Abstract
Multiple studies highlight the benefits of effective mentoring in academic medicine. Thus, we sought to quantify and characterize the mentoring practices at academic health centers (AHCs) with Clinical and Translational Science Awards (CTSA). Here we report findings pertaining specifically to mentor training at the level of the KL2 mentored award program, and at the broader institutional level. We found only four AHCs did not provide any form of training. One‐time orientation was most prevalent at the KL2 level, whereas formal face‐to‐face training was most prevalent at the institutional level. Despite differences in format usage, there was general consensus at both the KL2 and institutional level about the topics of focus of face‐to‐face training sessions. Lower‐resource training formats utilized at the KL2 level may reveal a preference for preselection of qualified mentors, while institutional selection of resource‐heavy formats may be an attempt to raise the mentoring qualifications of the academic community as a whole. The present work fits into the expanding landscape of academic mentoring literature and sets the framework for future longitudinal, outcome studies focused on identifying the most efficient strategies to develop effective mentors.
Keywords: mentoring, KL2 program, mentor training, CTSA
Introduction
Effective mentorship in academic medicine is a key element in the success of junior researchers.1, 2, 3, 4 It promotes the career development and achievement of mentees as evidenced by publication record, grant success, academic achievement and personal growth, and fortifies professional commitment to a research track.5 Mentorship is also beneficial to the mentors themselves, and to the institution as a whole, as it is associated with enhanced career satisfaction, professional recognition, and creation of a conducive research atmosphere, all of which may increase productivity, funding, faculty recruitment, and faculty retention.6, 7 The general consensus that effective mentorship is important in the development of junior researchers is underscored by the existence of funding mechanisms which have a mandatory mentorship component such as the CTSAs early‐career KL2 Mentored Clinical Research Scholar Program awarded by the National Center for Advancing Translational Sciences.8 Effective mentorship may be especially important to early‐career clinical/translational scientists, such as KL2 scholars, given the multidisciplinary, wide scope, and longitudinal nature of their research projects.
What constitutes “effective mentoring practices,” and the mechanisms by which to foster these practices at academic health centers (AHCs), has been explored by several groups in recent years.9, 10, 11, 12, 13 For instance, Keyser et al. highlight the “top‐down” approach to instilling effective mentorship practices at AHCs, by outlining key mentoring domains (such as fostering strong mentor‐mentee relations, and optimizing the qualification of mentors) that may be strengthened through policies and activities at the institutional level, or by administrative bodies such as KL2 programs.9 One way in which these mentorship domains may be developed and/or strengthened is via the implementation of mentor training systems. The literature on mentor training is limited, especially in the research realm, but documented training programs do exist and there is preliminary evidence indicating the positive effects of training on mentoring abilities. For example, Feldman et al. recently reported sustained increases in self‐described confidence on several domains of mentoring skills by participants of University of California, San Francisco's Mentor Development Program.13, 14 However, there is limited documentation regarding the existence and format of mentor training practices at AHCs in the United States.
In this paper we report the frequency and format of mentor training practices at AHCs receiving a CTSA KL2 mentored award. We obtained these data in association with a larger survey conducted between November 2010 and January 2011 (findings published in Tillman et al.10). At the time of the survey, there were 55 AHCs with such awards (this number grew to 60 AHCs in 2012), providing a large pool of KL2 programs within which to investigate mentor training practices.
Methods
Survey development
Building on the framework developed by Keyser et al.9 and utilizing expert advice by leaders in the field, relevant literature, and other surveys, we developed a 69‐item survey tool on mentoring activities and policies within the KL2 program and more broadly at the institution (for details, refer to et al. 10). Eleven of the 69 items focused on mentor training at the KL2 program level and 8 parallel items focused on training at the institutional level. Respondents were asked to report whether they: (i) offered and required; (ii) offered but did not require, or (iii) did not offer the four common types of training formats: one‐time orientation, informal peer interaction, Web‐based training, and formal face‐to‐face training. An “I don't know” option was also provided. If AHCs indicated that they utilized the formal face‐to‐face format, they were then asked to identify the degree to which 13 specified topic areas were a focus in their formal face‐to‐face training session. AHCs could select from “not a focus,” “minor focus,” “major focus,” “I don't know,” or indicate “other” focus areas. Respondents could also share their opinion on the barriers to effective mentoring in an open‐ended question format: “In your opinion, what are the most significant barriers to a successful mentoring program?”
Survey administration and data collection
We administered the Web‐based survey to 55 CTSAs from November 2010 to January 2011. KL2 program educational leaders were contacted at all 55 sites prior to receiving the survey, to confirm that they were the pertinent recipients and could answer questions about mentoring at both the KL2 and institutional level. Nine KL2 educational leaders responded by identifying alternate respondents for KL2 and institutional questions. Thus, we sent three versions of the survey: a survey for respondents to both KL2 and institutional level questions (n = 46), a survey for those responding just to KL2 level questions (n = 9), and a third version for those responding to just the institutional level questions (n = 9). Upon closing the survey, we followed up with phone interviews to clarify inconsistent or unclear responses.
