A CASE STUDY OF A LEADERSHIP CRISIS IN HIGHER EDUCATION
SCHOOLS OF PHARMACY
Patricia A. Chase
B.S., Albany College of Pharmacy, 1971
M.S., University of North Carolina Chapel Hill, 1985
A thesis submitted to the
Faculty of the Graduate School of the
University of Colorado at Denver
in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy
Administration, Supervision and Curriculum Design
1995 by Patricia Chase
All rights reserved
This thesis for the Doctor of Philosophy
Patricia A. Chase
has been approved
Chase, Patricia A. (Ph.D., Administration, Supervision and Curriculum
A Case Study of a Leadership Crisis in Higher Education: Schools of
Thesis directed by Assistant Professor Nancy Sanders
The budget problems of the 1970s created a perception of a
leadership crisis in higher education that has spanned 25 years. Only in
the last five years, however, has this perceived epidemic infected the
nation's health sciences centers (HSC). Due to health care reform, the
schools on the HSC are now experiencing budget shortages similar to
those of other schools in higher education and cries of a leadership crisis
are being heard. This study investigates the phenomenon of a leadership
crisis in one of the schools on the health sciences center campus: the
school of pharmacy.
This research contributes to the research on leadership in higher
education by examining a case of leadership crisis. It was hypothesized
that a leadership crisis would be manifested in deans as high turnover,
shorter tenure and overall discontent with the job. Phenomomenological,
interpretive methods were used to investigate the perception of a
leadership crisis in pharmacy schools.
Phases one and two were qualitative, while phases three and four
were quantitative. In phase one, a pilot study was conducted to
determine the overall perception of leadership in schools of pharmacy. In
phase two, a survey of 25 pharmacy school deans collected their
perceptions of the crisis, including its causes and symptoms. In the third
phase, the turnover of pharmacy school deans was calculated for the last
25 years. Finally, in phase four, the tenure of these deans for the last 20
years was determined.
The results of this study show that the deans hold the perception
there is a leadership crisis in schools of pharmacy. The analysis of
turnover and length of tenure do not support this belief. Study results do
show problems in the search processes for pharmacy deans. Results also
implicate the rapidly changing HSC environment in creating significant
pressures on those in positions of leadership. The study concludes that
the crisis talk obscures real fears about a changing environment and
the lack of effective training for leaders.
This abstract accurately represents the content of the candidate's thesis.
I recommend its publication.
The Prophet Gilbran wrote: Work is love made visible
I would like to dedicate this work to Dr. Nancy Sanders who made
the words of Gilbran come alive. Throughout this project she demonstrated
an extraordinary amount of patience and understanding. She gave a
tremendous amount of help, just because she cared. Nancy is a teacher, a
mentor and a friend. Thank you, Nancy.
My family also gave a tremendous amount of understanding and love.
I could not have completed this project without their support. To Jim, Julie,
Adam and Alison, Thank you! I love you!
There were also very special individuals who gave me trusted advice
and support throughout the project. Dr. Alan Davis (UCD), Dr. Jordan
Cohen (University of Kentucky) and Dr. Susan Meyer (AACP) gave me
valuable assistance at key points in this project. Thank you for your
Finally, there were faculty members at UCD who also gave their time
and talents to this project, and helped me complete this degree. This
includes Dr. Michael Murphy, Dr. Julie Carnahan, Dr. Paul Bauman, and Dr.
Susan Ford. Thank you all!
1. INTRODUCTION ...................................... 1
Purpose and Scope of the Study ................... 3
Origin and Interest of Concern ..................... 6
Leadership Theories ................................ 8
A Crisis in Leadership? .......................... 10
Symptoms of the Problem ........................ 12
Investigating Leadership Symptoms ............... 14
A Crisis or Not? ................................. 17
Have the HSC's Lost Their Immunity ............... 18
Contents of the Thesis ........................... 21
2. REVIEW OF THE LITERATURE ........................... 23
What is Leadership ................................ 23
Leadership in Higher Education .................... 31
Theories of Adcademic Leadership ............... 35
Trait Theories ................................. 3 5
Contingency/Environmental Theories .............. 39
Leadership Requirements on the
Heath Sciences Center ........................... 41
Leadership Requirements in
Schools of Pharmacy ............................. 43
Academic Administration of the Future ........... 46
What is a Leadership Crisis? .................... 50
Turnover as a Symptom of Crisis ................ 52
Theories of Tenure ............................... 55
Summary ............................................ 58
3. BACKGROUND INFORMATION ............................. 61
The Health Sciences Center ......................... 61
The HSC Crisis ................................... 64
HSC's vs the Parent University ................... 65
The School of Pharmacy ............................. 77
The Organizational Structure ..................... 80
Degree Programs .................................. 81
Accreditation .................................... 85
The Pharmacy Dean ................................ 85
Selection of Deans ............................... 86
Summary ............................................ 87
4 METHODOLOGY ...................................... 8 8
Research Design .................................... 89
The Four Phases of Study ........................... 92
Phase One: The Pilot Study ....................... 94
Phase Two: The Crisis Investigation .............. 96
Phase Three: The Turnover Study ................. 99
Phase Four: The Tenure Study .................... 100
Summary ........................................... 102
5. RESULTS ........................................... 104
Phase One: The Pilot Study ........................ 104
Research Findings ............................... 106
Contribution to Understanding ................... 109
Phase Two: The Crisis Survey ...................... Ill
Question 1: Is There a Leadership Crisis ........ 112
Contribution to Understanding ................... 114
Question 2: The Definition
of the Word Crisis .............................. 114
Contribution to Understanding ................... 117
Question 3 : Symptoms of the Crisis ............. 118
Contribution to Understanding ................... 120
Question 4: Causes of the Leadership Crisis ... 123
Contribution to Understanding ................... 130
Question 5: The Importance of
Environmental Issues ............................ 130
Contribution to Understanding ................... 134
Question 6: Identification of
Environmental Issues ............................ 134
Contribution to Understanding ................... 136
Phase Three: The Turnover Study .................. 145
Contribution to Understanding ................... 145
Phase Four: The Tenure Study .................... 14 8
Contribution to Understanding ................... 148
Summary ........................................... 149
6. CONCLUSIONS AND RECOMMENDATIONS ................... 153
Purpose and Focus ................................. 153
Research Question #1: What is a
Leadership Crisis in Higher Education ........... 155
Theory .......................................... 155
Data ............................................ 157
Relevance/Meaning ............................... 159
Recommendations ................................. 161
Research Question #2: Is there a Leadership
Crisis in Pharmacy? ............................. 163
Theory .......................................... 164
Data ............................................ 167
Relevance/Meaning ............................... 171
Recommendations ................................. 175
Summary ........................................... 180
A. The Pilot Survey ............................... 182
B. The Crisis Survey ............................. 184
C. Analysis of the Number of Deans
in Schools of Pharmacy ...................... 185
D. Analysis of the Number of Administrative Changes
in Schools of Pharmacy from 1966-1994 ......... 186
E. Analysis of Number of Open Positions
1975-1995 ..................................... 188
F. Analysis of the Turnover of Deans ............. 18 9
G. Analysis of the Tenure of Deans in
Schools of Pharmacy from 1974-1994 ............ 190
H. Analysis of the Tenure of Pharmacy Deans ..... 191
BIBLIOGRAPHY ......................................... 192
Severe budget problems in higher education almost twenty-five
years ago created the perception of a leadership crisis. Joseph Kauffman
(1983) traced the history of this crisis back to the 1970s, and he
described the difficult role of the academic leader. Kauffman stated that
in the 1970s, the "crisis manager" became commonplace in higher
education. As the environment changed, role expectations changed. He
If the change is swift, as it has been since the early 1970s,
presidents may not be able to change quickly enough to satisfy the
conflicting perceptions of what is required....By the mid 1970s,
the public image of the president was of a harried, if energetic,
executive type rushing through revolving-door positions (p. 244).
The claims of a crisis in higher education leadership have persisted
for almost 25 years. In a recent article, Lovett (1994) reflected on the
continuing problems. She wrote:
For an industry with only about 3,600 chief executives, higher
education is blessed with a wealth of scholarly research and
accumulated vision about leadership in academe. Despite these
resources, one hears plenty of gloomy talk about a crisis of
leadership (p. A44).
In 1983, Kauffman wrote that the symptoms of the crisis included
the high turnover of academic administrators and the disenchantment
with higher education on the part of citizenry and legislatures. He
discussed the paradoxes in the college presidency by observing that
"those who enjoy it are not very successful, and those who are
successful are not very happy" (Kauffman, 1983, p. 241). He concluded
that the job was considered impossible.
Lovett (1994) also concluded that because of new role
requirements for academic administrators, colleges continue to
experience a leadership crisis and the role of the dean is not as attractive
as it was once thought to be. From these two authors, it appears that
the leadership crisis in higher education has persisted, relatively unabated
or unchanged, for many years.
Although the perception of a leadership crisis in higher education
has existed for 25 years, only in the last five years has this epidemic
infected the nation's heath sciences centers (HSC). Apparently, these
centers have been immune to the problems in higher education. Perhaps
this immunity stemmed from the multiple funding sources: research,
patient care and education. However, with health care reform syphoning
off many of these revenue sources, these centers now face the same
budgetary constraints that initiated the problem in higher education. It is
not surprising therefore, to hear calls about changing leadership
requirements, and even the presence of a leadership crisis, emanating
from these centers. For example, in a 1994 address to the Annual
Meeting of the American Association of Academic Health Centers, Dr.
Walter J. McNerney stated that very few health sciences centers have
leaders with the right training, and that leaders must acquire new skills to
manage in times of resource constraints (Howe, Osterweis & Rubin,
1994). Chi (1994) reported on the widespread perception of a leadership
crisis in the nation's pharmacy schools.
Purpose and Scope of the Study
This research will explore the phenomenon of leadership crisis in
higher education. I will address two major purposes. The first of these is
to examine the leadership crisis that began in higher education in the
1970s, and to learn what is what is meant by a "crisis of leadership".
This question will be answered through extensive review of the literature
on leadership and the crisis in higher education.
The second purpose is to study the perception of an emerging
crisis on the health sciences center and uses the case of schools of
pharmacy. Is there a leadership crisis in America's schools of
pharmacy? Given the recent, multiple calls concerning the leadership
crisis in schools of pharmacy, this appears to be an unfolding problem.
To develop an understanding of this phenomenon, I used both qualitative
and quantitative research methods. Qualitative methods included
interviews with key academic administrators in schools of pharmacy.
Quantitative methods included researching databases of current and past
deans to calculate length of tenure and turnover rates.
