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Table 2 Supplementary illustrative quotations

From: Burnout and the role of authentic leadership in academic medicine

Construct of Authentic Leadership Theory

Quotation

Participant Type

Balanced Processing:

Leadership’s lack of engaging employees in decision-making makes them feel powerless

Participant A: “I feel like they know that we have to be there, so they don’t really invest much in keeping us happy and pleased at work because we can’t really do anything about it. That’s how I feel--kind of disenfranchised. I don’t really have much agency in actually making any change. You’re just kind of this cog, but you can’t really do anything about it because you don’t have the power.”

Participant B: “We just have no negotiating power, if you will. And so to the hospital, it feels like we’re just cheap labor to get the work done…like we’re in this training program until we’re done with it. And if we don’t finish it, then we’re not a trained physician; we can’t go get an actual job. We have no power (to influence decisions).”

Trainees

Relational Transparency:

Honesty from Leaders about faculty ideas

Participant A: “If the first issue that you raised were better addressed and there were better communication and transparency and inclusiveness [from the clinical leadership], you wouldn’t need—so, the thing is that you can get the unintended consequence of becoming sort of a lobby group with an antagonistic thing going on.”

Participant B: “…if they [the leadership] had the transparency and they were open to us and kept us informed, we wouldn’t need another [advocacy] group. This would be [needed] if they’re not willing to do that.”

Clinical Faculty

Internalized Moral Perspective:

Leadership values and shows trust in staff

It’s not enough just to pay lip service [to the importance of clinical care]. You have to have something to back that up.

Clinical Faculty

Self-Awareness:

Leadership encourages work-life balance

One faculty member explained a previous experience this way: “…when you signed your letter of offer, it said ‘60 hours’ and then the Dean would lean in and say ‘Of course, if you’re going to be successful and advance, you’re going to work 70 or 80 hours a week.’ And so, when I came here [and no one in Leadership expected 70–80 hours/week], I realized that people, in part, take—they are better about putting some limits around their practice so that they have that personal time.”

Clinical Faculty