Mentorship in the Context of Interdisciplinary Geriatric Research: Lessons Learned from the RAND/Hartford Program for Building Interdisciplinary Geriatric Research Centers

In light of the growing trend toward formalized research mentorship for effectively transmitting the values, standards, and practices of science from one generation of researchers to the next, this article provides the results of an exploratory study. It reports on research mentorship in the context of interdisciplinary geriatric research based on experiences with the RAND/Hartford Program for Building Interdisciplinary Geriatric Research Centers. At the end of the 2-year funding period, staff from the RAND Coordinating Center conducted 60- to 90-minute open-ended telephone interviews with the co-directors of the seven centers. Questions focused on interdisciplinary mentorship activities, barriers to implementing these activities, and strategies for overcoming them, as well as a self-assessment tool with regard to programs, policies, and structures across five domains, developed to encourage research mentorship. In addition, the mentees at the centers were surveyed to assess their experiences with interdisciplinary mentoring and the center. According to the interviewees, some barriers to successful interdisciplinary mentoring included the mentor's lack of time, structural support, and the lack of a clear definition of interdisciplinary research. Most centers had formal policies in place for mentor identification and limited policies on mentor incentives. Mentees uniformly reported their relationships with their mentors as positive. More than 50% of mentees reported having a primary mentor from within their discipline and had more contact with their primary mentor than their secondary mentors. Further research is needed to understand the complexity of institutional levers that emerging programs might employ to encourage and support research mentorship.     

Mentoring the mentor: another tool to enhance mentorship

Highlighting in a proactive fashion the importance of mentoring and of mentoring the mentors helps enrich how our medical societies can further contribute to the well-being of society at large. Implementation of a successful mentoring program is likely to perpetuate and grow the positive effects of mentorship, and mentoring-the-mentor considerations raised herein are likely to enhance overall mentorship. Mentoring the mentors provides an alternative "top down" approach to complement the essential and more traditional "bottom up" emphasis that we currently aim to provide to trainees on the importance of identifying appropriate mentors and what it takes to be role model mentees.     

The impact of COVID-19 on mentoring early-career investigators: “Everything can wait. Listen more than usual and share your own struggles”

The COVID-19 pandemic disrupted almost all sectors of academic training and research, but the impact on human immunodeficiency virus (HIV) research mentoring has yet to be documented. We present the perspectives of diverse, experienced mentors in a range of HIV research disciplines on the impact of COVID-19 on mentoring the next generation of HIV researchers.In November to December, 2020, we used an online data collection platform to cross-sectionally query previously-trained HIV mentors on the challenges related to mentoring during the pandemic, surprising/positive aspects of mentoring in that context, and recommendations for other mentors. Data were coded and analyzed following a thematic analysis approach.Respondents (180 of 225 mentors invited [80% response]) reported challenges related to relationship building/maintenance, disruptions in mentees’ training and research progress, and mentee and mentor distress, with particular concerns regarding mentees who are parents or from underrepresented minority backgrounds. Positive/surprising aspects included logistical ease of remote mentoring, the relationship-edifying result of the shared pandemic experience, mentee resilience and gratitude, and increased enjoyment of mentoring. Recommendations included practical tips, encouragement for patience and persistence, and prioritizing supporting mentees’ and one''s own mental well-being.Findings revealed gaps in HIV mentors’ competencies, including the effective use of remote mentoring tools, how to work with mentees in times of distress, and the prioritization of mentor well-being. Mentors are in a unique position to identify and potentially address factors that may lead to mentees leaving their fields, especially parents and those from underrepresented backgrounds. We discuss implications beyond the COVID-19 pandemic.     

