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The Quality of Dental Faculty Work-Life: Report on the 2007 Dental School Faculty Work Environment Survey

Key words: dental faculty, academic environment, quality of faculty work-life, job satisfaction, faculty development

	Abstract

Top Author information Abstract Dental education in context:... Methodology: 2007 dental school... Results Discussion Conclusion Appendix References

 
This report is the third in a series of articles on the dental school work environment commissioned by the American Dental Education Association’s Commission on Change and Innovation in Dental Education. The report is based on the most extensive research to date on faculty satisfaction in the dental school environment. The purpose of the study was to assess faculty perceptions and recommendations related to work environment, sources of job satisfaction and dissatisfaction, and professional development needs. More broadly, the study intends to provide insight into the "change readiness" of dental schools to move forward with curricular improvements and innovations. Findings are based on 1,748 responses from forty-nine U.S. dental schools obtained during the time frame of February to April 2007. The total number of respondents constituted 17 percent of all U.S. dental school faculty. The average response rate per school was thirty-six (21 percent). To elucidate the data in terms of issues related to the quality of faculty work-life based on demographics, the authors compared perceptions of various aspects of the work culture in academic dentistry among faculty with different academic ranks and academic degrees and by other variables such as age and gender, tenure versus non-tenure appointments, and full- versus part-time status. Quantitative and qualitative analyses show that the majority of faculty members described themselves as very satisfied to satisfied with their dental school overall and with their department as a place to work. Tenured associate professors expressed the greatest level of dissatisfaction. Opportunities for and support of professional development emerged as an area requiring substantially more attention from dental schools. The authors of the study suggest that dental school leaders use these findings to assess their individual dental school’s work environment and to plan changes as needed.

The quality of faculty work-life as influenced by the educational environment is a basic concern to recruitment and retention of faculty. In turn, faculty satisfaction with the work environment influences the likelihood of implementing and sustaining educational innovations. Research on efforts to enhance curricula in health professions education and incorporate educational best practices demonstrates that faculty motivation and readiness to implement innovative models of education are the primary rate-limiting factors and often constitute the most profound barriers to adoption of new techniques.^5–12 Budgeted vacant positions in U.S. dental schools have averaged over 300 annually for the past decade, with 8–11 percent of faculty of record departing each year. Lower academically ranked faculty predominate among those departing, with approximately one-third leaving dental education to enter private practice. Given these data, it is reasonable to hypothesize that low job satisfaction and poor quality of faculty work-life are challenges for the nation’s dental schools.^13–16 Anecdotal observations confirm an overworked and stressed faculty, but there are few data available to reach firm conclusions about the dental school work environment.

The purpose of this study was to assess faculty perceptions and recommendations related to work environment, sources of job satisfaction and dissatisfaction, and professional development needs. More broadly, the study gives insight into the "change readiness" of dental schools to move forward with curricular improvements and innovations. The survey, conducted by the Academy for Academic Leadership on behalf of the American Dental Education Association’s (ADEA) Commission on Change and Innovation in Dental Education (CCI), constitutes the most extensive national study of the dental school faculty environment to date. It is the final in a series of initiatives on dental faculty work-life sponsored by the ADEA CCI. A symposium entitled "Change, Innovation, and the Quality of Faculty Work-Life" at the 2007 ADEA Annual Session constituted the first step. Subsequent steps included an article by Trower addressing how to make academic dentistry more attractive to new faculty, particularly those from Generation X.¹⁷ In addition, Trotman et al. presented findings from two interview-based qualitative assessments of faculty perceptions about work-life along with preliminary findings from the 2007 Dental School Faculty Work Environment Survey.¹⁸ In this article, we present a quantitative and qualitative analysis of the outcomes of this survey with comparisons among categories of respondents.

	Dental Education in Context: The Higher Education Environment

Top Author information Abstract Dental education in context:... Methodology: 2007 dental school... Results Discussion Conclusion Appendix References

 
Pyle et al. outlined a number of challenges facing dental education as a "case for change."¹⁹ While dental education faces unique challenges, the broader higher education milieu is relevant to understanding the dental school work environment. By many accounts, higher education is in the midst of unprecedented change. Public funding of higher education has fluctuated over the past decade and is projected to trend downward in the years to come.^20,21 At the same time, policymakers, perhaps best exemplified in the recent Spellings Commission, are demanding greater accountability for educational outcomes.²² Competition for the best students continues to grow, with universities putting substantial resources into value-added student services that have little to do with the traditional academic missions of higher education.^23,24 The globalization of higher education means that universities compete both at home and abroad for students and revenues. The methods of discovery and learning are shifting structurally, politically, and in terms of human resources. As these winds of change blow through the academy, many faculty members find themselves in an environment that is only a semblance of the one they entered years before. These changes affect the way faculty conduct their work and the quality of their faculty work-life.

In perhaps the most extensive, data-driven examination of the American faculty in more than a decade, Schuster and Finkelstein found that faculty job satisfaction has significantly eroded to the point that only about one-third of faculty characterize themselves as "satisfied" or "very satisfied," a decline from about 50 percent a generation ago.² American faculty are not alone. A recent study conducted on occupational stress among Canadian university faculty involving fifty-six universities and 1,470 respondents concluded that the overall level of stress was high, with 13 percent of respondents exhibiting signs of distress as reported on the general health component of the survey. Among ten different measures used in the survey, work-life balance was the most consistent stress-related measure predicting low job satisfaction and negative health symptoms.²⁵ These findings, indicative of high occupational stress, are similar to national surveys recently conducted in the United Kingdom and Australia.^26,27 These studies, crossing three continents, point to a common set of environmental changes currently affecting faculty work in the United States—specifically, major reductions in funding; more reliance on part-time, non-tenure-track, contract faculty; increasing workload, particularly associated with research and publication; growth in salaries that falls below that in other professions; and faculty members’ perception that they have lost influence within the academic organization.

