Research  SMART goals and other goal setting strategies in the University Library and  review the "Making SMART Goals Smarter" article located in the Week 5 Electronic Reserve Readings .  Refer  to the stages of coaching and mentoring found on pg. 18 of  Student-Centered Coaching .  Design  a professional learning opportunity for coaches of teachers who need to implement effective instruction in order to meet their students' needs.  Create  an 8- to 10-slide presentation for your professional learning opportunity, in which you address the following:  Identify three possible target areas in which growth may be warranted and provide justification for each area selected. Write three goals for each target area--two SMART goals and one goal using another goal setting strategy that you discovered. List strategies for fostering awareness, modeling, and providing motivation during the stages of coaching and mentoring. Discuss professional learning communities and explain how you might incorporate them as a coach or mentor.  Include  speaker notes, APA-formatted in-text citations, and a reference slide.  Week 5 - readings Making SMART Goals Smarter Goal-setting In this article… Study the differences between goals and objectives and get some valuable insights on how to use SMART goals in a health care organization. A critical role of leadership is goal setting.1  As our health care system continues to evolve, physician executives will be called upon to play increasingly proactive roles in formulating appropriate goals for their respective health care organizations (HCOs). With what looks like a major perspective shift from provider-driven volume to consumer-driven value,2-4 physician leaders will be entrusted with the responsibility of ensuring high standards of care throughout the extended process of resource realignment. How well they are able to formulate effective goals will have, no doubt, a major influence on the future success of their respective HCOs. In times of system turbulence, goal initiation is usually a far better alternative than goal response. It should be noted initially that, as popular as the concept of SMART goals has become in recent years, it is also somewhat of a misnomer. The terms goals, sub-goals, and objectives are often used interchangeably, which has often been the source of unnecessary confusion, and as goal-setting theory continues to develop as a useful body of knowledge, related application benefits can be markedly improved when their differences are more clearly understood. Together with an HCO’s mission, vision, strategies and tactics, goals and objectives serve as the foundation elements for most major programmatic initiatives. An organization’s mission is basically its reason for being. Its vision describes where it wants to be in the future, and its values are a statement of the principles that form its moral foundation.5  Collectively, they are the basis for devising the supporting goals and object.

1. Research
SMART goals and other goal setting strategies in the
University Library and
review
the "Making SMART Goals Smarter" article located in the
Week 5 Electronic Reserve Readings
.
Refer
to the stages of coaching and mentoring found on pg. 18 of
Student-Centered Coaching
.
Design
a professional learning opportunity for coaches of teachers who
need to implement effective instruction in order to meet their
students' needs.
Create
an 8- to 10-slide presentation for your professional learning
opportunity, in which you address the following:
Identify three possible target areas in which growth may be
warranted and provide justification for each area selected.
Write three goals for each target area--two SMART goals and
one goal using another goal setting strategy that you discovered.
List strategies for fostering awareness, modeling, and providing
motivation during the stages of coaching and mentoring.
Discuss professional learning communities and explain how you
might incorporate them as a coach or mentor.

2. Include
speaker notes, APA-formatted in-text citations, and a reference
slide.
Week 5 - readings
Making SMART Goals Smarter Goal-setting In this article…
Study the differences between goals and objectives and get
some valuable insights on how to use SMART goals in a health
care organization. A critical role of leadership is goal setting.1
As our health care system continues to evolve, physician
executives will be called upon to play increasingly proactive
roles in formulating appropriate goals for their respective health
care organizations (HCOs). With what looks like a major
perspective shift from provider-driven volume to consumer-
driven value,2-4 physician leaders will be entrusted with the
responsibility of ensuring high standards of care throughout the
extended process of resource realignment. How well they are
able to formulate effective goals will have, no doubt, a major
influence on the future success of their respective HCOs. In
times of system turbulence, goal initiation is usually a far better
alternative than goal response. It should be noted initially that,
as popular as the concept of SMART goals has become in recent
years, it is also somewhat of a misnomer. The terms goals, sub-
goals, and objectives are often used interchangeably, which has
often been the source of unnecessary confusion, and as goal-
setting theory continues to develop as a useful body of
knowledge, related application benefits can be markedly
improved when their differences are more clearly understood.
Together with an HCO’s mission, vision, strategies and tactics,
goals and objectives serve as the foundation elements for most
major programmatic initiatives. An organization’s mission is
basically its reason for being. Its vision describes where it
wants to be in the future, and its values are a statement of the