Exploring Mentoring Experiences,Perceptions, and Needs of General Internal Medicine Clinician Educators Navigating Academia: a Mixed-Methods Study

BackgroundFew studies examined specific mentoring needs and preferences of clinician educators (CEs). Further research on CEs’ perceptions of mentoring adequacy, as related to educational development and career advancement, is needed.ObjectiveThe study aims were to (1) explore general internal medicine CEs’ experiences as mentees within various mentoring models; (2) examine the perceived quality, nature, and impact of mentoring on career development; and (3) determine whether specific models of mentoring impact their attitudes towards mentoring.DesignSequential mixed methods study design answered the study questions.ParticipantsSociety of General Internal Medicine members identifying themselves as CEs.Main measures/ApproachParticipants completed an anonymous online survey and a subsample participated in two semi-structured focus group discussions. Outcomes of interest were perceptions of mentoring experiences, and perspectives on quality of mentoring as well as mentoring needs specific to clinician educators.Key ResultsOne hundred thirty-nine participants completed the survey (37% response rate) with 20 participants in focus group discussions. Among CEs with perceived high-quality mentor relationships (e.g., reporting strongly agree), peer mentorship was viewed as adequate mentorship (45% (n = 17) vs 24% (n = 24), p < 0.05), as beneficial for career development (77% (n = 40) vs 48% (n = 41), p < 0.01) and as being challenged to become a better CE (58% (n = 30) vs 35% (n = 29), p < 0.05), compared to reporting agree or lower. Qualitative analysis generated four themes: (1) A mentoring team promotes career advancement, (2) peer mentors are important at every stage of a CE’s career, (3) there is inadequate mentoring specific to CE needs, and (4) mentoring needs protected time and skill development.ConclusionsThe traditional dyadic mentoring relationship may not adequately address all professional needs of CEs. A mentoring team can provide valuable perspectives on career goals. Peer mentoring can be powerful for professional growth. Mentoring needs change at different career stages and training in mentoring skills is essential.KEY WORDS: clinician educator, mentoring experiences, peer mentor, mentee, mentor     

Cultivating Medical Education Research Mentorship as a Pathway Towards High Quality Medical Education Research

The lack of effective and consistent research mentorship and research mentor training in both undergraduate medical education (UME) and graduate medical education (GME) is a critical constraint on the development of innovative and high quality medical education research. Clinical research mentors are often not familiar with the nuances and context of conducting education research. Clinician-educators, meanwhile, often lack the skills in developing and conducting rigorous research. Mentors who are not prepared to articulate potential scholarship pathways for their mentees risk limiting the mentee’s progress in early stages of their career. In fact, the relative paucity of experienced medical education research mentors arguably contributes to the perpetuation of a cycle leading to fewer well-trained researchers in medical education, a lack of high quality medical education research, and relative stagnation in medical education innovation. There is a path forward, however. Integration of doctoral-level educators, structured inter-departmental efforts, and external mentorship provide opportunities for faculty to gain traction in their medical education research efforts. An investment in medical education research mentors will ensure rigorous research for high quality innovation in medical education and patient care.The recent report from the Institute of Medicine (IOM)¹ calling for finance reform for graduate medical education based its findings on evidence within medical education, while simultaneously acknowledging that there was a limited amount of such evidence. In response, Asch & Weinstein² noted that the paucity of medical education research and funding for such research “reflects a systematic lack of research investment in an area of health care that we believe deserves better.” However, inadequate funding is only one aspect of the complex problem of increasing the quality and quantity of medical education research (MER). To cultivate the high quality MER that can support critical decision-making, medical education must focus on the development of highly qualified MER mentors.     

La relación mentor-aprendiz en medicina

This study will review various aspects of the mentoring process, mainly in the medical field (both educational and research), in order to describe the mentor's role, the characteristics of the ideal mentor and mentee, how to find a good mentor, mentoring types, the benefits of a mentor-mentee relationship, and potential obstacles and possible solutions. Our ultimate goal is to encourage potential mentors to become actual mentors, and potential mentees to actively seek a mentor and not lose the opportunity to receive this precious gift that many of us have been fortunate to enjoy.     

