A Novel Measure of "Good" Mentoring: Testing Its Reliability and Validity in Four Academic Health Centers

Group peer mentoring is effective for different demographic groups of biomedical research faculty: A controlled trial

INTRODUCTION

Improved mentoring of midcareer researchers in medical schools has been identified as an important potential avenue for addressing low vitality and high burnout rates in faculty, and the scarcity of both underrepresented minority (URM) faculty and women in biomedical research. To address the need for widescale effective mentoring, we sought to determine whether a group peer mentoring intervention (C-Change Mentoring and Leadership Institute) for early midcareer research faculty was effective for different demographic groups in a controlled trial.

METHODS AND MATERIALS

Thirty-five diverse early midcareer faculty and 70 propensity-matched (PM) control subjects matched to intervention subjects on a) study inclusion criteria; b) gender, race, and ethnicity, degree, rank, years of experience, publications, grants; and c) pretest survey outcome variables, participated in the intervention. The C-Change Participant Survey assessed vitality, self-efficacy in career advancement, research success, mentoring others, valuing diversity, cognitive empathy, and anti-sexism/anti-racism skills at pretest and intervention completion. Analysis using multiple regression models included outcome pretest values and indicator variables for intervention, gender, URM status, and MD vs. PhD. Hypotheses regarding differential effectiveness of the intervention by demographic group were tested by including cross-product terms between the demographic indicator variables and the intervention indicator. Missing data were addressed using chained equations to create 100 data sets.

RESULTS AND DISCUSSION

The intervention participants had significantly higher (favorable) scores than PM controls for: self-assessed change in vitality; self-efficacy for career advancement, research, and mentoring others; cognitive empathy; and anti-sexism/racism skills. The benefits of the intervention were nearly identical across: gender, URM vs non-URM faculty, and degree MD/PhD, except vitality significantly increased for non-URM subjects, and not for URM faculty. Self-assessed change in vitality increased for URM and non-URM.

CONCLUSION

The intervention worked successfully for enhancing vitality, self-efficacy and cross-cultural engagement across different demographic groups of biomedical research faculty.

Does Sponsorship Promote Equity in Career Advancement in Academic Medicine? A Scoping Review

Sponsorship describes a set of actions wherein an influential champion (sponsor) uses their position to actively support a colleague's career by helping them gain visibility, recognition, and/or positions. There is growing awareness of the importance of sponsorship for career advancement in academic medicine, particularly for women and those who are historically underrepresented and excluded in medicine (UIM). This scoping review examines the current landscape of evidence, and knowledge gaps, on sponsorship as it relates to career advancement in academic medicine for women and UIM faculty. We searched peer-reviewed literature in PubMed, Embase, and Web of Science (WoS) over the past 50 years (from 1973 through July 2023). Sixteen studies were included in the final review. We found relative consensus on sponsorship definition and value to career advancement. Heterogeneity in study design limited our ability to directly compare study outcomes. All included studies focused on gender differences in sponsorship: two of four quantitative studies found men were more likely to receive sponsorship, one reported no gender differences, and one was insufficiently powered. All but one of the qualitative studies reported gender differences, with women less likely to access or be identified for sponsorship. The mixed-methods studies suggested sponsorship may vary by career stage. Only two studies analyzed sponsorship for UIM populations. The existing data are inconclusive regarding best ways to measure and assess sponsorship, what institutional support (e.g., structured programs, formal recognition, or incentives for sponsorship) should look like, and at what career stage sponsorship is most important. Addressing this knowledge gap will be critically important for understanding what sponsorship best practices, if any, should be used to promote equity in career advancement in academic medicine. We advocate for commitment at the institutional and national levels to develop new infrastructure for transparently and equitably supporting women and UIM in career advancement.

Randomized controlled trial of a group peer mentoring model for U.S. academic medicine research faculty

Introduction

Midcareer is a critical transition point for biomedical research faculty and a common dropout point from an NIH-funded career. We report a study to assess the efficacy of a group peer mentoring program for diverse biomedical researchers in academic medicine, seeking to improve vitality, career advancement, and cross-cultural competence.

Methods

We conducted a stratified randomized controlled trial with a waitlist control group involving 40 purposefully diverse early midcareer research faculty from 16 states who had a first-time NIH R01 (or equivalent) award, a K training grant, or a similar major grant. The yearlong intervention (2 to 3 days quarterly) consisted of facilitated, structured, group peer mentoring. Main study aims were to enhance faculty vitality, self-efficacy in achieving research success, career advancement, mentoring others, and cultural awareness and appreciation of diversity in the workplace.

