David Schleich, ND

Conceptual Competencies: Part 1

Education

Naturopathic Deans make or break naturopathic medical education. This group of about two dozen NDs around North America have been described more than once as the profession’s most enduring visionaries. Over the years, there have been many players, each with his or her own style and impact: consider, for example, Sensenig, Zeff, Pizzorno, Raskin, Mittman, Snyder, Khalsa, Smith, Wolf, Scotten, Ross, De Groote, Pimentel, Martin … among many others. Over those same years, in our various colleges and programs within universities, those leaders have started and sustained our educational programs, shaping the professional formation of naturopathic medicine in very direct ways. They have continuously assessed goals, set new ones, and worked hard to motivate their colleagues and students to keep one eye on the larger picture and one eye on the year’s enrollment.

Their paychecks are modest. Their workloads are overwhelming. They focus endlessly on converting goals into specifics and more than once watched programs contract or cash flows converge uncomfortably close to trip-points along the Department of Education’s composite ratio continuum. Through tough times and good, they have kept going, whether they are creating curriculum, paying bills, building library collections, figuring out how to get learning management system platforms into the delivery equation, launching new methodologies to deliver an ever-changing curriculum, or, every Monday morning, keeping the doors open. And, they have done these things using a particular and complex set of competencies. Have those competencies changed in recent years? Are they any different from what we have needed all along?

Whatever approach to academic management our college Deans or academic administrators adopted over the years, they knew that the naturopathic medical education machine carries numerous special burdens all at the same time. Our medicine’s detractors have long pointed at our educational processes, resources, practices and outcomes, and have conveniently found fault, invariably unaware of the long secured and increasingly unjustified privileges of their own systems as they cast judgement from behind the berms of “the Match,” subsidized capital, mainstream political and policy support and public understanding. Nevertheless, for decades our Deans have kept chugging along.

In the early days, many were volunteers. They had to learn on the job, either becoming teachers through their role as mentors or, later, merging into teaching via a residency or through the adjunct faculty route. Some chose to shift into teaching and administration after some time in clinical practice. Eventually, help came from the public sector, as new academicians added naturopathic medicine to their repertoire from other professions or other graduate sectors, bringing career experience from higher education and inevitably adding best practices into the framework and design of our own programs. The need for strong academic leadership competencies, while always present, is more pressing today than ever. The need for a systematic approach to developing an apprenticeship pathway for such leaders is essential for the continuing expansion of the profession. However, as Levin and Dennison (1989) pointed out, the present and near-future shifting post-secondary environment is a daunting and confusing landscape for any new manager, whatever his or her background.

Competencies and Flashpoints in a Transforming Landscape

It may be helpful, then, to describe the most prominent conceptual competencies that scholars in the academic leadership field consider useful. This academic conversation has been going on for decades. Underpinning the managerial culture in our naturopathic programs, colleges and universities are assumptions that they can be directed and that change can be managed; essentially, that we can create the future we want (Deegan et al., 1985; Levin & Dennison, 1989). Change is ever present in naturopathic education, and we now face the burgeoning “integrative and functional medicine” arena, where there are those who, with impunity, cherry pick from what we do and have been doing for a century. We need strong academic leaders to define our place in this scramble.

Today’s naturopathic college or program is a complex landscape where many factors continuously influence the competencies our leaders need in order to steer his or her colleagues and students safely ahead. For one thing, our programs are not publicly assisted or publicly governed, but are nevertheless subject to government-linked accreditation, which assumes very specialized knowledge about the higher education sector, including its standards and its processes. Additionally, the stakeholders in our programs historically have not taken kindly to autocratic processes and top-down decision-making, inside or outside the profession. Thus, as Dennison has pointed out, “a strictly managerial approach is unlikely to be compatible with a collegial environment.” (Baldrige et al., 1977; Cohen, 1990; Raisman, 1990) Our leaders push back when they feel their institutions’ primary mission might be challenged or misunderstood. For example, the proliferation of programming at our educational institutions is as much about securing the fiscal and political health of the institution as it is about protecting the viability of the ND programs within them. Finally, our programs are not only places of classroom learning, but are also where precious and critical clinical skills are developed. Thus, there are very real professional preparation and public safety dimensions to the “product” of our programming—naturopathic physicians ready to treat patients in a healthcare marketplace where so-called integrative medicine MDs, DOs and functional medicine proponents are talking our talk.

