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RESEARCH

ommentary

re We Training Leaders? Conversations withhree Leaders

AROL PORTER, PhD, RD, FADA

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his issue of the Journal contains two articles relatedto leadership. The first describes dietetics students’perceptions of their own skills, and found that these

tudents believe that they demonstrate leadership in aariety of settings (1). The second article identifies com-etencies that are important for those holding the posi-ion of hospital foodservice director (2). The authorssked those currently working in this position and hos-ital executives who hire and supervise these directorsbout the importance of these competencies and the prep-ration of the registered dietitian to assume this position.ietetics professionals were not perceived to be highly

ompetent in some of the leadership and operations man-gement skills that were identified as important.Although we cannot conclude that the dietetics stu-

ents described in the first article will not become lead-rs, we do have many midlevel and senior-level dieteticsrofessionals who are not willing or able to take leader-hip roles. Certainly, our academic and clinical standardsddress leadership knowledge and skills (3), yet it seemshat our profession has many “followers” who feel under-ppreciated, complain about their compensation, andenerally feel unhappy about their professional lives.Is this unique to our profession? This was explored in

hree conversations with leaders: a chief operating officer,dean of a business school, and a dietetic intern.

ONVERSATION WITH A CHIEF OPERATING OFFICERhe chief operating officer at UCSF Medical Center wassked to describe her perceptions of the leadershiptrengths and weaknesses of department directorsmidlevel managers) in health care. She did not focus onegistered dietitians or even people at UCSF Medicalenter, but on experiences she has had with midlevelanagers in all disciplines over the years.Her impressions of these managers were that they

. Porter is director, Department of Nutrition and Foodervices, UCSF Medical Center, and associate adjunctrofessor, Department of Pediatrics, University of Cali-ornia at San Francisco.

Address correspondence to: Carol Porter, PhD, RD,ADA, Department of Nutrition and Food Services, Uni-ersity of California, 505 Parnassus Ave, Room M-294,an Francisco, CA 94143-0212. E-mail: carol.porter@csfmedctr.orgCopyright © 2005 by the American Dietetic

ssociation.0002-8223/05/10508-0001$30.00/0

ddoi: 10.1016/j.jada.2005.05.018

204 Journal of the AMERICAN DIETETIC ASSOCIATION

ere good “operators,” that they were skilled at “mindinghe store,” and that they were experts in their area ofnfluence. They were good patient and employee advo-ates and managed crises well. However, there were ar-as in which she thought that midlevel managers coulde stronger leaders: challenging the status quo, thinkingore broadly, planning ahead, owning issues, and solving

roblems across disciplines.She said that leaders are not in their jobs to promote

hemselves. They should be easing the work lives of theirmployees and worrying about their employees’ well-eing. They need to create an environment that encour-ges and opens doors for others. A strong organizationas leaders who give their employees confidence to doheir jobs (4).

There is a delicate balance between competence andonfidence, she said. It weakens people to move up theareer ladder too quickly. One must always be aware ofoundaries when taking risks, yet people must be willingo take risks to be leaders. They cannot be timid. Leaderseed to be provocative by probing and challenging cur-ent thinking (5,6). They should not let people feel tooomfortable.

ONVERSATION WITH THE DEAN OF A BUSINESS SCHOOLhe dean of business administration at The Citadel

Charleston, SC) is a graduate of the United States Mil-tary Academy, received his PhD in organizational behav-or and political science from the Massachusetts Institutef Technology, was a White House Fellow, and taught athe military academy and several business schools beforeoing to The Citadel.He was asked how business schools and the army cre-

te leaders who take action in crisis, especially whenheir decisions can result in great risk to the people theyead. His response was that they teach men and womenhat risk and reward go hand-in-hand. Every leadershipnitiative, every new opportunity carries risk, but all of us

ust learn to “step off the edge” into the unknown if were to serve our society and realize our potential. Fur-hermore, none of us will really ever be satisfied if we doot achieve that potential. Indeed, in his view, the sourcef most unhappiness in the workplace is just this unwill-ngness to take risk and thereby achieve our potential.

He recommended reading a speech given by Theodoreoosevelt about taking risks, with the caveat that theording reflected a different world in the early part of the0th century.“It is not the critic who counts, not the man who points

ut how the strong man stumbles, or where the doer of

eeds could have done better. The credit belongs to the

© 2005 by the American Dietetic Association

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an who is actually in the arena; whose face is marred byhe dust and sweat and blood; who strives valiantly; whorrs and comes up short again and again; . . . who knowshe great enthusiasms, the great devotions and spendsimself in a worthy course; who at the best, knows in thend the triumph of high achievement, and who, at worst,f he fails, at least fails while daring greatly; so that hislace shall never be with those cold and timid souls whonow neither victory or defeat” (7).

