including supervisors appears to be

unrelated to the REM’s having had prior clinical experience. None of the measures that asked

evaluators to assess interpersonal skills showed significant differences in the REMs’ evaluations.

It appears that REMS with and without clinical experience relate to supervisors, peers,

subordinates, and physicians equally well (Table 6.3).

72

Table 6.1


by Clinical and Nonclinical Cohort



Clinical

Experience

Positive Medium Negative Chi Sq


With clinical

experience

38

(36%)

45

(42%)

11

(10%)

11

(10%)

1

(1%)

106

.282

No clinical

experience

85

(40%)

86

(40%)

31

(14%)

13

(6%)

0

(0%)

215


Clinical

Experience



With clinical

experience

64

(60%)

28

(26%)

7

(7%)

6

(6%)

1

(1%)

106

.928

No clinical

experience

124

(58%)

55

(26%)

19

(9%)

14

(7%)

1

(0%)

213


Clinical

Experience



With clinical

experience

52

(49%)

33

(31%)

12

(11%)

8

(8%)

1

(1%)

106 .564

No clinical

experience

124

(58%)

57

(27%)

20

(9%)

10

(5%)

3

(1%)

214


Clinical

Experience



With clinical

experience

42

(40%)

35

(33%)

14

(13%)

13

(12%)

2

(2%)

106 .116

No clinical

experience

90

(43%)

71

(34%)

36

(17%)

9

(4%)

3

(1%)

209

73

2. SELF-DEVELOPMENT


Clinical

Experience



With clinical

experience

49

(46%)

39

(37%)

12

(11%)

5

(5%)

1

(1%)

106

.329

No clinical

experience

107

(50%)

65

(31%)

16

(8%)

20

(9%)

4

(2%)

212


Clinical

Experience



With clinical

experience

44

(42%)

38

(37%)

12

(12%)

9

(9%)

1

(1%)

104

.946

No clinical

experience

88

(41%)

75

(35%)

31

(15%)

16

(8%)

3

(1%)

213


Clinical

Experience



With clinical

experience

52

(49%)

29

(27%)

20

(19%)

5

(5%)

0 106

.158

No clinical

experience

114

(54%)

62

(29%)

21

(10%)

14

(7%)

0 211


Clinical

Experience



With clinical

experience

56

(53%)

34

(32%)

12

(11%)

4

(4%)

0 106 .786

No clinical

experience

124

(59%)

58

(28%)

20

(10%)

7

(3%)

1

(0%)

210


Clinical

Experience



With clinical

experience

40

(38%)

37

(36%)

22

(21%)

4

(4%)

1

(1%)

104 .307

No clinical

experience

86

(41%)

88

(42%)

25

(12%)

9

(4%)

2

(1%)

210

74

3. OUTLOOK


Clinical

Experience



With clinical

experience

39

(37%)

43

(41%)

16

(15%)

7

(7%)

0

(0%)

105

.845

No clinical

experience

75

(35%)

85

(40%)

38

(18%)

13

(6%)

2

(1%)

213


Clinical

Experience



With clinical

experience

61

(58%)

32

(30%)

6

(6%)

6

(6%)

0 105 .105

No clinical

experience

129

(61%)

57

(27%)

18

(9%)

3

(1%)

4 211


Clinical

Experience



With clinical

experience

63

(60%)

25

(24%)

13

(12%)

3

(3%)

1

(1%)

105 .089

No clinical

experience

136

(64%)

62

(29%)

11

(5%)

4

(2%)

0 213


Clinical

Experience



With clinical

experience

38

(36%)

38

(36%)

17

(16%)

11

(10%)

1

(1%)

105 .326

No clinical

experience

101

(48%)

69

(33%)

25

(12%)

15

(7%)

1

211


Clinical

Experience



With clinical

experience

58

(55%)

34

(32%)

11

(10%)

3

(3%)

0 106 .298

No clinical

experience

125

(60%)

69

(33%)

11

(5%)

3

(1%)

0 208

75


Clinical

Experience



With clinical

experience

59

(57%)

33

(32%)

7

(7%)

4

(4%)

0 103 .779

No clinical

experience

112

(53%)

74

(35%)

17

(8%)

6

(3%)

2

(1%)

211



Clinical

Experience



With clinical

experience

43

(41%)

35

(34%)

18

(17%)

7

(7%)

1

(1%)

104

.803

No clinical

experience

89

(42%)

69

(33%)

43

(20%)

8

(4%)

2

(1%)

211


Clinical

Experience



With clinical

experience

27

(26%)

44

(42%)

25

(24%)

8

(8%)

0

(0%)

104

.680

No clinical

experience

53

(25%)

80

(38%)

59

(28%)

18

(8%)

3

(1%)

213


Clinical

Experience



With clinical

experience

19

(18%)

39

(37%)

30

(29%)

15

(14%)

2

(2%)

105 .510

No clinical

experience

37

(17%)

76

(36%)

72

(34%)

20

(9%)

20

(9%)

214


Clinical

Experience



With clinical

experience

46

(43%)

38

(36%)

13

(12%)

8

(8%)

1

(1%)

106 .290

No clinical

experience

107

(50%)

60

(28%)

33

(16%)

12

(6%)

0 212

76


cultures

Clinical

Experience



With clinical

experience

42

(40%)

41

(39%)

18

(17%)

4

(4%)

0 105 .784

No clinical

experience

94

(45%)

74

(35%)

33

(16%)

8

(4%)

2

(1%)

211


Clinical

Experience



With clinical

experience

30

(29%)

39

(38%)

26

(25%)

9

(9%)

