RESEARCH

S8 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS

Commentary

Are We Training Leaders? Conversations withThree LeadersCarol Porter, PhD, RD, FADA

ARTICLE INFORMATION

Copyright ª 2014 by the Academy of Nutrition and Dietetics.2212-2672/$36.00http://dx.doi.org/10.1016/j.jand.2014.02.022

This article is reprinted from the August 2005 issue of theJournal of the American Dietetic Association (2005;105(8):1204-1205).

THIS ISSUE OF THE JOURNAL CONTAINS TWO ARTICLESrelated to leadership. The first describes dieteticsstudents’ perceptions of their own skills, and foundthat these students believe that they demonstrate

leadership in a variety of settings.1 The second article iden-tifies competencies that are important for those holding theposition of hospital foodservice director.2 The authors askedthose currently working in this position and hospital execu-tives who hire and supervise these directors about the impor-tance of these competencies and the preparation of theregistered dietitian to assume this position. Dietetics profes-sionals were not perceived to be highly competent in some ofthe leadership and operations management skills that wereidentified as important.Although we cannot conclude that the dietetics students

described in the first article will not become leaders, we dohave many midlevel and senior-level dietetics professionalswho are not willing or able to take leadership roles. Certainly,our academic and clinical standards address leadershipknowledge and skills,3 yet it seems that our profession hasmany “followers”who feel underappreciated, complain abouttheir compensation, and generally feel unhappy about theirprofessional lives.Is this unique to our profession? This was explored in three

conversations with leaders: a chief operating officer, a deanof a business school, and a dietetic intern.

CONVERSATION WITH A CHIEF OPERATINGOFFICERThe chief operating officer at UCSF Medical Center was askedto describe her perceptions of the leadership strengths andweaknesses of department directors (midlevel managers) inhealth care. She did not focus on registered dietitians or evenpeople at UCSF Medical Center, but on experiences she hashad with midlevel managers in all disciplines over the years.Her impressions of these managers were that they were

good “operators,” that they were skilled at “minding the

store,” and that they were experts in their area of influence.They were good patient and employee advocates andmanaged crises well. However, there were areas in whichshe thought that midlevel managers could be strongerleaders: challenging the status quo, thinking more broadly,planning ahead, owning issues, and solving problems acrossdisciplines.She said that leaders are not in their jobs to promote

themselves. They should be easing the work lives of theiremployees and worrying about their employees’ well-being.They need to create an environment that encourages andopens doors for others. A strong organization has leaderswho give their employees confidence to do their jobs.4

There is a delicate balance between competence and con-fidence, she said. It weakens people to move up the careerladder too quickly. One must always be aware of boundarieswhen taking risks, yet people must be willing to take risks tobe leaders. They cannot be timid. Leaders need to be pro-vocative by probing and challenging current thinking.5,6 Theyshould not let people feel too comfortable.

CONVERSATION WITH THE DEAN OF A BUSINESSSCHOOLThedeanof business administrationat TheCitadel (Charleston,SC) is a graduate of the United States Military Academy,received his PhD in organizational behavior and political sci-ence from the Massachusetts Institute of Technology, was aWhite House Fellow, and taught at the military academyand several business schools before going to The Citadel.He was asked how business schools and the army create

leaders who take action in crisis, especially when their de-cisions can result in great risk to the people they lead. Hisresponse was that they teach men and women that risk andreward go hand-in-hand. Every leadership initiative, everynew opportunity carries risk, but all of us must learn to “stepoff the edge” into the unknown if we are to serve our societyand realize our potential. Furthermore, none of us will reallyever be satisfied if we do not achieve that potential. Indeed,in his view, the source of most unhappiness in the workplaceis just this unwillingness to take risk and thereby achieve ourpotential.He recommended reading a speech given by Theodore

Roosevelt about taking risks, with the caveat that thewording reflected a different world in the early part of the20th century.“It is not the critic who counts, not the man who points out

how the strong man stumbles, or where the doer of deedscould have done better. The credit belongs to the man who isactually in the arena; whose face is marred by the dust and

ª 2014 by the Academy of Nutrition and Dietetics.

