Evaluating MSL Performance and Advocating for a Promotion

Introduction

Effective performance evaluation helps leaders identify strengths and weaknesses relative to the overall mission; through careful evaluation of what is working and not working related to achieving goals, one can focus on areas for improvement, create benchmarks for achievement and provide data to make informed decisions. Performance evaluations create a snapshot of current performance capabilities and track progress toward enhancing performance in a systematic manner. With this in mind, it is essential to define the characteristics of a job description that will lead to the successful execution of the duties. Also, considering key competencies and behaviors for a position guides the ability to measure performance. A good performance measure should be based on activities that leaders can assess and control or influence; activities need to be able to be measured and realistic. Evaluating performance, providing feedback, and coaching to elevate performance seeks to move staff toward a promotion opportunity. A stratified competency framework with defined performance standards at various proficiency levels of a position offers a roadmap for career pathways; a competency model is an objective approach to formally evaluate readiness for promotion across teams. Identifying differentiating behaviors for field medical teams also elevates the expectations of all of those new to the role and in the role for a longer period of time.

Competencies drive the delivery of value as a function of MSL performance. As the pool of Medical Affairs (MA) key stakeholders expand beyond healthcare practitioners and patients, leveraging data sets that provide insights into trends and behaviors will also allow MSLs to refine and improve their interactions. This will help to develop more targeted and impactful engagement plans. Data analysis provides insights into past behaviors and, in some cases, can be used to reveal current behaviors. Nevertheless, due to a constantly evolving landscape, accurately predicting current trends and behaviors based on data may be difficult. Thus, the development of targeted approaches may be challenging, as the rationale behind the outputs may be unclear. Therefore, sentiment research may yield useful data for Field Medical organizations and allow them to identify and gravitate towards their desired state with a baseline assessment, which can be tracked on a longitudinal basis to see shifts in knowledge and awareness levels of ecosystem stakeholders. To that end, MSL impact can be measured to evaluate best practices, which in turn can help with current and future competency needs.

As part of the MSL Society 2022 annual conference, some of the authors led an interactive workshop on “Evaluating MSL Performance and Advocating for a Promotion”.

Key objectives of the workshop included:

Understanding the challenges and solutions to guide performance evaluation and staff promotion
Creating a more consistent and well-documented competency-based model for MSL career growth and development
Discussing ways to use metrics and performance evaluations
to show accomplishments that can lead to promotion
Linking field coaching and feedback to continuous improvement
that advocate for moving to the next level

Background challenges and obstacles to effectively evaluating and reward performance: What are the problems?

Field medical teams are involved in a variety of activities across their regions in support of external KOLs and in support of internal stakeholders, thus the metrics and ability to compare performance across the field medical team are problematic. Additionally, one would not compare a new MSL to a highly experienced MSL in terms of expected performance if they share the same title or position level. It’s helpful to consider creating experience bands and proficiency levels for more appropriate comparisons. Further, there are regional differences that may yield less opportunities to deliver value across some regions and the leaders should give consideration to some degree of parity to make comparisons among regions to look at MSL efforts and the value they deliver. Metrics will never tell a complete story. In addition to metrics, consider deliverables, value-added efforts, overall effort to reach goals, and ways of working; look at how the work is done and achievements happen, in addition to what is accomplished and the quality of the output.

Many facets of the field medical role are very subjective and sometimes hard to quantify. Additionally, MSL deliverables and opportunities vary by territory and therapeutic area. An MSL working in a large metropolitan area (e.g. New York City) may have more meeting opportunities than an MSL working in the Midwest. However, they need to have the same method of evaluation and determination of value in their performance. The creation of an MSL competency model helps to bridge this gap.

How Can Development of an MSL Competency Index Help Overcome These Challenges and Provide a More Consistent Path to Promotion: What are Some Solutions?

The development of a competency index provides more clarity and transparency to what is expected and how MSLs will be evaluated
Competency Index, behaviors, proficiency levels, plus competency-based Field Coaching Reports (FCRs) provide cross-departmental documentation for use in ongoing evaluations/feedback and roll up into reporting that can inform annual reviews and promotion review committee meetings
The level playing field for managers and MSLs; expectations and definitions are calibrated for consistency in application across the team
Greater staff motivation with clarity surrounding the performance evaluation process and areas of assessment

Using competencies in FCRs and when providing performance feedback throughout the year, ensures a seamless performance review process where staff understands areas they need to focus on for growth and have clarity around how to build capabilities to higher levels.