U.S. dental school faculties have not been immune to the changes encompassing their parent institutions. The environmental changes affecting U.S. higher education in general have had a similar impact on dental education. One could argue that dental education has suffered, and in most cases accommodated, more tumultuous change than the academy as a whole. Haden et al. found that dental schools have compensated for faculty shortages by utilizing part-time faculty, redistributing teaching loads, dividing duties, and providing interdisciplinary coverage, including the use of generalists to teach in specialty areas.¹³ Bailit et al. observed that the difference in income between generalists who are faculty and those who are in private practice approximated $86,000 in 2000. For specialist faculty and private specialist practitioners, the difference was $170,000.²⁸ While these data are average salary differences across academic ranks and do not take into account income from faculty practice and benefit packages (health insurance for faculty, spouse, and family, retirement plans, paid vacation, educational stipends) available from university systems, the gap is significant and growing. This income gap combined with heavy workloads and, for some, student debt may explain why 36 percent of faculty separations in 2004–05 were departures to enter private practice.¹⁵

	Methodology: 2007 Dental School Faculty Work Environment Survey

Top Author information Abstract Dental education in context:... Methodology: 2007 dental school... Results Discussion Conclusion Appendix References

 
The research protocol for this study was reviewed and approved by the Institutional Review Board of the University of Texas Health Science Center at San Antonio (UTHSCSA) in February 2007 as exempted research (IRB Protocol #HSC20070528E). The objectives of the study were to:

1. determine faculty members’ perceptions of work-life and school environment that influence their decision making about academic careers in dental education;
   
2. identify academic work environment factors that are sources of satisfaction to dental school faculty and those that are sources of dissatisfaction; and
   
3. determine faculty members’ perceptions about the availability and value of professional development resources and activities at their dental school, including mentoring, career growth planning, faculty development and continuing education programs, and administrative and peer support.
   

The Dental School Faculty Work Environment Survey was based on two sources: the Faculty Job Satisfaction Survey developed for the Study of New Scholars at the Harvard Graduate School of Education by Trower and Chait (this survey instrument has been used since 2003 in a variety of higher education institutions including professional schools); and an online survey used for assessing career enhancement needs that could be addressed in faculty development programs at UTHSCSA that was developed by Hendricson in his capacity as director of the Educational Research and Development Division at UTHSCSA.

Design and Subjects
The questionnaire for this study was designed in an online format that employed a forced choice "menu" format, but included opportunities for write-in responses. The overall questionnaire consisted of twenty-nine questions and a total of ninety-nine items that requested responses. Practice administrations during instrument development and pilot-testing indicated that completion time was approximately twenty minutes. The questionnaire included six sections:

1. background information: dental school, highest academic degree obtained, length of time as a faculty member (current position and all positions during career), current academic rank, tenure- vs. non-tenure-track, full-time vs. part-time, department or discipline, race/ethnicity, age, gender, total compensation, and main focus of academic appointment (teaching, research, service, administration, combination);
   
2. satisfaction with day-to-day activities as a faculty member;
   
3. professional development support and resources, including mentoring;
   
4. satisfaction with professional development opportunities and mentoring;
   
5. perceptions of dental school environment and culture; and
   
6. perceptions of the dental school as a place to work.
   

The questionnaire was pilot-tested with a sample of forty-two health professions education faculty, including dental school faculty members at the UTHSCSA, in January 2007. Following modifications based on pilot-test feedback, the full questionnaire was distributed electronically to faculty at fifty-six U.S. dental schools during the time frame of February to April 2007. The chair of the ADEA CCI, Dr. Kenneth Kalkwarf, sent emails to the deans of each U.S. dental school informing them of the aims and methodology of the study and the projected uses of the data by ADEA. Deans were informed that they could elect to decline participation if they so desired. The link (URL address) to the Dental School Faculty Work Environment Survey and the IRB-approved information sheet (equivalent to a subject consent form for exempted education research) accompanied the message to the deans.

All full- and part-time dental school faculty in clinical, basic science, and behavioral departments were eligible to complete the questionnaire.

Distribution
The ADEA CCI has implemented mechanisms to facilitate a national discussion of curricular issues and sharing of strategies that foster innovation in dental education. One mechanism was to establish a network of faculty who serve as ADEA CCI liaisons at U.S. dental schools. The goals of the ADEA CCI liaison network are to promote two-way communication between the schools and the commission, serve as a conduit for information exchange between the ADEA CCI and the faculty who implement the curriculum for students, and provide leadership for implementation of educational innovations. Recruitment of ADEA CCI liaisons as site coordinators for this study provided two benefits: 1) it facilitated response by having the questionnaire come from faculty peers at each campus as opposed to the ADEA central office; and 2) it provided an opportunity for the liaisons to communicate with their peers about faculty development issues and thus raise their visibility at their schools. ADEA CCI liaisons at each dental school distributed the questionnaire by email (with an embedded link to the host website) to the faculty at their respective dental schools initially in February 2007 and for a second time in April 2007. The liaisons received an explanatory message from the investigators that was used as the participation invitation message for their faculty peers. This message described the study’s objectives and projected uses of the data by ADEA.