Analysis and data collection occurred in phases with each stage
deepening the understanding of the case being studied. The data were
collected as the study proceeded, following leads from one phase to the
next. The first phase of data collection was a pilot study that
investigated the perception of a leadership crisis with three of the senior
members in pharmacy academic administration. A survey of four
questions was developed, data were collected and transcripts of
interviews analyzed. These data provided a perspective on the notion of
a leadership crisis and suggested questions for a wider group of
respondents. Additionally, this phase provided insight into the
perception of a leadership crisis and gave direction to revising the survey
prior to interviewing additional participants.
The second phase was a study of 25 deans. A random sample
was asked six questions about their perceptions of the leadership crisis in
schools of pharmacy. They represented both new deans (in their office
less than two years) and seasoned deans (in office greater than two
years). The objective of this phase of the dissertation was to understand
the perception of the crisis in schools of pharmacy, its causes and
symptoms, and to determine key environmental issues in these schools.
Transcripts of interviews were coded into categories and results
In Phase Three, I collected data to calculate the turnover of deans
in schools of pharmacy over the last twenty-five years. A comprehensive
list of deans was assembled with the assistance of the American
Association of Colleges of Pharmacy (AACP). I determined the turnover
of pharmacy deans and compared this rate to other academic
In Phase Four, I collected additional information on the tenure of
deans in schools of pharmacy. Using a rolling average method, I
determined the length of tenure for pharmacy deans for the last 20 years.
Origin of Interest and Concern
The perception of a leadership crisis in higher education has
existed for over 20 years. It is important to understand what is meant by
a leadership crisis and why it appears to remain unresolved in higher
education. Also, why is the perception of a crisis now spreading onto
the nation's health sciences centers? The academic environment has
become more difficult and the organizations are considered anarchies
(Cohen, March & Olsen, 1972). It is imperative to learn what the
continuing leadership crisis in higher education implies for these leaders
and for those preparing to go into leadership positions in academia.
The problem in schools of pharmacy appears to be unfolding over
the last few years, so this case can provide timely data and could benefit
the profession by illuminating important issues affecting pharmacy
education. Additionally, study of the perceived crisis can offer the
profession of pharmacy useful recommendations to assist in designing
solutions to remedy the problem. It is also important to understand if
there is an actual crisis or what Scott (1983) called "crisis-talk". She
"The very idea o.f crisis management as the self-declared style
and purpose of the new administration conveys a certain iron,y, for
in the name of managing crises (in the sense of resolving them),
crisis managers may, in fact, be provoking or intensifying them"
The issue of leadership crisis in higher education has been primarily
studied in a retrospective process. Examining a crisis in a concurrent time
frame and determining its causes and symptoms would be beneficial in
understanding this phenomenon. Finally, this research could also provide
a systematic way to study a crisis in other disciplines. Ping (1986)
observed that in universities, the challenge is not just to recognize
problems, but to recognize them in a timely fashion and to address the
issues they represent. Analysis of problems can give early warning of
change and possible future crisis. It is then possible to "marshal the
forces necessary to address the problems" (p. 9).
There are literally thousands of books on leadership and over 350
definitions of the word. One author categorized the conceptual theories
of leadership into six models. Cohen's (1993) models include: trait
theories, power and influence theories, behavioral theories, contingency
theories, cultural and symbolic theories, and cognitive theories.
Although there are many theories of leadership, two of Cohen's
models help to assess leadership requirements in higher education. Both
the trait and contingency models are relevant to this issue. In reviewing
the traits required of academic administrators, Skipper (1978) used factor
analysis to describe the two most important dimensions of the effective
leader. He found that these individuals must have traits in two areas:
administrative and personal. Administrative skills he identified as
knowledge of position, communications, planning ability, human
relations, organization and management, judgement and quality of
performance. Personal qualities included traits such as responsibility,
willingness to act, thoughtfulness and ethical conduct, flexibility,
integrity, self control, intellectual efficiency, personal relations,
motivation to achieve, and creativity.
Birnbaum (1992) stated that traits alone do not necessarily predict
leadership ability and that leadership effectiveness depends on the
environment, the organizational culture and subordinates' expectations.
Therefore, the contingency or environmental theories, are important
considerations in any discussion of leadership. These theories state that
leaders must adapt their style and behavior to the environment and that
skills and approaches must be continually developed. Many authors felt
that leadership requirements must change in times of environmental
stress. Bensimon (1989) and Bolman and Deal (1991) illustrate how the
environment dictates a change in leadership requirements.
The works of Cribben (1981) are also beneficial in understanding
leadership requirements in times of environmental change. Cribben
used the metaphor of a pair of scissors to describe leadership. One blade
represents the leader's traits and the other blade represents the situation
that provides the leader with both constraints and opportunities. Cribben
concluded that the skillful leader is able to make his personal behavior
congruent with environmental realities.
In response to environmental change in higher education, it
appears that a leader must use different, or new skills to manage. If the
leader is unwilling or resistant to this approach, the results could be seen
as a crisis in leadership. Many writers feel that additional education
would assist academic administrators in meeting the challenges of the
changing academic environment (Green 1981; Kauffman, 1983;
Draugalis, 1992; Wilcox and Ebbs, 1992).
A Crisis of Leadership?
The literature in higher education (Scott, 1983) and in pharmacy
education (Cohen, 1993) implicate academic leaders as the cause of
current problems, referring to the situation as a "leadership crisis" (Lovett
1994). How did the term crisis come to be linked with leadership in
One of the most thorough studies on the leadership crisis in higher
education was conducted by Scott (1983). In her study, Scott observed
that very much like the Roaring Twenties, a golden age preceded the
onset of the problems in higher education. Education flourished in the
postwar boom of the 1950s and then accelerated in the 1960s. This
decade brought unprecedented expansion, billion dollar construction
projects, burgeoning enrollments and increased numbers of faculty.
In the early 1970s, the first great wave of budget cuts put a
precipitous end to the golden age. The education depression began.
Cheit (1971) predicted doom and gloom for higher education. He
believed that the depression in higher education of the 1970s would
outstrip in severity and potential longevity the experience of the Great
Depression. Bartell (1975) however, took issue with Cheit and observed
that the crisis was not of the magnitude of a great depression, but rather
the basis for new forms of public assistance and a need for increased
managerial expertise in educational administration.
Scott also compared the problems in education to the Great
Depression. She framed the situation as multidimensional, including
factors that were closely interrelated and mutually reinforcing making
their resolution more problematic. She believed the dimensions were
financial and political. She considered the financial factors the primary
cause of the leadership crisis. The political factors, she observed,
included two aspects. The first "revolves around new discontents and
power struggles among opposing segments of the academic community
that, from an administrative viewpoint, generate a problem of order" (p.
2). The second aspect was a diminished sense of the legitimacy of the
college and a loss of confidence in its purposes and priorities. This lack
of legitimacy, according to the Carnegie Commission (1973), also
weakened administrative leadership in higher education. One result of
this turmoil is what Trachtenberg (1981) called "presidential burnout" (p.
4), which he considered a serious national problem in higher education
administration. Scott (1983) observed that "the vocabularies of crisis are
sometimes apocalyptic...more often, however, they are a blend of
guarded pessimism and pragmatism" (p. 2).
Symptoms of the Problem
The literature in higher education clearly fixes the cause of the
problem on the budgetary issues and the solution as a need for
strengthened academic leadership. Review of the literature on the
budget problems of the 1970s indicates the symptoms were manifested
in two areas, in the environment and in a breakdown of academic
Environmental symptoms. Aspects of the budget problems in
higher education were seen in environmental symptoms including college
closings, faculty and staff layoffs, lack of program
development/advancement, steep increases in tuition, decreasing
numbers of students enrolling in college due to shrinking job markets and
delays in faculty salary increases and promotions. The Carnegie Council
on Policy Studies in Higher Education (1980) stated that in response to
the crisis, schools had redirected their efforts to survival. Some of the
survival tactics included:
The lowering of admissions requirements
The search for nontraditional students, who in the past have been
the least preferred
The increased emphasis on retention of students, sometimes
regardless of their performance
The turn toward vocational and professional subjects following
The effort to find top leadership which is good at cost accounting
or at recruitment of students or at fund raising or at all three; to
find managers for survival who will balance the books, recruit the
students and raise funds instead of innovators and planners for a
different and hopefully better future, (p. 27)
Trachtenberg (1981) stated "The situation is one of grave and
deepening crisis, as institutions of higher education struggle with rising
inflation and declining enrollment, with tenured faculty who have nothing
to do and overworked assistant professors who have no where to go"
Leadership symptoms. Other symptoms of the budget problems
were framed as a crisis of leadership. Keller (1983) stated, "One of the
most significant developments in postwar academic life has been the
progressive breakdown of governance and leadership" (p. 27). He
reported on The Commission on Strengthening Presidential Leadership
which met in the early 1980s. This commission concluded "that
strengthening presidential leadership is one of the most urgent concerns
on the agenda of higher education in the United States" (p. 102).
Critics expected that good academic leadership would devise ways to
overcome the barriers and find the cure for higher education's ills
(Bensimon, Neumann & Birnbaum, 1989).
Investigating Leadership Symptoms
Webster's Dictionary (1988) defines crisis as a crucial or decisive
point or situation, or an unstable state of affairs. It appears that the
leadership crisis was seen in high burnout and turnover rates of
academic administrators (Trachtenberg, 1981); the changing selection
criteria used for academic administrators (Hughes, 1987); and the
recognition that the very nature of the job of the administrator had
changed. The leadership symptoms are the ones that some authors
believe are problematic for higher education today. (Cibulka &
Mawhinney, 1995; Lovett, 1994).
Turnover of administrators. Trachtenberg (1981) claims that
because of the budget problems, the burnout of academic administrators
"occurs faster and more frequently now" (p. 4). Mooney (1992)
suggests that there is a widespread perception that the turnover of
college presidents is high, there is a consensus about the increasing
difficulty of the position, and of the need for programs to develop new
administrative skills to prevent turnover.
Selection of administrators. Other authors believe that budget
problems cause a change in the selection of academic administrators.
The traditional approach to selecting academic administrators has been
for their scholarly qualifications rather than for their administrative
experience (Hughes, 1987). Consequently, they may lack or be
perceived to lack administrative skills. Trachtenberg (1981) stated that
the president's role had changed, and the new qualities required may not
be recognized by present search and screen procedures for
In 1981, Green stated, "Higher education's reluctance to recognize
the need to prepare its academic administrators in any systematic way
reflects the values of the academy, but not necessarily its needs" (p. 11).
The debate on the qualifications of academic administrators in higher
education continued through the 1980s and it appears that discussion
continues to this day. In 1994, Lovett noted that historically deans were
valued and selected because of their scholarly work. "Today, however,
the candidate who is skillful in finances and/or possesses strong political
abilities is the one selected for these positions" (p. A44).
