Mentoring in Clinical-Translational Research: A Study of Participants in Master’s Degree Programs Aileen P. McGinn, Ph.D.1, Linda S. Lee, Ph.D.2, Adriana Baez, Ph.D.3, Jack Zwanziger, Ph.D.4, Karl E. Anderson, M.D.5, Ellen W. Seely, M.D.6, and Ellie Schoenbaum, M.D.1 Abstract Research projects in translational science are increasingly complex and require interdisciplinary collaborations. In the context of training translational researchers, this suggests that multiple mentors may be needed in different content areas. This study explored mentoring structure as it relates to perceived mentoring effectiveness and other characteristics of master’s-level trainees in clinical-translational research training programs. A cross-sectional online survey of recent graduates of clinical research master’s program was conducted. Of 73 surveys distributed, 56.2% (n = 41) complete responses were analyzed. Trainees were overwhelmingly positive about participation in their master’s programs and the impact it had on their professional development. Overall the majority (≥75%) of trainees perceived they had effective mentoring in terms of developing skills needed for conducting clinical-translational research. Fewer trainees perceived effective mentoring in career development and work-life balance. In all 15 areas of mentoring effectiveness assessed, higher rates of perceived mentor effectiveness was seen among trainees with ≥2 mentors compared to those with solo mentoring (SM). In addition, trainees with ≥2 mentors perceived having effective mentoring in more mentoring aspects (median: 14.0; IQR: 12.0–15.0) than trainees with SM (median: 10.5; IQR: 8.0–14.5). Results from this survey suggest having ≥2 mentors may be beneficial in fulfilling trainee expectations for mentoring in clinical-translational training. Clin Trans Sci 2015; Volume 8: 746–753

Keywords: clinical research, translational research, mentoring Introduction

Mentoring clinical and translational researchers is a critical component of their success. The breadth and complexity of clinical-translational research and its associated methodologies has implications for trainee mentoring. DeCastro et al. recently reported that K23 recipients challenged the traditional primary mentor “dyadic” trainee model, referred to in this article as solo mentoring (SM), in favor of networks of mentors with a wider array of expertise.1 A mentoring committee (MC) or mentoring team (MT) can support a trainee at various times in their career with a range of expertise. The literature on clinical and translational mentoring has largely focused on recipients of career development awards and other early investigators.2–6 Less is known about trainees who are enrolled in NIH–supported Clinical Research Training Programs conferring master’s degrees in clinical research. These programs (i.e., the K30 Clinical Research Curriculum Award program and the Clinical and Translational Science Award program) aim to provide clinician scientists with the critical skills needed to conduct clinical research and include a didactic curriculum and a mentor guided research experience.7,8 Training is provided predominantly for physicians and is aimed at developing researchers who understand the complex issues associated with clinical, and increasingly translational, research and who are able to successfully compete for research funding. Among the professional organizations engaged in promoting high quality clinical-translational research training, three key stakeholders (Association for Clinical Research Training [ACRT], Association for Patient Oriented Research, and the Society for Clinical and Translational Science) merged into a single new organization in 2013, the Association for Clinical and Translational Science (ACTS), whose mission is to promote

research, education, advocacy, and mentoring to improve human health. In keeping with these goals, and by building on work that began under the ACRT Evaluation Committee,9 we conducted a study of selected training experiences with a focus on trainee’s perceptions of mentoring due to the significance assigned to mentoring in the training process and emergence of evolving models of mentoring. The study consisted of a cross-sectional survey which elicited information about professional background, satisfaction with participation in a clinical research master’s program, characteristics of mentoring arrangements and mentoring effectiveness perceived by trainees who completed master’s degrees in K30 Clinical Research Curriculum Award or Clinical and Translational Science Award supported programs. We report here the different types of mentoring structures, characteristics of their mentoring arrangements and mentoring effectiveness as perceived by the trainees. Methods

Survey development We developed this cross-sectional survey based on similar surveys in the literature.10–12 After refining the survey based on the results of a pilot study, it was administered in 2012–2013 as an online questionnaire using RedCap13–15 to master’s degree students, hereafter referred to as trainees, during the last few weeks of their final semester or shortly after graduating from their program, at one of five participating institutions: Albert Einstein College of Medicine, University of Illinois at Chicago School of Public