RESEARCH

sweat and blood; who strives valiantly; who errs and comesup short again and again; . who knows the great enthusi-asms, the great devotions and spends himself in a worthycourse; who at the best, knows in the end the triumph ofhigh achievement, and who, at worst, if he fails, at least failswhile daring greatly; so that his place shall never be withthose cold and timid souls who know neither victory ordefeat.”7

CONVERSATION WITH A DIETETIC INTERNOne of the dietetic interns at UCSF Medical Center talkedabout experiences she has had in her internship that fosteredleadership. She developed leadership skills when she had theopportunity to make decisions on her own, when she wasencouraged by preceptors to think independently, and whenshe was allowed to take calculated risks. She was empoweredand encouraged to look at the bigger picture when she hadthe opportunity to discuss her experiences and give objectivefeedback regarding the program. Leadership developmentwas stifled when a preceptor had only one teaching style andthat involved micromanagement.We can encourage our young professionals to take risks

within boundaries when preceptors give guidelines ratherthan dictums and allow interns to accomplish work in theirown way, as long as it meets desired outcomes.

COMPETENCE, CONFIDENCE, AND RISK TAKINGBoth competence and confidence enhance our ability to takerisk. Yet there are those who have these characteristics andare still afraid to make decisions, to move in new directions,or to put themselves into vulnerable positions. Do oureducational processes and professional practices focus somuch on accurate and safe work that we are unwilling to takerisks ourselves or let our students, dietetic interns, or youngstaff members take risks? Are we teaching our young pro-fessionals how to solve problems, to work across disciplines,to own issues, to challenge the status quo, to create, to lead?In his book, Crossing the Unknown Sea: Work as a Pilgrimage

of Identity, David Whyte describes an inner parental voicedeep inside us that tells us to stay away from the edge, tofind safe work, adventure only on the weekends of life and

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not in our work world. This voice, he says, affects our abilityto find meaning in our work, our ability to become leaders. Itresults in a feeling of powerlessness, having little faith in ourown opinions and ideas, being invisible, living in the shadow.We fill our workdays with busyness and speed, which isnoticed, praised, and makes us feel self-important, but be-comes so all-consuming that we do not stop and appraisewhat we are doing or see the bigger picture that underliesour work.8

As we talk about and plan for changes in the academic andclinical preparation of dietetics professionals, we must makesure that they are prepared to be leaders. Their educationsand work lives must offer them many opportunities tobecome good communicators, to lead multidisciplinarygroups in solving problems, to have the flexibility andfreedom to question how things are done, and the willing-ness to take professional risks. We should recognize that ifdietetics professionals are only competent, accurate, and safein their practice but have no leadership skills, they will bepart of a group of followers, not the leaders.

References1. Arendt SW, Gregoire MB. Dietetics students perceive themselves as

leaders and report they demonstrate leadership in a variety of con-texts. J Am Diet Assoc. 2005;105:1289-1294.

2. Gregoire MB, Sames K, Dowling RA, Lafferty LJ. Are registered di-etitians adequately prepared to be hospital foodservice directors? J AmDiet Assoc. 2005;105:1215-1221.

3. American Dietetic Association. CADE Accreditation Handbook. Chi-cago, IL: American Dietetic Association; 2002. Available at: http://www.eatright.org/Public/Files/accreditation_handbook.pdf. AccessedMay 2, 2005.

4. Kanter RM. Confidence: How Winning Streaks and Losing Streaks Beginand End. New York, NY: Random House Business Books, Crown Busi-ness; 2004.

5. Kanter RM. The enduring skills of change leaders. Ivey Bus J. May/June2000. Available at: http://www.iveybusinessjournal.com/view_article.asp?intArticle_ID¼216. Accessed May 2, 2005.

6. Heifetz R. Question authority. Harv Bus Rev. January 2004;82:37.

7. Roosevelt T. “In The Arena.” Speech given at the Sorbonne, Paris, 1910.Available at: http://hoopsu.homestead.com/motivtrarena.html. AccessedMay 2, 2005.

8. Whyte D. Crossing The Unknown Sea: Work as a Pilgrimage of Identity.New York, NY: Riverhead Books; 2001.

AUTHOR INFORMATIONC. Porter is director, Department of Nutrition and Food Services, UCSF Medical Center, and associate adjunct professor, Department of Pediatrics,University of California at San Francisco.

Address correspondence to: Carol Porter, PhD, RD, FADA, Department of Nutrition and Food Services, University of California, 505 Parnassus Ave,Room M-294, San Francisco, CA 94143-0212. E-mail: carol.porter@ucsfmedctr.org

ACKNOWLEDGEMENTSThe author thanks Tomi Ryba, MHA, chief operating officer, UCSF Medical Center; W. Earl Walker, PhD, dean, Business Administration, Robert A.Jolley chair, The Citadel, Charleston, SC; and Kristen Buckshi, MS, dietetic intern, UCSF Medical Center, for their thoughts and comments on thistopic.

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