0 104 .246

No clinical

experience

40

(19%)

92

(44%)

59

(28%)

17

(8%)

3

(1%)

211


Clinical

Experience



With clinical

experience

26

(25%)

41

(39%)

25

(24%)

10

(10%)

2

(2%)

104 .618

No clinical

experience

64

(30%)

76

(36%)

52

(25%)

17

(8%)

1

(0%)

210


Clinical

Experience



With clinical

experience

22

(21%)

33

(31%)

29

(28%)

14

(13%)

7

(7%)

105 .060

No clinical

experience

46

(22%)

86

(41%)

55

(26%)

19

(9%)

3

(1%)

209


Clinical

Experience



With clinical

experience

26

(25%)

46

(44%)

24

(23)

9

(9%)

0 105 .697

No clinical

experience

60

(28%)

89

(42%)

44

(21%)

15

(7%)

3

(1%)

211

77


Clinical

Experience



With clinical

experience

22

(22%)

38

(37%)

25

(25%)

14

(14%)

3

(3%)

102 .481

No clinical

experience

39

(19%)

92

(44%)

57

(27%)

17

(8%)

5

(2%)

210


Clinical

Experience



With clinical

experience

36

(35%)

47

(45%)

14

(13%)

6

(6%)

1

(1%)

104 .615

No clinical

experience

89

(42%)

76

(36%)

32

(15%)

13

(6%)

2

(1%)

212

*** <.001; ** <.01; *<.05


78

Table 6.2


Competency at the Same Career Stage, by Clinical and Nonclinical Cohort


Clinical

Experience

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Clinical

experience

2

(2%)

17

(17%)

73

(72%)

10

(10%)

0 102 .095

No clinical

experience

0

27

(13%)

145

(71%)

25

(12%)

6

(3%)

203

b. Communication

Clinical

Experience

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Clinical

experience

4

(4%)

30

(30%)

43

(43%)

22

(22%)

2

(2%)

101 .754

No clinical

experience

4

(2%)

67

(32%)

90

(43%)

40

(19%)

7

(3%)

208

c. Problem solving

Clinical

Experience

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Clinical

experience

3

(3%)

31

(31%)

54

(54%)

12

(12%)

0 100 .358

No clinical

experience

3

(1%)

55

(27%)

111

(54%)

29

(14%)

6

(3%)

204


Clinical

Experience

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Clinical

experience

5

(5%)

25

(25%)

53

(52%)

18

(18%)

0 101 .344

No clinical

experience

5

(3%)

54

(27%)

99

(50%)

36

(18%)

6

(3%)

200

79


Clinical

Experience

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Clinical

experience

5

(5%)

36

(36%)

44

(44%)

16

(16%)

0 101 .308

No clinical

experience

9

(4%)

69

(33%)

108

(52%)

19

(9%)

2

(1%)

207

f. Marketing/Strategic planning*

Clinical

Experience

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Clinical

experience

9

(9%)

35

(35%)

37

(37%)

14

(14%)

4

(4%)

99 .026*

No clinical

experience

4

(2%)

64

(32%)

78

(38%)

44

(22%)

14

(7%)

204

*** <.001; ** <.01; *<.05


80

Table 6.3


by Clinical and Nonclinical Cohort as They Relate to:

a. Supervisors

Clinical

Experience

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Clinical

experience

4

(4%)

37

(37%)

58

(58%)

99 .125

No clinical

experience

12

(9%)

52

(26%)

135

(68%)

199

b. Peers

Clinical

Experience

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Clinical

experience

6

(6%)

31

(31%)

62

(62%)

99 .897

No clinical

experience

15

(7%)

61

(29%)

131

(63%)

207

c. Subordinates

Clinical

Experience

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Clinical

experience

13

(13%)

37

(37%)

51

(51%)

101 .945

No clinical

experience

28

(14%)

71

(35%)

105

(51%)

204

d. Physicians

Clinical

Experience

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Clinical

experience

10

(10%)

34

(34%)

57

(57%)

101 .899

No clinical

experience

22

(11%)

72

(35%)

109

(54%)

203

e. Overall

Clinical

Experience

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total Chi Sq

P-value

Clinical

experience

7

(7%)

32

(32%)

60

(60%)

99 .947

No clinical

experience

16

(16%)

67

(67%)

119

(59%)

202

*** <.001; ** <.01; *<.05


81

Chapter 7: Identification of “Fast Trackers” and Strategies

to Enhance REM Interpersonal Skills

A second objective of the study was to determine whether or not healthcare organizations

identify fast-trackers and how organizations respond, if at all, to enhance the REMs’

interpersonal skills and integrate them into the organization.

For example, in previous research, fast-trackers were identified as ambitious, creative,

independent, and intelligent employees who exhibit leadership potential (Gritzmacher,1989).

They were considered to be “officer material” and were given high exposure positions and

assigned projects with senior management. In our study, eighty-two percent of senior executive

respondents indicated that interpersonal relationship skills were used to identify “fast trackers”

and potential successors to current leaders in their organization.

Useful Strategies and Programs That Have Enhanced Interpersonal Skills of Recent Entrant Managers This was an open-ended question that then asked the 181 senior executive respondents to identify

what they perceived to be useful strategies and programs that enhanced the interpersonal skills of

recent entrant managers. Their comments were classified into seven major categories that

included on-the-job training; formal in-house training; coaching/mentoring; external training;

leadership assessment; recruitment interviews; and no formal training (Table 7.1).

Coaching/mentoring (28%); formal in-house training (26%); and on-the-job training (25%) were

the most common methods used to bring the REM into the organization and orient him/her to the

work setting.