Mentorship of Underrepresented Physicians and Trainees in Academic Medicine: a Systematic Review

BackgroundThough the USA is becoming increasingly diverse, the physician workforce contains a disproportionately low number of physicians from racial and ethnic groups that are described as underrepresented in medicine (URiM). Mentorship has been proposed as one way to improve the retention and experiences of URiM physicians and trainees. The objective of this systematic review was to identify and describe mentoring programs for URiM physicians in academic medicine and to describe important themes from existing literature that can aid in the development of URiM mentorship programs.MethodsThe authors searched PubMed, PsycINFO, ERIC, and Cochrane databases, and included original publications that described a US mentorship program involving academic medical doctors at the faculty or trainee level and were created for physicians who are URiM or provided results stratified by race/ethnicity.ResultsOur search yielded 4,548 unique citations and 31 publications met our inclusion criteria. Frequently cited objectives of these programs were to improve research skills, to diversify representation in specific fields, and to recruit and retain URiM participants. Subjective outcomes were primarily participant satisfaction with the program and/or work climate. The dyad model of mentoring was the most common, though several novel models were also described. Program evaluations were primarily subjective and reported high satisfaction, although some reported objective outcomes including publications, retention, and promotion. All showed satisfactory outcomes for the mentorship programs.DiscussionThis review describes a range of successful mentoring programs for URiM physicians. Our recommendations based on our review include the importance of institutional support for diversity, tailoring programs to local needs and resources, training mentors, and utilizing URiM and non-URiM mentors.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-020-06478-7.KEY WORDS: mentorship, underrepresented in medicine     

Mentoring in genitourinary medicine

Mentoring is a process whereby one doctor (the mentor) facilitates and encourages another doctor (the mentee) to develop their career, in light of their own priorities. Mentees benefit from time dedicated to addressing their needs, challenging the status quo, and exploring ways to change. Mentoring schemes depend on the availability and enthusiasm of suitably trained mentors, as well as the voluntary participation of mentees. The specialty of genitourinary (GU) medicine is setting up such a scheme, which will initially be offered to new consultants. Workshops to train mentors are starting that are specifically tailored to our specialty. We discuss the principles and benefits of mentoring, different models that can be used, and potential difficulties. We also present the results of a survey that demonstrated widespread interest in mentoring within GU medicine.     

Defining the ideal qualities of mentorship: a qualitative analysis of the characteristics of outstanding mentors

Objective

The study's objective was to identify the important qualities of outstanding mentors as described by their mentees' letters of nomination for a prestigious lifetime achievement award in mentorship.

Methods

The Lifetime Achievement in Mentorship Award at the University of California, San Francisco, recognizes a faculty member who has demonstrated sustained mentoring excellence in the academic health sciences. Recommendation letters in support of the top 10 nominees in 2008 (n = 53 letters) were analyzed using grounded theory and constant comparative technique until thematic saturation was achieved.

Results

In 2008, 29 faculty members (of >1000 eligible senior faculty) were nominated. Nominees were 53 to 78 years old, and 30% were women. The nominees represented 4 schools (Medicine, Nursing, Pharmacy and Dentistry) and 22 departments/divisions. Five themes emerged from the analysis. Outstanding mentors: 1) exhibit admirable personal qualitites, including enthusiasm, compassion, and selflessness; 2) act as a career guide, offering a vision but purposefully tailoring support to each mentee; 3) make strong time commitments with regular, frequent, and high-quality meetings; 4) support personal/professional balance; and 5) leave a legacy of how to be a good mentor through role modeling and instituting policies that set global expectations and standards for mentorship.

Conclusion

This is the first study to describe the qualities of admired mentors by analyzing nomination letters for a prestigious mentoring award. Our results give new insight into how mentors foster the careers of junior faculty in the academic health sciences. The results can guide academic leaders on how to train and evaluate mentors.     