3. principles that form its moral foundation.5 Collectively, they
are the basis for devising the supporting goals and objectives
that assists the organization in fulfilling its mission and
realizing its vision. Goals Goals are the somewhat general ends
toward which much more specific sub-goals or objectives are
directed. This is where much of the confusion usually occurs.
Goals and objectives are very different concepts, whereas
subgoals and objectives are basically the same things. The
popularized term, SMART goals, actually refers more to sub-
goals and objectives than it does to the much broader term,
goals. In the outline that follows, the term objectives is used
because of its close association with Peter Drucker’s well-
known practice of management by objectives (MBO),6 and
because of its more practical use as a basic management skill.
Some of the commonly recognized distinctions between goals
and objectives include the following: An HCO’s mission,
vision, goals and objectives are inextricably related. They
comprise the fundamental “what” Difference Between Goals &
Objectives Goals Objectives Broad in scope Narrower in scope
General Specific Intangible Tangible Qualitative Quantitative
Abstract Concrete End result Required steps Hard to validate
Easy to validate Longer-term Shorter-term
of present and future organizational pursuits. Coupled with the
“how” of strategies and tactics, they form the blueprint for the
allocation of scarce economic resources. Each element is
important; however objectives are the principal means through
which they ultimately become operationalized. The careful
design and strategic use of operational objectives are important
leadership skills. Goal theory SMART goals have become a
widely used management tool in many of today’s HCOs. Part of
this popularity stems from the development of goal-setting
theory during the latter part of the last century, part of it from
the increasingly competitive need for greater intentionality, and
part of it, no doubt, stems from the often cited findings of the

4. 1953 Yale Goal Study as well as the 1979 Harvard Written Goal
Study. Earlier goal theory research by Latham and Locke7
involved extensive laboratory and field studies that clearly
indicated that participants who were given specific, In order to
reach a single goal, several enabling or supporting objectives
usually have to be met. In health care settings, this involves the
time and talents of trained professionals who function more on a
collegial basis than in the superior-subordinate relationships.
challenging goals consistently outperformed those who were
given vague, less challenging goals. The Yale Goal Study
surveyed 1953 Yale graduates, asking how many of them had
specific written goals for their future. It was determined that
three percent of them had such goals. A 20-year follow-up
survey indicated that the three percent of students with specific
written goals had accumulated more personal financial wealth
than the other 97 percent of the class combined. The Harvard
study followed the 1979 Business School graduates and
similarly found that only three percent of the graduates had
specific written financial goals, but ended up making 10 times
as much income as did the other 97 percent of the graduating
MBAs. The results of both the Yale and Harvard studies have
been frequently referenced in management texts as well as in
presentations by
a host of performance improvement consultants. Unfortunately,
a successful goal setting process is not quite as simple as these
examples might at first indicate. In the earlier development of
goal theory, the terms goals and objectives were not always
clearly distinguished and, as mentioned earlier, they are still
used synonymously, which often presents problems. As for the
results of the Yale and Harvard studies, it has become
increasingly clear that they are more likely the products of
urban myth than of validated research.8 Nonetheless, there now
exists a substantial body of research that supports a strong

