{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:42:52Z","timestamp":1788496972111,"version":"build-2803163510"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:00:00Z","timestamp":1652400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008136","name":"Case Western Reserve University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008136","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>Under-representation of women in leadership at Academic Medical Centers (AMCs) is a known challenge such that, in 2021, women made up only 28% of department chairs. AMCs are addressing the dearth of women leaders through targeted programming to create leadership pipelines of qualified women. The FLEX Leadership Development Program at the Case Western Reserve University (CWRU) School of Medicine prepares women faculty for increased leadership opportunities. FLEX includes the opportunity to leverage executive coaching to accomplish individual goals. The FLEX program has the explicit goal of increasing the number of women in visible leadership positions in academic medicine and health sciences. Semi-structured interviews were conducted with 25 graduates from seven FLEX cohorts (2012\u20132018). Participants reflected diversity in academic rank, terminal degree, racial\/ethnic background, years of employment, and institutional affiliation. Interviews consisted of eight questions with additional probes to elicit lived experiences. Analysis consisted of two-stage open- and axial-coding of interview transcripts to understand: What factors facilitated behavior change following FLEX training? The analysis revealed five overarching themes: (1) Communication skills; (2) Self-Efficacy; (3) Networking; (4) Situational Awareness; and (5) Visioning. FLEX graduates reported achieving both personal and professional growth by drawing upon peer networks to proactively seek new leadership opportunities. These results suggest that the enduring benefits of the FLEX Program include improved communication skills, expanded situational awareness and relational capacity, greater self-efficacy and self-confidence, improved networking with an understanding of the value of networking. All these factors led FLEX graduates to have greater visibility and to engage with their colleagues more effectively. Similarly, FLEX graduates could better advocate for themselves and for others as well as paying it forward to mentor and train the next generation of faculty. Finally, participants learned to re-evaluate their goals and their career vision to be able to envision themselves in greater leadership roles. The five factors that strongly influenced behavior change provide valuable constructs for other programs to examine following leadership development training. Ongoing studies include examining successful leadership position attainment, personal goal attainment, and measuring changes in leadership self-efficacy.<\/jats:p>","DOI":"10.3389\/fpsyg.2022.854488","type":"journal-article","created":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T09:27:22Z","timestamp":1652434042000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Breaking Through Barriers: Factors That Influence Behavior Change Toward Leadership for Women in Academic Medicine"],"prefix":"10.3389","volume":"13","author":[{"given":"Clara M.","family":"Pelfrey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Cola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Gerlick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Billie K.","family":"Edgar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumita B.","family":"Khatri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1038\/nm0502-439","article-title":"The other physician-scientist problem: where have all the young girls gone?","volume":"8","author":"Andrews","year":"2002","journal-title":"Nat. Med."},{"key":"ref2","year":"2018"},{"key":"ref3","first-page":"799","article-title":"AAMC project committee on increasing women's leadership in academic medicine","volume":"71","year":"1996","journal-title":"Acad. Med."},{"key":"ref4","year":""},{"key":"ref5","year":""},{"key":"ref6","doi-asserted-by":"crossref","DOI":"10.1108\/S1479-357120135","volume-title":"Transformational and Charismatic Leadership: The Road Ahead","author":"Avolio","year":"2013"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1097\/ACM.0000000000002398","article-title":"Mentorship is not enough: exploring sponsorship and its role in career advancement in academic medicine","volume":"94","author":"Ayyala","year":"2019","journal-title":"Acad. Med."},{"key":"ref8","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1002\/9781405164061.ch22","article-title":"Interorganizational networks,","volume-title":"The Blackwell Companion to Organizations","author":"Baker","year":"2017"},{"key":"ref9","volume-title":"Social Foundations of Thought and Action: A Social Cognitive Theory.","author":"Bandura","year":"1986"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1177\/031289628801300210","article-title":"Organisational applications of social cognitive theory","volume":"13","author":"Bandura","year":"1988","journal-title":"Aust. J. Manag."},{"key":"ref11","volume-title":"Self-Efficacy: The Exercise of Control.","author":"Bandura","year":"1997"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1146\/annurev.psych.52.1.1","article-title":"Social cognitive theory: an agentic perspective","volume":"52","author":"Bandura","year":"2001","journal-title":"Annu. Rev. Psychol."},{"key":"ref13","volume-title":"Social Learning and Personality Development.","author":"Bandura","year":"1963"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"16","DOI":"10.17730\/humo.7.3.f4033344851gl053","article-title":"A mathematical model for group structures","volume":"7","author":"Bavelas","year":"1948","journal-title":"Hum. Organ."