ONVERSATION WITH A DIETETIC INTERNne of the dietetic interns at UCSF Medical Center

alked about experiences she has had in her internshiphat fostered leadership. She developed leadership skillshen she had the opportunity to make decisions on herwn, when she was encouraged by preceptors to thinkndependently, and when she was allowed to take calcu-ated risks. She was empowered and encouraged to lookt the bigger picture when she had the opportunity toiscuss her experiences and give objective feedback re-arding the program. Leadership development was sti-ed when a preceptor had only one teaching style andhat involved micromanagement.

We can encourage our young professionals to take risksithin boundaries when preceptors give guidelines

ather than dictums and allow interns to accomplishork in their own way, as long as it meets desired out-

omes.

OMPETENCE, CONFIDENCE, AND RISK TAKINGoth competence and confidence enhance our ability to

ake risk. Yet there are those who have these character-stics and are still afraid to make decisions, to move inew directions, or to put themselves into vulnerable po-itions. Do our educational processes and professionalractices focus so much on accurate and safe work thate are unwilling to take risks ourselves or let our stu-ents, dietetic interns, or young staff members takeisks? Are we teaching our young professionals how toolve problems, to work across disciplines, to own issues,o challenge the status quo, to create, to lead?

In his book, Crossing the Unknown Sea: Work as ailgrimage of Identity, David Whyte describes an innerarental voice deep inside us that tells us to stay awayrom the edge, to find safe work, adventure only on theeekends of life and not in our work world. This voice, he

ays, affects our ability to find meaning in our work, ourbility to become leaders. It results in a feeling of power-essness, having little faith in our own opinions and ideas,eing invisible, living in the shadow. We fill our workdays

ith busyness and speed, which is noticed, praised, and

akes us feel self-important, but becomes so all-consum-ng that we do not stop and appraise what we are doing oree the bigger picture that underlies our work (8).As we talk about and plan for changes in the academic

nd clinical preparation of dietetics professionals, weust make sure that they are prepared to be leaders.heir educations and work lives must offer them manypportunities to become good communicators, to leadultidisciplinary groups in solving problems, to have the

exibility and freedom to question how things are done,nd the willingness to take professional risks. We shouldecognize that if dietetics professionals are only compe-ent, accurate, and safe in their practice but have noeadership skills, they will be part of a group of followers,ot the leaders.

he author thanks Tomi Ryba, MHA, chief operatingfficer, UCSF Medical Center; W. Earl Walker, PhD,ean, Business Administration, Robert A. Jolley chair,he Citadel, Charleston, SC; and Kristen Buckshi, MS,ietetic intern, UCSF Medical Center, for their thoughtsnd comments on this topic.

eferences. Arendt SW, Gregoire MB. Dietetics students perceive

themselves as leaders and report they demonstrateleadership in a variety of contexts. J Am Diet Assoc.2005;105:1289-1294.

. Gregoire MB, Sames K, Dowling RA, Lafferty LJ. Areregistered dietitians adequately prepared to be hospi-tal foodservice directors? J Am Diet Assoc. 2005;105:1215-1221.

. American Dietetic Association. CADE AccreditationHandbook. Chicago, IL: American Dietetic Association;2002. Available at: http://www.eatright.org/Public/Files/accreditation_handbook.pdf. Accessed May 2, 2005.

. Kanter RM. Confidence: How winning streaks and los-ing streaks begin and end. New York, NY: RandomHouse Business Books, Crown Business; September2004.

. Kanter RM. The enduring skills of change leaders.Ivey Bus J. May/June 2000. Available at: http://www.iveybusinessjournal.com/view_article.asp?intArticle_ID�216. Accessed May 2, 2005.

. Heifetz R. Question authority. Harv Bus Rev. January2004;82:37.

. Roosevelt T. “In The Arena.” Speech given at the Sor-bonne, Paris, 1910. Available at: http://hoopsu.homestead.com/motivtrarena.html. Accessed May 2, 2005.

. Whyte D. Crossing The Unknown Sea: Work as a Pil-grimage of Identity. New York, NY: Riverhead Books;

2001.

August 2005 ● Journal of the AMERICAN DIETETIC ASSOCIATION 1205