Where external training (10%) was provided, the senior executive respondent recommended

ACHE seminars, Vital Smarts training, and enrollment in graduate education programs. Six-

percent identified personality and leadership assessment tools that were administered in their

organization to identify management leaders. Five-percent of the respondents viewed the

recruitment process as being critical to the success of a recent entrant manager and thought

recruitment for organizational fit was important in bringing the right candidates who would

ultimately be successful into the organization.

82

Table 7.1

What Have Been Useful Strategies and Programs That Have Enhanced Interpersonal Skills

of Recent Entrant Managers? (Open End Response)

Strategies/Programs Examples Frequency Percentage

(%)

On the job training 73 25

Meeting participation

Group projects

Listening rounds

Employee forums

Project work

Role modeling

Formal In-house training 74 26

Manager orientation training

Talent management course

Leadership training

Coaching/Mentoring 81 28

Mentor and role playing

1-on-1 interaction

Peer coaching

Mentoring with senior

management

External training 25 10

ACHE seminars

Crucial conversations

Leadership Institute

Press-Ganey

Studer Group

University MBA

Leadership assessment 18 6

AONE assessment

Myers-Briggs

360-feedback

Recruitment interviews 13 5

Hire for attitude

Hire for organizational fit

Behavioral interviews

No formal or informal

programs

4 1

83

Conclusion

In Chapter 1, the background on intergenerational communication and conflict in the workforce

was discussed. The role of professionalism that includes interpersonal abilities and the emphasis

being placed on it by graduate programs were presented. The chapter concludes with challenges

that exist in healthcare organizations to recruit and retain recent entrants to the field of healthcare

management.

We then presented the overall evaluation of the 292 respondents who reported on a recent entrant

manager (REM) with whom they worked. They evaluated their REM on 26 different attributes

that we developed to measure interpersonal abilities. We learned that of the 26 interpersonal

attributes, there were only six where fewer than 70 percent scored above average. Ordered from

most to least deficient, these five included (1) the REM can read other people’s emotions well;

(2) the REM understands politics in the organization; (3) the REM uses a variety of techniques to

influence others; (4) the REM handles difficult people or situations with diplomacy, (5) the REM

confronts others about their mistakes, (6) the REM exercises authority easily.

In addition, when compared to their competencies at the REMs career stage, 30 percent or more

of the evaluators in this study said that current REMs are worse than they were in five areas:

developing others, marketing/strategic planning, communication, problem solving and

interpersonal skills. Finally, when asked to rate their REM interpersonally, 33 percent rated

them overall as average, 59 percent were rated above average and seven percent rated their REM

below average. (Somewhat lower ratings were given in relating to subordinates and physicians.)

Taken together, this overview shows that despite assertions to the contrary, there appears to be

special areas where less experienced healthcare managers can benefit from coaching. It may be

that such training can be offered in graduate programs, by the hiring organization or by

professional societies. Regardless, it will be necessary to confront these managerial deficiencies

in an era when we expect more output and higher quality from the healthcare work force.

The second part of this research focused on the respondents to the survey to determine if their

demographic characteristics, notably age (or generation) and gender showed differences in how

they evaluated their REM (Chapters 2 and 3). We learned that the evaluators’ generation showed

only two major effects. In both cases, the younger evaluators, Gen Xers, rated their REMs as

worse than older evaluators in confronting others about their mistakes. Also, Gen Xers felt that

their REMs did not work to develop others as well as they did when they themselves were

REMs.

That younger evaluators are more stringent than older evaluators has often been noted

anecdotally. For example, young assistant professors are sometimes taken to task by more senior

colleagues for being too exacting on students and on their peers. It may be that in any

hierarchical system, the immediate supervisor’s sense that it is part of their role to ensure the best

behaviors are nurtured to uphold quality standards in the organization or profession.

When we considered the gender of the evaluators, we learned that men to a greater extent than

women evaluate their REMs as more competent in a number of areas: dealing with facts to make

84

decisions, culturally correct behavior, knowing the politics in the organization and using a

variety of techniques to influence others. We know that healthcare management, as in so many

other fields, women have not achieved as high a rank as men have. It may be that women who

are charged with evaluating REMs are holding them to a higher standard than men do to help

ensure that those under their tutelage achieve high level positions based on areas of competence

that they want to impart.

The third part of the research sought to explore differences among REMs themselves as possible

correlates for interpersonal skill differences (Chapters 4-6). We focused on graduates of Health

Policy and Management and Business programs since these were the largest degree cohorts. The

REMs’ graduate educational background showed little difference.

The REMs age showed that on nine different measures, younger REMs obtain higher ratings

than their older counterparts. This may be a part of a universal phenomenon in which novices

who are younger are “cut more slack” than older individuals even though each group may have

equal experience in their role. The findings argue for treating older REMs with the same

consideration as that afforded their younger counterparts.

The only substantive area that showed significant differences between REMs with and without

clinical experience was in the area of marketing/strategic planning and, in this case, those

without clinical experience were rated as better or much better than senior executives felt they

were at that stage in their career. It may be that those without clinical experience have a more

rigorous academic background in this area.

However, with regard to the interpersonal skills area and developing others, we thought initially

that those REMs who had prior clinical experience would fare better in their interpersonal

evaluations than those without clinical experience. But this was not the case. It is difficult to

come up with an explanation for this lack of association. Anecdotal reports suggest that it is

those clinicians who show an aptitude for positive interpersonal relationships who are

encouraged to move into managerial ranks. The only way to obtain more definitive findings

would be to conduct longitudinal research in which interpersonal skills are measured when a

career is initiated.