Using a standard FCR Digital Tool and online coaching companion can more easily connect performance with evaluation data and dashboards. Following metrics with actions, and making coaching interventions, has a positive impact on-field performance. Combining FCR results with an online coaching companion tool, ties coaching to competencies with real-world actionable steps. The value of using a FCR digital tool is that it drives further organized data collection/metrics/insights and some tools embed A.I.(Artificial Intelligence), which automatically nudges MSLs to learning interventions important to group & individual performance growth.

Aligning appropriate training enables perceptible, positive change in behavior internally and externally. The FCR measures that in a way that can be easily traced back to a training curriculum. In this case, it’s not academic, it’s tied to real-world application. Also, assessments and quizzes are built directly into the same LXP (Learning Experience Platform) as the FCR to:

Serve as additional competence & confidence data points
Determine knowledge gaps
Trigger the completion of a curriculum
Test competency

Why is a Competency Framework Needed?

Review the published MSL competency framework provided below which lays out specific competency areas for success in a field medical role. Note how the sections are divided into three areas: Scientific Expertise, Collaboration, and Business Acumen. Additionally, three levels are defined for field medical roles: MSL, Senior MSL, and Executive MSL; these levels can be any title such as Level 1, 2, and 3 or MSL Manager, Senior MSL Manager, and Principal MSL Manager. Regardless of how one defines the titles for three levels of field medical role, it is useful to consider how these levels progress with increasing strategic focus, more independence, greater opportunity to mentor others, and the ability to take on additional responsibilities.

One consideration for promotion readiness is to have examples for each competency area that are consistently displayed for at least 6 months as an industry standard, although leaders may elect to choose another period to determine readiness.

Note that the FCR example also contains competencies with a 3-point rating scale to identify areas for improvement and open text boxes where performance observations or feedback can be outlined along with useful goals to build competencies.

MSL Competency Framework

Field Coaching Report – Competency Model

How do we apply the competency framework and FCR?

As a starting point, review the competencies alongside the MSL job description and assure that all relevant competencies for this field medical role are represented in the competency framework. Consider whether some competencies are emphasized, prioritized, or weighted more heavily than others.
Assure senior leadership has reviewed the competency framework you intend to use and is aligned with your assessment of key competency areas and prioritized competencies. Align the behaviors and proficiency levels for each competency so managers will understand how to coach and impact behavior.
Present the competency framework, behaviors, proficiency levels, and leadership view on competencies for the field medical role to the MSL team and engage in a dialogue around the competency definitions and the stratified levels for competencies if there are multiple MSL levels within the Medical Affairs division.
Use the competencies, behaviors, and proficiency levels when providing feedback and coaching to MSLs throughout the year; share areas of strength with examples from observations and areas where further growth is needed with action plans that will facilitate development.
Identify growth and development areas based on observations for MSL IDPs (individual development plans) and define action steps to take with routine progress checks and continued coaching to facilitate growth. Align a competency-based curriculum that offers learning resources that focus on filling competence & confidence gaps.
During performance reviews, consider competency-based examples where performance is on target, exceeding expectations, and where some competency areas may fall short, needing ongoing development.
As talent development reviews occur and for promotion review cycles, use the competency framework to detail specific examples of performance accomplishments; STAR format can be helpful (situation or task, actions MSL has taken and results achieved). Look at the level above the MSL’s current position level and consider whether the MSL has consistently demonstrated capabilities at the next level for all competencies which is an indicator of potential readiness to move to the next MSL level as a promotion. It is also essential to take into consideration that the MSL is achieving success in sync with the corporate culture or ways of working that are vital to success. Expect executive leadership to push back on promotions and that use of competencies with specific examples will be helpful to defend recommendations for promotion during these discussions.

As part of the workshop, attendees were asked the following question and their responses were analyzed for patterns and trends.

1. What is your biggest challenge in differentiating MSL performance?

Responses all pointed toward aspects of metrics as a significant area where leaders struggle to evaluate performance among the team. Specific comments made were noted below in three key metrics components:

METRICS

Territory differences
- KOL access, impact in the region, different opportunities, a region more developed
Quality vs Quantity
- How to measure and assess the value of the qualitative output?
- What is good vs excellent?
- How to value time/effort spent on activities?
- When tasks differ between staff, how to compare them?
- How to compare experienced staff to new MSLs?
Need competency framework
- Job description same for all levels (yet the pay is different)
- Set goals/expectations in advance

Considering regional differences such as size, KOL density, the sphere of influencers within a region, level of MSL development, and opportunities to partner, one can readily note that all regions are not created equal when it comes to assessing performance, and in particular, the value and impact potential within a region. Thus, this is a factor that leaders should consider when evaluating the level of effort and MSL activity to support region needs as part of the performance weighting.