Data reporting
We report on eight survey items on mentor training at the KL2 level, and eight at the institutional level. We also report responses to the open‐ended question regarding barriers to successful mentoring, which addressed mentor training specifically. Comments related to training that surfaced during follow‐up phone interviews are also described.
Results
Response rate
Of the 55 CTSAs surveyed, 53 (96%) provided responses pertaining to mentor training practices at the KL2 program level, while 51 (93%) provided institutional level responses.
Overall occurrence of mentoring
Thirty‐nine of responding AHCs (74%) provided some form of mentor training at the KL2 level, 35 (69%) had some form of training at the institutional level, and 4 (7.3%) reported that they did not offer any form of training at either of the two levels.
Frequency of mentor training formats at the KL2 level (Figures 1 and 2)
Figure 1.
Frequency of four common mentor training formats at the KL2 program level. Values within the bars represent the number of KL2 programs offering/not offering the four training formats. KL2 programs that were unsure whether they offered any given format type (responded “I don't know” to related survey items) were excluded from the count. n = 53 for one‐time orientation and informal peer training; n = 50 for Web‐based training; n = 52 for face‐to‐face training.
Figure 2.
Differentiating between the frequency of training formats offered at only the KL2 program, only at the institutional level, at both levels, or at neither level. Data are inclusive of required and not required programs. Top bars of each couplet: KL2 data, bottom bars: Institution (labeled “Inst.”). KL2 or institutional programs that were unsure whether they offered any given format type (responded “I don't know” to related survey items) were excluded from the count. n = 53 for one‐time orientation and informal peer training; n = 50 for Web‐based training; n = 52 for face‐to‐face training.
KL2 programs that reported having mentor training practices were asked to indicate which of the four commonly used training formats (one‐time orientation, informal peer training, formal face‐to‐face training, and Web‐based training) they employed, and which of these formats were mandatory. We found that of the 53 respondents, one‐time orientation was not only the most widely used format (n = 30; 57%), but also most likely to be required (of the n = 30 KL2 programs that offered this format, it was required by 17 [57%] of schools). Formal face‐to‐face and informal peer training were the next most common formats, each with 23 (43%) KL2 programs. The majority of KL2 programs that offered these two types of mentor training formats did not require it. Web‐based training was the least used format at the KL2 level (n = 14; 26%), and it was never mandatory.
Within the context of the broader institution we discriminated between the programs that offered mentor training formats at the: (i) KL2 level only, (ii) institutional level only, or (iii) at both levels. Of the mentor training practices offered only at the KL2 level, one‐time orientation was the most frequently used format (20 out of 39 KL2 programs with mentor training [51%]), followed by informal training (13 [33%]), Web‐based training (11 [28%]) and face‐to‐face training (9 [23%]). Most KL2 programs did not have training programs exclusively for KL2 mentors, with 27 (51%) KL2 level respondents reporting that training was available to others outside of the KL2 program. Of the mentor training practices offered only at the institutional level, Web‐based and face‐to‐face training were the most frequently used formats (each with 9 [26%]), followed by informal training (7 [20%]) and one‐time orientation (5 [14%]). Finally, of the mentor training practices offered at both the KL2 level and institutional levels, face‐to‐face training was the most frequently used format (14 AHCs).
Content and focus of Formal Face‐to‐Face training sessions at AHCs (Figure 3)
Figure 3.
Focus of face‐to‐face training sessions at the KL2 and Institutional levels. Data depict the degree to which KL2 and institutions that offered face‐to‐face mentoring focused on 12 content areas (“major focus” vs. “minor focus” vs. “not a focus”). (KL2: N = 23; institution: N = 19; excludes programs that responded “I don't know to related survey items).
Respondents offering formal face‐to‐face training (n = 23) were asked to estimate the degree to which their face‐to‐face programs focused on 12 discrete content areas, using a three‐point scale (“not a focus,” “minor focus,” “major focus”). “Promoting career development” was the most frequently reported “major focus” (20 [87%]), while “Promoting interdisciplinary and translational research” was least frequently reported (10 [43%]). Of the institutional programs offering face‐to‐face training (n = 19) the top content areas of major focus were “Responsible conduct of research,” “Acquisition of funding,” and “Addressing diversity” (each with 15 [79%]). “Improving clinical research skills” was the least frequently reported “major focus” (5 [26%]).
Concomitance of training formats (Table 1)
Table 1.