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1121\/1.1906679","article-title":"Communication patterns in task-oriented groups","volume":"22","author":"Bavelas","year":"1950","journal-title":"J. Acoust. Soc. Am."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1097\/00001888-200210000-00023","article-title":"Increasing women's leadership in academic medicine: report of the AAMC project implementation committee","volume":"77","author":"Bickel","year":"2002","journal-title":"Acad. Med."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1097\/ACM.0b013e31823ab4a8","article-title":"Women physicians: choosing a career in academic medicine","volume":"87","author":"Borges","year":"2012","journal-title":"Acad. Med."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1108\/02621710810840730","article-title":"Competencies in the 21st century","volume":"27","author":"Boyatzis","year":"2008","journal-title":"J. Manag. Dev."},{"key":"ref19","volume-title":"Resonant Leadership: Renewing Yourself and Connecting With Others Through Mindfulness, Hope, and Compassion.","author":"Boyatzis","year":"2005"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.leaqua.2011.08.003","article-title":"Examination of the neural substrates activated in memories of experiences with resonant and dissonant leader","volume":"23","author":"Boyatzis","year":"2012","journal-title":"Leadersh. Q."},{"key":"ref21","doi-asserted-by":"crossref","DOI":"10.4159\/9780674029095","volume-title":"Structural Holes: The Social Structure of Competition.","author":"Burt","year":"1992"},{"key":"ref22","first-page":"345","article-title":"The network structure of social capital,","volume-title":"Research in Organizational Behavior","author":"Burt","year":"2000"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"721","DOI":"10.7326\/M17-3438","article-title":"Achieving gender equity in physician compensation and career advancement: a position paper of the American college of physicians","volume":"168","author":"Butkus","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1097\/ACM.0000000000000552","article-title":"The effect of an intervention to break the gender bias habit for faculty at one institution: a cluster randomized, controlled trial","volume":"90","author":"Carnes","year":"2015","journal-title":"Acad. Med."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.whi.2016.11.003","article-title":"Recruitment, promotion, and retention of women in academic medicine: how institutions are addressing gender disparities","volume":"27","author":"Carr","year":"2017","journal-title":"Womens Health Issues"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.1097\/acm.0000000000002146","article-title":"Gender differences in academic medicine: retention, rank, and leadership comparisons from the national faculty survey","volume":"93","author":"Carr","year":"2018","journal-title":"Acad. Med."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1089\/jwh.2015.5608","article-title":"Retaining faculty in academic medicine: the impact of career development programs for women","volume":"25","author":"Chang","year":"2016","journal-title":"J. Women's Health"},{"key":"ref28","volume-title":"Constructing Grounded Theory","author":"Charmaz","year":"2014"},{"key":"ref29","first-page":"13","article-title":"From physician to physican leadership,","volume-title":"Cultivating Leadership in Medicine","author":"Cola","year":"2019"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"12714","DOI":"10.5465\/AMBPP.2017.12714abstract","article-title":"Discovering factors that influence physician scientist success in academic medical centers","volume":"2017","author":"Cola","year":"2017","journal-title":"Acad. Manag. Proc."},{"key":"ref31","volume-title":"Foundations of Social Theory.","author":"Coleman","year":"1990"},{"key":"ref32","volume-title":"The Positive Philosophy (H. Martineau, Trans; Vol. 2).","author":"Comte","year":"1853"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1097\/ACM.0b013e31816be551","article-title":"Evaluating a leadership program: a comparative, longitudinal study to assess the impact of the executive leadership in academic medicine (ELAM) program for women","volume":"83","author":"Dannels","year":"2008","journal-title":"Acad. Med."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1089\/jwh.2018.7252","article-title":"No room to \u201clean in\u201d: a qualitative study on gendered barriers to promotion and leadership","volume":"28","author":"Ellinas","year":"2019","journal-title":"J. Women's Health"},{"key":"ref35","year":"2013"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1097\/acm.0000000000001250","article-title":"Inequities in academic compensation by gender: a follow-up to the national faculty survey cohort study","volume":"91","author":"Freund","year":"2016","journal-title":"Acad. Med."},{"key":"ref37","volume-title":"Primal Leadership: Realizing the Power of Emotional Intelligence.","author":"Goleman","year":"2002"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1086\/225469","article-title":"The strength of weak ties","volume":"78","author":"Granovetter","year":"1973","journal-title":"Am. J. Sociol."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1086\/228311","article-title":"Economic action and social structure: the problem of embeddedness","volume":"91","author":"Granovetter","year":"1985","journal-title":"Am. J. Sociol."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.obhdp.2012.03.007","article-title":"Leader self and means efficacy: a multi-component approach","volume":"118","author":"Hannah","year":"2012","journal-title":"Organ. Behav. Hum. Decis. Process."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1177\/1359105313493650","article-title":"Clinician styles of care: transforming patient care at the intersection of leadership and medicine","volume":"19","author":"Huynh","year":"2013","journal-title":"J. Health Psychol."