Driven by the conviction the school needed to increase its leadership development to successfully navigate change in health care - especially in academic medicine taught across campuses and amid competing priorities - KU School of Medicine sought the help of a home-grown specialist.

An initial group of 19 participants from the Wichita and Kansas City campuses is now about halfway through a pilot training program with the Kansas Leadership Center. The Wichita-based KLC began providing civic leadership training for Kansans in 2007 and has since grown to deliver custom programs to businesses and organizations in Kansas and across the country.

"Just like any organization, we face institutional challenges. Multiple campuses have to come together on issues with many moving parts," said Julie Galliart, Ed.D., associate dean for faculty affairs and development in Wichita.

"Health care is such a chaotic environment. When you add the academic component to that, it just increases the complexity," said Brian Pate, M.D., chair of KU Wichita Department of Pediatrics. "You've got researchers; you've got educators; you've got master clinicians; you've got administrators. All these important and complementary roles just increase the complexity of how you navigate challenges and opportunities."

Encouraged by KLC's suggestion that a concrete problem makes training more real and effective, the medical school zeroed in on a big and timely one: providing the teams working on diversity, equity and inclusion initiatives skills to help them better do their work.

Diversity is a big umbrella, encompassing ethnicity, race, sexual preference, gender identity, socioeconomic status, geography and more. Recently, KU Medical Center increased its efforts to become more diverse, including creating the position of vice chancellor for diversity, equity and inclusion.

Galliart, Pate and Nancy Davis, Ph.D., now professor emeritus, reached out to the KLC last year. They had been exposed to KLC training in recent years, with Pate even taking a teaching course. They and Brad Barth, M.D., associate dean of faculty development in Kansas City, are observing the eight virtual sessions facilitated by KLC faculty Kevin Bomhoff and Donna Jean Wright.

The program participants represent a variety of areas - physicians, human resources, finance, graduate medical education, research and more - and serve on various committees working on different diversity, equity and inclusion initiatives. The hope is they'll take what they learn about leadership and put it to work on the initiatives already in progress, such as reviewing curriculum through an anti-racism lens.

"We wanted to offer a timely intervention, using these KLC principles to try to make progress on issues that can feel too big for one person to make a difference," Galliart said. "All of these diversity initiatives are adaptive challenges and leading that kind of change requires a leadership skill set we wanted to help equip people with."

In the program, participants are given reading and other pre-class work ahead of meetings and come prepared to discuss and work through the content. One of KLC's core tenets is that leadership is a skill not a position, that a title alone doesn't make a leader. Participants study and practice four KLC competencies: diagnosing the situation, managing self, energizing others and intervening skillfully. The goal is to bring transformational, sustainable change throughout the organization.

To make a broad topic manageable, the KLC created a case study zeroing in on a piece of the diversity puzzle: recruiting and retaining diverse faculty. The case involved interviews with a half-dozen faculty and staff about where the school stood on attracting and keeping diverse faculty, what it had tried in the past, why it is important, how a diverse faculty connects to a diverse study body, and what was holding the school back.

A part of KLC's philosophy involves digging into the problem at hand and learning to distinguish between technical and adaptive challenges. The point is that often we fail to make progress on challenges because we apply technical solutions - trying to fix it and check it off a list - without obtaining a deeper understanding of the issue and why people feel the way they do about it.

As a simplified example, a physician removing an appendix is confronting a technical problem, one with clear-cut solutions not requiring change of hearts and minds. Adaptive problems are more challenging and potentially frustrating, such as convincing a patient to alter their diet to prevent diabetes or persuading a parent a vaccination is safer than the measles.

Another part of the training involves exploring multiple perspectives and interpretations of a problem, in effect trying to put oneself in another's shoes. Related to that is assessing the different stakeholders involved, which KLC calls factions.

Samuel Ofei-Dodoo, Ph.D., MPA, CPH, research educator and assistant professor in the Department of Family & Community Medicine in Wichita, is participating in the program. He joined the medical school's Diversity and Inclusion Cabinet after coming to KUSM-Wichita in 2016 and has seen the school and colleagues become more aware of and receptive to diversity efforts. He's found the emphasis on exploring factions enlightening.

"If you don't understand somebody's position, you won't be able to change their mind," Ofei-Dodoo said. "There are people who might be ‘opponents' to diversity, equity and inclusion activities, although they might not openly show it or directly say it. To make headway, we will need to find out why such people might oppose those activities. Is it because they are afraid of losing something like power or control? Is it because of their training or where they grew up? We might not know their reasons, but this training is giving us the skills to break everything down and to use different approaches in different situations. Learning from different people from different backgrounds is invaluable."

Hinano Gray is principal business officer for the medical school, and is based on the Kansas City campus but works with other campuses as well. With the program, she has seen the value in listening to others who work in different roles but toward a common mission. Another realization is it can be unrealistic to go into an issue thinking you're going to change people's minds.

"How do you open up the minds and hearts of people who may not be interested in diversity and inclusion? Well, that's the environment of people I grew up with and love," said Gray, whose mother is Tahitian. "So part of me really wants to understand and help build bridges so we can communicate more effectively with one another. That's a skill that can be applicable to anything where there are differing opinions."

Fellow participants and facilitators are deeply engaged, Gray said. "I'm always shocked at the end of these sessions that I've never looked at my clock. I'd say that is a testament to how good this training is."

"The idea is that this is a pilot, a good experience to then grow the program," Davis said. "Ultimately any other transformational change issue is fair game for this course, such as developing and implementing new programs or recruiting medical students and residents. Those are very big opportunities for change."

For starters, the initial participants will be "champions" of the approach. "We have been trained to be the trainers, to share the knowledge we have," Ofei-Dodoo said.

"We hope this cohort goes on to tackle varied adaptive challenges," Pate said. "We are not asking them to address the problem of diversity and then stop."