Response Rate and Subject Demographics
Through April 15, 2007, a total of 1,748 faculty from forty-nine U.S. dental schools responded to the survey. The total number of respondents constituted 17 percent of all U.S. dental school faculty. The average response rate per school was thirty-six (21 percent). In some cases, respondents did not answer all questions or skipped items within a question, so the actual number of responses ranged from 1,621 to 1,748 on individual items. Approximately two-thirds of the respondents were male, with white/Caucasian constituting the large majority of both males and females (Table 1).

Table 3 shows respondents by age. Although the age of respondents may appear to be decidedly skewed, the age distribution is indeed representative of dental school faculty.¹⁵

• full-time versus part-time faculty;
  
• academic degree, considering dental only, dental plus doctorate, dental plus master’s, doctorate only (e.g., Ph.D.), and master’s as the highest degree;
  
• academic rank, considering assistant professor, associate professor with tenure, associate professor without tenure, and professor;
  
• tenure- versus non-tenure-track for full-time faculty;
  
• ethnicity; and
  
• gender.
  

Data were downloaded into a statistical software table (JMP, SAS Institute, SAS Campus Drive, Cary, NC 27513) and edited as necessary to conform to the above list of independent variables, e.g., "clinical assistant professor" was edited to "assistant professor." Distributions were produced, and contingency tables were constructed for chi-square determination to test significance of perceived differences using the JMP software. In analyses using ethnicity as the independent variable, "American Indian/Native Alaskan" and "Other" were eliminated because of too few responses for valid chi-squares, as was the case for "Instructor" and "Other" when academic rank was the independent variable. In addition, where responses were "Not applicable" or missing, those respondents were not included in the statistical analysis for that specific variable. To ensure cautious interpretation because of the multiple comparisons made, significance was set at p<.01.

In addition to the quantitative data, survey responses included 404 written comments to the final question on the survey: "Please comment on any aspect of faculty life in dental schools that has not been explored in this survey." Overall, approximately 23 percent of the respondents submitted answers to this question. The methodology employed for analyzing the written comments was based on recommendations for analysis of qualitative data by Denzin and Lincoln.²⁹

The initial qualitative analysis of written comments identified sixteen sets of interrelated issues, hereafter described as themes. Five faculty members at the University of Texas Health Science Center at San Antonio (UTHSCSA) Dental School were each provided a portion of the narratives and were asked to independently review the responses, identify the prevailing themes from their perspectives, and rank the themes in order of frequency. These individuals were members of the Faculty Development Committee at the UTHSCSA Dental School and/or served as members of the ADEA CCI liaison team for this school. The four independent reviews were compared to each other to produce the summary that appears in the Appendix. Descriptive titles for the themes were created, and the themes were sequenced to reflect the frequency of expression by the questionnaire respondents.

	Results

Top Author information Abstract Dental education in context:... Methodology: 2007 dental school... Results Discussion Conclusion Appendix References

 
The results displayed in Tables 4–10 show the overall responses to various items in the survey. We have also highlighted areas in which statistically significant differences emerged from cross-tabulation of variables. Where there are no statistically significant differences associated with the variable, no comments are made. Data are presented based on responses to the following: satisfaction with day-to-day activities as a dental school faculty member; professional development opportunities and support; the culture of your dental school; the dental school as a place to work; and general assessment of faculty work-life, including work and life balance.

It is notable that more than 70 percent of all respondents indicated they were highly satisfied to satisfied with the overall way they spend their time as a faculty member, the nature of teaching assignments, and the intellectual challenge associated with their teaching responsibilities. By contrast, approximately one-third noted being dissatisfied to highly dissatisfied with the support and recognition for quality teaching at their schools, the amount of time provided for research, and the amount of time to write papers or prepare presentations for professional meetings.

Differences Associated with Academic Rank.
Comparing day-to-day activities to demographic variables showed a significant difference (p<.0001) among the four professorial ranks in "the overall way I spend my time as a faculty member." More professors were highly satisfied (35 percent) than other ranks (19–26 percent), and associate professors with tenure were the most dissatisfied (11 percent compared to 4–6 percent for the other ranks). A trend emerged across a number of items: "my overall teaching workload"; "the intellectual challenge associated with my teaching responsibilities"; "the support and recognition for quality teaching"; and "the extent and nature of interaction with my faculty colleagues." Professors indicated a significantly higher level of satisfaction in all of these areas, followed by associate professors without tenure and assistant professors. For all of these items, associate professors with tenure showed significantly higher levels of dissatisfaction.

Differences Associated with Tenure/Non-Tenure Status.
A significant difference was also evident for the item "overall way I spend my time as a faculty member" when comparing tenure- versus non-tenure-track full-time faculty (p<.01). More non-tenure-track faculty were satisfied (50 percent versus 42 percent), and fewer were dissatisfied (4 percent versus 8 percent). Likewise, among full-time faculty, non-tenure-track faculty had a greater percentage of highly satisfied responses than tenure-track faculty related to "opportunities to work closely with students and really get to know their capabilities and needs" (32 percent compared to 23 percent). Non-tenure-track faculty were more dissatisfied and highly dissatisfied (52 percent) than tenure-track faculty (37 percent) related to "the amount of time I have for research."