5. positive relationship between setting specific goals and
achieving better outcomes.9 General vs. specific Goals tend to
be somewhat general, whereas objectives are much
disagreements. Also implicit in the measurement criteria is the
important concept of accountability. It is much more difficult to
avoid accountability when measurement criteria are clear and
not subject to interpretation. Achievable: If the established
objectives are not reasonably achievable with respect to
available time, talent and resources, frustration is sure to
follow. It is up to the physician executive to set objectives that
are realistic. This can be best accomplished through a process of
negotiation and consensus. Comparative benchmarks from other
similar organizations can also be helpful. The use of “reach”
objectives, which are a bit more ambitious, can be used as well,
with the understanding that they exceed normal expectations
and will require exceptional levels of effort and commitment.
Relevant: Few things are more frustrating to organizational
leadership than to observe busy professionals using up scarce
resources without a clear direction. Too much time is spent
“doing the wrong things right” or “being in the thick of some
very thin issues.” It is natural for staff to focus on those things
that they find interesting and enjoyable. Unfortunately those
things might make only marginal contributions toward the more
important, overarching goals. This can easily occur when goal
relevance has not been made explicit. There is rationalized
justification based mostly on the exertion of effort without
sufficient validation that what is being done is, in fact, relevant.
A similar problem occurs when there is an absence of
prioritization. When this occurs, efforts get focused on
objectives that, although reasonably relevant, are decidedly
lower more specific. Goal statements are typically formulated at
higher, more strategic organizational levels, while objectives
are geared more toward tangible, operational targets. In order to
reach a single goal, several enabling or supporting objectives
usually have to be met. In health care settings, this involves the

6. time and talents of trained professionals who function more on a
collegial basis than in the superior-subordinate relationships
around which the MBO and SMART goal processes were
originally developed. The following SMARTER objectives
criteria take this important difference into account along with
the substitution of the term objectives, which more accurately
reflects the operational level of focus. The first step in making
SMART goals SMARTER is to refer to them as SMARTER
objectives. Subsequent steps include the following: Specific:
Making objectives specific is an essential first step. It brings a
much needed practical reality to distinguishing effort from
results. Effort, while indeed admirable, only amounts to a wheel
spinning exercise if intended results do not follow. In the
process, valuable time and resources are wasted. Committing
objectives to writing in plain language leaves no doubt about
exactly what needs to be accomplished. Measurable: There is a
long-standing saying in management circles that, “You can’t
manage what you don’t measure.” Objectives should be
quantified so that the degree of accomplishment can be
accurately measured. Specific measurement criteria will
eliminate the possibility of future M
in terms of overall priorities. Lower priority objectives are
pursued at the expense of addressing the higher, more important
ones. The most straightforward way to ensure that objectives
are relevant is through prior validation of the relationship of
expected outcomes with the intended goals and then to list each
objective in writing in their order of priority. Time bound:
Some versions of SMART goals list “timely” as the attribute
represented by the letter T. In the outline presented here, T
indicates “time bound” which is considered to be more
appropriate than “timely” in as much as timeliness is implied in
the preceding “relevant” attribute (if an objective is truly
relevant it is sine qua non, timely), and “time bound,” further
makes it clear that the objectives are to be accomplished by an

7. agreed-upon point in time. As soon as possible is simply not an
acceptable timeframe. Without a predetermined deadline, there
is only a general notion about due dates, which
in turn generates a less than rigorous pursuit of closure. Where
there is only a loose expectation of closure, prioritizations and
associated time management requirements are more apt to lack
needed discipline. Engaging: Adding engagement to the
SMARTER objectives criteria is particularly relevant for the
physician executive. Few things are more valuable to busy
clinicians than their time. Waste it once and second chances
will be much harder to come by. Merely laying out a pre-
established objective is not about to excite busy clinicians, nor
will it promote a sense of participation. Change theorists would
be quick to point out that where there is
no “ownership” of an objective, meaningful stakeholder
engagement will be difficult at best. In its absence, efforts to
meet the intended objective more likely will be met with only
tacit levels of acceptance or possibly some degree of
resistance.10 A lack of involvement will almost certainly lead
to a lack of engagement. A more effective approach is to
involve clinicians in formulating the objectives from the very
beginning. Describe the circumstances behind the intended
objective and solicit creative input. This will help to provide a
much needed sense of “ownership” in both the objective and its
achievement. Ample evidence exists that confirms that
individuals are much more likely to support those things they
help to create. The proverb, “Tell me and I’ll forget; show me
and I may remember; involve me and I’ll understand,” has
proven to be remarkably compatible with current change theory
findings. Rewarding: Motivational studies have demonstrated
that rewards are essential factors in bringing about desired
behavior. Motivation can be described as “the process through
which unsatisfied needs and wants lead to drives that are aimed
at goals or incentives.”11 Satisfaction of goals or wants is