New roles and responsibilities. As a result of the budget problems
in higher education, that the administrator's role changed dramatically.
Reisman (1978) observed that visionary academic leadership was lacking.
He summarized the struggles of academic administration by observing
that the very nature of the job had changed so dramatically that it was
no longer a job for an educator. Green (1988) reflected that the job of
college presidents changed from that of an education leader to that of a
fund raiser, financial manager and politician in an endless quest to obtain
scarce financial resources. Austin and Gamson (1983) stated that to be
successful, the academic manager must be adept and many roles. They
listed these roles to include: politician, zoo keeper, orchestra conductor
and a dispensing machine operator.
Wiseman (1991) proposed "a president in whose tenure the
university does not raise more money than it did before is a president
who is looking for a new line of work" (p. 6). He stated that most
presidents spend their time meeting with those individuals and groups
that could help the university financially or that had influence. Because
fund raising is now a necessary part of the job, he felt that anyone who
does not excel at it cannot make a good president. He observed that
many presidents complain that fund raising and external affairs take up
so much time that they have little time left over for the academic agenda
which normally defines their leadership capacity. In short, presidents do
not have enough time to reflect thoughtfully upon the very things for
which they are presumably gathering support (p. 6).
A Crisis or Not?
There appears to be much disagreement as to the presence of a
true crisis. The debate in higher education has continued for over twenty
years and has ranged from calls warning of a Great Depression to simply
the necessity to retrain academic administrators. While the budget
problems did force some schools to close, the other environmental
symptoms mentioned previously have faded. The problems in academic
leadership seem to continue; if this is a true crisis or not, is yet to be
determined. From the literature, it appears that there is an ongoing need
to .train academic administrators to be flexible and to modify their roles in
the presence of environmental change. Perhaps the leadership crisis is
framed by the failure of some individuals to acquire the necessary skills.
Have the HSCs Lost Their Immunity?
The HSC was immune from the budget problems present in other
areas of higher education in the 1970s, and in fact, were enjoying a
golden age. In the last five years however, health care reform has
started to cause budget problems in these centers. It is not surprising
therefore to hear calls about a crisis of leadership emanating from these
centers. For example, the Annual Meeting of the American Association
of Academic Health Centers studied the changing leadership roles (Howe,
Osterweis & Rubin, 1994). One keynote speaker, Dr. Carolyn
Aschenbrener, presented the challenge for university leadership in the
impending health care reform. She stated that academic health centers
are facing leadership problems and that leaders must be able to
"organize, motivate and inspire their constituents." She observed that
"this is particularly true now when our environment is in such upheaval"
(p. 29). Dr. Walter J. McNerney concurred, observing that the time has
come to train key leaders in management, because the traditional
leadership skills are no longer sufficient to manage the complex
institution. He stated, "In today's environment it is no longer enough to
be from the right school and to have published. There is a know how to
management as there is to clinical practice" (p. 95). He noted that very
few health centers have leaders with the right training. The meeting
concluded with a call for academic leaders on health sciences centers to
possess the new skills that will be required in times of resource
constraints. Skills such as conflict management and negotiation,
planning, oral and written communications and exposure to finance and
economics will be critical for success.
Writers from schools of pharmacy are also warning of a similar
crisis in leadership in the United States' 75 pharmacy schools. These
calls mirror the three problems underlying the leadership crisis in higher
education: turnover, selection procedures and changing roles of the
deans in schools of pharmacy. For example, Chi (1994) indicated that
there is a widespread perception that a leadership crisis exists in
pharmacy schools, and more than a dozen positions for deans in schools
of pharmacy were open. Trinca (1993) observed that as one position
was filled, two more opened. Cohen (1993) wrote that there is a dearth
of qualified individuals able and willing to assume major positions of
leadership in schools of pharmacy, and that the turnover of people in
these positions is very high.
Rutledge (1994) focused the discussion of the leadership crisis on
the unrealistic expectations of search committees. He stated that
"Search committees are looking for a knight arriving on a white horse to
solve all their problems" (p. 119). Kinnard and Harcleroad (1993) pointed
out that the expectations of pharmacy deans have changed so
dramatically that a new set of traits is required. They described a "new
breed" of academic administrator who clearly understands the mission of
the university and who can coordinate the resources of the community to
achieve common goals.
Contents of the Thesis
The chapters in this thesis are designed to provide answers to the
research questions. Since a key issue in this research is the concept of
leadership, Chapter 2 will delve into the literature on leadership.
Included in this chapter is information on leadership theories and
[leadership in higher education. Two models of academic leadership will
be explored. Next, specific leadership requirements on the HSC and in
schools of pharmacy are presented. Proposals for future requirements in
academic management are listed. Finally, it will explore the concept of
leadership crisis and how it is manifested in higher education (e.g.
turnover and shortened tenure).
Chapter 3 will focus on examining the environment of the health
sciences center and will provide contrast to the traditional, or parent
university. Since the case study is in a school of pharmacy, the
demographic and program characteristics of schools of pharmacy will be
Chapter 4 will give a detailed description of the research
methodology utilized in this study. This chapter is divided into two
sections. In section one, the concept of phenomomenological research
will be presented. In the second section, I will give a detailed descriptio
of the investigative processes for each phase of the study.
In Chapter 5 the results and analysis of data will be presented.
Using a combination of tables and thick descriptions, I will present key
information garnered from the qualitative and quantitative phases.
In Chapter 6, I will answer the study questions and discuss the
results of the study. Finally, I will draw conclusions and offer
recommendations for additional study.
REVIEW OF THE LITERATURE
This chapter will first discuss the concept of leadership and trace,
some of the theories that describe requirements for leaders. Then I will
look at leadership in higher education and review the key environmental
and trait theories related to academic leadership. Continuing to refine
this discussion, I will delve into the issue by examining leadership on the
HSC and finally leadership in pharmacy schools. This chapter will
conclude by examining the literature on leadership crisis and determine if
turnover of administrators is indicative of a leadership crisis.
What Is Leadership?
The modern word, leader, derives from the thousand-year old
Anglo-Saxon root word, laedare. Ladeare meant to lead people on a
journey. Leadership has been recognized as vital in every culture for the
last 1,000 years and millions of pages have been written on it. Over
350 definitions of the word exist, and everyone recognizes the need for
leadership in times of uncertainty. Leaders help followers through
difficult times by reducing fear and building confidence. Leaders help us
see possibilities and discover new resources. With the hundreds of views
on this subject, how does one make sense of all the rhetoric?
Levey (1991) noted,
Unfortunately, for those who are interested in the scholarship on
leadership, it is a jungle of abstruse academic theories and
simplistic popular prescriptions. Nor is much of the empirical work
very useful to the practicing executive (p. 8).
Cohen (1993, pp. 352-354) divided conceptual theories of
leadership into six models which serve to classify hundreds of different
descriptive observations of leadership styles and characteristics. His six
models include: trait theories, power and influence theories, behavioral
theories, contingency theories, cultural and symbolic theories and
cognitive theories. I have summarized Cohen's classifications in
Cohen's Models of Leadership Theories
Models of leadership theories Elements
Trait theories These theories attempt to develop a body of knowledge concerning the required traits of a successful leader. These theories ascribe to the concept that if a person can acquire the requisite knowledge and skills, he or she will become an effective leader.
Power and influence These theories place the acquisition of power and use of influence as key components of leadership. Bennis and Nanus (1985) found that it is not individual power, but rather the empowerment of others that was the key element of leadership. Transformational leadership is in this category.
Behavioral theories These theories are advanced by social scientists to describe leadership according to personal styles. Bass (1981) for example, contrasted the autocratic or collegial, authoritarian or democratic, directive or participatory leader. Other researchers worked to develop a comparison of task-oriented behavior and relationship-oriented behaviors.
Contingency theories The contingency or situational theories addresses the issue of leadership with a focus on the environment. Situational leadership dictates that leaders adapt their style and behavior to the environment.
Cultural and symbolic These theories state that the leader is responsible to articulate and carry on the norms of the institution while valuing its traditional values.
Cognitive These theories blend ideas from the power and symbolic models of leadership.
Most people agree that the characteristics of a good leader do not
fit into a single model but are defined retrospectively by analyzing great
leaders and their environments. For example, James MacGregor Burns
(1978) wrote one of the most quoted works on leadership. Burns, a
historian and political scientist, studied great leaders like Ghandi, Wilson,
and Lenin. Burns believed that because we fail to grasp the essence of
leadership that is relevant to our times, we cannot agree on the
standards by which to measure it. He concluded, "Leadership is one of
the most observed, yet least understood phenomena on earth" (p. 2).
In his Pulitzer Prize winning work, Burns developed the concepts of
transactional and transformational leadership. Transactional leadership is
based on an exchange of services between the leader and follower for
various kinds of rewards, and recognition that the leader controls. It
focuses on basic, extrinsic motives and needs.
In contrast to this, Burns believed that transformational leadership
is more potent. The transforming leader "recognizes and exploits an
existing need or demand of a potential follower;".... "seeks to satisfy
higher needs" and "engages the full person of the follower." The
relationship results in a "mutual stimulation...that converts followers into
leaders" (p. 4). Transformational leadership focuses on gaining
cooperation and participation from followers and on higher-order, intrinsic
psychological needs for esteem and self actualization.
Birnbaum (1992) observed that transformational leadership was an
anomaly in higher education. He stated:
"Because the goals and enduring purposes of an academic
institution are likely to be shaped by its history, its culture and the
socialization and training of its participants, rather than by an
omnipotent leader, attempts at transformational leadership are
more likely to lead to disruption and conflict than to desirable
outcomes (p. 29).
Cribben (1981) eloquently discussed myths regarding leadership.
His myths included that leaders must have personality; they must be
democratic; they have "genes" (e.g. people are born leaders); they have
to be cute and clever; they must have charisma; they have to have the
right situation to be a leader, and finally they have to be aggressive to be
a leader. Cribben also described the situational factors of leadership.
Many people believe that leadership is situational, but he observed that
while a situation can make or break a leader, this is only half of the
equation. He used the metaphor of a pair of scissors to describe
leadership. One blade represents what the leader brings to the situation
in terms of personal talents: philosophy, education, experience,
competence, attitudes, etc. The other blade is the situation that provides
the leader with both constraints and opportunities. The skill, he noted is
not in the situation, but in the leader's ability to make his personal
behavior congruent with the realities.
Bass (1987) operationalized Burns' theory by developing a
multifactor leadership questionnaire. Where Burns saw transformational
and transactional leadership as ends of a continuum, Bass saw them as
complementary. He believed that, at given times, the leader must know
which leadership factor should be used in a given situation.