Differences Associated with Academic Degrees.
Another area of significant difference (p<.0001) emerged from the analysis based on academic degrees. More faculty with a dental degree plus a master’s (37 percent) were highly satisfied than the other groups (17 percent to 30 percent) in response to "opportunities to work closely with students and really get to know their capabilities and needs." Faculty with doctorates (e.g., Ph.D.) and dental degrees plus doctorates had the lowest percentage of highly satisfied responses (17 percent and 18 percent, respectively). More faculty with doctorates were dissatisfied with "the nature of my teaching assignments" (7 percent) than those with dental degrees only (3 percent). These findings may relate to varying expectations of the different groups by academic credential. For example, Ph.D.’s and D.D.S./Ph.D.’s may see themselves as more purely academic with different expectations than others. More dental degree plus master’s degree faculty (36 percent) were highly satisfied than the other groups (19–25 percent) with "the overall quality of students I teach."

In response to "the amount of time I have for research," analysis revealed a significant difference (p<.0001) in that 26 percent of respondents holding dental degrees were highly dissatisfied, compared to other groups ranging from 9 to 21 percent. Those with dental degrees and doctorates (17 percent) and doctorates (15 percent) had more highly satisfied responses than the other groups (4–7 percent). Doctorates gave the most satisfied responses: 39 percent compared to 18–27 percent for the other groups. These findings probably reflect the demands for teaching and clinic supervision placed primarily on clinical faculty.

There were no significant differences in responses to items related to day-to-day activities based on race/ethnicity or gender.

Written Responses.
The most prevalent theme in the written comments, mentioned by 28 percent of those who commented, concerned workload. Respondents described workloads as excessive and extremely varied. Written comments underscored the lack of time for professional development and other activities, with the requirement for extensive weekend and evening work to accomplish routine job functions. A number of comments indicated dissatisfaction with hiring practices that fail to recruit faculty with the necessary qualifications for job performance. In general, respondents described a high level of stress and consequent turnover due to the perception of being overworked and understaffed. The Appendix includes specific issues associated with workload.

Professional Development Opportunities
The questionnaire asked about the availability of various professional development activities, services, and resources across seventeen different items. Table 5 shows the responses to this query.

Analysis of the data indicates that a number of basic professional development activities, especially those associated with new faculty, including mentoring, new faculty orientation, and career growth planning, are not available or not done, or respondents did not know about the existence of these activities. For the item "there is a formal mentoring program for junior faculty who are not tenured," only 25 percent of respondents indicated that such support existed at their school. For the item "there is a formal mentoring program for faculty who are new to the dental school regardless of academic rank," only 20 percent of respondents indicated that such mentoring was available. In regard to "an orientation program for first-year faculty," 60 percent indicated that these orientations are not available/not conducted or responded that they were not aware of new faculty orientations at their school, while 45 percent indicated not available, not done, or do not know for the item "faculty members in my department develop career growth plans and meet with our department chair/division director/supervisor to set goals and plan professional enrichment activities." There were similar absences of professional development activity in several areas related to promotion and tenure, or the respondents reported that they did not know if these activities occurred. In reviewing these data for the initial article that presented selected and preliminary findings from this questionnaire, Trotman et al. concluded that minimal progress has been made to clarify the faculty evaluation process or assist faculty in understanding expectations associated with promotion and tenure.¹⁸

Respondents were asked if, at some point in their career, a more senior faculty member effectively served as a mentor and helped in the respondent’s professional development. Fifty-nine percent responded affirmatively, while 35 percent indicated that they had not received mentoring or professional guidance from a senior faculty member. Six percent did not consider the item applicable.

Whereas the items in Table 5 addressed the availability of specific professional development activities, the questionnaire also asked about the respondent’s level of satisfaction with professional development support and resources at his or her dental school. Table 6 summarizes the responses across eight areas.

It is notable that one in four respondents were dissatisfied with the "mentoring I have received from senior faculty," and overall, only 42 percent of respondents indicated that they were satisfied with this aspect of professional development. Approximately 25 percent of respondents were dissatisfied with "resources available to support research," and overall, only 36 percent of respondents indicated that they were satisfied with this aspect of professional development. Twenty-two percent also expressed dissatisfaction to high dissatisfaction with the "physical environment." In general, across all the items, the level of satisfaction with professional development support and resources was lower than for other areas examined in the survey. Across all items in Table 6, roughly one-quarter of individuals responded that their dental schools provided only adequate support in the various areas of professional development support and resources.

Differences Associated with Academic Rank.
Significant differences (p<.0001) existed among the academic ranks in response to "the commitment of my department chair/division director/supervisor to help me succeed as a faculty member." Professors gave the highest percentage of highly satisfied responses (38 percent compared to 26–32 percent for other ranks), while associate professors with tenure gave the highest percentage of highly dissatisfied and dissatisfied responses (30 percent compared to 13–17 percent for other ranks). Analysis revealed similar responses about "mentoring I have received from senior faculty," "opportunities to collaborate with other faculty," and "resources available to support research." In all cases, associate professors with tenure expressed significantly higher levels of dissatisfaction than did faculty at other ranks. Professors indicated the highest levels of satisfaction for all items.