Another question posed to workshop participants was:

2. Which competency areas are most vital in today’s MSL field medical role?

Responses were graphed to show the frequency distribution of competencies leaders believe is most essential for current MSLs. Of the 49 responses, presentation skills and strategic focus were most commonly identified. Other responses indicate more soft skills are needed. In the past, one may have seen more focus on scientific acumen, however, today’s MSL needs strong strategic capabilities alongside emotional intelligence and soft skill savvy. Clearly, the competencies needed for success in a field medical role are broader than many other positions and reflect the evolution of the role with a greater need for nuanced dialogue, insights, and aligning with medical strategies to deliver value.

Prioritized Competencies for Success in MSL Role Today

N=49 responses

36% indicated Presentation Skills or Strategic Focus to be the most needed competency area in field medical affairs.

Performance Evaluation Cycle

Performance evaluation can be described as a cyclic process where goals are defined, observations occur leading to coaching and feedback on performance that culminates in a formal review with an overall evaluation. New goals are set and the process continues.

As the leader works with the MSL to establish clear goals and defined metrics for their region and calibrate expectations, there should be periodic checks done by the team leader to assess progress toward goals. The assistance or advice provided to the MSL to foster success through coaching and feedback from observations which may include internal stakeholder feedback as well as any feedback from field teams or external activities. Through a consistent coaching and feedback process, there should be no surprises during the performance review process and the MSL should feel encouraged, inspired, and supported to take on more challenging goals that deliver value back to the organization.

Sources of Performance Evaluation

The data for performance evaluation generally comes from a variety of sources as shown in the graphic below; the most common is direct observation such as viewing presentations or KOL meetings the MSL leads as well as looking at dashboard metrics to gauge levels of productivity that support value-added efforts. The team leader may also seek feedback from internal stakeholders and other field team members to share their input based on MSL efforts and this is referred to as indirect observation because the team leader is not there to observe directly. The team leader will also look at partnerships within the team and across the organization where the MSL may lend support such as with speaker training, leading conferences, supporting ad boards, assistance to draft standard response letters for medical information and so many more possible ways MSLs are involved with medical and strategic needs.

Type A High Performers

High performers are also known as high achievers. They’re the employees who consistently take on more work and leadership tasks and are eager to go above and beyond what their role requires. Type A personalities are typically driven, ambitious, and successful, and may even live longer due to their tenacity.¹ But, they are also more stressed and prone to depression, anxiety, and relationship problems. Type A personalities need encouragement to have more patience with themselves and others; don’t create unrealistic expectations. They need reassurance that failure is part of learning and will help them grow.

Consider these useful approaches when leading Type A Personality – High Performers:

Use direct language
Stay productive; focus on actions to take
Encourage healthy competition to take on challenges
Reduce stress factors; it’s ok to say no or not now at times
Create goal-oriented tasks that enhance focus
Give them leadership roles and training opportunities
Offer autonomy and let them show you what they can do
Don’t be late or delay efforts; keep projects on track
Have a timeline with clear expectations
Talk development often and give regular feedback/coaching

Workshop participants discussed key questions about performance evaluation in small groups; their responses are summarized.

Questions Asked of Workshop Participants and Group Feedback:

1. Is there a standard evaluation and promotion process for MSLs at your company?

If yes, what is it?
If no, how has this created more challenges for the managers and impacted MSL retention?

YES – We use forms, timelines, and competencies in our performance evaluation and promotion process.

There is a need to be more transparent with the performance process across teams
Staff struggle with why another is promoted and not them

YES – We have some performance resources, yet it is variable and should be enhanced

Need to include tenure timelines and ways to assess readiness for promotion

NO – No standard performance evaluations in place

2. Does your company currently use an MSL Competency Index to evaluate performance and recommend for promotion?

Which competencies are most widely used and/or valued in evaluating performance?
What is an effective blend of MSL competencies and Key Performance Metrics that should go into an annual performance plan?