In their very popular book on leaders, Bennis and Nanus (1985)
stated that there is a chronic "crisis of governance, a persuasive
incapacity of organizations to cope with the expectations of their
constituents" (p. 2). They identify a new leader as one who commits
people to action, converts followers into leaders and an individual who
converts those leaders into change agents. This is called "transformative
leadership"(p. 3). By interviewing 90 leaders, they condensed their
findings into four strategies that were common to all participants: they
create focus, they communicate a vision, they build an environment of
trust, and they creatively deploy themselves and exhibit a positive self-
regard. Bennis and Nanus observed, "Leadership seems to be the
marshaling of skills possessed by a majority but used by a minority"
Bolman and Deal (1991) noted that much is written about leaders'
traits, styles and deeds, but too few people pay attention to how leaders
think. They believed that the education of leaders should focus on
problem-solving and decision-making skills. In this regard, they advanced
their concept of four frames: organizational, human resource, symbolic
and political. They hypothesized that leaders should be able to diagnose
the environmental situation and operate from the appropriate frame.
The majority of the leadership literature is grounded in a
retrospective, historical frame and studies individuals who were
considered to be great leaders. These narratives attempt to discern how
these individuals' characteristics separated them from other, non-leader
types. Tichy and Devanna (1990) promote the development of
transformational leaders and contrast their characteristics with those of
transactional leaders. They studied the characteristics of individuals who
they believed were in the process of becoming recognized as
transformational leaders. They developed a list of seven common traits
which they hypothesized to be key skills/attitudes of transformational
leaders (pp. 271-280). Table 2.2 reviews the key attributes of
Key Attributes of Transformational Leaders
Change agents Transformational leaders articulate the fact that they are change agents.
Courageous Transformational leaders are prudent risk takers but are also willing to take a stand.
Belief in people Transformational leaders combine sensitivity to individuals and a belief in empowering all people in the organization.
Value-driven Transformational leaders can articulate a set of core values and they exhibit behaviors that support their values.
Life long learners Transformational leaders learn from their mistakes and have a life long commitment to self development.
Able to deal with complexity, ambiguity and uncertainty. Transformational leaders can cope with and frame problems in a complex environment.
Visionary Transformational leaders can dream and translate those images so other people can share them, and together they can work towards a common goal.
Levey (1991) stated that the wealth of information on leadership
"often revealed fragmentary and unconnecting findings and conclusions"
(p. 12). Additionally, he believed that language and methodology barriers
make it difficult to compare and evaluate studies across different
Leadership in Higher Education
One of the landmark works on higher education leadership was
written by Cohen, March and Olsen in 1972. They stated:
The American college or university is a prototypic organized
anarchy. It does not know what it is doing. Its goals are either
vague or in dispute. Its technology is familiar but not understood.
Its major participants wander in and out of the organization. These
factors do not make a university a bad organization or a
disorganized one; but they do make it a problem to describe,
understand, and lead (p. 2).
Perhaps the perception of a leadership crisis in higher education is
due to the "organized anarchy" in higher education and not due to the
lack of leadership. Hughes (1987) observed that traditionally academic
administrators had been selected for their scholarly qualifications rather
than for their administrative experience. He proposed that they were able
to manage because of the self-paced environment. However, with the
dramatic changes that occurred starting in the 1970s, academic
administrators lacked, or were perceived to lack administrative skills
(Hughes, 1987). Green (1988) also discussed leadership problems in
rapidly changing organizations. She observed, "The harder the times,
the more intense is the wish for leaders who can transcend the
limitations placed on them by circumstances....and the wish for heroic or
pathfinding leadership flourishes when organizations flounder" (p. 33).
Claims of a leadership crisis and calls for new leadership skills in
higher education administrators span 20+ years (Cheit, 1971; Bartell,
1975; Trachtenberg, 1981; Scott, 1983; Birnbaum, 1983; Keller, 1983;
Kerr, 1984; McDade 1987; Murphy, 1988; Green 1988; Bensimon,
Neumann & Birnbaum, 1989; Simms & Simms, 1991; Wilcox and Ebbs,
1992; Keller, 1993; Lovett, 1994). In 1994, Lovett stated that faculty
members complain that academic administrators come in two genres:
bureaucrats, who are harmless, but ineffective; and political operatives,
who are too interested in career development to grapple with difficult
issues. She stated that in the past deans were valued and selected
because of their scholarly work. Today however, the candidate who is
skillful in finances and/or possesses strong political abilities is the one
selected for these positions. Lovett concluded that we place too much
emphasis on the concept of "magical thinking", putting unrealistic
expectations on the administrator (p. A44). Consequently, we believe
that this person can solve all problems for us.
Kinnard and Harcleroad (1993) observed: "Most universities are
collections of scholarly mobs tended to by deans that are selected from
the local mob, or one from across town" (p. 282). They noted that
academic leaders only receive episodic leadership experiences rather than
educational programs to become good administrators. They call for a
new breed of academic manager who clearly understands the mission of
the university and who can coordinate the resources of the community to
achieve common goals.
Some authors suggest that the role of the administrator is difficult
due to the complexity of the academic institution. Bolman and Deal
(1991) concluded that modern organizations are so complex they cannot
be understood from a single-frame perspective, and that a manager who
can use multiple frames will be more effective. They suggest that
"managers who understand and use only one or two of the frames are
like a highly specialized species: they may be well adapted to a very
narrow environment but extremely vulnerable to changes in climate or
competition" (p. 216). Managers and leaders should understand the
concept of reframing and use all four frames to resolve organizational
dilemmas. Bolman and Deal believed that each frame is important under
different organizational conditions and that managers must be able to
match frames to situations. For example, they proposed that when
resources are scarce and getting scarcer, the political frame is believed to
be the most salient (p. 326). Given the rhetoric about declining
resources in universities, it is understandable that administrators are
expected to become politically oriented.
Bensimon (1989) measured the capabilities of university presidents
by using the four frames developed by Bolman and Deal. She found that
the university president who can think and act using more than one
frame may be able to fulfill the many expectations of the office more
skillfully than one who cannot differentiate among situational
requirements. In her study of 32 presidents, she found only one who
espoused use of all four frames. She concluded that as an academic
leader, the ability to reframe appears to be critical for success, if not
In 1993, Keller reviewed the difficulties of academic
administration. He observed, "Leadership in universities demands an
exceedingly high level of sensitivity, rhetorical skill, consultation and
courage as well as a thick skin and perseverance. But it is indispensable"
Theories of Academic Leadership
Of the 5 classifications of leadership theories proposed by Cohen
(1993), I feel that the trait and contingency (environment) theories are
key in a study of academic leadership. These two theories will be
reviewed in this section. As was noted earlier, Cribben suggests that
personal talents and environment are two most important factors in
Many articles discuss the requisite skills and abilities of the
successful academic administrator. For example, some researchers
focused on the identification of a set of traits (knowledge, attitudes, skills
and abilities) that are essential to lead in higher education. (Birnbaum,
1983; Murphy, 1988; Bensimon, 1989; Dill, 1980; Gardner, 1990;
Cohen, 1993, Detmer & Finney, 1993; Lovett, 1994).
Skipper (1978) used factor analysis to describe the two most
important dimensions of the effective leader at the college or university
level as administrative skills and specific personality characteristics:
Administrative skills were defined as: knowledge of position, planning ability, human
relations, leadership, organization and management, judgement and quality of
Personal characteristics included: leadership, responsibility, willingness to act,
thoughtfulness and ethical conduct, flexibility, integrity, self control, intellectual
efficiency, personal relations, motivation to achieve and creativity.
The most effective academic administrators were identified as
people who had relationships that were characterized by mutual respect
and warmth, who developed well-defined organizational patterns, who
kept channels of communication open, who articulated goals and who
kept morale high.
Enarson (1978) recommended that effective academic
management be evaluated in four areas: tasks, problems, skills and
attributes. Tasks include planning, organizing, staffing, directing,
reporting and budgeting. Problems involve issues such as inadequate
financial support, curricular revisions, and faculty "retooling". Skills
include negotiation, time management, and communication; and
attributes include wisdom and shrewdness.
John Gardner (1990) focused on the qualities of successful
academic leaders. These qualities include skills such as long-term
thinking; networking with constituencies beyond their own jurisdiction;
placing emphasis on intangibles such as vision, values, ethics and
motivation; developing or inherently possessing political skills to work
with conflicting requirements of multiple constituencies; developing an
institution-wide rather than department focus, and thinking in terms of
Birnbaum (1992) studied academic administrators and suggested
that they must recognize the interactions between the bureaucratic,
collegial, political and symbolic frames in colleges and universities if they
are to be effective. He conducted a five year study of college leaders
and developed a list of ten research-based principles of good academic
leadership (p. 172). For example, his leadership principles included
making a good impression, knowing how to listen, emphasizing core
values, encouraging others to be leaders, evaluating your own
performance and knowing when to leave.
Murphy (1988) listed six expectations of leaders in education: a
sense of clear personal vision; a good knowledge base; strength;
initiative; courage and tenacity; forceful communication and the ability to
amass power and use it for organizational improvement. Finally, they
must be "take charge" individuals who solve "knotty problems along the
way" (p. 654).
Some authors focus on the importance of management and
administrative skills for academic administrators. For example, Draugalis
(1992) observed that given the complexity of these positions,
administrative skills may be more important requisites for dean
candidates than the traditional research and teaching expertise.
Cohen (1993) supported the concepts of transformational and
transactional leadership in education. Transactional leadership depends
on high levels of communication between leaders and followers to
achieve agreed upon shared goals. In higher education, this requires a
concerted effort on the part of the academic leader to cultivate faculty
and to demonstrate his/her commitment to the basic values and
philosophy of the organization. In contrast to this, the transformational
leader in higher education must create a new vision and carry out a
transformation of the institution. Cohen believed that the two most
critical qualities of leaders in higher education are the ability to
communicate effectively and the ability to manage and plan strategically
in the rapidly changing environment. He developed five major leadership
roles: articulate a clear vision for the college and its programs, set the
college's agenda for the future, gather and analyze information that will
affect the school's programs, generate a commitment to a high quality
program, communicate extensively with people, and develop an excellent
Birnbaum (1992) concluded, however, that traits alone do not
necessarily predict leadership ability. He stated, "The effectiveness of
different styles appears to depend on subordinates' expectations,
environmental contingencies, and values and perceptions related to
organizational culture (p. 37).
Many writers suggest that the environment causes the
administrator to develop a set of knowledge, skills and abilities.
Dill (1980) stated, "Deanships are ephemeral creatures of place, time,
discipline, personalities and circumstances" (p. 262).