The final part of the research sought to determine if senior executives identified “fast-trackers” in

their organization with an emphasis on advancing them to leadership positions (Chapter 7). We

found that eighty-two percent of senior executive respondents identified fast-trackers for

advancement. The respondents indicated that coaching/mentoring; formal in-house training; and

on-the-job training were the most common methods used to bring the REM into the organization

and enhance their interpersonal skills.

The research conducted offers the opportunity to delve more deeply into the correlates of

successful interpersonal relationships. One immediate next step would be to conduct multivariate

analyses to help identify the strongest correlates of interpersonal skills among the REMs. Also,

special analyses might be conducted to determine if those organizations that have codified

methods to nurture interpersonal proficiency benefit from such programs. Do their REMs remain

longer with the organization? Are they promoted more rapidly? Are there human resource

85

outcomes that are impacted by such programs such as less absenteeism, higher morale and even

higher quality of care? These and other questions can be studied using the line of inquiry

initiated here.

Study Limitations The study survey was directed to 2,200 members of the American College of Healthcare

Executives with a response rate of 31 percent. The majority of the respondents (55%) were

employed at freestanding hospitals and the REM experiences at these locations may be different

from the experiences of REMs at system hospitals (32%) and corporate headquarters (13%). In

addition, we asked a senior executive to assess the interpersonal skills of REMs without getting

the perspectives of other senior executives or for that matter, the REMs themselves. Both of

these groups may disagree with the assessment offered by the respondent to this survey.

Furthermore, the respondents could choose the candidate to evaluate. Because of this, they may

have selected persons who they believe shows promise in healthcare management and

particularly in regard to interpersonal skills. Thus the findings, which are generally positive, may

be the result of selection bias. Similarly, the responses of senior executive managers may not be

entirely objective when they compared their own interpersonal skills with their REMs. It may be

that over time individuals forget their weaknesses and emphasize their strengths.

86

Appendix I: Survey Instrument

The Interpersonal Skills of Recent Entrants

to the Field of Healthcare Management Survey

The Interpersonal Skills of Recent Entrants to the Field of Healthcare Management

To help us understand the training needs of entrants to the field of healthcare management, we are asking selected affiliates of ACHE to share their impressions of novice managers with whom they work on a regular basis. Novice managers are denoted as individuals who are new to management. They may also have had extensive clinical experience but have been healthcare management practitioners for five years or less. For this survey, we need you to identify one individual whom we will refer to as “the novice manager” in this survey.

1. Can you identify a recent entrant to the field of healthcare management (e.g., a manager with

five or fewer years of healthcare management experience) with whom you work on a regular

basis?

o Yes o No (end survey)

2. In what capacity do you interact with the novice manager? (Check all that apply.)

o I am their immediate supervisor o I am a formally identified mentor to the novice o I am an informal mentor to the novice o I am in a work group with the novice o My office is located near the novice’s workspace o Other (please specify how you interact with the novice

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

3. Novice manager’s approximate age: ______________

4. Novice manager’s gender:

o Female o Male

87

5. Novice manager’s marital status:

o Married o Living in a marriage-like relationship o Separated or divorced o Widowed o Single (never married) o Don’t know

6. Does the novice manager have any children?

o Yes o No o Don’t know

7. Which of the following best describes the novice manager’s race/ethnicity? (Check all that

apply.)

o American Indian, Eskimo or Aleut o Asian or Pacific Islander o Black/African American o White/Caucasian o Hispanic or Latino o Other (please specify)____________________________________ o Don’t know

8. Did the novice manager complete graduate work in the following degree program?

o Health policy and management/health administration o Business administration o Public administration o Community and health science o Nursing o Medicine o Did not complete graduate study o Other: please specify ____________________________________ o Don’t know

9. Does the novice manager have prior clinical experience?

o Yes 1 (Answer Q. 10) o No ...................................................................... 2 (Skip to Q. 11) o Don’t know .......................................................... 3 (Skip to Q. 11)

10. If yes, how many years (estimate)? ______________

88

This part of the survey asks you to assess the characteristics of the novice manager.

11. Following is a series of paired comparisons that represent polar opposites. Please circle the number that best

represents your view of the targeted manager you are evaluating.


1 2 3 4 5

This manager’s personal values are

always consistent with the

management team. 1 2 3 4 5

This manager’s personal values are

not consistent with the management

team.

This manager is honest about his

mistakes. 1 2 3 4 5

This manager is not always honest

about his mistakes.

This manager seeks feedback for

projects from others who are more

knowledgeable. 1 2 3 4 5

This manager does not seek feedback

from others who are more

knowledgeable.

This manager is sufficiently self-

assured. 1 2 3 4 5

This manager is not sufficiently self-

assured.

This manager is receptive to

constructive criticism. 1 2 3 4 5

This manager is not receptive to

constructive criticism.

This manager sets challenging

goals for his staff. 1 2 3 4 5

This manager does not set

challenging goals for his staff.

This manager exercises authority

easily. 1 2 3 4 5

This manager does not exercise

authority easily.

This manager takes direction well. 1 2 3 4 5

This manager does not take direction

well.

This manager can read other

people’s emotions well. 1 2 3 4 5

This manager cannot read other

people’s emotions well.

This manager shows appropriate

respect to his superiors. 1 2 3 4 5

This manager does not show

appropriate respect to his superiors.

This manager has a positive mental

attitude. 1 2 3 4 5

This manager does not have a

positive mental attitude.

It is easy for this manager to work

with others. 1 2 3 4 5

It is not easy for this manager to work

with others.