Our Deans must develop and have handy specific competencies, yet those very competencies are shifting and sometimes reeling as we absorb the riptides of public policy and the gyrations of imbalanced competition in the health economy. Omnipresent are recurrent issues such as governance (Dennison, 1994, 1995; Dennison & Gallagher, 1996; Baldridge et al., 1977); funding (Hough, 1992); responsibility and accountability (Hufner, 1991), currency and effective visioning (Tierney, 1993). Also at the gates of the city are habits of short term crisis management, which enable the development and refining of certain competencies over others. Periods of growth benefit from competencies that are different from those needed to navigate periods of contraction. Growth phases, for example, bring challenges of staff recruitment, capital investment and branding, along with the parallel challenges of state and provincial licensing for our graduates. Whatever the climate, as the reach of our programs expands, the ability to respond with agility is crucial. Certain “flashpoints of controversy” (Skolnik, 1987) are going to come up in both scenarios.

An example of such a flashpoint is the need for professional competency in curriculum design, measurement and evaluation and finance function, including fundraising. Indeed, questions of funding limitations have been gnawing at the energy and focus of our academic leaders all along. Such pressures exacerbate the need for competencies to be crisp, practiced and reliable among our Deans and chairs whose shoulders are expected to carry whatever immutable ill is blowing in the next fiscal period.

Over the years, whatever the economic climate, our Deans have been generally autonomous within the higher education sector, enjoying a kind of exclusivity in accredited naturopathic medical education theory and practice. At the gates, however, competition encroaches. In this terrain, running a collegial ship to optimize resources and to assure safe harbor in the unforgiving change accompanying post-Affordable Care Act and transforming biomedicine realities, there are competencies that can help.

Challenges Facing our Deans

• Public governance, especially in the form of accreditation
• Shared governance pressures and aspirations toward collegiality
• Finding trustees for our boards who understand our history and care about our future
• The vagaries of post-secondary financing
• The dual-edged sword of responsibility and accountability to our stakeholders and to civil authority
• The imperative of understanding the needs of naturopathic medical students as learners as well as professionals preparing for a difficult health marketplace

Thoughtful governance has had an enduring impact on the naturopathic medical education environment, as our programs have sought and continue to seek professional, state and regional institutional affirmation of our standards, quality and track record. In earlier manifestations of our programs, NDs did the bulk of the governance work. That has changed over time as more public members join our boards from the worlds of higher education, finance, law, insurance, other non-profits, business and industry. Understanding the basic documents of each of our institutions must now be accompanied by specific fields of expertise, given the emergence of rival programming and the need for ambitious capital campaigns. In this regard, and extrapolating from Birnbaum’s analysis in How Colleges Work (Birnbaum, 1988), it becomes clear that this competency includes understanding the political history and current political reality of non-university post-secondary institutions on both sides of the border. Navigating the necessary changes within our colleges and universities as they edge away from the historically necessary influence of the profession’s own members is something our Deans struggle with today more than ever. Alumni often don’t understand why curriculum drifts headlong toward the biomedicine paradigm, even though that shift arises from the scope changes the profession’s state and national associations create. Understanding the roles of government-endorsed entities such as accreditation bodies or offices of degree authorization, whose impact on accountability and on student funding is immediate and demanding, is central to our Dean’s basic tool kits.