Results

Compared to the control group, the intervention group's increased vitality did not reach statistical significance (P = 0.20), but perceived change in vitality was 1.47 standard deviations higher (D = 1.47, P = 0.03). Self-efficacy for career advancement was higher in the intervention group (D = 0.41, P = 0.05) as was self-efficacy for research (D = 0.57, P = 0.02). The intervention group also valued diversity higher (D = 0.46, P = 0.02), had higher cognitive empathy (D = 0.85, P = 0.03), higher anti-sexism/racism skills (D = 0.71, P = 0.01), and higher self-efficacy in mentoring others (D = 1.14, P = 0.007).

Conclusions

The mentoring intervention resulted in meaningful change in important dimensions and skills among a national sample of diverse early midcareer biomedical faculty. This mentoring program holds promise for addressing the urgencies of sustaining faculty vitality and cross-cultural competence.

Are researchers in academic medicine flourishing? A survey of midcareer Ph.D. and physician investigators

Introduction

Midcareer research faculty are a vital part of the advancement of science in U.S. medical schools, but there are troubling trends in recruitment, retention, and burnout rates.

Methods

The primary sampling frame for this online survey was recipients of a single R01 or equivalent and/or K-award from 2013 to 2019. Inclusion criteria were 3-14 years at a U.S. medical school and rank of associate professor or two or more years as assistant professor. Forty physician investigators and Ph.D. scientists volunteered for a faculty development program, and 106 were propensity-matched controls. Survey items covered self-efficacy in career, research, work-life; vitality/burnout; relationships, inclusion, trust; diversity; and intention to leave academic medicine.

Results

The majority (52%) reported receiving poor mentoring; 40% experienced high burnout and 41% low vitality, which, in turn, predicted leaving intention (P < 0.0005). Women were more likely to report high burnout (P = 0.01) and low self-efficacy managing work and personal life (P = 0.01) and to be seriously considering leaving academic medicine than men (P = 0.003). Mentoring quality (P < 0.0005) and poor relationships, inclusion, and trust (P < 0.0005) predicted leaving intention. Non-underrepresented men were very likely to report low identity self-awareness (65%) and valuing differences (24%) versus underrepresented men (25% and 0%; P < 0.0005). Ph.D.s had lower career advancement self-efficacy than M.D.s (P < .0005).

Conclusions

Midcareer Ph.D. and physician investigators faced significant career challenges. Experiences diverged by underrepresentation, gender, and degree. Poor quality mentoring was an issue for most. Effective mentoring could address the concerns of this vital component of the biomedical workforce.

Using a Modified Delphi Approach and Nominal Group Technique for Organisational Priority Setting of Evidence-Based Interventions That Advance Women in Healthcare Leadership

BACKGROUND

Few studies address how to prioritise organisational interventions that advance women in leadership. We report on the relevance, feasibility and importance of evidence-based interventions for a large healthcare organisation. This study supports the first stage of implementation in a large National Health and Medical Research Council funded initiative seeking to advance women in healthcare leadership.

METHODS

An expert multi-disciplinary panel comprised of health professionals and leaders from a large healthcare network in Australia participated. The initial Delphi survey was administered online and results were presented in a Nominal Group Technique workshop. Here, the group made sense of the survey results, then evaluated findings against a framework on implementation criteria. Two further consensus surveys were conducted during the workshop.

RESULTS

Five priority areas were identified. These included: 1. A committed and supportive leadership team; 2. Improved governance structures; 3. Mentoring opportunities; 4. Leadership training and development; and 5. Flexibility in working. We describe the overall priority setting process in the context of our findings.

CONCLUSIONS

With evidence and expert input, we established priorities for advancing women in healthcare leadership with a partnering healthcare organisation. This approach can be adapted in other settings, seeking to advance women in leadership.

Advancing women in healthcare leadership: A systematic review and meta-synthesis of multi-sector evidence on organisational interventions

BACKGROUND

Women are underrepresented in healthcare leadership, yet evidence on impactful organisational strategies, practices and policies that advance women's careers are limited. We aimed to explore these across sectors to gain insight into measurably advancing women in leadership in healthcare.

METHODS

A systematic review was performed across Medline via OVID; Medline in-process and other non-indexed citations via OVID; PsycINFO and SCOPUS from January 2000 to March 2021. Methods are outlined in a published protocol registered a priori on PROSPERO (CRD42020162115). Eligible studies reported on organisational interventions for advancing women in leadership with at least one measurable outcome. Studies were assessed independently by two reviewers. Identified interventions were organised into categories and meta-synthesis was completed following the 'ENhancing Transparency in REporting the synthesis of Qualitative research' (ENTREQ) statement.

