April 2020 LEADERSHIP ALUMNI NEWSLETTER

LETTER FROM THE EDITOR, WISSAM GEORGES DEEB, MD

Welcome to the 5th edition of the AAN Leadership Alumni Newsletter.

I want to take this opportunity to acknowledge that during these unprecedented times when the power of connecting with colleagues from across the globe is more important than ever that we will continue engaging and supporting you through the ongoing publication of this newsletter, and other means. You are an important part of our worldwide health care community and together we will get through these difficult times.

In this edition, we interview Dr. Holly Hinson, an Emerging Leaders Program alumnus. By engaging with the AAN, she has recognized the importance of identifying role models and the crucial role of mentors. Dr. Hinson acknowledges the essential part the Academy has played in launching her research career. The discussion, then, shifts towards her leadership in creating the LGBTQI section at the AAN, which she continues to chair. The LGBTQI section has three goals (1) equal access to care, (2) retention of sexual and gender minority neurologists, and (3) improving the cultural competency of neurologists. Finally, Dr. Hinson provides her insight on the Equity, Diversity, and Inclusion Joint Coordinating Council (EDI JCC) and her role as an associate editor for EDI at the Neurology® journal.

Next, Dr. Leigh Maria Ramos-Platt elaborates on the functions and goals of the EDI JCC through a discussion with Dr. Charlene Gamaldo. The EDI JCC is an overarching council that coordinates the efforts of multiple committees and sections to help the AAN adapt to the evolving needs of its members and the patients they serve.

Following this, Dr. Marianna Spanaki-Varelas summarizes the projects of three leadership programs: Emerging Leaders Program (ELP), Diversity Leadership Program (DLP), and Transforming Leaders Program (TLP). The emerging leaders have proposed solutions to improve neurology residents’ coding and billing knowledge and to increase AAN membership engagement. The diversity leaders have suggested three phases to bring together patients, caregivers, and organizations to promote the need for research funding. Finally, the transforming leaders have addressed the increased demand for neurological care and presented some approaches to improve access.

The leadership programs, akin to the rest of the AAN, aim to continue fostering a diverse group of participants. Dr. Beau Nakamato presents the geographic variety of participants in the Metrics and Goals section. Furthermore, he presents an initiative to increase engagement opportunities with the AAN with three new leadership roles. I hope that you will all consider applying to these leadership positions.

As an extra incentive for all us, Dr. Na Tosha N. Gatson’s article features the success story of Dr. Hope O’Brien, who shares with us some great leadership pearls: optimism, professional creativity, and risk-taking. We also share the success of Dr. Cumara O'Carroll as she recently received the Mayo Clinic Arizona Diversity and Inclusion Award.

No leadership newsletter is complete without the great advice that our consultants provide. Julie Anderson advises us on some pitfalls when giving feedback and the importance of avoiding sugarcoating. “Workplace feedback based on strengths allows for both honesty and compassion, all while creating a foundation of trust — no sugarcoating necessary.” Robbin Stubblefield expands on the role of emotional intelligence in our communications. She provides an example of four emotional intelligence skills that can help us avoid the “bad” and the “ugly” in discussions.

Finally, the editorial team members express their thanks to the AAN president, Dr. James Stevens, for providing an article to the leadership programs’ alumni. Dr. Stevens reaffirms the commitment of the AAN to diversity and inclusion, and encourages us, the alumni, to engage and lead the change at the Academy and in our institutions.

The editorial team and I hope that you enjoy this edition of the AAN Leadership Alumni Newsletter.

REMEMBER! Official AAN Leadership Program hashtag #AANleadership

Call for Feedback

The editorial team plans to embed short video interviews with alumni in upcoming editions. These videos will be 3- to 5-minutes long, focusing on one to two questions. The proposed items are:

How has your participation in the leadership program affected your leadership journey?
Describe how the leadership program has affected your life.
Did any of the learned skills take you by surprise? Unexpected impact?
Describe the impact of the connections you made in the leadership program.
How has your participation in the leadership program influenced your leadership skills?
Describe instances where you put the leadership skills you learned into practice.
If you had to convince a colleague to participate in an AAN leadership program, what would you say?
What was your experience like working through either a personal or group leadership program project?
How has your participation in the leadership program impacted patient care?

If you have comments or suggestions, please send them to AlumniEditor@aan.com.

Want to be featured in the newsletter or on Synapse? Review the end of the newsletter.

Spotlight on Alumni

The AAN Leadership Program Interview with Holly Hinson, MD, MCR, FAAN

Career Path and Perspective

By MARIANNA V. SPANAKI-VARELAS, MD, PHD

Spanaki: Dr. Hinson, you have both active neurocritical care and research backgrounds, can you tell us how and when did you get involved with the AAN?