Written Comments.
Comments about professional development comprised a prominent theme, mentioned by 12 percent of respondents. In general, comments indicated dissatisfaction with the amount of effort dental schools give to developing faculty skills and career guidance. Respondents mentioned a lack of funding to support travel to meetings. Comments underscored a concern about inadequate faculty development support and career guidance for junior and minority faculty. While some respondents described mentoring experiences as uneven, a number of comments indicated that respondents experienced positive mentoring, primarily by proactive department chairs. Specific quotes about professional development are found in the Appendix.

The Culture of Dental Schools
The survey inquired about a number of items related to the overall culture—values, attitudes, behaviors, and related norms—at the respondent’s dental school. Table 7 shows the responses to these items.

The large majority of respondents (87 percent) either agreed or strongly agreed that "I enjoy my interactions with faculty colleagues." Seventy-six percent feel that they "have a comfortable niche in my department." Over two-thirds of the respondents agreed or strongly agreed that their department chair/division director/supervisor "treats me fairly" in comparison to other faculty. There was strong indication that faculty and students have constructive (rather than "us against them") relationships.

One out of four respondents specified disagreement to strong disagreement that "the overall physical appearance of my dental school makes a good impression." Thirty percent did not find that "the overall culture of the dental school is characterized by openness to new ideas." In perhaps a related assessment of the "openness" of the school culture, one-third expressed dissatisfaction with reasonableness of "the decision-making process in the school about issues that face the whole faculty."

Differences Associated with Academic Rank.
The trend associated with academic rank noted previously continued with responses about the culture of the dental school in that professors showed higher levels of satisfaction than other ranks. Forty-two percent of professors agreed that "faculty colleagues are eager to help" compared to other ranks, which ranged from 30–33 percent in agreement with the statement. Sixteen percent of associate professors with tenure disagreed with the item compared to 7–10 percent from other ranks. Associate professors with tenure were also most likely to disagree that "my department chair/division director/supervisor treats me fairly" when compared to other faculty, with 20 percent either disagreeing or strongly disagreeing. By comparison, other groups ranged from 6 percent to 11 percent disagreement, with 48 percent of professors agreeing with the statement about fairness of treatment. Associate professors with tenure were also more likely to strongly disagree (17 percent compared to 9–13 percent) with the overall culture being "characterized by openness to new ideas," the reasonableness of "the decision-making process in the school about issues that face the whole faculty" (22 percent compared to 9–15 percent), and satisfaction with "the diversity of the dental school faculty" (19 percent compared to 11–14 percent).

Differences Associated with Tenure/Non-Tenure Status.
There was a significant difference (p<.002) between tenure and non-tenure faculty about the expectation for conformity within the department, with non-tenured faculty giving more strongly agree responses (23 percent versus 15 percent). Sixty-six percent of full-time non-tenured faculty expressed their satisfaction with the level of faculty diversity in the school by agreeing or strongly agreeing, compared to just over half of tenured faculty.

Differences Associated with Academic Degrees.
Faculty who have dental plus master’s degrees showed a greater likelihood of agreeing that their "faculty colleagues are eager to help me with projects," with about one-third strongly agreeing compared to 19–20 percent of other respondents.

Differences Associated with Race/Ethnicity and Gender.
White/Caucasian faculty were more likely to strongly agree (30 percent) that their "contributions to the department are recognized by my colleagues" than were non-whites (20 percent). White/Caucasian faculty were also more likely to agree (41 percent compared to 38 percent of non-whites) and non-whites were more likely to strongly disagree (9 percent compared to 4 percent) about satisfaction associated with diversity. Where diversity is concerned, there was also a significant difference (p<.0001) between genders, with males more likely to agree (43 percent compared to 34 percent) and females more likely to disagree (18 percent compared to 10 percent) with the statement "I am satisfied with the diversity of the dental school faculty, including age, gender, and race/ethnicity."

Written Responses.
A substantial percentage (21 percent) of respondents who submitted written responses expressed concern about their dental school within the larger context and culture of the academic health center. Some indicated a sense that the dental school environment is less academic than other schools in their health science center. Comments reflected concerns about how other schools within the health science center view the dental school. In particular, issues associated with lack of research collaboration, little interaction among dental faculty and others within the health science center, lack of effort to develop community-based programs, and lack of support from central health science center and parent university administrators led some respondents to describe their dental schools as isolated. Others commented on aging and declining physical plants compared to other schools in the health science center. The Appendix includes specific issues associated with the theme of the dental school within the academic health center.

The Dental School as a Place to Work
This section of the survey addressed satisfaction related to the department as a place to work, central administration, and salary and benefits (Table 8). A large majority, 73 percent of respondents, indicated that they were very satisfied to satisfied with their place of work, "all things considered." A similar number, 73 percent, expressed satisfaction with their benefits. In contrast, 30 percent were dissatisfied to very dissatisfied with the central administration of the dental school’s concern about "the work environment for the ‘in the trenches’ faculty," while another 20 percent were neutral. Thirty-nine percent of respondents were dissatisfied to highly dissatisfied with their total compensation package. A similar number, 38 percent, were very satisfied to satisfied.

Differences Associated with Academic Rank.
When assessing the department/division/administrative unit "as a place to work," associate professors with tenure chose very dissatisfied to dissatisfied more often than did the other ranks (22 percent compared to 9–12 percent for other ranks). As expected based on the analysis described above, professors were the most likely to be very satisfied (40 percent versus 25–33 percent). Associate professors with tenure also chose "strongly disagree" more often (20 percent) than others (10–12 percent) when asked if the central administration of the dental school cares about the faculty work environment. Professors identified themselves as very satisfied to satisfied more often than other ranks (53 percent compared to 29–38 percent) relative to their level of satisfaction with their total compensation package.