Kinnard (1992) stated that a New American University must be
designed around strong and integrated strategic planning, entrepreneurial
leaders and leaner administration. He believed that entrepreneurial
leaders will be required to deal with budget crises that will continue to
plague universities this decade.
Cohen (1993) hypothesized that the two most critical qualities of
leaders in higher education are the ability to communicate effectively and
the ability to manage and plan strategically in a rapidly changing
environment. He developed five major leadership roles: articulate a clear
vision for the college and its programs, set the college's agenda for the
future, gather and analyze information that will affect the school's
programs, generate a commitment to a high quality program,
communicate extensively with people, and develop an excellent
management team. Cohen concluded that in attempting to determine
which traits are required to be a successful leader, examination of the
unique characteristics of the environment is essential.
Leadership Requirements on the Health Sciences Center
Detmer and Finney (1993) noted, "There is a dearth of research on
the leadership" of health [science] centers (p. 10). To date, the majority
of studies investigating academic leadership have been done on the
traditional university campus. Most observers believe that leadership on
the HSC has unique challenges. On a health sciences center campus,
academic administrators face the problems of the traditional parent
university, but they are confronted additionally with the challenges of
health care reform and its potential impact on the education of health
care professionals. Administrators in these centers must not only deal
with managing an academic institution, they must also manage the
"business" of health care.
The University Hospital Consortium (UHC) conducted research
looking at some of the challenges facing these centers in the 1990s.
This study concluded that the HSC leadership must be willing to assume
a change-oriented style and that leaders must emulate the characteristics
required in business leadership. These characteristics included: defining
and communicating a vision, building external relationships, recruiting
excellent people, being politically savvy (UHC, 1995, p. 3).
Cohen (1993) stated that the leadership problems on the academic
health sciences center are different today due to the declining resources
and the "frenetic pace of change that engulfs all of society in this era of
information and technology" (p. 354). Cohen hypothesized that because
of the environmental difficulties on the HSC, a different set of skills and
abilities are required to manage.
Wilson and McLaughlin (1984) developed a list of the
constituencies making demands on the medical school dean. These
constituencies include faculty, students, unrepresented minorities,
university officials, alumnae parents, boards of trustees, affiliated
hospitals, third party payers, Medicare and Medicaid, medical center
patients, doctors, foundations, state legislators, state higher education
agencies, the Equal Employment Opportunity Commission (EEOC) and
about ten more authorities. They concluded that the multiple and
conflicting agendas of these constituencies have created a tense
environment for the academic administrators of the HSC, possibly
contributing to the increase in turnover of academic administrators.
In discussing the uncertain future of HSCs, Aschenbrener (1993)
concluded that because many centers are confronting similar leadership
problems, the leaders in these organizations should learn from the
experiences of others (p. 29).
Leadership Requirements in Schools of Pharmacy
Of the five schools (Medicine, Nursing, Dentistry, Pharmacy, and
Allied Health) typically found on a HSC campus, the school of pharmacy
is generally one of the smallest. In this environment, as the leader of the
school, the dean is in the key position to acquire resources for the
school's programs. What is the leadership role of this individual, and
what qualities are key to success?
Trinca (1993) questioned if the rewards of the position were
sufficient to attract qualified individuals to the position of dean, noting
that many searches have dragged on for many years. He concluded that
"there is a need to both enrich and strengthen the leadership and
management pipeline for pharmacy schools" (p. 291). Cohen (1993)
observed there is a "paucity of qualified individuals able and willing to
assume major positions of leadership in higher education and the
characteristics of leadership do not fit into a single model but emerge
retrospectively from an analysis of the leader and the environment they
operate within" (p. 351).
Dr. Richard Penna (1994) observed that there is a deficit in
leadership at pharmacy schools, and that pharmacy is no different that
medicine or dentistry. He stated: "They too are suffering from a dean
shortage, and they're probably in worse shape" (p. 18). He noted that
there are several reasons why pharmacy school dean positions are not
being filled: expansion of new schools, retirement or death of long-term
deans, movement of deans from one school to another that is considered
more prestigious with better funding and resources. Additionally, he
observed that there is a hesitancy on the part of qualified people to apply
for the position. Penna (1994) noted that "the job is perceived to be not
as glorious as it once was" (p. 16). He concluded that pharmacy schools
have not found a dean because they "haven't found the right match"
(p. 16). This indicates perhaps a confusion on the part of faculties and
search committees in determining the qualifications required to be a dean.
Rutledge (1994) described the process that is used to select a
dean in a School of Pharmacy. He concluded that extended vacancies
occur because schools do not adequately prepare and conduct a search
for a dean. Cohen (1993) stated that there is a strong belief that unless
a school recruits an established dean, then the typical search process
may have difficulty identifying potentially successful leaders. This may
indicate a lack of confidence on the part of search committees to select a
candidate who has not previously served as a dean.
But what are the requisite knowledge, skills and abilities of the
pharmacy dean? A study conducted by Vanderveen (1988) examined the
self perceived leadership styles of pharmacy school deans using a
managerial grid concept. Twenty-six percent of all deans participating
(N = 127) preferred a style of management that reflected a low regard for
both people and tasks. The author concluded that leadership in colleges
of pharmacy may be lacking. He concluded, "Better defined and
structured career pathways providing enhanced management training and
experience for future deans along with heightened sensitivity to the
importance of assessing management skills by search committees might
result in improved leadership skills of the pharmacy deans" (p. 148).
Kinnard and Harcleroad (1993) stated that to manage in
tomorrow's universities a "new breed of academic manager who clearly
understands the mission of the university and who can bring together the
academic community and the limited resources to achieve their common
goals" (p. 290). They concluded that development of management skills
must become a routine activity within pharmacy schools.
In his discussion of academic leadership in schools of pharmacy,
Wolf (1993) discussed the works of Cohen and March. He concluded
that the leadership and ambiguity these authors observed in American
universities in the 1970s and the 1980s is certainly present in schools of
pharmacy in the 1990s.
Academic Administration of the Future
There is a substantial difference of opinion in the higher education
literature as to the leadership requirements of academic administrators in
the future. Some writers proposed that academic administrators should
become more business-like. Kauffman (1983) compared the manner in
which educational institutions select leaders with the business world. He
noted that in academia, leaders were selected through a process of
natural selection. In contrast to this, business organizations found it
beneficial to identify and groom future leaders.
Green (1981) provided an overview of the environments of
business and higher education. She observed, "The substantive gaps
between higher education and business are profound and obvious; the
value systems and organizational structures underlying each institution
are more dissimilar than alike" (p. 13). Because of this, Green argued
that there is a reluctance by faculties to accept administratively-oriented
individuals as deans and presidents. The typical individual is chosen from
the faculty and his first commitment is to teaching and research.
Green compared the preparation of academic administrators with
business leaders. She noted that movement into academic administration
was rarely accompanied by formal preparation and most new academic
administrators learned their roles by performing them. In academia, the
culture holds that the experience of being a faculty member is the only
grooming an administrator needs. In contrast, business leaders are
extensively prepared prior to assuming their roles. Additionally, Green
observed that the nature of the university affected the interpretation of
leadership. She stated, "Academics do not consider administration to be
a very lofty art....when administration is viewed in this way, training for
it cannot be valued" (p. 13). She concluded this view had to change.
Indeed, leadership training began changing in the 1960s when the
golden age saw the tremendous expansion of educational institutions and
programs. At that time, training focused on curriculum, leadership styles,
and the management of growth and ample resources. The severe budget
crisis of the 1970s redirected this training to financial management of
limited budgets, marketing, strategic planning etc. Green predicted that
the pressures of the 1980s and 1990s would silence the debate about
management and leadership in higher education. She proposed:
Leadership efforts will be needed to promote the development of
new hybrid academic administrators who are part educational
leader and part manager and who can successfully preserve a
constructive tension between the academic and managerial
components of their roles.
"These leaders will require preparation to cope with the
management of large, but insufficient budgets and declining
enrollments and to respond to the pressures of federal and state
regulations, taxpayers, and student consumers, (p. 15)
Green summarized that the task of academic leadership will be
difficult, and leadership development will become increasingly urgent.
Simms and Simms (1991) observed that colleges and universities
are losing public support and trust because the university has become so
businesslike. In addition, the university president has been transformed
from an academic to a public relations person. They cite several
references that compare the university president to a shrewd
businessman who is primarily concerned with maintaining a proper level
of funding. They believed however, that when this transformation occurs
the university loses its "noble and transforming purpose" (p. 5).
In his review of the status and future direction of educational
administration, Willower (1987) stated that in the future, comparative
studies in the policy studies should be helpful due to the "possibilities for
inquiry on differential power and governance" (p. 26). In the next 25
years, he observed, educational administration needs a resurgence of
energies devoted to serious study of politics. Reductions in schools of
education and tight economies have created pressures for scholars to
focus on the short term survival. In support of this, Bensimon, Neumann
and Birnbaum (1989) observed that during a financial crisis, a leadership
style that combines political acumen and rational management is
beneficial. The majority of academic administrators however, are not
trained to be financial managers, politicians and public relations experts.
Perhaps that is one reason many academic administrators are unhappy
with the role of dean.
Wilcox and Ebbs (1992) noted that leadership in higher education
was under intense pressure to change so as to respond to societal issues
resulting from economic and social forces. These authors make us
wonder if we need a new type of academic administrator managing
higher education and resolving the crises.
What is a Leadership Crisis?
As noted in Chapter 1, the 1970s budget problems caused
environmental and leadership symptoms. While the environmental
symptoms are not as prominent today, descriptions of the leadership
crisis continue to be at the forefront of discussions.
Keller (1993) attributed the continuing crisis to several factors
such as budget threats and the persistence of naivete and bias about
organizational planning. He stated,
Americans live in a capitalist industrial society and for the
most part work in medium-sized and large organizations run
with the help of bureaucracies. Yet many professors, like
Chinese mandarins, have a bias against business and
commercial activities. They abhor organizational needs, and
they detest bureaucracies. Like blacksmiths, cowboys and
bookstore proprietors, university scholars tend to be in
modern society but not really part of it. This makes
planning, organizational behavior, good financial practices
and modern management difficult in higher education, (p.34)
In a thoughtful reflection on the crisis, Bartell (1975) suggested
that while the financial difficulties may have been a temporary threat to
the survival of colleges and universities, new institutional constraints
make the colleges less attractive to the kinds of people that are
necessary for the survival of quality institutions. He proposed that rapid
turnover of university administrators, decreased length of terms and a
change in the quality of academic life for the president were all indicators
of the leadership crisis. But can this be empirically studied?