Hinson: I got involved somewhat early in my career, specifically in medical school. I was an active member of our SIGN chapter when I was a student at the University of Texas in San Antonio. And then, as a fourth year, I had the good fortune to receive the SIGN scholarship to attend the Annual Meeting. That particular year I went to the meeting and was able to connect with the residency program that I had matched into, which was the University of Maryland. The faculty there were extraordinarily kind and excited about me joining the program that following year. They adopted me for the meeting, driven by the chair of neurology at the time, Bill Weiner. He—and I'm not advocating people do this necessarily—snuck in his residents into the President’s Reception. So we attended this incredible reception in Miami. Dr. Sandra Olson was president of the AAN that year.

"[To] see a woman president of the Academy was a huge thing. It showed me that there was a potential pathway for me at the AAN, and that was really meaningful."

Dr. Weiner scooped all of us up and thrust us into Dr. Olson’s sphere, and we all got pictures taken with her. It made a massive impression on me; because to see a woman president of the Academy was a huge thing. It showed me that there was a potential pathway for me at AAN, and that was meaningful. I think that initial positive experience and exposure to the Academy got me excited about being a member and participating throughout my career.

Spanaki: All right. It is awe-inspiring that you got involved with the AAN early in your career. It conveys a vital message to medical students and residents that the sooner you get engaged, the better it's going to be for the individual themself and the profession. So I'm glad that you are setting this example. This discussion leads me to the next question, how did the AAN help you advance your career as a practicing neurocritical care physician and researcher?

Hinson: I think that the AAN has had the most profound impact on my research career, at least initially. As an active AAN member, I was fortunate to know about some of the research scholarships that were offered by the AAN, particularly the research fellowships. And so in 2012, I applied for and was awarded the practice training fellowship, which launched my research career. It allowed me the time and funding to start my master’s degree in clinical research that I then completed as a junior faculty member here at OHSU.

"[The AAN research fellowship] gave me this immediate network of people that were in very similar career stages and encountering some of the same challenges that I was as a beginning clinical researcher."

I was able to start the formal training that I needed to have the expertise to conduct high-quality clinical research. And, because of that sound start, I later had to relinquish that award early because I got an institutional K12. I think that that was in large part due to the work that I was already doing in the practice training fellowship. Beyond funding, the award itself plugged me into a network within the AAN of both mentors, as well as peers. And I would say I especially benefitted from the peer mentorship that I received. I met senior fellows and junior faculty who were starting in their clinical research careers.

It gave me this immediate network of people that were in very similar career stages and encountering some of the same challenges that I was as a beginning clinical researcher. And it was terrific to have that type of community to bounce ideas off of and to grow, even though we were in different disciplines. I felt so incredibly supported, again, from an early career stage.

Spanaki: You nicely highlight how the AAN does not only support or help practicing neurologists but also neurologists with research interest. We should not forget that early involvement with the Academy can help both practicing neurologists and research neurologists. I want to shift gears now and focus on your role as a mentor in the women's leadership program. How important is it to provide mentorship to women neurologists?
Hinson: Right. I think that's a great question. I think many people wonder exactly that. In my opinion, our experiences shape who we are as people, as physicians, and as leaders. So moving through the world as a woman is a particular experience, and it's certainly not the same for all women, but there are definite commonalities. Women have been historically underrepresented among leaders, so sharing experiences and creating community builds a support network for some of the challenges that women leaders face.
And I would argue that mentorship and sponsorship are essential for all groups, but especially for historically underrepresented groups. I think this transmits the message that there is a place for you, and then there is a pathway to that success within leadership. And I think this becomes especially important as one identifies in multiple underrepresented groups because the number of role models in leadership starts to shrink. Having these support structures is incredibly vital and inspirational.

"I would argue that mentorship and sponsorship are important for all groups, but especially for historically underrepresented groups."

Spanaki: One of your achievements is that you are the founding member and inaugural chair of the AAN LGBTQI section. Can you tell us about the mission and the future direction and goals of the section?

Hinson: Sure. So the creation of the LGBTQI section was, in some ways, the culmination of the experience and exposure I got as an Emerging Leaders Program participant. It gave me the tools to realize something that I had wanted to do at the AAN for a long time.
Our goals are three-fold. The first is to promote equal access to quality neurologic care and the elimination of disparities and improvement of outcomes through education and research specifically for sexual and gender minorities. The second is to enhance the retention and promotion of those who identify as sexual and gender minorities in neurology and to create an inclusive environment for the training of neurologists. And then thirdly, part of our purpose is to enhance the professional development of neurologists concerning culturally competent medical care.

Initially, when we created the section, our biggest goal was to develop cultural competency programming specifically for the Annual Meeting, which we have done. For the last two years, we have had a specific course within the education portion of the Annual Meeting. It offers two hours on a variety of topics that are pertinent to caring for patients that identify as sexual and gender minorities. In this course, we focus on some of the terminologies, how to make one's clinic welcoming, and how to capture sexual orientation and gender identity data or SOGI data in the electronic health record.

Looking ahead, what we're hoping to do is to create more evergreen content for the American Academy of Neurology. We want to focus on online cultural competency training programs because not all members can attend the meeting, and those that do are pulled in a lot of different directions. There's much fabulous programming in each Annual Meeting; you can't necessarily attend everything that you want.