Differences Associated with Academic Degrees.
Faculty with doctorates (43 percent) and dental degrees plus doctorates (38 percent) agreed more often than other groups (28–32 percent) that the central administration of the dental school cares about the faculty work environment. Faculty with dental degrees only (20 percent) and master’s only (20 percent) chose "disagree" more often than did the others (12–13 percent). Doctorates only were most satisfied with their "total compensation package"—40 percent choosing agree compared to those with dental degrees only, 27 percent of whom chose agree. Perhaps not surprisingly, given the discrepancy between private practice and academic salaries, faculty with dental degrees only strongly disagreed most often (17 percent versus 6–10 percent).

Differences Associated with Full-Time/Part-Time Status.
Full-time faculty were more likely to agree that the central administration of the dental school cares about the work environment for faculty (35 percent compared to 23 percent), and part-time faculty were more likely to be neutral (28 percent compared to 18 percent). Full-time faculty more often selected "very satisfied/satisfied" to indicate their level of satisfaction of total compensation (33 percent) than did part-time faculty (19 percent). Part-time faculty also chose "strongly disagree" with satisfaction about their compensation package more often than did full-time faculty (18 percent compared to 12 percent).

Written Comments.
Most of the themes in the written comments relate in one way or another to the dental school as a place to work. Twenty-seven percent of those providing written comments expressed perceptions of a disconnect between administration and faculty, providing elucidation to responses about the central administration of the dental school shown in Table 8. Some described the relationship as adverse, while others stated that their administration does not respect faculty, involve faculty appropriately in change efforts, or accept feedback from faculty. Areas of dissatisfaction in administration-faculty relationships included those associated with curriculum change and teaching. While some respondents were specifically critical of their deans, others reported optimism related to the style, work ethic, and responsiveness of new deans. The Appendix includes specific issues associated with faculty-administration relationships.

Fifteen percent of those submitting written responses expressed concern about their level of compensation. Some noted that low salaries are a barrier to recruitment and retention of new faculty and negatively influence students’ consideration of academic careers. While many comments reflect the theme of being overworked and underpaid, written comments mentioned workload issues approximately twice as often as compensation. The Appendix includes specific issues associated with compensation.

Thirteen percent of respondents made comments about promotion standards and compensation for teachers and researchers. In general, this theme included traditional concerns expressed by primarily teaching faculty about researchers receiving preferential treatment in hiring, salary, awards, and advancement. Some suggested that usual recruitment and hiring practices are bypassed to recruit researchers. Others noted that faculty with primarily teaching appointments have to teach more and engage more often in university service to compensate for researchers who do not participate actively in teaching or service. Comments indicated the perception that the reward system is not linked to performance, particularly when teaching is compared to research. Some respondents expressed dissatisfaction with the hiring of new faculty at higher salary levels than long-standing faculty. The Appendix provides further delineation of issues associated with this theme.

Analysis of written comments resulted in a number of less-mentioned themes. These themes, mentioned in less than 10 percent of all narrative comments, along with investigator commentary, are found in the Appendix.

General Assessment of Faculty Work-Life
As one means of providing an overall summary of questionnaire feedback, respondents were asked to provide a general assessment of their work-life. Table 9 shows that, considering all factors in the questionnaire, 62 percent of respondents rated their dental school as an excellent or good place to work.

Continuing a trend found in other responses in the questionnaire, a significant difference existed (p<.0001) relative to academic rank. Professors chose "excellent" more often than did other ranks (35 percent compared to 22–24 percent), with tenured associate professors selecting "fairly bad" more often than did the other ranks (12 percent compared to 4–6 percent). Whites/Caucasians chose "excellent" more often than did other groups (28 percent compared to 20 percent), but also selected "fairly bad" more often than non-whites (7 percent compared to 3 percent). There were no significant differences in response based on gender, academic degree, or tenure/non-tenure status.

Table 10 shows that 71 percent of respondents were very satisfied to satisfied with their overall balance of work and other aspects of life. Full-time faculty chose "dissatisfied" more often (15 percent) than did part-time faculty (5 percent), and part-time faculty chose "very satisfied" more often than did full-time faculty (40 percent versus 23 percent). Associate professors with tenure chose "dissatisfied" more often than did other ranks (19 percent compared to 9–15 percent), while professors chose "satisfied" more often (49 percent compared to 37–43 percent). A significant difference (p<.0001) in response is associated with gender. Females chose "dissatisfied" more often (17 percent) than did males (13 percent). Males chose "satisfied" (47 percent versus 38 percent) and "very satisfied" (29 percent versus 24 percent) more often than did females.

	Discussion

Top Author information Abstract Dental education in context:... Methodology: 2007 dental school... Results Discussion Conclusion Appendix References

 
With a study this broad, it is difficult to mine all the nuances associated with statistically significant differences associated with the cross-tabulation of variables. There are, however, a number of clear messages conveyed by the data.

The assessments of dental school culture (Table 7) and the dental school as a place to work (Table 8) and the overall assessment of the work environment and work-life balance (Tables 9 and 10) convey a positive but mixed message about the dental school work environment. The message is positive because more than half of the respondents gave an "excellent" or "good" overall assessment to faculty work-life (Table 9). Only 8 percent considered their faculty work-life as "fairly bad" or "awful." Seventy-three percent indicated that they were very satisfied, all things considered, with their department/division/administrative unit as a place to work. Surprisingly, given a clear message from these data and previous reports that faculty workloads are substantial and increasing, 71 percent answered that they were "very satisfied" to "satisfied" with their overall work and life balance.