I find it easy to trust this manager. 1 2 3 4 5

I find it difficult to trust this manager.

Others find it easy to trust this

manager. 1 2 3 4 5

Others do not find it easy to trust this

manager.

89


1 2 3 4 5

This manager deals with facts

when deciding on issues. 1 2 3 4 5

This manager does not deal with fact

when deciding on issues.

This manager is sensitive to

culturally correct behavior when

communicating with diverse

cultures.

1 2 3 4 5

This manager is not sensitive to

culturally correct behavior when

communicating with diverse cultures.

This manager is open to new ideas. 1 2 3 4 5

This manager is not open to new

ideas.

This manager confronts others

about their mistakes. 1 2 3 4 5

This manager does not confront

others about their mistakes.

This manager handles difficult

people or situations with

diplomacy.

1 2 3 4 5

This manager does not handle

difficult people or situations with

diplomacy.

This manager communicates

directly about controversial issues. 1 2 3 4 5

This manager fails to communicate

directly about controversial issues.

This manager is in control of his

emotions. 1 2 3 4 5

This manager is not in control of his

emotions.

This manager enjoys his work. 1 2 3 4 5

This manager does not enjoy his

work.

This manager has a good sense of

humor. 1 2 3 4 5

This manager does not have a good

sense of humor

This manager understands politics

in the organization. 1 2 3 4 5

This manager does not understand

politics in the organization.

This manager uses a variety of

techniques to influence others. 1 2 3 4 5

This manager does not use a variety

of techniques to influence others.

This manager builds rapport with

peers and others on the

management team.

1 2 3 4 5

This manager does not build rapport

with peers and others on the

management team.

90

12. Please rate the novice manager on the following five competencies when compared with your own

competence at his/her career stage. (Circle one number on each line.)

Much worse

Worse

About the

same

Better

Much better

Managerial ethics & values ................... 1 2 3 4 5

Communication ..................................... 1 2 3 4 5 Problem solving .......................................... 1 2 3 4 5 Interpersonal skills ..................................... 1 2 3 4 5 Developing others ...................................... 1 2 3 4 5

13. Please rate the interpersonal skills of the novice manager on a scale of 1 (poor) to 10 (excellent) as they

relate to:

Poor Average Excellent

a. Supervisors……. 1 2 3 4 5 6 7 8 9 10

b. Peers…………… 1 2 3 4 5 6 7 8 9 10

c. Subordinates……. 1 2 3 4 5 6 7 8 9 10

d. Physicians………. 1 2 3 4 5 6 7 8 9 10

e. Overall………….. 1 2 3 4 5 6 7 8 9 10

14. Are interpersonal relationship skills used to identify “fast trackers” and potential successors to current

leaders?

o Yes o No o Don’t know

15. What have been useful strategies and programs that have enhanced interpersonal skills of novice managers?

(Open end response) _________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________ Thank you for completing this survey. By so doing, you have helped your professional society develop action plans to better prepare future healthcare leaders.

91

Appendix II: The Impact of the REM’s Education on How They Were Evaluated—

All Degree Categories (Chapter 4)

Appendix Table 4.1

Paired Comparisons on Dimensions of Interpersonal Competency, by All Degree Categories


This manager’s personal values are always consistent with the management team*



Health Policy &

Management

65

(44%)

58

(39%)

20

(41%)

6

(4%)

0 149 .041*

Business 26

(45%)

16

(28%)

8

(14%)

8

(14%)

0 58

Clinical and Allied

Health

7

(27%)

14

(54%)

2

(8%)

2

(8%)

1

(4%)

26

Other 8

(29%)

12

(43%)

6

(21%)

2

(7%)

0 28

No Graduate Degree 13

(27%)

22

(46%)

7

(15%)

6

(13%)

0 48




Health Policy &

Management

88

(59%)

40

(27%)

12

(8%)

8

(5%)

0 148 .316

Business 36

(62%)

13

(22%)

5

(9%)

3

(5%)

1

(2%)

58

Clinical and Allied

Health

15

(58%)

8

(31%)

1

(4%)

1

(4%)

0 26

Other 15

(54%)

7

(25%)

0

6

(21%)

0 28


(64%)

2

(18%)

1

(9%)

1

(9%)

0 11




Health Policy &

Management

86

(58%)

39

(26%)

15

(10%)

7

(5%)

1

(1%)

148 .747

Business 30

(52%)

20

(34%)

6

(10%)

1

(2%)

1

(2%)

58

Clinical and Allied

Health

11

(42%)

9

(35%)

3

(12%)

3

(12%)

0 26

Other 16

(57%)

7

(25%)

2

(7%)

3

(11%)

0 28


(54%)

10

(21%)

7

(15%)

3

(6%)

2

(4%)

48

92




Health Policy &

Management

62

(42%)

52

(36%)

23

(16%)

8

(5%)

1

(1%)

146 .691

Business 21

(36%)

22

(38%)

11

(19%)

4

(7%)

0 58

Clinical and Allied

Health

9

(35%)

9

(35%)

3

(12%)

4

(15%)

1

(4%)

26

Other 12

(43%)

9

(32%)

3

(11%)

3

(11%)

1

(4%)

28


(46%)

10

(22%)

10

(22%)

3

(7%)

2

(4%)

46

2. SELF-DEVELOPMENT




Health Policy &

Management

80

(54%)

41

(28%)

13

(9%)

13

(9%)

1

(1%)

148 .667

Business 25

(45%)

18

(32%)

7

(13%)

5

(9%)

1

(2%)

56

Clinical and Allied

Health

12

(46%)

10

(38%)

2

(8%)

2

(8%)