NO – We use a checklist for responsibilities/expectations; need to understand levels of performance to advance our performance evaluation process

Move from MSL to Sr MSL based on “great relationships” / “attended advisory boards” which is not ideal

YES – We have performance evaluation tools and use them with transparency in our teams

Promotion Review Committee (PRC)

Once you have your MSL Competency Framework and Model in place you are ready to operationalize your program.

From an operations perspective, a PRC usually includes the Medical Affairs Leadership team and Human Resources. The committee generally meets twice a year to review proposed candidates for consideration. The set PRC meeting schedule helps managers and MSLs know how to coach and plan for promotion milestones.

Process:

Using the MSL competency framework, the MSL managers document with examples how the MSLs are functioning in those next level roles. Using examples is key to confirm competency in that specific area. We would recommend that MSLs should be functioning at that that next level competency for at least 6 months before being submitted for a promotion.

Meeting:

During the PRC meeting each nominating manager is given 10-15 minutes to present each candidate up for promotion. Highlighting their background training, time in the role, and the top 3-5 next level competencies that the MSL is excelling in is a good model for the presentation. After the presentation, the Medical Affairs Leadership team and HR are allowed to ask questions for follow-up and clarification. It is good practice to make sure all the nomination forms and supporting documents are received by the PRC members at least 5 business days prior to the meeting to allow for adequate review time.

Follow-up:

The PRC is expected to follow-up with the presenting manager with final decisions and recommendations within 5 business days of the meeting.

3. What parameters do you use to define “optimal performance”?

What are behaviors, benefits and positive results of optimal performance? What are negative impacts when performance is not optimal?

Optimal Performance:

Quality Interactions that yield valuable insights
Measurement of non-HCP activities and impact
Feedback from internal and external stakeholders
Being proactive; takes self-initiative with projects (self – driven)
Metrics that are pre-defined
Positive Results of Optimal Performance: self-motivation / consistency, adaptable, change enabler / positive change agent
Negatives when Performance is Not Optimal: unwillingness to change; poor team culture, lowering the bar; highly subjective performance data: MSL Involvement, internal projects, ad boards, IIR involvement, feedback from stakeholders, informal metrics

Summary

This workshop focused on 4 key aspects of performance evaluation and the promotion process:

1) Problems encountered when evaluating performance and promotion readiness and how to best address these needs.
2) Using and adapting a competency model for MSL evaluation, development, and growth that fosters good documentation for key performance areas.
3) How to balance metrics and other performance feedback sources to determine promotion readiness based on accomplishments founded in capabilities.
4) Ensuring competencies are built into the FCR and approach for consistent feedback and development that guides staff toward promotion

The most significant issue when evaluating MSL performance was metrics, whether there are differences in regions that impact opportunities to add value, access issues, examining how to measure impact and value and level of MSL experience as well as the need for a competency framework to systematically define core capabilities for field medical roles. Workshop participants were asked to identify which competencies were vital to success in the MSL role today. Of the 49 responses, presentation skills and strategic focus were most commonly identified. Other responses indicate a desire for more soft skills such as adaptability, emotional intelligence, and relationship building. More focus on technology as a competency area was noted.

The performance review process is cyclic with goal setting, coaching, and feedback as well as formal performance reviews that guide into the next cycle with new goals established. Sources of performance feedback may include direct or indirect observations, partnerships, KPIs / metrics that are pre-defined, and productivity levels. There is a high degree of subjectivity in the evaluation process which is why having an objective competency framework with definitions, stratified levels, and integration of competencies into field coaching tools or reports affords more consistent methods of assessing staff performance as well as guiding development needs using competencies. A promotion review committee comprised of medical affairs leaders and HR partners establishes a formal process to review nominees for promotion using the competencies to detail examples of performance levels above the current position as justification for supporting a promotion.

When participants were asked if they have a process for performance evaluation and promotion or whether they have an MSL competency framework, there were mixed responses indicating some organizations have nothing in place, some have imperfect tools that are evolving or need enhancement while others have more robust formalized performance and promotion review procedures in place. Clearly, there is more work to be done for many groups who seek to improve their ability to evaluate staff and document promotion readiness by instituting a competency framework for field medical.

Using competencies in FCR when providing performance feedback and coaching ensures a seamless performance review process where the staff understands areas they need to focus on for growth and have clarity around how to build capabilities to higher levels. Consider using a digital FCR which can provide additional data on learning needs and potentially nudge MSLs regarding areas to focus on. Further, evaluation of MSL impact through the use of a targeted approach to assessing external stakeholder baseline knowledge, tracking areas on a longitudinal basis to see a shift in knowledge and awareness levels provides a line of sight to how MSL education evolves understanding. Elevating MSL best practices can help identify current and future competency needs. Leveraging data that provides insights into trends and behaviors will allow MSLs to refine and improve their interactions to develop more targeted and impactful engagement plans.