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA; 2Practice of Medical Education, Duke University School of Medicine, Durham, North Carolina, USA; 3Departments of Pharmacology and Otolaryngology-Head and Neck Surgery, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA; 4Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA; 5Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, USA; 6Department of Medicine, Harvard Medical School, and Vice Chair of Faculty, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA. 1

Correspondence: Aileen P. McGinn ([email protected]) DOI: 10.1111/cts.12343

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Health, Duke University School of Medicine, University of Texas Medical Branch, and University of Puerto Rico Medical Sciences Campus. Each participating site obtained IRB approval. The surveys were anonymous as some survey questions, particularly those regarding the perceived effectiveness of one’s mentor(s), could be uncomfortable to answer honestly and thereby bias the results. We developed and maintained two databases, one for identifiers and one for survey responses, linked by an ID number, to protect trainee identity. As part of the consent process we provided information regarding procedures for protecting individual identities to the trainees. Response rate A total of 73 trainees were sent survey requests; of these 53 (72.6%) responded. One of these 53 respondents did not consent to the study and 11 partially completed the survey with insufficient data. The analysis was based on the 41 complete surveys (56.2%). Trainee characteristics In addition to basic demographic information, respondents provided information on time spent during their masters training in research, education, clinical, and other types of activities. Satisfaction with the participation in the master’s program and choosing a clinical-translational research career was assessed by asking trainees to indicate their agreement or disagreement on a series of three questions. Trainees also rated their quality of life on a scale of 1–100 (1 being the worst and 100 being the best imaginable) upon completion of the master’s program. Mentoring structure We asked trainees to indicate whether they had one mentor (i.e., SM) or multiple mentors. Those who responded that they had more than one mentor were then asked about the structure of their mentor group. They could choose a MT, defined as primarily meeting with each mentor on their team individually, or a MC, defined as primarily meeting with the all mentors as a group. Those who reported SM were asked to provide information about this one primary mentor only. Those who reported a MT were asked to provide information on up to three individual mentors and to rank these individuals in approximate order of how often they sought the advice of each (primary, secondary, and tertiary mentors). Those who responded that they had a MC reported on the MC as a whole. For the purpose of these analyses we combined responses for trainees who reported having a MT or MC (≥2 mentors) and compared them to those trainees who reported SM. Mentoring characteristics Trainees selected among nine options (Table 2) for what motivated them to be mentored by each individual mentor and were able to check all that applied. Additionally, communication methods for each primary, secondary, and tertiary mentor were collected for trainees who reported SM or MT, but not those who reported a MC. Each trainee reported on how many times per month they utilized various modalities to communicate with their mentor(s). Responses were categorized into: less than once per week, once per week and more than once per week. Perceived mentoring effectiveness Trainees were asked a series of questions regarding how effective each of their mentors, or MC as a whole, was in various aspects WWW.CTSJOURNAL.COM

of mentoring including developing clinical research skills and providing career guidance. Responses were collected on a 5-point Likert scale (very effective, effective, neither effective or ineffective, ineffective, very ineffective) and were collapsed into two categories for analyses: effective (effective or very ineffective) and not effective (neither effective or ineffective, ineffective, or very ineffective). Not applicable was an additional option to all questions as not all mentors may have been intended or expected to serve in all aspects of mentoring. Trainees with a MC answered these questions with respect to the committee as a whole. Those trainees with a MT answered each question separately for their primary, secondary and tertiary mentors (as applicable) and the trainee was determined to have effective mentoring if any one of their mentors were effective in that role. Statistical analysis Descriptive statistics were obtained using STATA version 13.1 (College Station, TX, USA) and are provided as number and percentage (n; %) for categorical variables and median and interquartile range (median [IQR]) for continuous variables. Formal statistical comparisons were not conducted as this is a small descriptive study. Results