8. typically sought through various kinds of rewards that are either
internal, external, or some combination of both. Current
research suggests that physicians are motivated far more by
internal rewards such as an intellectual challenge, a meaningful
purpose, and a sense of accomplishment.12,13 While much of
what is used in an MBO process has been incorporated into the
SMARTER objectives approach, there are crucial differences
that directly apply when working with physicians. The MBO
process was designed for a superiorsubordinate relationship that
is unlikely to work very well with medical colleagues. Instead,
SMARTER objectives rely on collegial relationships through
which objectives are negotiated as a means of promoting
“ownership” along with a sense of intellectual challenge and
meaningful purpose. This approach takes more time and
requires greater interpersonal skills; however it affords a much
higher probability of success. Pursuing well-defined objectives
has not been without its critics. One major objection centers
around problems that result from focusing exclusively on fixed
objectives in the midst of an uncertain and changing
environment. The presence of conflicting objectives also poses
potential problems, as does a failure to provide appropriate
feedback. To avoid these issues, physician executives should
make sure that sufficient flexibility, intra-organizational
alignment, and real-time feedback are built into the design
process. It is also important to ensure that all necessary support
elements are in place. Without them, the objectives run the risk
of being seen as unrealistic, which will diminish chances for
future staff engagement. On the other hand, the careful design
and implementation of wellconstructed objectives will provide
exceptionally valuable tools for improving say-do ratios and
getting important things done on time.
References: 1. Burns LR, Bradley EH, Weiner BJ. Health Care
Management Organization Design & Behavior 6th ed. Clifton
Park, NY: Delmar Learning; 2012. 2. Lee TH. Putting the Value
Framework to Work. N Engl J Med 2010; 363:2481-2483. 3.

9. Porter ME. What Is Value in health Care? N Engl J Med 2010;
363:2477-2482. 4. Bohmer MJ, Lee TH. The Shifting Mission of
Health Care Delivery Organizations. N Engl J Med 2009;
361:551-553. 5. Griffith JR. White KR. The Well-Managed
Healthcare Organization 6th ed. Chicago, IL: Health
Administration Press; 2007. 6. Drucker PF. The Practice of
Management. New York: Harper & Rowe, Publishers; 1954. 7.
Latham GP, Locke EA. Goal setting – a motivational technique
that works in Hackman JR, Lawler EE, Porter LW (Eds)
Perspectives on behavior in organizations 1983 New York:
McGraw Hill; 1983, pp. 296-304. 8. Fast Company Magazine. If
Your Goal Is Success, Don’t Consult These Gurus.
http://www.fastcompany.com/ magazine/06/cdu.html. Accessed
August 8, 2011. 9. Borkowski N. Organizational Behavior,
Theory, and Design in Health Care. Sudbury, MA: Jones and
Bartlett Publishers; 2009 10. Kotter JP. Leading Change.
Boston, MA: Harvard Business School Press; 1996. 11.
Borkowski, N Organizational Behavior in Health Care 2nd ed
Sudbury, MA: Jones and Bartlett publishers; 2011. 12.
Lepnurum R. Cornerstones of Career Satisfaction in Medicine.
Can J Psychol 2008; 51:40-45. 13. Ratanawongsa N, Howell EE,
Wright SM. What motivates physicians throughout their careers
in medicine? Compr Ther 2006; 32:210-217.