0 26

Other 15

(54%)

9

(32%)

3

(11%)

1

(4%)

0 28


(42%)

18

(38%)

2

(4%)

6

(13%)

2

(4%)

48

The manger is receptive to constructive criticism



Health Policy &

Management

63

(43%)

54

(37%)

18

(12%)

11

(8%)

5

(3%)

146 .162

Business 20

(34%)

22

(38%)

12

(21%)

3

(5%)

1

(2%)

58

Clinical and Allied

Health

9

(36%)

8

(32%)

4

(16%)

4

(16%)

0 25

Other 13

(46%)

9

(32%)

3

(11%)

3

(11%)

0 28


(48%)

11

(23%)

7

(15%)

4

(8%)

3

(6%)

48

93




Health Policy &

Management

86

(59%)

40

(27%)

10

(7%)

11

(7%)

0 147 .262

Business 25

(44%)

20

(35%)

8

(14%)

4

(7%)

0 57

Clinical and Allied

Health

13

(50%)

6

(23%)

7

(27%)

0 0 26

Other 12

(43%)

9

(32%)

5

(18%)

2

(7%)

0 28


(53%)

11

(23%)

9

(19%)

2

(4%)

0 47

This manager is open to new ideas***



Health Policy &

Management

96

(65%)

32

(22%)

16

(11%)

3

(2%)

0 147 .001***

Business 29

(50%)

23

(40%)

5

(9%)

1

(2%)

0 58

Clinical and Allied

Health

12

(46%)

7

(27%)

3

(12%)

4

(15%)

0 26

Other 17

(63%)

5

(19%)

4

(15%)

1

(4%)

0 27


(47%)

19

(40%)

3

(6%)

3

(6%)

0 47




Health Policy &

Management

62

(42%)

62

(42%)

17

(12%)

4

(3%)

1

(1%)

146 .925

Business 22

(38%)

26

(45%)

6

(10%)

3

(5%)

1

(2%)

58

Clinical and Allied

Health

8

(33%)

10

(42%)

5

(21%)

1

(4%)

0 24

Other 10

(37%)

9

(33%)

6

(22%)

2

(7%)

0 27


(38%)

15

(32%)

10

(21%)

3

(6%)

1

(2%)

47

94

3. OUTLOOK




Health Policy &

Management

57

(39%)

58

(39%)

21

(14%)

11

(7%)

1

(1%)

148 .553

Business 25

(43%)

22

(38%)

8

(14%)

3

(5%)

0 58

Clinical and Allied

Health

6

(24%)

14

(56%)

4

(16%)

1

(4%)

0 25

Other 9

(32%)

12

(43%)

6

(21%)

1

(4%)

0 28


(25%)

17

(35%)

14

(29%)

4

(8%)

1

(2%)

48




Health Policy &

Management

91

(63%)

37

(26%)

11

(8%)

3

(2%)

3

(2%)

145 .904

Business 32

(55%)

19

(33%)

5

(9%)

2

(3%)

0 58

Clinical and Allied

Health

15

(58%)

9

(35%)

0 2

(8%)

0 26

Other 18

(64%)

7

(25%)

2

(7%)

1

(4%)

0 28


(55%)

14

(30%)

5

(11%)

1

(2%)

1

(2%)

47

This manager has a positive mental attitude*



Health Policy &

Management

99

(68%)

38

(26%)

8

(5%)

1

(1%)

0 146 .036*

Business 32

(55%)

22

(38%)

3

(5%)

0 1

(2%)

58

Clinical and Allied

Health

14

(54%)

7

(27%)

5

(19%)

0 0 26

Other 17

(61%)

6

(21%)

3

(11%)

2

(7%)

0 28


(58%)

11

(23%)

5

(10%)

4

(8%)

0 48

95




Health Policy &

Management

71

(49%)

54

(37%)

12

(8%)

9

(6%)

0 146 .270

Business 25

(43%)

18

(31%)

10

(17%)

4

(7%)

1

(2%)

58

Clinical and Allied

Health

7

(28%)

7

(28%)

5

(20%)

6

(24%)

0 25

Other 10

(36%)

10

(36%)

6

(21%)

2

(7%)

0 28


(21%)

10

(21%)

6

(13%)

2

(4%)

1

(2%)

47




Health Policy &

Management

86

(59%)

50

(34%)

7

(5%)

2

(1%)

0 145 .745

Business 34

(59%)

21

(36%)

3

(5%)

0 0 58

Clinical and Allied

Health

14

(54%)

9

(35%)

2

(8%)

1

(4%)

0 26

Other 15

(56%)

7

(26%)

4

(15%)

1

(4%)

0 27


(57%)

13

(28%)

5

(11%)

2

(4%)

0 47




Health Policy &

Management

78

(54%)

51

(35%)

12

(8%)

3

(2%)

1

(1%)

145 .739

Business 31

(53%)

22

(38%)

4

(7%)

1

(2%)

0 58

Clinical and Allied

Health

11

(44%)

11

(44%)

1

(4%)

2

(8%)

0 25

Other 16

(57%)

6

(21%)

4

(14%)

2

(7%)

0 28


(50%)

17

(37%)

3

(7%)

2

(4%)

0 46

96





Health Policy &

Management

63

(43%)

48

(33%)

29

(20%)

6

(4%)

0 146 .873

Business 28

(48%)

17

(29%)

11

(19%)

1

(2%)

1

(2%)

58

Clinical and Allied

Health

9

(36%)

9

(36%)

4

(16%)

2

(8%)

1

(4%)

25

Other 11

(39%)

9

(32%)

6

(21%)