Additionally, we'd like to make that material available to residency programs that wish to incorporate this as part of their curriculum. Education is a massive piece of what we're hoping to do. We also really want to encourage further research into how sexual and gender minority identity impacts neurologic health care.

We know, for example, that gender-affirming hormones can impact antiepileptic drugs. As a field, we are starting to try to address this more carefully, with well-designed clinical research studies in hopes of improving the health care for this patient population. Finally, we're also advocating for the inclusion of SOGI data of our patients in the Axon Registry and of our members within the demographics that the AAN collects. Because the mission statement of the AAN is to be indispensable to the membership, we need to know our members comprehensively so that we can serve them better.

"The LGBTQI section has three goals: (1) equal access to care, (2) retention of sexual and gender minority neurologists, (3) improving the cultural competency of neurologists."

Spanaki: Despite being a new section, I think that the AAN LGBTQI section has had an impact on other societies. If I'm not mistaken, the American Epilepsy Society (AES) invited you to speak at its meeting in Baltimore in December 2019. What was the topic of your talk?

Hinson: Sure. That particular workshop was about serving diverse patient populations that have epilepsy. I was a panelist on that program. I'm so happy that some of the subspecialty societies are recognizing that this type of support for clinicians can improve neurologic care. Furthermore, it can start to eliminate some of the well-documented health care disparities for sexual and gender minorities.

Spanaki: You highlighted the impact that the AAN LGBTQI section can have on subspecialty societies, and this is very important. You are also a member of the Equity, Diversity, and Inclusion Joint Coordinating Council (EDI JCC). Can you describe for our readers the scope of this council?

Hinson: The purpose of the Joint Coordinating Council on Equity, Diversity, Inclusion, and Disparities is to improve equity, diversity, inclusion, and to address health care disparities within neurology and patient care. It was envisioned in 2018 by the Diversity Leadership Program participants and was acted upon by the AAN. The EDI JCC develops and maintains guidelines and educational programs for department leadership regarding EDI issues, as well as fostering transparency and monitoring progress.

Most importantly, the EDI JCC coordinates efforts across the AAN. As you know, the AAN is a reasonably complex and well-iterated organization. Sometimes it's hard for all groups to know about all the efforts and all the initiatives in all parts of the AAN. This council oversees all of these EDI efforts and harmonizes them to avoid duplication.

Spanaki: Last but not least, in your opinion, what are the significant challenges that neurologists face in the present or will be facing in the future?

Hinson: I think it's two-fold and inter-related. The first is the pipeline of new neurologists, both as clinicians, but then also as researchers. We know from the data that there will be a significant gap between the number of aging persons and the number of neurologists able to care for those persons. In my opinion, a way to attract the best and the brightest to neurology is to communicate that our field is open and welcoming to all kinds of people just as long as they share the same passion for neurology that we do.

"Dr. Hinson discusses the challenges facing the field of neurology with the expected shortage of clinical and research neurologists."

I think having sections like the LGBTQI section and leadership programs such as the DLP transmits a welcoming and inclusive message to students. This message will encourage them to consider neurology for their careers. As a tangible example, during our first meeting of the LGBTQI section in 2017, a Brazilian medical student rotating in the US came up to me. While holding back tears, they expressed that this was the very first time that they felt safe to be themself in a professional setting. They saw neurology as a home for their future career partially because of that safety in addition to their intellectual interest in the field. And to me, in that one moment, founding the section was completely worth all the effort that it took.

The other parallel concern I have is a pipeline issue. It is about young scientists being discouraged due to the challenges of getting funded in parallel to the pressures of repaying student loan debt. The support and the mentorship that is required to compete for grants successfully is not necessarily a guarantee in all academic centers. And I think it's sometimes easy to get discouraged with rejections and also the pressures from one’s department to keep up with billing and produce RVUs. On top of that, protected time is a precious, rare resource.

And even if you do have that time, making sure that you get the right kind of mentorship to support your success is not always guaranteed. As we turn towards the future, I hope that we as a field institute more programs to help young scientists. Furthermore, we need to support their mentors to allow more mid and senior career faculty to have the time to mentor the next generation adequately. I think that's what's going to advance science and will enable us to bring treatments that change people's lives.

Spanaki: We appreciate your perspective. Is there anything else or any additional comments that you would like to share?

Hinson: Yeah. I'm exceedingly pleased to serve as an Associate Editor for EDI at the green journal. I feel honored to serve in this role with Dr. Roy Hamilton. I am encouraged by the steps that the journal has made in the wake of some missteps to improve the quality of the articles that the journal is publishing. I think this represents the growth and maturation of our EDI efforts as a field, and I am delighted to be a part of it.

Spanaki: Excellent. I think we can conclude the interview. Thank you for your time.

The Emerging Leaders Program has been supported in part by Acorda Therapeutics, Inc; Alexion Pharmaceuticals, Inc; Allergan, Inc; Sanofi Genzyme; Supernus Pharmaceuticals Inc; and UCB, Inc.