Trainee characteristics Descriptive statistics for the 41 trainees in the analytic sample are provided in Table 1, overall, and by type of mentoring structure. About one-third (n = 12, 29.3%) of respondents reported SM and two-thirds (n = 29, 70.7%) reported more ≥2 mentors (MT: n = 24, 58.5% and MC: n = 5 12.2%). All 24 trainees who reported a MT provided information on primary and secondary mentors; only three trainees reported information on a tertiary mentor. Race-ethnicity of the sample varied with slightly less than half reporting non-Hispanic white (n = 20, 48.8%), a quarter Hispanic (n = 10, 24.4%) and one-fifth Asian/Pacific Islander (n = 9, 22.0%). While enrolled in the master’s program, almost half of the trainees were faculty (instructor, assistant, associate, or full professors; n = 19 [46.3%]). Just about all of the trainees on faculty had completed a residency (18/19; 94.7%) prior to the master’s program and half had also completed a fellowship (10/19; 52.6%). The other half of trainees who were not faculty while enrolled in the master’s program were concurrently enrolled in a fellowship program (n = 16; 40%), a residency program (n = 3; 7.5%) or medical school (n = 2; 5.0%). Similar rates of trainees reported SM regardless of whether they were still in medical training (28.6%: 6/21) or if they were on faculty (26.3%; 5/19). Although the majority of trainees held (n = 28) or obtained (n = 2) an MD degree while in the master’s program the sample included three pharmacists (PharmD), one psychologist (PsyD), one dentist (DDS), and two PhDs. Consistent with the large proportion with clinical degrees, almost three-quarters of the trainees (n = 31; 75.6%) reported having clinical responsibilities while concurrently participating in the master’s program with a median of 10 hours of clinic per week (IQR: 8–16); 2 (IQR: 0–4) on-call nights per month and 2 (IQR: 1–4) service months per year. As expected, a large part of the trainee’s time during the master’s program was spent in the training program (median [IQR]: 15 hours/week [10–20]) and in research (median [IQR]: 20 hours/week [15–30]) and this was fairly consistent across the mentoring structure types. VOLUME 8 • ISSUE 6

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All respondents, N = 41 (100.0)

Solo mentoring (SM), N = 12 (29.3)

≥ 2 Mentors, N = 29 (70.7)

Non-Hispanic white

20 (48.8)

6 (50.0)

14 (48.3)

Hispanic

10 (24.4)

3 (25.0)

7 (24.1)

Asian/Pacific Islander

9 (22.0)

2 (16.7)

7 (24.1)

Other

2 (4.9)

1 (8.3)

1 (3.5)

N(%)* Race/ethnicity

Academic ranks while in master’s program Medical student

2 (5.0)

1 (9.1)

1 (3.5)

Resident

3 (7.5)

3 (27.3)

0 (0.0)

16 (40.0)

2 (18.2)

14 (48.3)

19 (46.3)

5 (41.7)

14 (48.3)

No

33 (82.5)

8 (72.7)

25 (86.2)

Yes

7 (17.5)

3 (27.3)

4 (13.8)

10 (24.4)

5 (41.7)

5 (17.2)

31 (75.6)

7 (58.3)

24 (82.8)

Fellow Faculty



Administrative positions while in program

Any clinical responsibilities while in program No Yes Clinic hours/week

10 (8-16)

8 (4-10)

12 (8-18)

On-call nights/month‡

2 (0–4)

1.5 (0.5–3.0)

2 (0–4.9)

Service months/year

2 (1–4)

1.5 (1.0–3.0)

2 (0–4)

Master’s training program

15 (10–20)

12.5 (10–20)

15 (10–20)

Research





Hours per week spent in:‡ 20 (15–30)

27.5 (10–36)

20 (15–25)

Teaching/education

5 (1–5)

1 (0–5)

5 (3–5)

Clinical/patient care

10 (5–20)

6 (0–10)

15 (8–25)

39 (95.1)

11 (91.7)

28 (96.6)

2 (4.9)

1 (8.3)

1 (3.5)

If I had to do it all over again I would still participate in this master’s program Agree Disagree

My involvement in the training program has had a positive effect on my professional life Agree

38 (92.7)

11 (91.7)

27 (93.1)

Disagree

2 (4.9)

1 (8.3)

1 (3.5)

Uncertain

1 (2.4)

0 (0.0)

1 (3.5)

If I had to do it all over again I would again choose a clinical/translational research career Agree

36 (87.8)

9 (75.0)

27 (93.1)

Disagree

2 (4.9)

2 (16.7)

0 (0.0)

Uncertain

3 (7.3)

1 (8.3)

2 (6.9)

80.0 (60.0–89.0)

63.0 (45.0–89.5)

80.0 (72.0–88.0)

Quality of life at the time of survey (1 = worst to 100 = best)‡

*All data reported as number and percentage unless otherwise noted. † Faculty includes instructor, assistant, associate, and full professor. ‡ Median and interquartile range.

