Early Careerist Study

Download the Early Careerist Leadership Study Summary

Background and Introduction

At the recently completed annual meeting of the Association of University Programs in Health Administration (AUPHA), Quint Studer had the opportunity of being the HCA Forum speaker. During that session, he reflected on the fact that healthcare organizations have a very important role to play in the healthcare reform debate currently taking place in Washington, DC. He emphasized that healthcare leaders have a core obligation to do everything possible to create and sustain excellence at all levels. Quint has written extensively about accountability and execution as the cornerstones for organizations to thrive in an uncertain environment. The point he made at the AUPHA meeting was that management of our healthcare organizations truly matters at least as much as does financing and aligning payment incentives.

Given the importance of management and leadership to the future of healthcare delivery, it is worth asking whether we are appropriately preparing students for entry into our profession. Do students possess the competencies upon graduation to perform in a manner that significantly benefits their organizations? Can new graduates effectively engage in the activities that translate to highly effective healthcare delivery in organizations that hold people accountable, attract and retain the very best staff and align the behavior of teams? The Commission on Accreditation of Healthcare Management Education (CAHME) now requires that all accredited graduate healthcare management programs employ competency based education as the foundation for the preparation of their students. Rather than specify a particular competency model to use, CAHME allows the individual program to either develop their own set of competencies (in alignment with the 19 required curricular elements needed for accreditation) or use another model. While the competency requirement has been in place for two years, many persons holding current management roles were saying that current graduates did not possess the requisite skills needed for success in their initial positions as early careerists.

The premise of this study is that if in fact a gap exists between what the field needs and what students are being prepared to do we can identify those gaps and suggest ways in which healthcare management education can be made more relevant to both students and organizations who hire those graduates.

Study Objectives

• Determine the specific competencies new healthcare management graduates should possess upon graduation
• Assess the abilities of new healthcare management graduates to perform in the workplace
• Measure the difference between the competencies that new graduates need and those which they possess

Sample and Research Method

A web based survey was designed and distributed to 101,000 persons in the Studer Group database. The dependent variables in the survey were 27 competencies (excluding subcompetencies) that are common to a number of CAHME accredited graduate healthcare management programs. The competencies fall under the following six domains: Leadership, Communication and Relationship Management, Business Skills and Knowledge, Professionalism and Healthcare Knowledge.

Respondents were given three weeks to complete the survey. In addition to basic demographic information, respondents were asked to identify their job title, length of time holding a managerial/supervisory position and highest level of education obtained. Three questions were asked around the 27 competencies including:

• Respondents’ perception of their own competency as an early careerist
• The importance of specific competencies that new managers need to possess
• The actual level of competency held by new graduates of accredited MHA programs (or equivalent)

Persons who did not hold a managerial or supervisory position were screened out. At the conclusion of the study period, 3,712 usable questionnaires were returned and analyzed.

Key Findings Summary

• There is a significant perceived gap between the skills that MHA students possess and those that they need to be successful as new managers
• New graduates are reported to be most competent in the areas of: writing, presentation skills, healthcare trends and issues, information and technology management, financial management and healthcare standards and regulations
• New graduates are reported to be least competent in the areas of: hiring and firing staff, holding individuals accountable, engaging employees, aligning team behaviors, negotiation skills and risk management.
• Respondents recall their competency as early careerists as significantly different than persons currently graduated

Initially, the respondents were asked to assess their own skill in the 27 competency areas. The areas in which respondents viewed themselves as very competent at the start of their career were:

Those areas in which respondents viewed themselves as least competent are the start of their career were:

In the next set of questions, respondents were asked which competencies were important for new managers to possess. The six competencies mentioned as very important were:

Conversely, respondents ranked which among the competencies were seen as not at all important for new MHA graduates to possess. They included:

Finally, we asked respondents to assess the competency of new MHA graduates in each of the 27 areas. Those areas in which new graduates were perceived as very competent included:

In contrast, the top six areas in which new MHA graduates were viewed as not at all competent included:

Analysis and Conclusions

Examining the data obtained in this survey suggests that there are significant gaps between the skills that new MHA graduates posses and those that they need to be successful in the workplace. The table below looks at the ten competencies cited as very important for new graduates to have and then compares the percentage that are viewed as very competent versus those who are not at all competent.

The prior table makes clear the profound gap that exists between what practitioners say is needed by new health management graduates and the skills that they possess. The competencies most strongly called for are in the interpersonal aspects of health management yet the areas in which new graduates are most competent are in written and formal communication, their knowledge of healthcare trends and the very structured and content rich domains of IS/IT, financial management and healthcare law and regulation.

It is legitimate to ask if students in health management programs are being prepared to effectively enter the field of practice in a way that brings the greatest value to their organizations. While the curriculum of accredited graduate and certified undergraduate health management programs contains academic content that relates to the skills most needed they are most frequently smaller parts of larger classes including organization behavior and leadership. There are typically discrete courses in health law, finance, economics, and IS/IT. Verbal and written communication is generally woven into every course in the curriculum. In many cases, the relationship side of management is not experienced until the student goes into their internship or residency and is not emphasized in class – at least not to the same degree as other content.

Summary

This study examines the competencies that are needed for entry level healthcare managers from the perspective of 3,712 management professionals who responded to an online survey that asked them to assess the competency of new MHA graduates in 27 different areas. There is a large gap between the ten most important competencies and the skills possessed by new careerists. The skills that new graduates generally possess are in areas for which there are discrete classes or a cross-cutting curriculum. The skills that new graduates are weakest in are those in actual hands-on management and are not typically taught as whole classes or are deferred until the field experience.