In 1981, Trachtenberg (1981) wrote a very opinionated article on
the difficulties in the role of university president. He felt that a crisis
exists in academic leadership and that the burnout of administrators is
very high. He attributed the crisis to the recruiting process for these
administrators and the demands that are placed on the president. The
recruiting process is flawed because in most searches, the candidate who
survives the tough scrutiny is the one who is the least provocative. He
observed that it may take several years before those involved in the
process "awaken to the fact that bland, noncommittal leadership is not
what the times require" (p. 5). He believed that in the tough university
environment, the processes to select the president were
counterproductive and these administrators required special skills.
Trachtenberg also noted that the demands on the president were
unrealistic. He pointed out that these administrators get very little
positive feedback and many conflicting signals in their daily work life.
College presidents, he observed, do not complain that the position is a
difficult one. What they do complain about is that faculty members do
not understand the difficulty of their position. He commented, "It hurts
to see so much empathy being taught in the classrooms and to find there
is so little of it for oneself" (p. 6). This sense of isolation contributes
to presidential burnout. He concluded that this burnout can be very
serious for academic institutions since finding the replacements can be
very time consuming. The search process sometimes takes years, during
which time "the president's dysfunction can worsen and the school
suffers as a result" (p. 8).
Turnover as a Symptom of Crisis
If the environmental problems are too complex and the role of the
academic administrator is much more difficult, then perhaps that explains
why deans are leaving their jobs earlier. Shorter tenures and a high
turnover may be symptoms of the leadership crisis.
Banaszak-Holl and Greer (1994) examined the turnover of deans on
the HSC. These researchers studied medical school deans and found that
the turnover of these leaders has greatly increased in the past five
decades. They suggested that if deans are chosen on the basis of
traditional academic status and other similar criteria, the turnover may be
occurring because the deans lack the management and interpersonal
skills needed to carry out their complex duties. They argued that deans
may not be prepared to "effectively interact with and share authority
with a variety of other senior administrators and faculty while remaining
individually responsible for the school's education, research and service
programs" (p. 1). Alternatively, they suggested that the turnover may
simply be a reflection of the rapid growth and change in the mission of
the academic health sciences center.
Banaszak'Holl and Greer recommended that additional studies
exploring the causes of dean's turnover should be conducted, specifically
addressing the personal and environmental causes of turnover. Results
of these data can assist in developing a set of expectations for deans in
the future and subsequently decrease turnover.
In pharmacy circles, several authors have commented that the
turnover of deans is very high, thereby indicating leadership problems.
Cohen (1993) observed that the turnover of people in academic
administration in pharmacy education is very high, and Rutledge (1994)
stated that for the past several years more than 12 of the 75 Schools of
Pharmacy have been searching for a dean. He observed that the
pharmacy academy is not making progress in having a full complement of
leadership in its schools. This turnover is occurring at a time when major
changes and challenges are occurring in the profession of pharmacy, He
concluded that "we need for each school to have dynamic stable
leadership in the dean's position" (p. 118).
A high turnover of leadership in key positions may be a symptom
of the crisis. Turnover affects the quality of academic programs and
stalls necessary curriculum and program changes. The institution
becomes potentially crippled while an interim dean takes charge.
In addition to the costs associated with recruitment and selection,
other organizational problems can be identified such as the inability of the
campus to move forward with short and long term planning, the loss of
administrative continuity and the straining of inter and intra college
relationships. The HSC reflects a major industry in most cities, with
significant financial impact on their communities.
Theories of Tenure
Banaszak-Holl and Greer (1994) found that the dean's length of
tenure was decreasing. The average tenure of medical school deans was
less than four years. In examining the shortened tenure of the deans,
they concluded that the increased frequency of shorter tenures may
indicate problems for the institution and the individuals.
Green and McDade (1991) described the three phases of the
dean's job cycle that occur rather predictably over the years of the job:
entry, growth and maturation.
The entry phase. Until the first crisis arises (at approximately three
months) the dean thinks that the job is great. During the first crisis, he
finds the job to be impossible and begins seriously to rethink his decision.
In the second year, he finally realizes that through hard work he can
make it. These authors found that a new dean takes approximately two
years to feel in control of the job and proactive rather than reactive.
These researchers found that there is no training ground for most
administrative positions in higher education. Most deans do not have the
opportunity to learn their position through experiences in the intermediary
positions, as assistant and associate deans.
In addition, new deans are more reluctant to give up their faculty
duties. Green and McDade stated, "New deans live with one leg still
firmly planted in the faculty and the other just stepping into
administration" (p. 105). This occurs because some deans are in the
process of completing the research they started before entering the
deanship. However, many find that they cannot do both activities well,
e.g. administration of the school and research. They reported that many
new deans expressed feelings of defection from their disciplines. The
risk is that before they can find acceptable models of administrative and
leadership success, they must shed old models of faculty success.
The growth phase. In this phase, lasting between years 2-4,
deans master the details of their jobs and may feel comfortable in their
new role. During this phase, Green and McDade observed that deans
must redefine themselves. At this point, they must decide to go on in
administration or return to the faculty. This is problematic. If
returning to the faculty, the deans must continue to define their role in
their old discipline; however, as was observed previously, attempting to
balance both the administrative and research areas well is almost
The maturation phase. In the next four to eight years, deans
have essentially mastered the task. They are comfortable with their role
and understand how to manage the institution. At this point, they
frequently become involved with national associations, develop an
expertise in administration, and begin to publish and present papers.
Green and McDade observed that at this stage, deans may also serve as
mentors to other new deans. At this time, the deans realize that they
may not be able to return to their previous discipline without significant
"retooling" (p. 106). In areas which are highly scientific and rapidly
changing, deans have great difficulty returning to their faculty role.
Consequently, deans must decide if they will go on to a higher level in
academic administration, remain at the dean level, or return to faculty.
This chapter reviewed the literature on leadership. Although there
appear to be many theories of leadership, there are two models that help
to assess leadership requirements in higher education. Both the trait and
contingency/environment models are relevant to this issue and they were
presented in this chapter.
In reviewing the traits required of academic administrators, authors
suggested two areas administrative and personal. Administrative
skills such as knowledge of position, communications, planning ability,
human relations, organization and management, judgement and quality of
performance. Personal qualities included traits such as responsibility,
willingness to act, thoughtfulness and ethical conduct, flexibility,
integrity, self control, intellectual efficiency, personal relations,
motivation to achieve, and creativity.
Birnbaum (1992) stated that traits alone do not necessarily predict
leadership ability. He felt that leadership effectiveness depends on the
environment, the organizational culture and subordinates' expectations.
The contingency, or environmental theories state that leaders must adapt
their style and behavior to the environment. Cohen (1993) stated that in
attempting to determine how to become a successful leader, examination
of the unique characteristics of the environment is essential.
Additionally, many authors felt that leadership requirements must
change in times of environmental stress. The works of Bensimon (1989)
and Bolman and Deal (1991) illustrate how the environment dictates
leadership requirements. To respond to changes in the academic
institution, some authors recommended that academic administrators
must become more business-oriented (Wilcox & Ebbs, 1992).
I feel that the works of Cribben (1981) were especially beneficial in
understanding leadership requirements in times of environmental change,
resulting from problems such as budget shortages. He uses the
metaphor of a pair of scissors to describe leadership. One blade
represents the leader's traits and the other blade represents the situation
that provides the leader with both constraints and opportunities. Cribben
concludes that the skillful leader is able to make his personal behavior
congruent with the realities.
This chapter demonstrates that in response to the leadership crisis
in higher education, many writers feel that additional education would
assist academic administrators in meeting the challenges of the changing
academic environment (Green 1981; Kauffman, 1983; Draugalis, 1992;
Wilcox and Ebbs, 1992).
This chapter will cover two areas. First I will give an overview of
the programs on a HSC campus. Then I will contrast the unique
environment of the HSC with that of the parent university. Finally, I will
review the demographic and program characteristics of pharmacy
schools. I feel a discussion of the environment is essential so the reader
will be knowledgeable about the environments of both schools of
pharmacy and HSCs, so that so comparisons to other academic settings
may be considered.
The Health Sciences Center
A health sciences center typically consists of a teaching hospital,
the schools of medicine and nursing, and one or more other schools
teaching ancillary health-professional disciplines such as pharmacy,
dentistry and physical therapy. Most HSCs contain three or four health
schools but the number varies from one to seven. A unique feature of
the HSC is that instruction in the health sciences cannot be accomplished
except in a service setting. Health care delivery is a co-equal function of
the HSC, along with education and research. Consequently, no other
academic department or professional school in the university shares this
degree of service orientation.
HSCs are typically subdivisions of a parent university, but a few
are autonomous health universities. The HSC may be located on the
same campus as the parent university, but it is usually located near an
urban center with accessibility to special patient populations such as the
indigent. Governance in HSCs varies greatly. Some models have a
university-owned teaching hospital while others have affiliation
agreements with hospitals used for teaching. These affiliations are key in
the educational mission of the schools such as pharmacy, since a
majority of the experiential portion of the curriculum is taught in the HSC.
Over 100 health sciences centers exist in the U.S. today, and most are
integral components of major research universities, the parent university.
All writers agree that HSCs are complex. Complexity arises from
internal and external factors. Vogel (1980, p. 11) listed the internal
factors to include multiple missions, issues of professionalism, growth,
and faculty and house staff issues. External factors include changing
patient and public expectations about health care, new patterns of health
education and training, changing student bodies, different financial
arrangements, increased governmental activities and the changing
expectation of health professions.
On a health sciences center campus, academic administrators face
the same problems found on the parent university, but they are also
confronted with the challenges of health-care reform and its potential
impact on the education of health-care professionals. Daily newspapers
report the myriad of plans for changing the provision of health care in
America. These changes are predicted to cause a shift in the supply and
demand for both the quality and quantity of health-care professionals
Dr. Harold Shapiro, the keynote speaker at the 1993 Annual
Meeting of the Association of Academic Health Centers listed several
issues facing health sciences centers: public concern and dismay about
the rapidly rising costs that are necessary to sustain the current
programs, public concern about the outputs of these institutions, and a
sense that the character and mix of these activities need to be
restructured. Additionally, he noted public concern about the quality,
accessibility and future role of these institutions.
The HSC Crisis
As discussed previously, the leadership crisis in higher education
appears to be spreading to the HSC and to schools of pharmacy. This
section is designed to provide a better understanding of the differences
between the parent university and the health sciences center.
When universities started experiencing the budget crisis in the
1970s the HSC was exempt from these problems due to the fact that
most of their budget was generated from patient revenues and research
endeavors. These days have changed. Detmer and Finney (1993)
believed that the HSC will be especially vulnerable to critical review this
decade, given their large operating budgets, high faculty salaries and the
lengthy period between scientific breakthroughs in the lab and
marketplace availability of research applications. The recent growth in
academic health sciences centers is perceived by some to be a threat to
the academic integrity of the entire university (Burrow, 1993).