Diversity and Inclusion at the AAN – the Role of the EDI JCC

By LEIGH MARIA RAMOS-PLATT, MD

For an organization to succeed and attain its goals, all influencing factors, quantifiable or not, must be considered. In recent years, Diversity and Inclusion have emerged as two of these driving factors. The AAN has recognized their importance to meet the needs of neurologists and the patients we treat. The Academy wants to develop inclusive leadership, identify current needs, and prepare for the future.

The AAN developed the Equity, Diversity, and Inclusion Joint Coordinating Council (EDI JCC) to meet these goals and enhance the practices of its members through leadership. The merit of physician leadership in health care is gaining prominence in recent years (1). To emerge as champions for our patients, we need to improve the diversity in leadership. The association between diversity in leadership and improved outcomes has been seen universally throughout and across industries (2,3,4). We asked Dr. Charlene Gamaldo, a participant in the first Transforming Leaders Program, a member of the AAN Board of Directors, and Vice Chair of the EDI JCC, about the role of the EDI JCC in the AAN.

Dr. Gamaldo answered, “The council will serve as a coordinating council. It will aid in identifying both areas and methods to facilitate increasing inclusion and diversity across the organization. Moreover, it will highlight and celebrate areas and strategies already demonstrating solid strides in achieving this mission. The council will serve as a listener, a facilitator, and a communicator of what the organization is currently doing. It will assess how efforts may potentially be improved across the organization. It will celebrate the gainful strides and achievements made in this front both publicly to membership and directly to leadership within the organization.”

Our patient population is changing. By 2050, ethnic minorities will comprise about 50% of the patients we see as physicians. To meet these needs, we need to increase our diversity and cultural competence, particularly in leadership positions. Only 4% of professors in US medical schools come from underrepresented ethnic minorities (5). In hospitals, while patient populations continue to become more diverse, those in hospital leadership positions have not kept up with this change. This discrepancy was noted by an article published in The Hospitalist in June 2016 (6).

The EDI JCC has well recognized that diversity training is of prime importance to meeting the needs of the AAN and the field of neurology. The AAN has answered by integrating diversity training into the myriad leadership programs it offers. As our patient population changes, the EDI JCC must continue to survey the changing needs for the AAN. Dr. Gamaldo commented, “We have seen and will continue to see greater diversity in our membership, leadership, patient populations, and various stakeholder representatives. Thus, it would seem paramount that our future leaders receive training and exposure in the importance of recognizing and leveraging the diversity and inclusion in forging future strides towards advancement in neurological care.”

Diversifying leadership is complicated. Systems and thought processes need to be changed. The AAN will face struggles that the EDI JCC will need to continue to address. Dr. Gamaldo and the committee she serves seem ready for this challenge. “The overarching mission of the AAN is for the organization to not only REFLECT but ACT in a manner that celebrates and values the breadth and diversity of our members and the community which we serve. I see this as an ongoing mission resting most notably in the journey towards achieving this goal and not one that can be marked by a final achievement or destination. Methods, perceptions, and definitions of what it means to create and be an inclusive environment will continue to evolve, so both the challenge and inspiration for the AAN are to remain a leader in this arena.”

program HIGHLIGHTS

Recent Group Projects

By MARIANNA V. SPANAKI-VARELAS, MD, PhD

Different Leadership Programs within the AAN not only support the growth and advancement of their leaders-members but yield meaningful projects in alignment with the mission and vision of the Academy. In this issue of the Leadership Alumni Newsletter, we highlight some of the most recent projects:

Improving neurology residents’ coding and billing knowledge (ELP)
Increasing AAN membership engagement (ELP)
Bringing together patients, caregivers, and organizations to promote the need for research funding (DLP)
Addressing the increased demand for neurological care (TLP)

Emerging Leaders Program (ELP)

The ELP participants divided into two cohorts.

Cohort 1: Improving neurology residents’ coding and billing knowledge

The Medical Economics & Management (MEM) and the Medical Education (MedEd) Committees jointly tasked one of the Emerging Leaders groups with the question, “How can the AAN educate residents about practice management issues, including coding and reimbursement?” As a group, they agreed that existing training and Academy resources had not adequately prepared us (neurologists) to grapple with these issues. They noted that this was a widely shared sentiment, as reported in survey data from current trainees and program directors. The proposed solution was presented to a group of senior academy leadership from these committees at the 2019 Annual Meeting in Philadelphia. It centered around the creation of the Resident Practice Academy (rPA), a cross-platform, longitudinal educational program and resource hub designed to leverage technological resources to provide ongoing, near-real-time education and actionable feedback with periodic, intensive, hands-on training. Critically, the program revolved around the concept of interfacing with trainees where and how they would engage with other successful learning opportunities—at the bedside, delivered through a mobile app (or web view) capable of providing not only quickly accessible guidance but ongoing feedback on performance. They proposed combining this technological approach with an ongoing curriculum, delivered “locally” through enhanced cooperation with state neurological societies, which will gradually grow a deeper bench of practice management experts within each institution through a train-the-trainer program. This program, carefully designed based on feedback from trainees and program directors, will begin to address the acknowledged gap in practice management training put forth in the MEM and MedEd committees’ question.