2

(7%)

0 28


(33%)

16

(35%)

10

(22%)

4

(9%)

1

(2%)

46




Health Policy &

Management

36

(24%)

51

(35%)

47

(32%)

10

(7%)

3

(2%)

147 .256

Business 19

(33%)

23

(40%)

13

(22%)

3

(5%)

0 58

Clinical and Allied

Health

6

(24%)

13

(52%)

4

(16%)

2

(8%)

0 25

Other 7

(26%)

10

(37%)

7

(26%)

3

(11%)

0 27


(15%)

21

(44%)

12

(25%)

8

(17%)

0 48




Health Policy &

Management

26

(18%)

60

(41%)

41

(28%)

18

(12%)

3

(2%)

148 .470

Business 10

(17%)

18

(31%)

22

(38%)

3

(5%)

5

(9%)

58

Clinical and Allied

Health

21

(84%)

10

(40%)

8

(32%)

5

(20%)

0 25

Other 5

(18%)

10

(36%)

10

(36%)

3

(11%)

0 28


(23%)

13

(27%)

16

(33%)

6

(13%)

2

(4%)

48

97




Health Policy &

Management

79

(54%)

41

(28%)

19

(13%)

8

(5%)

0 147 .383

Business 25

(43%)

19

(33%)

11

(19%)

3

(5%)

0 58

Clinical and Allied

Health

9

(35%)

9

(35%)

5

(19%)

3

(12%)

0 26

Other 12

(43%)

8

(29%)

3

(11%)

4

(14%)

1

(4%)

28


(45%)

17

(36%)

6

(13%)

3

(6%)

0 47

This manager is sensitive to culturally correct behavior when communicating with diverse cultures



Health Policy &

Management

67

(46%)

53

(36%)

21

(14%)

5

(3%)

0 146 .283

Business 26

(45%)

21

(36%)

9

(16%)

2

(3%)

0 58

Clinical and Allied

Health

10

(40%)

8

(32%)

6

(24%)

1

(4%)

0 25

Other 12

(43%)

9

(32%)

5

(18%)

2

(7%)

0 28


(34%)

20

(43%)

0 1

(2%)

1

(2%)

47


REM Education 1 2 3 4 5 Total Chi Sq

P-value

Health Policy &

Management

29

(20%)

59

(41%)

43

(30%)

12

(8%)

2

(1%)

145 .453

Business 19

(33%)

22

(38%)

15

(26%)

2

(3%)

0 58

Clinical and Allied

Health

5

(20%)

11

(44%)

7

(28%)

2

(8%)

0 25

Other 9

(32%)

10

(36%)

8

(29%)

1

(4%)

0 28


(15%)

22

(47%)

9

(19%)

8

(17%)

1

(2%)

47

98




Health Policy &

Management

42

(29%)

60

(41%)

31

(21%)

12

(8%)

0 145 .207

Business 17

(29%)

18

(31%)

17

(29%)

4

(7%)

2

(3%)

58

Clinical and Allied

Health

2

(8%)

11

(44%)

8

(32%)

3

(12%)

1

(4%)

25

Other 11

(39%)

9

(32%)

4

(14%)

4

(14%)

0 28


(26%)

18

(38%)

12

(26%)

5

(11%)

0 47




Health Policy &

Management

30

(21%)

58

(40%)

41

(28%)

16

(11%)

1

(1%)

146 .097

Business 19

(33%)

20

(34%)

13

(22%)

4

(7%)

2

(3%)

58

Clinical and Allied

Health

3

(12%)

6

(24%)

8

(32%)

5

(20%)

3

(12%)

25

Other 8

(29%)

9

(32%)

5

(18%)

4

(14%)

2

(7%)

28


(11%)

22

(49%)

14

(31%)

3

(7%)

1

(2%)

45




Health Policy &

Management

39

(27%)

62

(42%)

33

(23%)

10

(7%)

2

(1%)

146 .744

Business 20

(34%)

21

(36%)

11

(19%)

6

(10%)

0 58

Clinical and Allied

Health

3

(12%)

13

(52%)

5

(20%)

4

(16%)

0 25

Other 7

(25%)

11

(39%)

9

(32%)

1

(4%)

0 28


(26%)

23

(49%)

7

(15%)

4

(9%)

1

(2%)

47

99




Health Policy &

Management

25

(17%)

64

(45%)

36

(25%)

15

(10%)

3

(2%)

143 .338

Business 10

(17%)

27

(47%)

17

(29%)

3

(5%)

1

(2%)

58

Clinical and Allied

Health

2

(8%)

9

(36%)

8

(32%)

6

(24%)

0 25

Other 10

(37%)

7

(26%)

7

(26%)

2

(7%)

1

(4%)

27


(21%)

19

(40%)

11

(23%)

5

(11%)

2

(4%)

47




Health Policy &

Management

61

(42%)

58

(40%)

15

(10%)

10

(7%)

2

(1%)

146 .396

Business 24

(41%)

20

(34%)

13

(22%)

1

(2%)

0 58

Clinical and Allied

Health

6

(24%)

12

(48%)

7

(28%)

0 0 25

Other 13

(46%)

8

(29%)

4

(14%)

2

(7%)

1

(4%)

28


(34%)

20

(43%)

6

(13%)

5

(11%)

1

(2%)

47

Note: “Clinical and Allied Health” includes medicine and nursing. “Other” includes public administration, legal, and community

health science.