Since so many key elements of the HSC diverge from the parent
university, it is important to understand the differences between the
institutions. In their work The Sick Citadel. Lewis and Sheps (1983)
argued that because the HSC has a special relationship to the health care
needs of the region, it is clearly differentiated from the rest of the
university. The HSC is unique since it must function in two different
worlds: both academic and nonacademic environments. Thus, they
concluded that the HSC is faced with "unique responsibilities and tasks
that universities and their faculties do not readily welcome, accept or
cherish" (p. xvii).
HSCs vs the Parent University
Crispell and Vogel (1980) stated that the relationship between the
health center and its parent university has been debated for over 100
years. Detmer and Finney (1993) noted that the relationship of the
health sciences center and the parent is complex and sometimes uneasy.
They used the metaphor of the patent:child relationship noting that often
these relationships are complicated by tensions and opportunities for
cooperation. They listed factors that have created this tension, such as
the large size of the HSC campus and its large operating budget relative
to the rest of the university. Ridky and Sheldon (1993) stated that the
HSC usually accounts for approximately 50% of the federal competitive
research dollars and the indirect costs that come to the state and the
parent campus. Other factors that complicate the relationship include the
fact that the service orientation of the HSC is not understood nor fully
appreciated by non-HSC faculty members who are often jealous and
resentful of the HSC faculty whose higher salaries are supplemented by
academic practice plans. Teaching loads and research standards for
university faculty, when contrasted with their HSC counterparts are also
sources of inequality.
Crispell and Vogel (1980) listed additional factors that prevent the
HSC from developing a closer relationship with the parent university.
These include the arrogance of medical facilities combined with the
arrogance of faculties in the parent university who view their own fields
as the only truly academic ones. Frequently, they observed, the faculty
members in the parent university view medical and professional schools
as trade schools. Additionally, given the administrative complexity of
the HSC, many presidents and governing bodies have allowed the center
to develop its own policies and procedures, and rules and regulations.
Given a higher level of autonomy to govern itself, as long as it balances
its budget, the health sciences center creates controversy among the
other university schools who have to "play by the rules" (Crispell &
Vogel, 1980, p. 38).
The Mission. The triparae mission of the health sciences center is
unique and differs from the parent university since it includes a patient
care component. The mission of the HSC is dedicated to service (patient
care), education, and research. Often the three goals conflict with each
other and produce ambiguity and governance problems within the health
sciences center (AAHC 1980, p 6). Because the three missions of the
HSC are so closely intertwined, the HSC is especially vulnerable to the
current economic and structural changes taking place in our health care
system (The Commonwealth Fund Report, 1985, p.2). The financing of
these three functions has developed through a network of subsidies that
is based on payments for patient care in the affiliated university hospital.
Reimbursement for this care has traditionally included the cost of the
teaching and research missions. Financial implications will be discussed
in greater detail in a following section.
The culture and traditions. The disciplines of healing: medicine,
pharmacy and nursing have a long tradition of respect and esteem in
society. A societal covenant that confers this esteem on practitioners of
these disciplines is not restricted to the United States; it is a covenant
that is enjoyed in most countries of the world. Since the quality of care
is dependent on the knowledge level of the health professionals, this
privileged status has been extended to the educational institutions that
prepare the future health-care practitioners.
The nation's health-care educators have worked diligently to
maintain the unique traditions and knowledge base of professional
medical education. A well-defined set of heuristics exists for each
medical discipline and little "contamination" is permitted. Consequently,
the medical school is responsible for training physicians and for
overseeing intern and resident programs. The pharmacy school trains the
pharmacists, and the nursing school trains nurses. Each discipline is
separated into a mythologically unique body of knowledge and skills.
Kinnard (1992) observed that faculty members thrive in the midst of their
own discipline's jargon. This is the culture and traditions of health-care
Dramatic changes in health-sciences education are predicted to
occur as the nation's hospitals restructure the knowledge and skill
requirements of health-care workers. The professional schools in the
HSC have been arrogant in deciding the terminal competencies of their
graduates and rarely seek input from the employers of their graduates.
Consequently, many health care practitioners are not being trained to
meet the new challenges occurring with health care reform.
Financial issues. HSCs are funded by multiple, flexible funding
sources. The centers have been funded by research grants, tuition,
patient care revenues and state subsidies. Additionally, the faculty
funding in each professional school is often offset by contracts with
outside providers. For example, salary support frequently is given to
schools of pharmacy for special services given by clinical faculty
members while they provide service in hospitals.
The HSC budget in many universities represents 50% or more of
the total university expenditures (Crispell & Vogel, 1980). Faculty
members on the parent university often view this as an inequitable use of
funds in spite of the fact that much of the revenue is from outside
Traditionally the HSC has enjoyed an exemption from marketing its
services to prospective patients (Detmer & Finney, 1993). High level
technologies and medical expertise, cutting-edge specialties and a
regional stature attract critically ill patients to the center. Additionally,
most HSCs deliver a significant amount of free or indigent care to 40
million Americans. Reimbursement for indigent care is critical to the
financial health of the HSC. For many years, HSCs and teaching
hospitals have been in the favorable status of receiving extra funding
though two federal programs that subsidize the cost of graduate medical
education. Hospitals receive the indirect medical education cost, which
allows the hospital to bill Medicare at a higher rate for its medical
education training programs.
The second reimbursement is the graduate medical education
factor, which is a direct cost based on the number of full-time residents
in the teaching hospitals. These two funding sources have assisted the
HSC to remain competitive with other non-teaching hospitals. However,
both of these programs are being challenged in today's health care
In September 1993, the Chronicle of Higher Education reported
that the proposed health care reforms could lead to the collapse of
certain academic health centers (Jaschik, 1993). This collapse was
predicated on the decrease in the revenue streams of the health center
which would create crisis in the education programs, research, clinical
services, and scholarship commitments.
The relative financial independence of the HSC schools has
allowed them to expand faculty and facilities at a faster rate than the
parent campus. This growth has created animosity in faculty outside the
HSC since this expansion appears to be inequitable and not based on the
total university needs. Public funding for the HSCs was especially
generous during the 1 960-80s as the nation identified a need for a better
supply of well-trained health care practitioners. In the 1990s, this funding
has evaporated, changing the budgets for HSC faculty members who
have been accustomed to liberal funding sources. The HSC faculty feels
that the university does not adequately support its educational program
and that they are working longer hours to generate income which is used
by the university for other schools which do not conduct research.
In addition to seeing a shrinking research grants from the National
Institutes of Health (NIH) and other sources, the clinical faculty must
compete with other providers who are not responsible for research and
education. Fiscal survival threatens to replace the core values of the
HSC making teaching a "loss item" (Pellegrino, 1982, p. 24).
Faculty issues. Faculty salaries represent a large item in the HSC
budget. In the last few decades, there has been a dramatic increase in
the number of faculty members, the specialization of their training and
their reimbursement. Between 1959 and 1973 the number of full-time
faculty members in academic clinical departments rose from 2,200 to
24,000; a 1,100% increase (Vogel, 1980, p. 14). This tremendous
growth was due to the increase in research and continued development
of specialty areas.
Vogel (1980) noted that one source of complexity on the HSC is
the professionalism of many of its employees, since professionalism
implies a higher degree of autonomy in working relationships between
employees and with the organization itself. The salaries for the faculty
on the HSC are generally more favorable than for faculty members on the
parent university. Additionally, since salary is not based on rank in the
health sciences, this creates hostility towards the health science faculty
members. Salary inequities occur because of the support given by
research and practice plans as well as the competition with private
practice salaries to retain excellent faculty members.
Teaching loads are much smaller and more elective for HSC faculty
members because, for many, a significant proportion of their time is
dedicated to research. Many of the schools negotiate the number of
classes that will be taught by individual faculty members, using the
service, education and research missions as the framework. Additionally,
the HSC schools benefit greatly from a large cadre of volunteer, unpaid
faculty members. Volunteer faculty is frequently used by the HSC to
further relieve the teaching loads of faculty members. Volunteer faculty
members give lectures and serve as preceptors for the experiential
components of the programs.
Due to outside funding, the student.faculty ratio is very low in the
HSC schools in comparison to the parent university. In the medical
school for example, the ratio may be as low as 1:1 while in the school of
pharmacy the ratio may be as much as 1:25 or more.
DuVal (1982) noted the "faculties are tired; most are tenured", and
the outside world does not look attractive to them. Consequently, they
are occupying slots that could be taken by younger faculty" (p. 18). He
observed that "since they are products of the era of plenty (the 1960s
and 1970s) they have neither the understanding nor the will to confront
the nature of the problems" (p. 18). Many problems exist in the
awarding of tenure, especially in medical schools. As schools have
inculcated their mission of service, education and research into the
expectations for faculty members, they have modified tenure to account
for these differentiated roles and responsibilities. This approach is
scorned by the arts and science faculty who feel the policies in the health
schools are too liberal and not based on scholarship. A Rand Corporation
study (Williams, Carter, Hammons, Poenter, 1987) looked at tenure in
the HSC. This study concluded that the survival of the center depends
on integration of schools and the relinquishment of some autonomy on
the part of departments.
Student issues. Students on the HSC are different from the
parent university. Students enter the HSC schools possessing a
undergraduate degree, or having a significant fraction of one completed.
Because the students have completed several years in higher education,
they are generally more mature and come to these programs highly
motivated. Typically a large number of applicants compete for the few
open slots and admissions committees frequently look at candidates with
average GPAs close to 4.0.
Detmer and Finney (1993) observed that student demographics
will change greatly in this decade. The typical student has been a white
male. There are more women, minorities and older students (over the age
of 25) who will require more flexibility on the part of faculty members;
these students will require modifications in the curriculum to meet their
lifestyle needs. This will challenge the entire educational process of the
health science disciplines. Detmer and Finney continued, "The academic
enterprise at present owns too much of the students' lives in the early
years of their professional training and the specialty board control too
many prerogatives during the latter half of ... professional upbringing"
(p. 9). They concluded that the education and training of these
professionals will determine how effective our health care system of the
future will be. They believe that students will need more flexible training
experiences than has been provided by HSCs to date.
Curriculum. There are several differences between the curricula of
the HSC and the parent university. The HSC curriculum has been
extremely homogenous and rigidly maintains its focus on the preparation
of a very narrow spectrum of health care specialists, e.g. physicians,
nurses and pharmacists. This paradigm is most reminiscent of the trade
school approach to education, where the student learned a trade through
a hands-on approach to learning. Indeed, one common attribute of all of
the health professions is that they require a mandatory experiential
component. In contrast to this, the parent university produces a wide
range of generalist-graduates in literally hundreds of potential disciplines.