Concomitance of mentor training formats
| (a) KL2 level | |||
|---|---|---|---|
| Format type | Number or formats offered | ||
| 1 | 2 | 3 | |
| (n = 13) | (n = 8) | (n = 11) | |
| One‐time orientation | 6 | 6 | 11 |
| Informal peer training | 4 | 3 | 9 |
| Web‐based training | 1 | 3 | 3 |
| Formal face‐to‐face training | 2 | 4 | 10 |
| (b) Institutional level | |||
|---|---|---|---|
| Format type | Number or formats offered | ||
| 1 | 2 | 3 | |
| (n = 13) | (n = 14) | (n = 6) | |
| One‐time orientation | 2 | 6 | 5 |
| Informal peer training | 2 | 8 | 5 |
| Web‐based training | 3 | 4 | 3 |
| Formal face‐to‐face training | 6 | 10 | 5 |
Uppermost rows display the number of programs that utilized a single format, two formats or three formats concomitantly, at the KL2 program (a) and institutional level (b). Rows report the number of times each format type was utilized in the mentor training mechanisms (when either 1, 2, or 3 formats were offered). n (KL2) = 53 and n (Institution) = 50 for one‐time orientation and informal peer training; n (KL2) = 50 and n (Institution) = 50 for Web‐based training; n (KL2) = 52 and n (Institution) = 50 for face‐to‐face training.
Next we quantified the concomitance of training formats (i.e. how frequently did programs utilize a single format vs. 2 vs. 3 vs. all 4) at both the KL2 and institutional level. Of the 39 AHCs reporting training at the KL2 level, 13 (33%) offered only one format, 8 (21%) KL2 programs concurrently offered two different formats, 11 (28%) KL2 programs offered three, and 7 (18%) KL2 programs offered all four formats (data are inclusive of “required,” and “offered but not required” formats). We further break down these data in Table 1. The rows represent the number of times the four surveyed formats were incorporated into training programs when 1, 2, or 3 formats were concomitantly employed. Congruent with Figure 1, the most commonly used format by KL2 programs that offered a single training format was one‐time orientation. One‐time orientation was also most likely to be included in a doublet (used in combination with the three other formats by two KL2 programs each) and triplet (one‐time, formal face‐to‐face, and informal training comprised the most commonly used triplet; n = 8).
Of the 35 AHCs reporting the presence of mentor training practices at the institutional level, 13 (37%) offered only one format, 14 (40%) offered two different formats, 6 (17%) offered three, and 2 (6%) offered all four. When only one format was offered, it was most likely to be formal face‐to‐face training (n = 6), while the most commonly occurring doublets were formal face‐to‐face/one‐time training and formal face‐to‐face/informal training (each with n = 4). Similarly to the KL2 level, the most common triplet was one‐time/face‐to‐face/informal peer training (n = 3).
Perceived Barriers to Mentor Training (Table 2)
Table 2.
Perceived barriers to effective mentor training
| “…[L]ack of faculty time to provide the mentoring training.” |
| “Attitudes of some scientists that mentoring is not something that can or needs to be taught.” |
| “Attitude that mentor training is not needed.” |
| “…[T]here isn't a full awareness of what being a mentor involves (It's not just research mentoring, it's skill, career, leadership development)” |
| “…[L]ack of assigned authority over mentoring across the institution or within its major colleges.” |
| “Time commitment and training…setting up logistics of training program for mentors. If you leave it to the mentor themselves you are going to get a hodgepodge of what's done, need over‐arching structure to mentoring and need to provide adequate training for mentors.” |
| “[The challenge of] having individuals devote time out of their busy day to learn more about mentoring” |
| “Lack of faculty time to provide the mentoring.” |
| “No requirement for being certified mentor, no specified training.” |
Comments received from AHCs (N = 9) related to mentor training, in response to an open‐ended question probing perceived obstructions to successful mentoring in general.
In a final question respondents were allowed to comment on barriers to mentoring in general, using an open‐ended format. In Table 2 we report the comments that referred to barriers in mentor training as a means of elucidating the perceived impediments to the implementation of training. Some of the reported barriers included a lack of knowledge/appreciation of the importance of mentor training, lack of resources to provide the training (time, logistics) and a lack of accountability in regards to who would organize the mentor training activities.
Discussion
In this paper, we provide a descriptive overview of the frequencies and formats of mentor training practices at the KL2 and institutional level at CTSA‐funded AHCs. Our results reveal that some form of mentor training was included within the majority of KL2 and institutional programs, with only 4 (7.3%) AHCs not offering any training. This finding implies that AHCs were aware of the potential advantages of implementing mentor training programs. This awareness is likely rooted in accumulating positive experiences with mentor training and the growing body of literature emphasizing the vital role of mentorship in academic medicine, and the potential use of training mechanisms to generate a pool of effective mentors. This view is also espoused by Keyser et al. and supported by recent preliminary findings.9, 14
Overall, we found that mentor training was more prevalent at the KL2 level, relative to the institutional level (KL2: 74%; Institution: 69%). The majority of training programs at AHCs were offered either exclusively at the KL2 level, or at both levels, and training programs offered exclusively at the institutional level were less common. Moreover, 27 KL2 programs (51%) reported that their training offerings were open to non‐KL2 faculty members. Such cross‐sharing of mentor training programs seems a cost‐effective use of limited institutional resources and consistent with the mission of the CTSA.