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1080\/17470919.2013.808259","article-title":"Visioning in the brain: an fMRI study of inspirational coaching and mentoring","volume":"8","author":"Jack","year":"2013","journal-title":"Soc. Neurosci."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1001\/archinte.167.4.343","article-title":"A targeted intervention for the career development of women in academic medicine","volume":"167","author":"Jagsi","year":"2007","journal-title":"Arch. Intern. Med."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"317","DOI":"10.5465\/19416520.2010.494827","article-title":"Organizational social network research: core ideas and key debates","volume":"4","author":"Kilduff","year":"2010","journal-title":"Acad. Manag. Ann."},{"key":"ref45","author":"Lautenberger","year":"2020"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1037\/h0057189","article-title":"Some effects of certain communication patterns on group performance","volume":"46","author":"Leavitt","year":"1951","journal-title":"J. Abnorm. Soc. Psychol."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1097\/ACM.0b013e318217e83b","article-title":"Stories from early-career women physicians who have left academic medicine: a qualitative study at a single institution","volume":"86","author":"Levine","year":"2011","journal-title":"Acad. Med."},{"key":"ref48","volume-title":"Social Capital: A Theory of Social Structure and Action.","author":"Lin","year":"2012"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1097\/ACM.0000000000001813","article-title":"Leadership development programs at academic health centers: results of a national survey","volume":"93","author":"Lucas","year":"2018","journal-title":"Acad. Med."},{"key":"ref50","author":"Mangurian","year":"2018"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1097\/00001888-200404000-00005","article-title":"Effects of participation in the executive leadership in academic medicine (ELAM) program on women faculty's perceived leadership capabilities","volume":"79","author":"McDade","year":"2004","journal-title":"Acad. Med."},{"key":"ref52","volume-title":"Social Learning and Imitation.","author":"Miller","year":"1945"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"100","DOI":"10.2189\/asqu.2005.50.1.100","article-title":"Social networks, the tertius iungens orientation, and involvement in innovation","volume":"50","author":"Obstfeld","year":"2005","journal-title":"Adm. Sci. Q."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1146\/annurev.soc.24.1.1","article-title":"Social capital: its origins and applications in modern sociology","volume":"24","author":"Portes","year":"1998","journal-title":"Annu. Rev. Sociol."},{"key":"ref55","volume-title":"Cultivating Leadership in Medicine.","author":"Quinn","year":"2019"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"2148","DOI":"10.1056\/NEJMsa1916935","article-title":"Women physicians and promotion in academic medicine","volume":"383","author":"Richter","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref57","doi-asserted-by":"crossref","DOI":"10.1037\/10788-000","volume-title":"Social Learning and Clinical Psychology.","author":"Rotter","year":"1954"},{"key":"ref58","first-page":"241","article-title":"Social learning theory,","volume-title":"Expectations and Actions: Expectancy-Value Models in Psychology","author":"Rotter","year":"1982"},{"key":"ref59","volume-title":"The Coding Manual for Qualitative Researchers","author":"Salda\u00f1a","year":"2016"},{"key":"ref60","doi-asserted-by":"crossref","DOI":"10.1037\/11256-000","volume-title":"Verbal Behavior.","author":"Skinner","year":"1957"},{"key":"ref61","volume-title":"About Behaviorism.","author":"Skinner","year":"1974"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1089\/jwh.2011.3394","article-title":"Factors impacting the departure rates of female and male junior medical school faculty: evidence from a longitudinal analysis","volume":"21","author":"Speck","year":"2012","journal-title":"J. Women's Health"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.mayocp.2013.10.012","article-title":"Leadership models in health care\u2014a case for servant leadership","volume":"89","author":"Trastek","year":"2014","journal-title":"Mayo Clin. Proc."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"425","DOI":"10.2307\/2786545","article-title":"An experimental study of the small world problem","volume":"32","author":"Travers","year":"1969","journal-title":"Sociometry"},{"key":"ref65","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511815478","volume-title":"Social Network Analysis: Methods and Applications.","author":"Wasserman","year":"1994"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1097\/ACM.0b013e31826dbfd1","article-title":"A culture conducive to women\u2019s academic success: development of a measure","volume":"87","author":"Westring","year":"2012","journal-title":"Acad. Med."},{"key":"ref67","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1086\/226141","article-title":"Social structure from multiple networks: blockmodels of roles and positions","volume":"81","author":"White","year":"1976","journal-title":"Am. J. Sociol."},{"key":"ref68","doi-asserted-by":"publisher","first-page":"361","DOI":"10.5465\/amr.1989.4279067","article-title":"Social cognitive theory of organizational management","volume":"14","author":"Wood","year":"1989","journal-title":"Acad. Manag. Rev."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2022.854488\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T09:27:50Z","timestamp":1652434070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2022.854488\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,13]]},"references-count":68,"alternative-id":["10.3389\/fpsyg.2022.854488"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2022.854488","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,13]]},"article-number":"854488"}}