Cohort 2: Increasing AAN membership engagement

The other group of the 2018-2019 Emerging Leaders Program was asked by the Member Engagement Committee (MEC) to address the question, “How can the AAN develop a framework to score and measure engagement to improve the AAN’s member engagement?” They presented their findings to members of the MEC, MedEd committee, and MEM committee at the AAN Annual Meeting in May 2019. The group adopted a broad definition of engagement as any interaction between an AAN member and the Academy to value members in all practice settings and levels of training; they termed this Member-Centered Engagement. They created a framework for scoring each interaction based on its value to both the member and the AAN, suggesting a scaled approach based on membership level. The group recommended subdividing and scoring activities within four major pathways of engagement: Advocacy, Research, Education, and Clinical activities. They also created interactive visualizations on performance in each domain for the member, allowing them to track performance and identify novel ways to enhance their engagement. To promote increased engagement, they proposed a multi-pronged approach: 1) allowing the AAN to track participation in real-time to identify highly engaged and at-risk members and distribute resources to optimize engagement, 2) allowing members to define priorities and goals for engagement to facilitate member engagement in areas of interest, 3) creating methods for members to interact with other members with similar preferences and experiences, and 4) providing direct Academy and external incentives to members based on their engagement.

Diversity Leadership Program

Bringing together patients, caregivers, and organizations to promote the need for research funding

When the Diversity Leadership Program (DLP) participants met in January 2019, the following question was proposed: “How can the Academy effectively engage patients, caregivers, the public and other organizations to help advocate for those who are affected by neurologic disease, demonstrate the value of neurologists, and promote funding for research in neurology?” In September 2019, the DLP participants presented a three-phased plan to the AAN Board of Directors.

Phase one consisted of five components:

Surveying patient needs and providing feedback
Building advocates by involving patients and capturing patient stories
Creating content for the public aimed at a 6th- to 8th-grade reading level
Optimizing our materials for mobile phone use and online access
Having a central message targeted to the layperson

Once patients’ engagement was increased, then phase two could start. Phase two consisted of four components: (1) further expanding our social media presence, (2) improving our reach with local partners to launch national campaigns with branding regionally, (3) collaborating with other organizations for advocacy efforts, and (4) aligning with the NIH.

The third phase would build on the other two phases and would set the AAN apart as the premier source of information for patients. This phase would establish the AAN as an invaluable resource with a seamless link to educational resources, advocacy efforts, Brain & Life, and recognized partners through the AAN website. Lastly, through the development of toolkits in this phase, patients could use this self-guided resource to become informed about their disease and the role of their neurologists, to encourage research involvement and funding, and to empower them to be advocates.

Transforming Leaders Program

Addressing the increased demand for neurological care

Dr. Ralph Sacco gave Transforming Leaders their group project. He asked: “How can the AAN address the mismatch between the supply of neurologists and the increasing need for neurologic care? Looking towards the future, develop a strategic plan that incorporates the pipeline, utilization of advanced practice providers (APPs), team-based care, and teleneurology.” They reported their recommendations to the AAN Board of Directors at their meeting in June 2019.

They started by explaining their vision: a world where individuals would have timely access to high-quality neurologic care. They identified the scope of the problem, including the AAN-developed projection that by 2025, 41 states will have a neurologist-patient need mismatch.

They identified three main elements to their strategy to tackle this looming problem: shape the demand, enhance the workforce, and advocate for value and engagement. Shaping the demand includes coping better with current demands by improving the education of non-neurologists, developing practice parameters, and stabilizing finances of technology-enhanced services. To enhance the workforce, they recommended incorporating APPs, improving team-based care through new leadership programs, and broadening the pipeline to include trainees beyond medical students. The third element of their strategy was to use the AAN’s well-developed advocacy arm to improve the mismatch through better compensation, alternate payment models, and funding research.

Dr. Sacco’s challenging question is a critical issue for our field and our patients. Though it’ll be tough to solve, this will hopefully create a framework the AAN Board of Directors can use over the next 10 years to reduce this mismatch and ultimately improve patient care.

A special thanks to Lynn Kataria, MD; Jonathan Smith, MD, FAAN; Christopher Tarolli, MD; Sharon Lewis, MD; Jennifer Juhl Majersik, MD, MS, FAAN; and Aisha Ahmed, MD, MBA for their collaboration on this article.

Metrics & Goals

By BEAU NAKAMOTO, MD, PhD, MBA, FAAN

The Concentration of Leadership Program Alumni by Location

The Leadership Development Committee and its subcommittees make a conscious effort to be mindful of the need for diversity in the leadership programs’ participants. In doing so, they strive to consider diversity from all angles, including geography. Below is the current geographical composition of the AAN leadership programs’ alumni from ELP, DLP, PLP, TLP, and WLN. The expansion of a peer network of neurologists continues to foster connections and resources across the United States.