*** <.001; ** <.01; *<.05


100

Appendix Table 4.2

Recent REMs Competencies Compared with Senior Executives Views of Their Own Competency

at the Same Career Stage, by All Degrees

a. Managerial ethics & values**

REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

0

14

(10%)

99

(72%)

19

(14%)

5

(4%)

137 .003**

Business 0 9

(16%)

45

(80%)

2

(4%)

0 56

Clinical and

Allied Health 1

(4%)

5

(20%)

14

(56%)

5

(20%)

0 25

Other 1

(4%)

7

(25%)

12

(43%)

8

(29%)

0 28

No Graduate

Degree

0 10

(21%)

35

(73%)

2

(4%)

1

(2%)

48

b. Communication

REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

2

(1%)

43

(31%)

61

(44%)

27

(19%)

7

(5%)

140 .209

Business 2

(4%)

20

(35%)

25

(44%)

9

(16%)

1

(2%)

57

Clinical and

Allied Health 3

(12%)

3

(12%)

14

(56%)

5

(20%)

0 25

Other 0 9

(32%)

14

(50%)

5

(18%)

0 28

No Graduate

Degree

1

(2%)

15

(31%)

18

(38%)

13

(27%)

1

(2%)

48

c. Problem solving

REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value e

Health

Management

1

(1%)

37

(26%)

72

(51%)

28

(20%)

5

(4%)

141 .338

Business 1

(2%)

15

(26%)

32

(56%)

7

(12%)

2

(4%)

57

Clinical and

Allied Health 2

(8%)

5

(20%)

18

(72%)

1

(4%)

0 25

Other 0 9

(35%)

14

(54%)

3

(12%)

0 26

No Graduate

Degree

1

(2%)

16

(36%)

24

(53%)

3

(7%)

1

(2%)

45

101


REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

2

(1%)

41

(29%)

71

(51%)

23

(16%)

3

(2%)

140 .583

Business 3

(6%)

17

(31%)

24

(44%)

9

(17%)

1

(2%)

54

Clinical and

Allied Health 2

(8%)

7

(27%)

14

(54%)

3

(12%)

0 26

Other 1

(4%)

3

(12%)

17

(65%)

5

(19%)

0 26

No Graduate

Degree

1

(2%)

9

(20%)

22

(48%)

12

(26%)

2

(4%)

46


REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

7

(5%)

49

(35%)

66

(47%)

16

(11%)

2

(1%)

140 .223

Business 3

(5%)

19

(33%)

32

(55%)

4

(7%)

0 58

Clinical and

Allied Health 4

(15%)

8

(31%)

7

(27%)

7

(27%)

0 26

Other 0 10

(37%)

14

(52%)

3

(11%)

0 27

No Graduate

Degree

1

(2%)

16

(34%)

26

(55%)

4

(9%)

0 47


REM

Education

Much

worse

1

Worse

2

About the

same

3

Better

4

Much

better

5

Total Chi Sq

P-value

Health

Management

2

(1%)

37

(27%)

54

(40%)

30

(22%)

13

(10%)

136 .101

Business 1

(2%)

18

(32%)

22

(39%)

13

(23%)

2

(4%)

56

Clinical and

Allied Health 3

(12%)

9

(36%)

7

(28%)

5

(20%)

1

(4%)

25

Other 3

(11%)

7

(25%)

14

(50%)

3

(11%)

1

(4%)

28

No Graduate

Degree

3

(6%)

22

(46%)

14

(29%)

8

(17%)

1

(2%)

48


health science.

*** <.001; ** <.01; *<.05


102

Table 4.3


by All Degrees as They Relate to:

a. Supervisors

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

6

(4%)

34

(25%)

93

(68%)

136 .726

Business 1

(2%)

21

(38%)

33

(60%)

55

Clinical and

Allied Health 1

(4%)

9

(38%)

14

(58%)

24

Other 2

(8%)

8

(31%)

16

(62%)

26

No Graduate

Degree

3

(7%)

15

(33%)

28

(61%)

46

b. Peers

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

9

(6%)

35

(25%)

96

(69%)

140 .260

Business 4

(7%)

24

(43%)

28

(50%)

56

Clinical and

Allied Health 1

(4%)

8

(33%)

15

(63%)

24

Other 3

(11%)

6

(22%)

18

(67%)

27

No Graduate

Degree

1

(2%)

18

(38%)

29

(60%)

48

103

c. Subordinates

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

20

(14%)

45

(32%)

74

(53%)

139 .637

Business 6

(11%)

25

(45%)

24

(44%)

55

Clinical and

Allied Health 7

(17%)

23

(56%)

11

(27%)

41

Other 3

(11%)

7

(25%)

18

(64%)

28

No Graduate

Degree

3

(6%)

23

(48%)

22

(46%)

48

d. Physicians

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

16

(12%)

47

(34%)

74

(54%)

137 .909

Business 3

(5%)

20

(36%)

33

(59%)

56

Clinical and

Allied Health 4

(16%)

5

(20%)

16

(64%)

25

Other 4

(14%)

7

(25%)

17

(61%)

28

No Graduate

Degree

5

(11%)

21

(45%)

21

(45%)

47

104

e. Overall

REM

Education


Chi Sq

P-value

Fair to

Poor

(1-4)

Average

(5-7)

Good to

Excellent

(8-10)

Total

Health

Management

11

(8%)

40

(29%)

88

(63%)

139 .296

Business 4

(7%)

23

(42%)

28

(51%)

55

Clinical and

Allied Health 2

(8%)

9

(38%)

13

(54%)

24

Other 2

(7%)

7

(25%)

19

(68%)

28

No Graduate

Degree

2

(10%)

21

(46%)

23

(50%)

46


health science.

*** <.001; ** <.01; *<.05


105

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