Competency in Complex Institutions

The need for competency related to the fact that our ND programs now exist mainly within larger institutions with a diversifying program mix is increasingly evident. Added to this is the American imperative of shared governance (Owen, 1995), which is accompanied by many pros and cons. Our Deans will have to know more about the origins and current manifestations of unionized faculty and the impact of collective agreements on our mission, purpose and vision. Our Deans have history lessons ahead to understand this aspect of higher education as new programs emerge within institutions where such arrangements already operate. Thus, the Dean of 2020, in search of conceptual competencies to tool up for a march through a decade or two of managing in the colleges, may also want to know about negotiation techniques (Ury, 1981 and 1991). An understanding of how organizational models can best be deployed to bring about success with program goals will help our programs avoid the persistent amnesia of some colleges and universities in the public sector, where tensions about workload arrangements and job security recur season after season (Cohen, Brawer, 1994).

Next month in Part 2 we will continue to review the competencies our Deans will need as we approach the end of the second decade of this new century.

References:

Baldridge, V., Curtis, D., Ecker, G., & Riley, G. (1977). Alternative models of governance in higher education. In G. Riley & V. Baldridge (Eds.), Governing Academic Organizations (pp. 2 –25). Berkeley, CA: McCutchan Publishing Corporation.
Cohen, A. (1990). The case for the community college. American Journal of Education, August, 426–442.
Cohen, A. M., Brawer, F. B. (Eds.). (1994). Managing Community Colleges: A handbook for Effective Practice. San Francisco, CA: Jossey-Bass.
Deegan, W., Tillery, D., & Melone R. (1985). The process of renewal: an agenda for action. In W. Deegan, D. Tillery, & Associates (Eds.), Renewing the American Community College (pp. 303-24). San Francisco, CA: Jossey-Bass.
Dennison, J., & Gallagher, P. (1986). Canada’s Community Colleges: A Critical Analysis. Vancouver, BC: UBC Press.
Dennison, J. (1994). The case for democratic governance in Canada’s community colleges. Interchange, 25, 25–37.
Dennison, J. (1995). Challenge and Opportunity: Canada’s Community colleges at the Crossroads. Vancouver, BC: UBC Press.
Hough, J. R. (1992). Finance. In B.R. Clark & G. Neave (Eds.), The Encyclopedia of Higher Education (pp. 1353 – 1358). Oxford, England: Pergamon Press.
Hufner, K. (1991). Accountability. In P. G. Altbach (Ed.), International Higher Education: An Encyclopedia, Volume 1 (pp. 47-58). New York, NY: Garland Publishing, Inc.
Levin, J., & Dennison, J. (1989). Responsiveness and renewal in Canada’s community colleges: a study of organizations. Canadian Journal of Higher Education, 19, 41–57.
Owen, S. L. (1995). Organizational culture and community colleges. In J. Dennison (Ed.), Challenge and Opportunity (pp. 141–168). Vancouver, BC: UBC Press.
Raisman, N. (1990). Moving into the fifth generation. Community College Review, 18, 15-22.
Skolnik, M. (1987). Canada. Higher education as a field of study. In P. G. Altbach (Ed.), International Higher Education: An Encyclopedia, Vol. 2. New York, NY: Garland.
Tierney, W.G. (1993). Building Communities of Difference: Higher Education in the Twenty-First Century. Westport, CT: Bergin and Garvey.
Ury, W., & Fisher, R. (1981). Getting to Yes: Negotiating Agreement Without Giving In. New York, NY: Penguin.
Ury, W. (1991). Getting Past No: Negotiating With Difficult People. New York, NY: Bantam.

David J. Schleich, PhD, is president and CEO of the National University of Natural Medicine (NUNM), former president of Truestar Health, and former CEO and president of CCNM, where he served from 1996 to 2003. Previous posts have included appointments as vice president academic of Niagara College, and administrative and teaching positions at St. Lawrence College, Swinburne University (Australia) and the University of Alberta. His academic credentials have been earned from the University of Western Ontario (BA), the University of Alberta (MA), Queen’s University (BEd), and the University of Toronto (PhD).