Note: The majority of our current leadership programs only accept US-based participants.

Leadership Program Participant Engagement

The AAN leadership programs aim to develop their participants by addressing critical leadership skills that are essential to the neurology profession and in turn, essential to patient care.

One result from the 2018-2019 pre- and post-assessments shows that, upon graduating from an AAN leadership program, AAN members have an increased desire to engage with the Academy.

Diversity Leadership Program (DLP), Emerging Leaders Program (ELP), Practice Leadership Program (PLP), Transforming Leaders Program (TLP), and Women Leading in Neurology (WLN) showing a strong desire for engagement with the AAN.

Engagement Opportunities

To meet this need, the Leadership Engagement Subcommittee (LES) is piloting a model that to grow further and establish the leadership alumni community and its opportunities. The model encompasses three primary areas of focus: (1) building a more profound sense of community through Synapse as a communication platform, (2) creating a library of learning resources for continued growth in leadership, and (3) establishing structured communication that formally acknowledges the value of leadership alumni at the AAN in addition to celebrating both personal and professional successes of leadership alumni.

To implement this new structure, the LES has created three new opportunities for involvement consistent with the stated primary areas of focus. Alumni of the leadership programs will fill the roles provided by these opportunities and lead in the planning and execution.

If you are interested in these opportunities, please contact Sarah Dietman at sdietman@aan.com.

Alumni Stories

Dr. Hope O’Brien

By NA TOSHA N. GATSON, MD, PhD

“If you’re always trying to be normal, you will never know how amazing you can be.”
—MAYA ANGELOU

Dr. Hope O’Brien, Associate Professor of Neurology at University Cincinnati Children’s Hospital, is a unique success story and an alumnus of the AAN’s Leadership Academy. My interview with Dr. O’Brien shows how beyond usual she is. Her story provides each of us with tools we can employ to excel. She has traversed steep roads, been uplifted by committed mentors, and developed an excellent skill set. Dr. O’Brien leads within the AAN and at her institution.

Heritage of Leadership: Dr. O’Brien noted that she grew up in a family that encouraged women and who knew the importance of education. She was groomed to aim high. She is grateful for that firm foundation. Her definition of success meant supporting herself while working to serve others. That is a commitment that she lives through her service to her work, community, family, and professional association. Dr. O’Brien has taken the heritage of leadership and thoroughly integrated it into her life. That heritage is one of the reasons that she diligently pursued research funding through the American Headache Society. Early in her career, she earned a leadership role as Fellowship Director by the end of her Headache Fellowship. As O’Brien progressed, she recognized the need to develop leadership acumen. Fulfilling the heritage of leadership meant that she would immerse herself in professional development that would move her forward in her career.

Leadership - Role vs. Skill: Dr. O’Brien sought leadership training through the American Academy of Neurology’s Diversity Leadership Program (DLP 2016). Her objectives upon entry were to learn critical leadership skills, fellowship with peers, and to align with mentors who could help her realize her aspirations. Dr. O’Brien is comfortable sparking innovations and sought mentors who supported her progressive thinking. In her own words, she functions “[…] outside the proverbial box.” Dr. O’Brien recalls feeling energized by the cohesive environment in the program. She noted that a well-rounded approach to leadership combines competencies from the business world with the field of medicine. She understands the benefits that come from cross-pollinating approaches to leadership. Dr. O’Brien provides three leadership skills that she deems critical for success:

Optimism - Dr. O’Brien captures the significance of this skill when she says, “No matter how challenging life can be, one can change the atmosphere of those around by staying positive and forward-focused.”
Professional Creativity - this skill allows physicians to expand their career horizons and overcome the misconception of limited career flexibility. She believes that being creative, having expansive horizons, and exploring a wide range of options can cure burnout.
Risk-taking - this is the skill that Dr. O’Brien attributes to moving her out of her comfort zone. She completed the program with confidence, established lifetime career mentors, and earned the respect of her peers. Shortly after completing the program, she continued her forward progression by completing an executive MBA degree from Xavier University.

Leadership Mentors: Dr. O’Brien credits DLP facilitator and leadership consultant Dr. Joanne Smikle for recognizing her potential and encouraging her to develop self-awareness. She also credits Smikle with helping her hone her communication strategies. Dr. O’Brien credits her career mentor, Dr. Carlayne Jackson, neurologist and physician leader, with inspiring her to be intentional in her actions and attitudes. She stated that Dr. Jackson taught her that leaders encourage others to lead.

Thank you, Dr. Hope O’Brien, for inspiring us with your story. Thank you for never striving for average, but instead, achieving amazing!

Dr. Cumara O’Carroll

Dr. Cumara O’Carroll is a graduate of the 2017 Diversity Leadership Program and has been awarded the Mayo Clinic Arizona Diversity and Inclusion Award at the 2019 Service Recognition Reception, which is in recognition of her yearly work, teaching, and research in Uganda. Dr. O’Carroll has been going to Mbarara University of Science and Technology and Mbarara Regional referral hospital every year since 2014.

