A structured mentorship program for medical college faculty on health research

Abstract

Background

A paradigm shift is required in faculty development programs on research skills, from theory-driven to hands-on practical approach. The objective of this study was to develop and implement a structured mentorship model for training of medical faculties in research skills.

Methods

An interventional study using functional mentorship and experiential learning based on a research project was conducted over a period of one year through two prevalidated modules: protocol and manuscript writing. We included early and mid-career medical faculty as mentees (mentor:mentee ratio—1:2). Module 1 consisted of eight days of active learning and 25 days of refinement period—the end point being submission of research proposal to the ethics committee. Module 2 consisted of six days of active learning and 15 days of refinement period with the end point being manuscript submission to a peer-reviewed journal. Context, Input, Process and Product model of evaluation was used for this program.

Results

All eight faculty who participated as mentees in this program completed the first module, developed protocols under this program and processed them through the ethics committee. Six of the eight participants of this original cohort attended the second module and five could submit their manuscript to a peer-reviewed journal within the stipulated date. Participants expressed improvement in their self-rating of research skills, satisfaction with the program and an overall favourable change in attitude towards research.

Conclusion

Structured mentorship program with the help of local mentors could enhance research skills of medical faculty.

Introduction

Research is one of the core functions of a medical college yet, India scores poorly in terms of research output among the medical faculty.1, 2, 3 With the medical education regulatory body incentivizing research publications for academic promotions, there is a mushrooming of predatory journals.⁴ With minimal formal training in the research process, there is a risk of faculty falling prey to such lures. Furthermore, literature suggests that research training programs for faculty need to shift focus from theory to practice.⁵ Sambunjak et al⁶, in a systematic review, reports that mentorship helps improve research productivity among the faculty.

Here, we have tried to emulate a model of a structured mentorship program for operational research promoted by the World Health Organization with other agencies.⁷ Here participants work on their selected research topic to build a research protocol and later a manuscript through the course with the help of dedicated mentors. Since this program incorporates a tangible outcome, we used a functional mentorship model in this program.⁸ Another theoretical underpinning for this training is experiential learning through working on a project.⁹ A group of local faculty members (the authors of this article) who had prior training and experience in research, formed a group to plan and implement this program.

We present our experience with the first batch of this mentorship program using the Context, Input, Process and Product model of evaluation.¹⁰

Materials and methods

Study design, setting and duration

This was an educational intervention study conducted among faculty of GMERS Medical College, Vadodara located in Central Gujarat. The local faculty members took the lead to develop a central research unit at our medical college, under which this intervention was carried out. The planning for the project started in February 2017, module 1 was run during July 2017 and module 2 during August 2018.

Context

This program was developed addressing the need for hands-on research training among faculty. We decided that the number of applications received for the program would serve as an indicator of the need for the program. To document the need objectively, we sent pretraining version of the research protocols written by participants to two external assessors. These assessors were faculty from other medical colleges who were experienced in training doctors in health research. They scored the protocols on 10 items, each carrying 10 marks. Each protocol was scored of a total of 100 marks.

Study participants

The applications were invited on a first-come-first-serve basis from all the faculties of our institute. Eligibility criterion was entry-level and mid-career faculty (Tutor, Assistant Professor, Associate Professor) who were willing to work on a research project of their interest as part of this training program.

Participants were asked to submit a draft of a proposed research protocol they wanted to work-on, 2 weeks before starting this program.

At the start of the training, baseline information was collected from faculty about their current engagement in research in a structured format, after taking written informed consent.

Inputs

We describe the human resource in the form of the mentor team, the training curriculum and it's validation as inputs to this program.

The mentor team for this program

We used the following criteria for selecting mentors.

• •The mentor should have extensive experience in ‘training others in research methodology’ and/or ‘conducting biomedical research’ and commits time to mentor allotted participants
• •The mentor is a locally accessible person (faculty working in the same institute or nearby institute within the city where program is conducted) so that s/he is available to the participants when needed.

Curriculum of the training program

Program schedule

The training was spread over two modules. Module 1 focused on protocol writing and module 2 on manuscript writing. Each module was conducted with two on-site workshops with 10–15 days refinement period in between. There was a one-year gap between two modules for the project data collection by participants. Fig. 1 provides an overview of the program structure and the expected outcomes. (Supplementary Material 1 for further details).

Fig. 1.

Overview of mentorship program.