The strategies behind choosing training types likely vary based on availability of resources, and KL2 and institutional context, including the size and quality of the pool of experienced mentors. We identified notable differences in the types and numbers of training formats utilized at the KL2 versus institutional level. Specifically, one‐time orientation, a “lower resource commitment,” was most prevalent at the KL2 program level (in programs that offered both single and multiple formats). At the institutional level, formal face‐to‐face training was the most utilized format, representing the majority among institutions that offered single, or multiple training formats. Given the smaller nature of KL2 programs, it is plausible that KL2 program directors rely on pre‐selection of seasoned mentors, deeming one‐time orientation sufficient training. With the incentive of raising the quality of mentorship of the academic community, resources at the institutional level may provide the ability to offer “higher resource commitment” face‐to‐face training options. Among the least employed formats was Web‐based training, even among AHCs that offered multiple mentor training format, consistent with the idea that many mentoring competencies, such as psychosocial and communication skills, are perhaps better developed via interactive formats.
We also found a general consensus between KL2 and institution programs regarding the top three content areas of mentor training programs. “Establishing expectations,” “Promoting career development,” and “Maintaining effective communication” were the major foci of face‐to‐face programs for both KL2 and institutions, whereas, research‐related areas ranked lowest. The low focus on research‐related skills during training sessions may be due to the existence of alternate programs solely dedicated to developing research competencies (e.g., responsible conduct of research training offered by AHCs). Our results also reveal that “Addressing diversity” was a higher focus at the institutional level than the KL2.
Given the limitations of survey‐based research, our results leave a number of questions unanswered. First, it is possible that survey respondents were unaware of, or misattributed, programs at the KL2 and/or institutional level which led to an over‐ or under‐reporting of programs. Second, we have documented the frequency of training formats, but lack data about actual participation in those programs. Third, the present study did not probe the rationales for the selection of chosen formats and training content. As such, we cannot be sure why programs have selected to employ certain training mechanisms, over others. Finally, we have no information about the impact of the offered programs on mentors’ competence or effectiveness in mentoring.
Going forward, the CTSA community would benefit from addressing some of the limitations outlined above to enhance the efficacy of their mentor training offerings. For instance, CTSAs could implement a thorough evaluation mechanism which: (i) monitors participation rates, (ii) assesses the alignment of training content with current literature on competencies required of effectual mentors, (iii) collects participant ratings/feedback on the efficacy of the training, and (iv) collects ratings/feedback from mentees of trained mentors. Collection of such empirical data would help determine the most utilized, well‐received, and effective training formats, and would allow for optimal evidence‐based mentor training program design, and efficient resource allocation.
To foster further innovation in their training programs, CTSAs could look to established training techniques/tools used in other fields such as in business, government, or secondary education. Furthermore, creation of a cross‐institutional repository of mentor training resources online would facilitate the sharing of training tools across the CTSA community, and would optimize resource use and funding. Finally, given the emphasis placed on mentorship at AHCs with CTSAs/KL2 awards, it would be interesting to identify the role of a CTSA/KL2 program in shaping the mentoring landscape at an AHC, by comparing CTSA and non‐CTSA institutions across various parameters including frequency, format, and effectiveness of mentor training practices.
Conclusion
In this paper we systematically characterize the format and frequencies of mentor training practices at AHCs, across the country, that received a CTSA KL2 award. Taken together, our data reveal that mentor training mechanisms were in place in the majority of surveyed AHCs at both the KL2 program level, and across the institution as a whole, with notable overlap between the two. Additionally, our findings suggest that the mentor training terrain is perhaps more diverse and comprehensive at the KL2 level, relative to the institutional level which is unsurprising given the KL2's mandated mentorship component. Finally, our paper fits well into the expanding landscape of literature focusing on the benefits of academic mentoring, key mentoring competencies, and the means by which to cultivate a multispecialty mentoring community, with the ultimate goal of enhancing the academic research experience.
Acknowledgments
The authors wish to thank the CTSA Education and Career Development Key Function Committee's Mentoring Workgroup for their expertise and advice on the initial drafts of the survey instrument, and for piloting it at later stages. This study was supported by National Institutes of Health (NIH) grant number 3UL1RR024156‐04S3 and by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number UL1 TR000040, formerly the National Center for Research Resources, grant number UL1 RR024156.
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