“The Mayo Clinic Arizona Diversity and Inclusion Award seeks to recognize and honor Mayo Clinic employees who perform in an exceptional manner to advance our vision to be recognized by patients, employees, peer institutions and the community, as the leading model for diversity and inclusion by: 1)providing high-quality, culturally appropriate care and service in a welcoming environment to all patients and employees; 2) demonstrating a commitment to recruitment, retention, promotion, and inclusion of underrepresented populations; 3) supporting and promoting diversity initiatives that establish and foster a more inclusive work environment; 4) valuing and leveraging differences that arise from diverse cultures and customs so all team members feel respected and are able to contribute to team success."

Congratulations, Dr. O’Carroll!

Consultant Corner

Strengths and the Pitfalls of Sugarcoating Feedback at Work

By JULIE ANDERSON

Workplace feedback that is routine, ongoing, and impromptu is fast replacing the annual performance review as the most effective way to foster growth and development.

How do we best deliver feedback, especially if it is to be routine and ongoing? Many of us are not taught how to address challenging situations annually, much less weekly. As a result, we end up sugarcoating or minimizing our message.

The idea of feedback is intimidating. Both delivering and receiving feedback are hard. Sugarcoating feedback, while well-intended, may be experienced as avoiding more significant, more painful truths. It is confusing and unclear. A focus on what is right can minimize this tension. By using words that acknowledge where people are uniquely talented, we not only convey sincerity, we build trust as people feel understood and known. Where there is trust, we nurture loyalty, productivity, and morale. If people genuinely believe we see the best in them, there is far more incentive to work together. Strengths-based feedback encourages people to lean in and step up. It conveys the message that we believe in their potential!

Workplace feedback is generally negative. What about focusing on strengths and reframing feedback as guidance, instead? We all want to be shown the way, to be encouraged by those that have our backs. Feedback sounds uncomfortable even before it is shared, while guidance in the form of impromptu conversations feels much more welcome.

To be effective, feedback—or guidance—needs to be positive, specific, and timely. As an example, consider this 'feedback sandwich,' where the action to be corrected is sandwiched between your observations of talents and strengths:

"Your optimism and warmth are having such a positive impact on staff morale.

Do you have a moment to catch up on how your patient communication is going? Last week we were contacted by three patients that haven't heard back from you. This gap in communication is impacting your ratings, and that reflects on the hospital. We need this addressed immediately.

I would love to see you expand your relational genius to patient follow-up. Let's check-in next week and make sure it's taken care of and that you have a plan going forward."

Remember that not all conversations need to focus on the negative. Take the time to acknowledge people when things are going right. A strengths-based culture focuses on what people do well routinely, and that encourages a greater willingness to change when challenges inevitably emerge.

It is said that honesty without compassion is cruelty. Workplace feedback based on strengths allows for both honesty and compassion, all while creating a foundation of trust—no sugarcoating necessary.

Emotional Intelligence and Communication

By ROBBIN STUBBLEFIELD

The Good, The Bad, and the Ugly (Mostly the 2nd Two): Using Emotional Intelligence to Have More of the Good

“The Good, The Bad and the Ugly - Mostly the 2nd Two” This was the subject line of an email I recently received from a coaching client. The catalyst to the email was a text exchange that went awry between the client and a colleague. In the big picture, they shared a vested interest in their department’s mission and recognized they had complementary strengths that could benefit their department. Unfortunately, during the text conversation, their emotions got the best of them and triggered behavior that sabotaged the interaction and led it down an unproductive and destructive path (the bad and ugly).

Effective communication is challenging because each of us brings different priorities, purposes, personalities, and perspectives to our interactions. Whether we acknowledge them or not, we also bring emotions and feelings. That is why using skills related to Emotional Intelligence in our communications is so important.

Emotional Intelligence (EI) is defined by MHS Assessments* as, “A set of social and emotional skills that allow us to effectively perceive and express ourselves, build and nurture relationships with others, cope with stress and challenges, and use emotional information to make meaningful and appropriate decisions.” In 2016, The World Economic Forum reported EI as one of the Top 10 Skills of 2020 in their Future of Jobs Report. EI is critical to a leader’s success.

In my coaching work with participants of the AAN’s Practice Leaders Program (PLP) and Transforming Leaders Program (TLP), participants often want to address topics and situations related to communication. In your work, you likely find yourself having to navigate different conversations, including giving feedback, negotiating, navigating and managing conflict, interacting with patients and their families, and meeting with a variety of stakeholders. As you prepare for and engage in these and other scenarios, consider using these EI skills and strategies to create more constructive and productive conversations (the good):

Emotional Self-awareness – Identify your possible triggers, assumptions, thoughts, beliefs, and emotions related to the focus of the discussion. Recognize biases you might have and how those might impact your approach and delivery during the conversation.
Emotional Expression – Be aware of your verbal and non-verbal behaviors. Ensure they align with your intentions for the conversation. Identify possible consequences of your reactions and actions.
Empathy – Try to view the conversation from the perspective of the other person(s). Consider what they perceive they might lose or gain from the exchange. Learn more, listen more. Be attentive to others’ verbal and non-verbal cues for insight into what they are thinking, feeling, and experiencing as you interact.
Flexibility – Recognize your communication and conflict style preferences. Consider how you might need to adapt your style. Find opportunities to gain different perspectives and reframe your thoughts, emotions, and responses related to the conversation.