The message is mixed because there are no clear benchmarks with which to compare these responses. In a survey of seventy-seven colleges and 6,773 tenure-track faculty, the Collaborative on Academic Careers in Higher Education concluded that, overall, faculty reported being "somewhat satisfied" with their department and "somewhat satisfied" with their institution as a place to work. Quantified on a scale of 1 to 5, with 5 indicating very high satisfaction and 1 signifying very low satisfaction, university respondents averaged scoring satisfaction with their department as 3.88 and with their institution as 3.65. This study also found that early career faculty rated their satisfaction with the balance between personal and professional time very low (2.8 on the 5-point scale).³⁰ A 2007 study of occupational stress among Canadian university faculty draws the conclusion, among many others, that 65 percent of the 1,470 faculty surveyed were satisfied in their jobs.²⁵ A similar study in Australia found that 58 percent were satisfied in their jobs.²⁷

While notable areas of dissatisfaction and concern exist—for example, associated with professional development activities and support (Tables 5 and 6) and a perceived dichotomy between faculty and administration (Table 7)—the responses indicate that the majority of dental faculty enjoy working in their dental schools and find their jobs fulfilling. In individual interviews with dental faculty, Trotman et al. found that many junior faculty said they had little control over their work schedule and overall academic life, in contrast to the expectations that brought them to academic careers rather than private practice. Still, the junior faculty liked the variety of tasks within the academic environment and saw this diversity as a positive factor.¹⁸

The authors believe that faculty satisfaction in the dental school environment compares favorably with that of higher education in general. While compensation is significantly lower for dental faculty than for dentists in private practice, total compensation is generally higher than for other faculty at the university.^31,32 That the majority of dental faculty are satisfied overall with the academic culture and find many aspects of their work-life to be stimulating and fulfilling is an important message to convey to students and others who might have an interest in an academic career.

One clear trend throughout the data is that the greatest dissatisfaction with the dental school work environment is among tenured associate professors. This finding, while a concern, is not unusual. Trotman et al. described research showing a divide between the perceptions of early and mid-career faculty compared to their senior colleagues about the academic environment.¹⁸ In a 1999 national survey of faculty, the U.S. Department of Education found that 12 percent of associate professors said they planned to leave the profession for jobs outside of academia within three years. The longer they remained at this rank, the greater the dissatisfaction. Associate professors who hold their rank for ten years or more experience greater stress and are more dissatisfied than other faculty.³³

The findings of our study indicate that approximately 15–20 percent of associate professors with tenure who responded to the survey appear to be unfulfilled and unhappy as dental school faculty. Some of these faculty members probably entered academia when expectations for promotion and tenure were different. In many higher education institutions, including dental schools’ parent universities, promotion to full professor is highly improbable without significant research and scholarship. Even while there is renewed interest in the scholarship of teaching, fostered by such national organizations as the Carnegie Foundation for the Advancement of Teaching and initiatives such as ADEA’s Scholarship of Teaching and Learning community and the ADEA/Academy for Academic Leadership Institute for Teaching and Learning, the findings from this study indicate that a sense of inequity between teaching and research persists. Without the probability of promotion and corresponding pay increases, tenured associate professors may have the sense of being "stuck" in their careers. These faculty members, who are likely to have already devoted fifteen to twenty years to their academic careers, may perceive that opportunities at the dental school are limited, but that, with tenure, departure from academia to private practice is not an attractive alternative.

One message from the survey findings is that dental schools should create more or better opportunities for mid-career development. To make their jobs interesting and to ensure their continued contributions to the dental school, mid-career faculty also need career planning. Mid-career faculty members, unlike their junior academic colleagues, are positioned to make a transition from securing a place in the institution to assuming broader roles at the dental school and the parent institution and in the profession. Chairs can assist these faculty members through regular performance review, goal setting, and opportunities to develop new areas of competency (e.g., administration, research, new areas of teaching, and mentoring). As in any discipline, some mid-career faculty may be content to continue on a predictable, even if personally and professionally unsatisfying, path. But mid-career faculty development should become a part of every dental school’s professional development activities.

Inasmuch as professional development plans need to be comprehensive and address faculty at all ranks, among the feedback that causes most concern in the survey are responses about professional development opportunities (Tables 5 and 6). The matter becomes more troublesome when faculty separations are considered. In 2004–05, ADEA reported that 36 percent of faculty departures were to enter private practice (a year earlier, nearly half of departures were to private practice). Of this number, 53 percent were at the rank of assistant professor. Based on the survey findings, assistant professors do not show particularly high levels of dissatisfaction about the work environment. Yet the exodus from dental schools each year is largely defined by departing assistant professors. There are likely a number of reasons for this phenomenon, but the survey data make clear that some dental schools are doing little for faculty to enhance early career development.

Seventy-six percent of survey respondents stated that "a formal mentoring program for faculty who are new to the dental school regardless of academic rank" was not available or they were not aware of such a program, which from our experience likely indicates that a program does not exist. Sixty percent stated that orientation programs for new faculty were either not available or they did not know of such programs. Nearly 50 percent of respondents reported that faculty did not develop career growth plans in collaboration with their chairs/division directors/supervisors or they did not know if this was done. The promotion and tenure process was unclear to many, with apparently little information provided on a formal basis. As a part of the ADEA CCI white paper initiative, Hendricson et al. delineated characteristics of effective faculty development and argued for its efficacy in improving teaching and facilitating curriculum change.³⁴ Based on survey responses, we conclude that many dental schools are not engaged in the basics of professional development that would assist in retention of new faculty.