Mentoring at the University of Pennsylvania: Results of a Faculty Survey

Background Research suggests mentoring is related to career satisfaction and success. Most studies have focused on junior faculty. Objective To explore multiple aspects of mentoring at an academic medical center in relation to faculty rank, track, and gender. Design Cross-sectional mail survey in mid-2003. Participants Faculty members, 1,432, at the University of Pennsylvania School of Medicine Measurements Self-administered survey developed from existing instruments and stakeholders. Results Response rate was 73% (n = 1,046). Most (92%) assistant and half (48%) of associate professors had a mentor. Assistant professors in the tenure track were most likely to have a mentor (98%). At both ranks, the faculty was given more types of advice than types of opportunities. Satisfaction with mentoring was correlated with the number of types of mentoring received (r = .48 and .53, P < .0001), job satisfaction (r = .44 and .31, P < .0001), meeting frequency (r = .53 and .61, P < .0001), and expectation of leaving the University within 5 years (Spearman r = −.19 and −.18, P < .0001), at the assistant and associate rank, respectively. Significant predictors of higher overall job satisfaction were associate rank [Odds ratio (OR) = 2.04, CI = 1.29–3.21], the 10-point mentoring satisfaction rating (OR = 1.27, CI = 1.17–1.35), and number of mentors (OR = 1.60, CI = 1.20–2.07). Conclusions Having a mentor, or preferably, multiple mentors is strongly related to satisfaction with mentoring and overall job satisfaction. Surprisingly, few differences were related to gender. Mentoring of clinician–educators, research track faculty, and senior faculty, and the use of multiple mentors require specific attention of academic leadership and further study.     

The benefits of being a senior mentor: Cultivating resilience through the mentorship of health professions students

ABSTRACT

Senior Mentor Programs (SMPs) pair community-dwelling older adults with health professions students to facilitate knowledge, improve communication skills, and promote positive attitudes regarding the aging process. Although evidence exists that SMPs meet these goals, the programs’ psychosocial impact on the senior mentors remains unexplored. The current study assessed 101 mostly female (64.4%) senior mentors (M age = 77.6) pre- and postprogram. Although mentors had no change in the amount of perceived ageism experienced or expectation of experiencing ageism, their concern/anxiety over ageism significantly decreased from pre- (M = 21.58) to posttest (M = 20.19). Qualitative thematic analysis indicated meaningfulness of program and scheduling difficulties as prevalent themes. Mentors who reported less concern about ageism following the program were more likely to have experienced ageism in the year prior to the program and to attend religious services more often, another potential intergenerational contact. These results highlight possible benefits of mentor service for older adults.     

Resident Satisfaction with Continuity Clinic and Career Choice in General Internal Medicine

Background

The quality of the continuity clinic experience for internal medicine (IM) residents may influence their choice to enter general internal medicine (GIM), yet few data exist to support this hypothesis.

Objective

To assess the relationship between IM residents’ satisfaction with continuity clinic and interest in GIM careers.

Design

Cross-sectional survey assessing satisfaction with elements of continuity clinic and residents'' likelihood of career choice in GIM.

Participants

IM residents at three urban medical centers.

Main Measures

Bivariate and multivariate associations between satisfaction with 32 elements of outpatient clinic in 6 domains (clinical preceptors, educational environment, ancillary staff, time management, administrative, personal experience) and likelihood of considering a GIM career.

Key Results

Of the 225 (90 %) residents who completed surveys, 48 % planned to enter GIM before beginning their continuity clinic, whereas only 38 % did as a result of continuity clinic. Comparing residents’ likelihood to enter GIM as a result of clinic to likelihood to enter a career in GIM before clinic showed that 59 % of residents had no difference in likelihood, 28 % reported a lower likelihood as a result of clinic, and 11 % reported higher likelihood as a result of clinic. Most residents were very satisfied or satisfied with all clinic elements. Significantly more residents (p ≤ 0.002) were likely vs. unlikely to enter GIM if they were very satisfied with faculty mentorship (76 % vs. 53 %), time for appointments (28 % vs. 11 %), number of patients seen (33 % vs. 15 %), personal reward from work (51 % vs. 23 %), relationship with patients (64 % vs. 42 %), and continuity with patients (57 % vs. 33 %). In the multivariate analysis, being likely to enter GIM before clinic (OR 29.0, 95 % CI 24.0–34.8) and being very satisfied with the continuity of relationships with patients (OR 4.08, 95 % CI 2.50–6.64) were the strongest independent predictors of likelihood to enter GIM as a result of clinic.