The HSC curricula are extremely focused with few options for
electives. This is required because of the examination and licensure
requirements for each of the health professions. In contrast to this, the
parent university offers many more curriculum choices and terminal
licensure requirements of graduates is not as prevalent.
Finally, because the traditional student was a full time white male,
the classes were offered on a very restricted schedule: Monday through
Friday between the hours of 8-4 PM. Classes are not offered in the
evenings or on weekends. It has been impossible for most students in
the professional health sciences to work full time while in school. Major
modifications to the traditional curriculums of the HSCs will be required
to meet the needs of the older, minority student population.
There has been little room for creativity in the curriculum for the
health disciplines and many of the curricula have not significantly
changed in decades. This is especially true of many of the basic science
courses, such as chemistry, anatomy and physiology. One of the
challenges of this decade will be for the faculty on the HSC to redesign
their curricula to emphasize prevention, primary care, wellness, public
health issues, health promotion and population-based approaches to
The School of Pharmacy
The American Association of Colleges of Pharmacy (AACP)
provided the statistic that as of December 1993 there were 75 U.S.
colleges and schools of pharmacy with accredited professional degree
programs. Twenty-one programs are in private institutions, and 54 are in
publicly-supported universities. There are three private, independent,
free-standing schools; the remaining 72 schools are university-affiliated.
The number of pharmacy programs have grown in the last ten
years from 72 schools in 1984-85 to an anticipated 77 in 1995.
Enrollment in that same period has also risen. In the 1993 fall semester,
pharmacy student enrollment ranged from 124 to 1,511 students per
school. Total full-time, first professional degree pharmacy student
enrollment was 32,938. O.f this number, 26,118 were in the B.S. in
Pharmacy program and 6,820 were enrolled in the Doctor of Pharmacy
(Pharm. D.) program. The applicant pool for pharmacy professional
degree programs is among the strongest of all health care professions.
The average school is receiving three to four applicants for each available
position. In the fall of 1993, there were 2,869 full-time, 380 part-time,
and 2,224 adjunct/volunteer pharmacy faculty members at these 75
Pharmacy is a professional school. Anderson (1986) defines a
professional school as:
an academic discipline that is closely connected with a recognized
profession and is created in response to rigid educational
requirements imposed upon a discipline by state laws and/or by a
powerful national organization composed of practitioners, (p. 100)
Pharmacy qualifies as a profession because it represents an
occupation that requires training in a specialized field of study.
Additionally, a minimum level of competency must be demonstrated; this
is typically measured by state boards.
Pharmacy has been called a profession in transition, shifting from a
"hard-science" to a patient-oriented, clinical profession (Wergin, 1993,
p. 278). Wergin noted that there are many forces changing the
profession and that it is experiencing both external and internal
pressures. External pressures include decreasing budgets, increasing
corporatization of professional practice, more government regulation and
societal issues such as the rise of consumerism. Internal pressures
include the changing demographics of students and faculty issues
including the changing roles and rewards systems.
Cohen (1992) framed the difficult situation in pharmacy schools by
discussing the funding crisis in higher education and listing the
major changes that need to be made in areas such as curriculum design,
development of problem solving formats for educational programs,
enhancement of graduate programs and the commitment to
multidisciplinary delivery of health care. He concluded that the changes
would have been challenging for these schools in the 1970s or 1980s
when budgets were healthy and federal support for education and
research were increasing. In the 1990s however, attempting to make
these changes will be a formidable task.
The Organizational Structure
Most pharmacy schools are divided into two distinct sections or
divisions. The basic science division is headed by a Ph. D. scientist who
frequently is not a pharmacist. This division includes faculty who teach
the basic science courses and who contribute the majority of the
research efforts to the school. Most of these faculty members are full
professors and tenured.
The other division is called Pharmacy Practice. This division is
headed by a Doctor of Pharmacy (Pharm. D). The faculty in this
department spend a majority of their time teaching, overseeing the
experiential rotations in hospitals and pharmacies and working in patient
care areas. These individuals are usually not tenured, do very little
research and typically are at the Assistant or Associate Professor levels.
Schools of pharmacy offer various graduate and undergraduate
programs leading to degrees in both pharmacy and non-pharmacy areas.
The B.S. in Pharmacy: The undergraduate degree awarded by
schools of pharmacy is the Bachelor of Science in Pharmacy (B.S.
Pharm). This degree is offered by 28 schools of pharmacy as the only
first professional degree. The B.S. program is a three year professional
program completed in a school of pharmacy. The preprofessional
program is two years and can be completed in community colleges or the
The professional program offers a fairly well defined, yet
compartmentalized curriculum. The first year is largely devoted to basic
science coursework. Students take courses in biochemistry,
pharmacology, and medicinal chemistry. These courses are taught by
Ph. D. basic science faculty members. In the second professional year,
the students take a combination of basic science courses, as well as
begin the practical, or professional component of the program. In the last
year, the student finishes the remaining professional courses and
completes approximately 18 weeks of externship rotations in areas such
as retail, hospital and clinical pharmacy sites. The professional and
experiential components of the pharmacy curriculum are taught by
Pharm. D. faculty members.
Graduate programs: Sixty-three schools offer graduate programs
in the pharmaceutical sciences at the Master of Science (M.S.) and
Doctorate (Ph. D.) levels. The M.S. programs are typically two year post-
B.S. programs that emphasize skill development in areas such as hospital
pharmacy and pharmacy administration. M.S. programs generally focus
on research and require a thesis. The Ph.D. programs are research-
oriented programs that are offered to students with or without a B.S. in
Pharmacy. Doctoral programs are offered in the basic sciences in areas
such as pharmacology, medicinal chemistry and pharmaceutics.
The Doctor of Pharmacy (Pharm. D.). The five year, B.S. program
was challenged in the 1960s (Mrtek, 1976). One of the key factors
fueling this challenge was that the role of the pharmacist was changing
from the traditional practice of compounding and distributing medications
to one focused on patient care. To respond to this change in practice, in
the early 1960s two California schools of pharmacy began offering a six
year Doctor of Pharmacy program. This program consisted of two
preprofessional and four professional years of study. This action caused
academic pharmacy to carefully examine the current pharmacy curriculum
and change it to provide more clinically-oriented, patient-focused
education. Additionally, the experiential component of the Pharm. D.
program emphasized the pharmacist's role in the management of drug
In 1992, a landmark decision was reached at the Annual Meeting
of the American Association of Colleges of Pharmacy (AACP). Meeting
delegates passed a resolution that the Pharm. D. degree would become
the official degree for all pharmacy schools. Since that decision, all
pharmacy schools have worked to develop a Pharm. D. program. There
are currently three different program designs for the Pharm. D. degree:
Entry level, Post-baccalaureate, and Track-in programs.
The entry level programs have followed California's lead eliminating
the baccalaureate program and offering only the Pharm. D. as the first
professional degree. These programs condense the didactic coursework
into a total of four years, and the student completes one year of
experiential rotations. Forty-seven schools offer the Pharm. D. as a first
professional degree. These programs do not have a research component.
The post baccalaureate option offers the Pharm. D. degree in a
two year post-baccalaureate program. These programs have one year of
didactic coursework and one year of experiential rotations. Like the entry
level programs, these programs generally do not require a research
project or thesis. Fifty-seven schools offer the Pharm. D. as a post-B.S.
degree. Finally, another set of schools offer a track-in option after the
first professional year of a baccalaureate program. The student does not
complete the B.S. program but receives the Pharm. D. degree in a six
year time frame.
The decision to make the Pharm. D. degree the official degree for
pharmacy graduates has not been supported by all schools of pharmacy.
Major barriers thwart efforts to implement this decision. For example,
most schools have been unable to secure the funding for the additional
year of training. Funding is required for increased faculty, facilities and
experiential cost requirements of the program. Some schools have
proposed cutting the number of baccalaureate students by 50% so the
school can afford to develop the Pharm. D. program; however, many
state legislatures will not support the proposal. Additional resistance is
being directed by national organizations such as the National Association
of Chain Drug Stores (NACDS) who believe that the five year program is
sufficient to train practitioners.
The goal of the accrediting body for schools of pharmacy, the
American Council on Pharmaceutical Education (ACPE) is to facilitate
quality assurance and quality enhancement for B.S. and Pharm. D.
programs. The Accreditation Standards and Guidelines represent the
characteristics of quality which schools of pharmacy should develop.
The Pharmacy Dean
The pharmacy school dean is often both the chief executive officer
and chief academic officer in a largely self-contained academic unit. The
pharmacy school typically runs its own recruiting, admissions,
registration, student affairs, and discipline. The position of the pharmacy
school dean is therefore considered analogous to that of the president of
a small independent college (AACP, Deanship Manual, 1994, p. 1).
Vanderveen (1988) presented an overview of the demographics of
pharmacy school deans. Of the 54 respondents in his study, the mean
age of the deans was 51 years and the mode age was 62 years. He
suggested that these statistics would naturally predict a higher turnover
of deans in the immediate future. These demographics are key to
understanding the number of vacant positions in schools of pharmacy.
Selection of Deans
In 1988, Vanderveen observed that selection of deans was based
on many individual qualifications. He wrote, "Qualifications in the
selection of pharmacy dean includes excellence in teaching or research,
ability to obtain grants, political astuteness, or even the fact that no one
else wanted the job" (p. 142). Recognizing the large number of
deanships available at any one time, AACP developed a Deanship Manual
(AACP, 1994). The manual was developed because of the growing
concern among pharmaceutical educators about the number of open
positions, the changing nature of the deanship and the apparent declining
interest of faculty to assume positions of academic leadership. AACP
has taken other measures attempting to address leadership concerns in
the schools of pharmacy. These efforts include a week-long conference
for new deans, and development of the Academic Management System
(AMS, 1994) which is a compilation of articles on running a school of
In this chapter I outlined the demographics and environment of
pharmacy schools and provided a contrast between the HSC and the
parent university. Because this environment offers special challenges for
leaders, an overview of its key features is essential to understanding the
As presented in Chapter 2, a perception of a leadership crisis
exists in pharmacy schools. Pharmacy writers focus on the high turnover
of administrators, the changing role of the dean in the rapidly changing
HSC environment and the unrealistic expectations of search committees
(Cohen, 1993; Trinca, 1993; Rutledge, 1994). These factors contribute
to the perception of crisis or an emergent problem in pharmacy
leadership. The goal of this research is to develop an understanding of
the perception of a leadership crisis in pharmacy schools.
This chapter is divided into two sections. First, I will discuss how I
used phenomomenological or interpretive-based methods to investigate
the perception of a leadership crisis in pharmacy schools. The second
section gives a detailed description of the investigative methods for each
phase of the study. Using a combination of qualitative and quantitative