We will never perfect our communication with others because we can’t control how others respond. But we can continue to improve our ability to communicate in an emotionally intelligent way so that we have more of the good versus the bad and the ugly.

The skills listed above represent four of 15 skills included in the EQ-i 2.0^® Model, which is based on the original BarOn EQ-i authored by Reuven Bar-On. MHS Assessments developed the Emotional Quotient Inventory (EQ-i 2.0) and EQ360, which assesses emotional and social intelligence related to 15 competencies grouped into five composite areas: Self-perception, Self-expression, Interpersonal, Decision Making, and Stress Management.

Leadership

Message from AAN President James C. Stevens, MD, FAAN

Dear Leadership Program Participants,

Several years ago, the American Academy of Neurology recognized the need to have smart, talented, inspired, and agile leaders in our specialty—leaders in our Academy, yes, but also in practices, academic medical centers, communities, and research labs across the country. The AAN knew that to make this possible, it had to develop the training programs that would challenge and bring out the best in members who aspired to be leaders.

You are the evidence of the wisdom of this approach the Academy has taken to strengthen neurology and ensure our collective future success. The breadth of the opportunities in our Leadership Program reflects the needs of our members and spans a neurologist’s career, from medical students to more seasoned professionals. We believe that diversity and inclusion are essential to the success of neurology and the AAN and must appropriately reflect our diverse membership and patient demographics. We know that burnout is an insidious factor in the daily lives of many members. Therefore, we are training members to take the lead in promoting wellness strategies for their fellow neurologists in their institutions. The unique needs of medical students, residents, women neurologists, and members in practice are answered with leadership education that will help them address their challenges insightfully and confidently.

Already, the AAN and its members are benefiting from your participation in these programs. I’ve been impressed by the quality of work and presentations to the board on critical assignments that are helping to shape and prepare the Academy for future success. This infusion of fresh insights and bold ideas is vital to help us respond to the unmet needs of neurologists and make their AAN membership even more valuable in their professional lives. Our Leadership Programs ensure a pipeline of high-quality future leaders for the AAN and in the field of neurology.

The AAN is thrilled that we have individuals who seek to become tomorrow’s leaders and find gratification in tackling the challenges that our field faces, leading neurology to a better place. The Academy is committed to meeting their needs in this aspect—complementing my overall desire during my term to improve member career satisfaction.
As participants, you are the best-informed influencers about the scope and quality of these programs. I hope you will encourage your colleagues to apply for the opportunities best suited to their needs and career goals. The future of our specialty—and our Academy—depends on it!

James C. Stevens, MD, FAAN
President, American Academy of Neurology

COMPETITION

In addition to seeking to develop video snippets for the leadership newsletter, we are asking our readership for creative submissions inspired by their experiences through the leadership programs. We are asking for original contributions such as essays, poems, haiku, paintings, or musical compositions.

The editorial team will review these submissions and potentially use them for upcoming newsletters or publish them on Synapse.

Please submit these contributions to AlumniEditor@aan.com.

Leadership Development Committee Vision and Mission:

Vision: All members will achieve their leadership potential.
Mission: To cultivate and inspire leaders in neurology and foster their engagement with the AAN

Editorial Team

Editor

Associate Editor

Contributors

We hope you have enjoyed this issue of the Leadership Newsletter.

Wissam Georges Deeb, MD

Editor

SUPPORTERS OF THE AAN LEADERSHIP PROGRAM

ACADIA Pharmaceuticals, Inc.

Acorda Therapeutics, Inc.

Alexion Pharmaceuticals, Inc.

The Allergan Foundation

Allergan, Inc.

Biogen

Eisai Inc.

Genentech, Inc., a member of the Roche Group

Greenwich Biosciences, Inc.

Lundbeck, LLC

Medtronic

Neurocrine Biosciences

Sanofi Genzyme

Supernus Pharmaceuticals, Inc.

UCB, Inc.

References:

Stroller J, Goodall A, and A Baker. “Why the Best Hospitals are Managed by Doctors, “ Harvard Business Review, December 27, 2016
Horwitz I, Sonilal M, and S Horwitz. “Improving Healthcare Quality Through Culturally Competent Physicians: Leadership and Organizational Diversity Training,” Journal of Healthcare Leadership, February 2011
www.morganstanley.com/ideas/gender-diversity-investor-guide, January 17, 2017
Brooks, D. “Why Diversity in Healthcare IT Matters,” Healthtech Magazine, October 9, 2019
www.studentdoctor.net, June 2016
Henkel G. “Does US Healthcare Need More Diverse Leadership?, “ The Hospitalist, June 2016