Conclusions

Resident satisfaction with most aspects of continuity clinic was high; yet, continuity clinic had an overall negative influence on residents’ attitudes toward GIM careers. Targeting resources toward improving ambulatory patient continuity, workflow efficiency and increasing pre-residency interest in primary care may help build the primary care workforce.Key Words: medical education—career choice, medical education—graduate, primary care, ambulatory medicine     

Surviving and Thriving as Physicians in General Internal Medicine Fellowship in the Twenty-First Century

General internal medicine (GIM) fellowships play an important role in the development of physician scientists and clinical educators, as well as leaders in academic medicine. Nevertheless, the challenges of developing another novel aspect to one’s career, along with balancing coursework, research productivity, clinical duties, and personal life during fellowship, can be overwhelming. Similarly, successfully securing a job at the end of fellowship can be a daunting process. In this article, we discuss the foundational tenets and themes of the GIM fellowship. These themes include (1) finding your purpose and passion, with a focus on selecting research coursework and developing an area of study; (2) the role and importance of mentorship, including the various kinds of mentorship that fellows require (traditional and peer mentorship, sponsors, and coaches), as well as how to be an effective mentee; (3) securing research funding; (4) landing a job; (5) and protecting time to meet personal goals. There is an increased need for a vibrant, diverse, and successful generation of general internal medicine researchers to advance our understanding of complex issues in clinical medicine and healthcare delivery and to inform health policy. It is our hope that this piece helps to support that mission.KEY WORDS: general internal medicine, research, fellowship, mentoring     

Helping other mothers effectively work at raising young children with type 1 diabetes

PURPOSE: This study examined the feasibility of a postdiagnosis parent mentoring intervention for mothers of young children (1-10 years old) newly diagnosed with type 1 diabetes. METHODS: A mixed-method, prospective, randomized, controlled clinical trial design was used. Parent mentors (experienced mothers who have successfully raised young children with type 1 diabetes) and mother participants with young children newly diagnosed with type 1 diabetes were recruited from 2 regional pediatric diabetes centers. The mentors were trained to provide informational, affirmational, and emotional support using Ireys' modified parent mentor curriculum. During a 6-month trial, mentors provided home visits and phone call support to the mothers who were randomized to the experimental group. The control group had the option of receiving the intervention after the 6-month trial. RESULTS: Mothers in the experimental group had fewer concerns, more confidence, identified more resources, and perceived diabetes having less of a negative impact on their family compared with mothers in the control group. Parent mentors provided important, practical day-to-day management information, reassurance, and emotional support during times of crises. CONCLUSIONS: A postdiagnosis parent mentoring intervention for mothers of children with diabetes appears to be feasible and potentially effective.     

A national survey on the current status of general internal medicine residency education in geriatric medicine

OBJECTIVES: The dramatic increase in the U.S. elderly population expected over the coming decades will place a heavy strain on the current health care system. General internal medicine (GIM) residents need to be prepared to take care of this population. In this study, we document the current and future trends in geriatric education in GIM residency programs. DESIGN, SETTING, PARTICIPANTS: An original survey was mailed to all the GIM residency directors in the United States (N = 390). RESULTS: A 53% response rate was achieved (n = 206). Ninety-three percent of GIM residencies had a required geriatrics curriculum. Seventy one percent of the programs required 13 to 36 half days of geriatric medicine clinical training during the 3-year residency, and 29% required 12 half days or less of clinical training. Nursing homes, outpatient geriatric assessment centers, and nongeriatric ambulatory settings were the predominant training sites for geriatrics in GIM. Training was most often offered in a block format. The average number of physician faculty available to teach geriatrics was 6.4 per program (2.8 full-time equivalents). Conflicting time demands with other curricula was ranked as the most significant barrier to geriatric education. CONCLUSIONS: A required geriatric medicine curriculum is now included in most GIM residency programs. Variability in the amount of time devoted to geriatrics exists across GIM residencies. Residents in some programs spend very little time in specific, required geriatric medicine clinical experiences. The results of this survey can guide the development of future curricular content and structure. Emphasizing geriatrics in GIM residencies helps ensure that these residents are equipped to care for the expanding aging population.