Mentorship for operational research capacity building: hands-on or hands-off?

Abstract

Mentorship is a key feature of operational research training courses run by the International Union Against Tuberculosis and Lung Disease and Médecins Sans Frontières. During the recent South Pacific paper writing module, the faculty discussed ‘hands-on’ mentorship (direct technical assistance) vs. ‘hands-off’ mentorship (technical advice). This article explores the advantages and disadvantages of each approach. Our collective experience indicates that ‘hands-on’ mentorship is a valuable learning experience for the participant and a rewarding experience for the mentor. This approach increases the likelihood of successful course completion, including publishing a well written paper. However, mentors must allow participants to lead and take ownership of the paper, in keeping with a first author position.

Mentorship has been defined as ‘providing an enabling relationship that facilitates another's personal growth and development’.¹ Strong academic mentorship is a key feature of the operational research (OR) courses run by the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF).^2,3 The OR courses consist of three separate, interlinked modules each of 5 or 6 days' duration: Module 1 focuses on developing a research protocol, including ethics considerations; Module 2 focuses on electronic quality-assured data collection and analysis using open access software (EpiData, Odense, Denmark); and Module 3 focuses on preparing a paper for submission (with the participant as first author) to a peer-reviewed journal and linking research to policy and practice. The teaching format for all three modules includes lectures, small group break-out sessions with mentors, and plenary sessions where participants present their work to the group and receive feedback from mentors and peers. Between Modules 1 and 3, specific milestones (submission of the protocol, completed ethics forms and EpiData files and submission of proof of data collection to course coordinators) must be achieved within pre-determined time frames for participants to proceed to Module 3. A scientific paper must then be submitted to a peer-reviewed scientific journal within 1 month of completing Module 3 for the participant to fulfil the requirements of the course and be entitled to receive the course certificate.

Most courses have 12 participants. In Modules 1 and 3, there are usually eight mentors working in four pairs, with each pair mentoring three participants. Each pair often has a senior and junior mentor, with the latter learning their craft from the senior, more experienced person. For Module 2, there are usually just four mentors, one for three participants. Mentors assist participants to develop their protocols and papers through iterative, side-by-side teaching that involves the sharing of protocol and paper versions through e-mail exchange. Between modules, and after Module 3, mentors maintain contact with their participants to help with data collection and analysis, paper writing, handling peer review and, in the event of rejection, preparation of the paper for an alternative journal. Due to their involvement and facilitation with protocol design, data collection and analysis, and paper writing, mentors share co-authorship of the final paper with the participant. A question arises as to which is the best approach to mentorship: the ‘hands-on’ or the ‘hands-off’ approach? In the present paper, we explore the advantages and disadvantages of each approach in writing a scientific paper.

ASPECT OF INTEREST

Let us assume we are in the 5-day Module 3 and we are writing a scientific paper.

‘Hands-on’ mentorship

The ‘hands-on’ mentoring approach works as follows. The participant writes the first draft of each section of the paper in the standard order (Background, Methods, Tables and Figures, Results, Discussion, Abstract, Title Page, Acknowledgements). Each section is sent to the mentors for their input. The primary mentor works with the participant in an iterative way to revise the text as required, either using track changes or over-writing the text. This is done through discussion and with the full consent of the participant. The amount of mentor-writing varies considerably depending on the participant's writing ability. Once a section is finished, it is saved and then sent by e-mail to the secondary mentor for input. This process is repeated for each section of the paper, with versions accumulating during the week until the final paper is ready on Day 5. By this time there may be up to 20 versions, depending on the number of iterations required.

The ‘hands-on’ mentor thus acts as a direct technical assistant and, depending on the experience and writing skills of the participant, the mentor's contribution to the paper will vary from being substantial to contributory. The advantages and disadvantages of this approach are shown in Table 1.

TABLE 1.

Advantages and disadvantages of the ‘hands-on’ mentorship approach with respect to the paper writing module and completion of the operational research course

‘Hands-off’ mentorship

In the ‘hands-off’ mentorship approach, the participant develops the first version of each section of the paper in the same sequence as previously described. This version is passed on to the mentor, who reviews it and then discusses with the participant how the section should be changed. However, the mentor does not make the changes – these are left for the participant. There is very little direct writing input from the mentor, as the participant writes most of the paper him/herself. The ‘hands-off’ mentor thus acts as a technical advisor, and tries to ensure that the advice is taken for each section of the developing paper. The advantages and disadvantages of this approach are shown in Table 2.

TABLE 2.

Advantages and disadvantages of the ‘hands-off’ mentor approach with respect to the paper writing module and completion of the operational research course

DISCUSSION

Effective mentorship is a critical component of the success of the OR courses. However, the art, skills and implementation of mentorship are not easy, and for every mentor the approach will depend on each mentor's philosophy of education and training, and his/her assessment of the abilities of the participant. While studies evaluating the role of mentorship in general have been published,^4–8 we can find no published work on mentorship in OR, and, in particular, mentorship for writing a scientific paper.

In both the ‘hands-on’ and ‘hands-off’ approaches, the participants meet the criteria for lead authorship as they are foremost in designing the study, data collection and analysis, and are thus the primary authors in writing the paper. It is our collective experience that ‘hands-on’ mentorship provides participants with a better chance of successfully completing the OR course and getting a paper published. However, there is a risk that the mentor does more of the writing than the participant and that the participant has less sense of ownership. A careful balance thus needs to be struck. Participants must do enough of their own work to learn from the experience and to feel ownership of the first author position, while mentors must ensure adequate quality of writing. The final paper needs to reach a high enough standard to do justice to the research and to have a good likelihood of publication. Certainly, a capable participant will require less ‘over-writing’ by the mentor, but others will require more. It is thus crucially important for the mentors to acquire a clear understanding of participant capability at the beginning of the week.

Does ‘hands-on’ mentorship work? Feedback from participants indicates that observing mentors write is a valuable learning experience and meets learning needs. It appears to ensure success in publication,³ and we hope this will promote an enthusiastic embrace of OR by public health workers, which is the ultimate aim of the course. Whether participants develop the necessary skills to undertake OR and publish on their own after the course is another question, and one for which at present we do not have the answers. However, we are now carefully following up those participants who have successfully completed courses to assess how well they do and whether they can progress on their own. We will report on this in the future.