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In 1994, the University of Louisville board of trustees mandated that each school develop a methodology for post-tenure review. Ten years after implementation, this article provides an update on the process and its outcomes.In the case of an unsatisfactory evaluation, a faculty member is re-reviewed two years later. Failed reviews trigger the creation of a faculty development plan. The plan includes specific and measurable requirements to be met within one year, with an additional year to demonstrate success. The plan must clearly state objective goals related to the area of deficiency, development activities that the faculty member will engage in, and resources the institution will provide for the faculty member to achieve the stated goals.Soon after implementation, an increase in retirement rates was observed. Since then, more than 250 post-tenure reviews have been completed in the school of medicine, and over 95% of faculty reviewed received ratings of satisfactory. Outcomes for faculty receiving ratings of unsatisfactory vary. Overall, results suggest that post-tenure review at the University of Louisville School of Medicine has facilitated faculty revitalization not only for those who failed, but also for others as they prepare for the evaluation process. The key to the success of this program is its nonpunitive nature. The focus on faculty development and the resulting reinvigoration of the careers of faculty put a positive spin on what otherwise would have been perceived as a top-down measure to increase faculty accountability.