There is another important message, one that is more tacit. There are a number of proxies in the data that reflect the change-readiness of dental education. Workload and time pressures are clear in both the quantitative and qualitative feedback from respondents. Dental schools are caught up by the same currents that push higher education to new places, yet the ways that higher education and dental education are provided have changed little. As Guskin and Marcy summarize the impact of these changes on faculty in a delivery system that remains relatively static: "The present educational system of courses, credits, and calendar-based systems of teaching and learning focuses by its very nature on how faculty work. As a result, all attempts to achieve efficiency and productivity within this system involve increase in faculty workload."³⁵

In a survey of North American dental schools that included questions about planned curriculum changes, Kassebaum et al. found that 88 percent of the respondents (fifty-six dental schools) identified faculty development as needed to make curriculum changes. This was by far the most mentioned area of need.³⁶ The ADEA CCI has maintained that faculty development is a necessary condition for change and innovation in dental education. To that end, ADEA has sought to provide new opportunities for faculty to gain necessary skills to improve curricula and all aspects of teaching and learning. In a February 2008 communication, Dr. Richard W. Valachovic, ADEA executive director, described the Association’s multipronged approach to encourage long and satisfying careers in academic dentistry.³⁷ Much remains to be done, and some of the faculty development necessary to retain faculty and equip them for lifelong academic careers can only be accomplished at the faculty member’s home institution.

	Conclusion

Top Author information Abstract Dental education in context:... Methodology: 2007 dental school... Results Discussion Conclusion Appendix References

 
The ancient Hebrew sage Qoheleth wrote, "Be warned: the writing of many books is endless, and excessive devotion to books is wearying to the body." Qoheleth might have written the same words about policy studies, reports, and the consequent excessive devotion to recommendations. The authors of this report make no additional recommendations for change. In the first companion article to this one, Trower provided ample guidance on making academic dentistry more attractive to Generation X faculty.¹⁷ In the second companion article, Trotman et al. made five recommendations to enhance the dental school work environment: 1) school administration (e.g., department chairs) should articulate clear expectations of faculty; 2) faculty members should do their homework: make sure the job "fit" and environment are good for them; 3) remember that teaching matters most; 4) establish a mentoring structure as the cornerstone of faculty development; and 5) create and maintain an atmosphere of enthusiasm among faculty, staff, and students. We encourage readers to review and consider these recommendations.

One of the basic purposes of the ADEA CCI is to give members of the academic dental community concepts and tools to improve and to innovate. To that end, the ADEA CCI has provided faculty development opportunities for teams of liaisons at each dental school. The ADEA CCI has commissioned a number of white papers intended to be practical guides for schools. The authors of this report, the final of three on the dental school work environment, hope that dental school leaders will use these documents as a means of self-assessment against a national benchmark. In particular, we underscore the challenge that dental schools face to advance faculty development as a means to improve work-life satisfaction and to facilitate the changes necessary to ensure the vitality of dental education well into the future.

	APPENDIX

Top Author information Abstract Dental education in context:... Methodology: 2007 dental school... Results Discussion Conclusion Appendix References

 
Issues Identified in Faculty Write-In Responses to 2007 Dental School Faculty Work Environment Survey

Note: Percentages add up to more than 100 percent because many respondents commented on more than one aspect of academic life.

	Author Information

Top Author information Abstract Dental education in context:... Methodology: 2007 dental school... Results Discussion Conclusion Appendix References

 
Dr. Haden is President, Academy for Academic Leadership, Atlanta, GA; Mr. Hendricson is Assistant Dean, Educational and Faculty Development, Dental School, University of Texas Health Science Center at San Antonio, and Director of Educational Programs, Academy for Academic Leadership; Dr. Ranney is a senior consultant, Academy for Academic Leadership, and Professor Emeritus, Dental School, University of Maryland; Dr. Vargas is Assistant Professor, Department of General Dentistry, Dental School, University of Texas Health Science Center at San Antonio; Dr. Cardenas is Assistant Professor, Department of Pediatric Dentistry, Dental School, University of Texas Health Science Center at San Antonio; Dr. Rose is Assistant Professor, Department of General Dentistry, Dental School, University of Texas Health Science Center at San Antonio; Dr. Ross is Assistant Professor, Department of General Dentistry, Dental School, University of Texas Health Science Center at San Antonio; and Dr. Funk is Clinical Associate Professor, Department of General Dentistry, Dental School, University of Texas Health Science Center at San Antonio. Direct correspondence and requests for reprints to Dr. N. Karl Haden, Academy for Academic Leadership, 1870 The Exchange, Suite 100, Atlanta, GA 30339; 404-350-2098; khaden{at}academicleaders.org.

This article is one in a series of invited contributions by members of the dental and dental education community that have been commissioned by the ADEA Commission on Change and Innovation in Dental Education (CCI) to address the environment surrounding dental education and affecting the need for, or process of, curricular change. This article was written at the request of the ADEA CCI but does not necessarily reflect the views of ADEA, the ADEA CCI, or individual members of the ADEA CCI. The perspectives communicated here are those of the authors.

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