FINDINGS

There were 91 eligible studies from 6 continents with 40 quantitative, 38 qualitative and 13 mixed methods studies. These spanned academia, health, government, sports, hospitality, finance and information technology sectors, with around half of studies in health and academia. Sample size, career stage and outcomes ranged broadly. Potentially effective interventions consistently reported that organisational leadership, commitment and accountability were key drivers of organisational change. Organisational intervention categories included i) organisational processes; ii) awareness and engagement; iii) mentoring and networking; iv) leadership development; and v) support tools. A descriptive meta-synthesis of detailed strategies, policies and practices within these categories was completed.

INTERPRETATION

This review provides an evidence base on organisational interventions for advancing women in leadership across diverse settings, with lessons for healthcare. It transcends the focus on the individual to target organisational change, capturing measurable change across intervention categories. This work directly informs a national initiative with international links, to enable women to achieve their career goals in healthcare and moves beyond the focus on barriers to solutions.

Development and preliminary testing of the collaboration for leadership and innovation in mentoring survey: An instrument of nursing PhD mentorship quality

BACKGROUND

High-quality PhD nursing student mentorship facilitates student and program success. Extant literature recommends evaluating and improving mentorship to foster optimal PhD student development. However, a comprehensive measure capturing all aspects of mentorship salient to PhD nursing student wellbeing and success is not available.

OBJECTIVES

The purpose of this pilot study was to develop a new instrument - the Collaboration for Leadership and Innovation in Mentoring (CLIM) - for quantifying important components of PhD student mentorship in nursing, and to preliminarily test its psychometric properties (content validity, sensitivity, test-retest reliability).

DESIGN

The study employed a cross-sectional design.

SETTING

The CLIM instrument was administered to nursing PhD students at a public state university in the United States.

PARTICIPANTS

Sixteen nursing PhD students at various stages in their degree progression completed the instrument.

METHODS

PhD nursing students developed unique items based on qualitative data collected by the University using an Appreciative Inquiry framework. Seven nursing and non-nursing experts with experience in PhD mentorship evaluated content validity. After revisions, the final 44-item instrument was administered at two time points (one month apart) to allow assessment of test-retest reliability. Test-retest reliability was evaluated using Spearman-rank correlations and data from students with ≥1 year of experience with their mentor.

RESULTS

Response rates were 94% for both administrations (n = 16). The instrument's overall Content Validity Index (CVI) was 0.91 (p = 0.05). Test-retest analyses resulted in high correlations (r = 0.91, p < 0.001), further supporting reliability of the CLIM instrument.

CONCLUSIONS

Preliminary evidence suggests that the CLIM instrument is a reliable instrument of PhD mentorship in nursing. However, additional testing in larger and more diverse graduate student populations is needed to evaluate internal consistency reliability, among other psychometric properties.

What Are the Unique Mentorship Needs of Fourth-Year Medical Students Applying to Pediatrics Residency?

OBJECTIVE

The qualities of good medical school mentors have been well described. However, there is little written about the mentoring needs of medical students applying to pediatrics residency.

METHODS

In order to characterize pediatrics interns' perspectives on the mentorship needs of fourth-year medical students applying to residency, the authors conducted an IRB-approved, qualitative-modified grounded-theory study using a brief survey and semistructured focus groups of pediatric interns in January and February 2018. Two investigators independently coded the focus group transcripts and reconciled codes to develop categories and themes using constant comparison, which were then reviewed by the third author for validation. To further ensure trustworthiness of analysis, participants were asked to comment on the themes' accuracy.

RESULTS

Eighteen pediatrics interns participated, representing 15 medical schools. Four major themes emerged: 1) effective mentors guide medical students to self-reflect and find their own answers about what is important to them in a residency program; 2) multiple mentors are helpful during the residency application process; 3) several key components of advising are often missing during the residency application process; 4) students find it difficult to be honest with their mentors if there is a perceived conflict of interest.

CONCLUSIONS

Medical students applying for pediatrics residency have specific mentorship needs and cite opportunities to improve this area of mentorship. Several key recommendations include utilizing multiple mentors and providing emotional support during the residency application process. In addition, near-peer mentorship is important for medical students applying to residency and should be facilitated by medical schools.

