Value, Support, and Advancement: An Organization's Role in Faculty Career Intentions in Academic Medicine.

Purpose: Faculty engagement in academic medical centers is essential to advancing efficient healthcare delivery, research productivity, and organizational quality. The authors used turnover theory to empirically examine factors that influence faculty engagement, including both aspirational and attrition-related career intentions.

Methods: Using a convergent, mixed methods design, the authors surveyed 284 faculty at a large Midwestern public university's school of medicine in Fall 2015, Fall 2016, and Spring 2017. The study's questionnaire included a series of scales which informed three outcome variables (promotion aspirations, leadership aspirations, and intent to leave the organization) and four groups (role strain, work-family conflict, organizational commitment and support, and departmental commitment and support) of predictor variables, all of which have been previously validated with medical faculty populations. The scales were followed by open-ended questions which allowed respondents to further elaborate on their experiences in their organization related to each outcome variable. The authors used a hierarchical multiple regression model to assess the effect of each of the four groups of predictor variables on the outcome variables and then employed an iterative thematic analysis of open-ended responses to further elucidate faculty's reported experiences.

Results: Organizational commitment and support were significantly associated with faculty's promotion aspirations, leadership aspirations, and intentions to leave the organization. Thematic analysis of participant responses to open-ended questions further revealed the specific career development support faculty desired, mainly, streamlined and transparent promotion and leadership processes; clear guidance to maneuver these processes; holistic professional development opportunities; feeling valued; and supports for clinical and administrative tasks.

Conclusion: Advancing organizational policy that supports infrastructure for evidence-based interventions and programming for the intentional career development of faculty is an important aspect of a proactive talent development and retention model in academic medical centers.