Thank you to all the MSL Society workshop participants in this session at the 2022 annual conference who shared vital perspectives on this topic!

REFERENCES:

https://www.healthline.com/health/what-is-a-type-a-personality What it really means to have a type A personality. Nov 3, 2022

Authors:

Larry Dollar, PharmD, MS, MSL-BC

Larry Dollar has been a Senior Director and Field Medical Head at Takeda Oncology since 2014. Larry has also served in various MSL and MSL Director roles with Sanofi/Aventis, TAP, and Millennium Pharmaceuticals since 2000. He received his BS in Pharmacy from the University of Kansas, his MS in Pharmaceutical Sciences from the University of Missouri-Kanas City, and his PharmD from Idaho State University. His pharmaceutical career also includes experience in clinical research, medical research, and regulatory affairs. Larry currently lives in Prairie Village, Kansas, and enjoys spending time with his wife and four children.

Cherie Hyder, PharmD, MSL-BC

Cherie Hyder is Syndicated National MSL Director at Syneos Health. In her previous job at Biohaven Pharmaceuticals, she supported a virtual launch of Nurtec ODT for acute migraine. She has been involved in drug development for more than 30 years, working at FDA in CDER and pharmaceutical companies including Pfizer, Lilly, Novartis, Solvay, and Avanir, among others. At the University of Missouri, she received a Doctor of Pharmacy degree with the intention to devote her career to pharmaceutical research. She has multiple adjunct faculty appointments and enjoys teaching opportunities

Celeste Mosby

Celeste brings over 25 years of industry experience to the learning solutions capability at Syneos Health. She is a recognized leader in the industry as a past Healthcare Business Women’s Syneos Health Luminary Award Winner and 2021 LTEN Excellence Award Winner. Celeste will bring deep industry experience, strong partnering skills, and keen insights on learning trends into strategic training conversations. Her expertise in Adult Learning, assessment, and measurement will also allow her to quantifiably demonstrate the value of learning/training.

ROLE AT SYNEOS HEALTH:

As General Manager, and VP of Design, Celeste is responsible for leading the Learning Solutions team, providing strategic guidance, and managing client relationships. Celeste is presently the Project Lead for strategic projects which include commercial, medical/clinical, R&D, and market access curriculum development & deployment strategies.

BACKGROUND & EXPERIENCE:

Celeste brought practical experience to every client engagement as Vice President of the global Life Sciences vertical for Wilson Learning. She set Wilson Learning’s strategic direction for content expertise and delivery for the life sciences marketplace and led a team focused on addressing the unique performance improvement needs of the industry. Celeste also worked in sales for Eli Lilly and as an Antiviral Marketing Specialist for Astra Pharmaceuticals in the hospital division and as a Clinical Liaison Manager at Managed Healthcare Associates, where she developed customized formularies, education, and pull-through programs for physicians, nurses, consultant pharmacists, and other healthcare professionals. Celeste has vast experience in Medical and Managed Markets delivery from her years as Director of many Brand Team projects at Managed EDGE a Euro RSCG company, now Havas, a leading Global Advertising Agency. Celeste built the Clinical, Medical, and Commercial Assessment, Measurement/Impact Evaluation & Survey Study practice within Syneos Health’s Learning Solutions group.

ADDITIONAL RELEVANT EXPERIENCE:

Celeste has been involved in projects covering multiple therapeutic areas as well as clinical/medical, hospital & managed markets environments. Understanding how to make sense of complex strategic and tactical integrated launch excellence, leadership, medical/clinical, sales or marketing solutions is a particular strength. Celeste also helps to lead the Learning Solutions group’s innovation in digital/virtual assessment, clinical survey study design & learning strategy.

Arshi Gupta

Arshi Gupta is a leader in the healthcare and life sciences industry and is at the helm of global and regional efforts leading to transform Clinical, Medical Affairs, and Commercial activities, with the last few years focused on the evolution of Medical Affairs. Arshi collaborates with life sciences organizations to help drive efficiency and support the lifecycle of an asset by transforming the underlying strategy and operational infrastructure with the use of data and innovative solutions.