Assessing mentoring: A scoping review of mentoring assessment tools in internal medicine between 1990 and 2019

BACKGROUND

Mentoring's success in enhancing a mentee's professional and personal development, and a host organisations' reputation has been called into question, amidst a lack of effective tools to evaluate mentoring relationships and guide oversight of mentoring programs. A scoping review is proposed to map available literature on mentoring assessment tools in Internal Medicine to guide design of new tools.

OBJECTIVE

The review aims to explore how novice mentoring is assessed in Internal Medicine, including the domains assessed, and the strengths and limitations of the assessment methods.

METHODS

Guided by Levac et al.'s framework for scoping reviews, 12 reviewers conducted independent literature reviews of assessment tools in novice mentoring in PubMed, Embase, Scopus, ERIC, Cochrane, GreyLit, Web of Science, Open Dissertations and British Education Index databases. A 'split approach' saw research members adopting either Braun and Clarke's approach to thematic analysis or directed content analysis to independently evaluate the data and improve validity and objectivity of the findings.

RESULTS

9662 abstracts were identified, 187 full-text articles reviewed, and 54 full-text articles included. There was consensus on the themes and categories identified through the use of the split approach, which were the domains assessed and methods of assessment.

CONCLUSION

Most tools fail to contend with mentoring's evolving nature and provide mere snap shots of the mentoring process largely from the mentee's perspective. The lack of holistic, longitudinal and validated assessments propagate fears that ethical issues in mentoring are poorly recognized and addressed. To this end, we forward a framework for the design of 'fit for purpose' multi-dimensional tools.

PRACTICE POINTS

Most tools focus on the mentee's perspective, do not consider mentoring's evolving nature and fail to consider mentoring holistically nor longitudinallyA new tool capable of addressing these gaps must also consider inputs from all stakeholders and take a longitudinal perspective of mentoring.

What Mentors Tell Us About Acknowledging Effort and Sustaining Academic Research Mentoring: A Qualitative Study

INTRODUCTION

Continuing education is necessary to foster new and effective research mentoring skills. We asked faculty about their research mentoring practices and what would support their skills and abilities as ongoing and effective research mentors.

METHODS

Twenty-two experienced mentors were interviewed and asked about perceived areas for improvement, and challenges and facilitators to continued research mentoring. Responses were analyzed with qualitative techniques using semistructured interviews, grounded theory, and a constant comparative analytic strategy.

RESULTS

The average time since the completion of the doctoral degree was 26 years. Twenty-one participants believed that more comprehensive institutional acknowledgment for their efforts would enhance research mentoring. This specifically included acknowledging their time spent and service (ie, effort) in multiple in-person and behind-the-scenes tasks. These research mentoring efforts were largely viewed as overlooked by the traditional focus on the achievement of tangible outcomes. Participants thought that a formal plan to organize research mentoring (such as a mentor's charter, and continuing education tailored to both novice and experienced research mentors) was needed to promote evolution of skills and documentation of time and service. Possible methods to support research mentors were suggested and included financial support for travel to national meetings, assistance in developing new projects, and consideration of mentoring activities in the process for academic promotion.

DISCUSSION

Research mentors wanted their achievements, time spent, and service (ie, effort) to be acknowledged by the institution. A formal written mentoring charter and corresponding continuing education could facilitate acknowledging achievements, time, and service and thus help to sustain academic research mentoring.

Transforming mentorship in STEM by training scientists to be better leaders

Effective mentoring is a key component of academic and career success that contributes to overall measures of productivity. Mentoring relationships also play an important role in mental health and in recruiting and retaining students from groups underrepresented in STEM fields. Despite these clear and measurable benefits, faculty generally do not receive mentorship training, and feedback mechanisms and assessment to improve mentoring in academia are limited. Ineffective mentoring can negatively impact students, faculty, departments, and institutions via decreased productivity, increased stress, and the loss of valuable research products and talented personnel. Thus, there are clear incentives to invest in and implement formal training to improve mentorship in STEM fields. Here, we outline the unique challenges of mentoring in academia and present results from a survey of STEM scientists that support both the need and desire for more formal mentorship training. Using survey results and the primary literature, we identify common behaviors of effective mentors and outline a set of mentorship best practices. We argue that these best practices, as well as the key qualities of flexibility, communication, and trust, are skills that can be taught to prospective and current faculty. We present a model and resources for mentorship training based on our research, which we successfully implemented at the University of Colorado, Boulder, with graduate students and postdocs. We conclude that such training is an important and cost-effective step toward improving mentorship in STEM fields.