Table 1. Trainee characteristics overall and by mentoring structure.

An overwhelming majority of the trainee’s agreed that if they had to do it all over again, they would still participate in the master’s program again (n = 39; 95.1%) and they felt that the involvement in the training program had a positive effect on their professional development (n = 38; 92.7%). Similarly high 748

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rates of agreement were reported for choosing a career in clinicaltranslational research if they had to do it all over again (n = 36, 87.8%). The median quality of life at the time of the survey was 80.0 (IQR: 60.0–89.0) on a scale of 1–100, with 100 being the best. Those with two or more mentors reported higher quality WWW.CTSJOURNAL.COM

McGinn et al. Mentoring in Clinical-Translational Research n

Solo mentoring (SM), N = 12

≥ 2 Mentors, N = 29

N (%)

N (%)

I needed access to his/her expertise

8 (66.7)

29 (100.0)

I needed access to equipment or resources I did not have

6 (50.0)

15 (51.7)

I wanted to encourage cross-fertilization across disciplines

1 (8.3)

6 (20.7)

What motivated you to be mentored by your mentor? (check all that apply)

I wanted improved access to research funds

5 (41.7)

9 (31.0)

I wanted increased prestige or visibility

4 (33.3)

10 (34.5)

I needed to learn about a specific technique/method

3 (25.0)

14 (48.3)

I had a large and complex problem that required pooling knowledge

1 (8.3)

7 (24.1)

I wanted to enhance my research productivity

7 (58.3)

23 (79.3)

I thought it would be fun to work with him/her

6 (50.0)

14 (48.3)

Table 2. Trainees motivation to work with mentor(s) by mentoring structure.

of life (80.0; IQR: 72.0–88.0) compared to those with one mentor (63.0; IQR: 45.0–89.5).

(median: 14.0; IQR: 12.0–15.0) compared to those with SM (median: 10.5; IQR: 8.0–14.5).

Mentoring characteristics Table 2 reports the trainees’ motivation for working with their mentors. A majority indicated that a motivation for working with their mentors was access to their expertise (SM: 8/12; 66.7%, ≥2 mentors: 29/29; 100.0%), access to equipment or resources (SM: 6/12; 50.0%, ≥2 mentors: 15/29; 51.7%), and wanting to enhance their research productivity (SM: 7/12; 58.3%, ≥2 mentors: 23/29; 79.3%). Additionally, approximately half of all respondents were motivated by the personal characteristics of the mentor, specifically they thought it would be fun to work with them (SM: 6/12; 50.0%, ≥2 mentors: 14/29; 48.3%). As reported in Table 3, scheduled face-to-face meetings, impromptu face-to-face meetings, and e-mail occurred at least once a week for the majority of trainees, regardless of their mentoring structure. Conversely, telephone calls, text messaging, and social networking sites were not common means of communication between trainees and their mentors. As seen in Table 4, regardless of the mentoring structure, the majority of trainees (≥75%) perceived their mentor as effective with areas related to helping them develop skills needed for careers in clinical-translational research, such as writing peer reviewed publications, developing posters/oral presentations for meetings, designing and conducting of research, and writing and revising grants. Likewise, trainees perceived that they had effective mentoring in traditional roles one would expect in a mentor: providing content expertise, constructive and useful critiques, motivation to improve work product, suggesting appropriate resources, challenging to extend abilities, assigning task that push them to develop new skills and serving as a professional role model. Conversely, fewer trainees (

Mentoring in Clinical-Translational Research: A Study of Participants in Master's Degree Programs.

Research projects in translational science are increasingly complex and require interdisciplinary collaborations. In the context of training translati...
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