The training methodology

Participants were exposed to short interactive lectures and one-to-one discussion with mentors on the research process. They then worked individually on their projects to develop components of their protocol and manuscript in respective modules. These components were presented in a plenary session by participants in MS word format to receive feedback from coparticipants and mentors.

The participating faculty went back to their departments and refined their protocols and manuscripts during the respective refinement periods. Participants were given module certificates only after completing the relevant outcomes of the respective module.

Validation of the training program

The draft of the training curriculum was sent to 3 external experts having experience in biomedical research and/or experience in training health professionals in biomedical research for their validation. These experts were professors from different specialist from different medical colleges in India. The training schedule was modified and finalised based on inputs from these experts.

Process

The program process was monitored through regular meetings among the mentors and participant feedback.

Participant feedback

We collected feedback from participants on a structured questionnaire at the end of both modules. This form covered aspects such as the content and organization of the training and sought suggestions for improvement.

Regular mentor meetings

We conducted a facilitator meeting at end of each day of the workshop. This was to see if the training program was implemented as planned and learnt from deviations, if any and make modifications as needed. During the follow-up period of both modules, mentors kept communication with the mentees and mentees asked for guidance where required during this phase.

Product

Products were accounted for under the broader headings of outcomes, global satisfaction of participants, their self-rating of competency and their reflections on the learning experience.

Outcomes

The identified program outcomes were: participating faculty submitting their protocol to the ethics committee at the end of module 1 and submitting the manuscript to peer-reviewed journal at the end of module 2. We intended the manuscript be submitted to journals indexed with reputed indexing agencies.

Global satisfaction of participants

Participants were asked to rate the module 1 and 2 on a 5-point Likert scale (very poor, poor, average, good, and excellent).

Participants self-rating their competency

We asked the participants to rate their competency regarding essential components of protocol and manuscript writing using a retrospective pre-post questionnaire. Both questionnaires contained 12 items and responses were recorded on a 10-point Likert scale.

Reflections by participants on their learning experience

Borton's model of reflection was explained and three sample reflections were shared with the participants.¹¹ They were requested to reflect on their experience of this training program and submit reflections using this model.

Data analysis

Our participant size being eight, we have deliberately used actual numbers instead of percentages. We have used median and mean ± standard deviation for the data measured on quantitative scale. The qualitative data were processed by manual content analysis.¹² Two male faculty, trained in qualitative research, independently read the reflections and prepared primary codes and themes using an inductive approach. Through discussion, a consensus was reached on the codes and themes for the presentation of the reflective narratives.

Ethics

The project protocol for this mentorship project was approved by the local institutional ethics committee.

Results

Context

Number of applications

We received 12 applications. The first eight participants submitting applications with a draft research protocol were selected in this first batch.

Participants and their profile

The basic and research profile of the eight faculty participating in this training program is shown in Table 1. Two participants had prior experience of supervising postgraduate dissertations. Only half of the participants had any prior training in research; most common mode being a research methodology workshop. Although all participants had research publications in indexed journals, only half of them had experience of processing the project protocol through the ethics committee. Five participants reported zero citations to their publications while three reported 8, 19 and 76 citations. Among the research projects that participants took up under this training program, there were three clinical trials, four cross-sectional studies and one diagnostic test study.

Table 1.

Basic and research profile of the training participants (n = 8).

	No.
Basic profile
Gender
Female	8
Department
Paraclinical	3
Clinical	5
Designation
Associate Professor	3
Assistant Professor	5
Median (min – max) years of teaching experience	10 (8–21)
Number of participants having experience as postgraduate teacher	02
Research profile
Prior training in research methodology	04
Prior experience of training others on research methodology in formal setting	00
Prior experience of undertaking research projects (except own dissertation)	04
Median (min – max) number of publications in indexed journal	7 (0–12)
A prior publication in Medline indexed journal	02
Presented research work in scientific conference in last 5 years	03
Currently serving as reviewer in any peer-reviewed journal	02

Assessment of the pretraining version of protocols

The mean (±SD) score on assessment of pretraining version of protocols by external experts was 30 (±17.8) of 100. The experts felt that there was room for improvement in the following areas: data analysis plan, addressing ethical issues, clarity on the data collection process and expected outcomes of the study and referencing.

Inputs

As per the eligibility criteria, we could form a team of four core mentors for this program: three from community medicine and one from pharmacology. Among the four mentors, three were from the same institute in which this program was conducted and one was from a nearby medical college. We kept the mentor:mentee ratio of 1:2 so each mentor had two mentees.

Process

The mentorship program curriculum was implemented through two modules each spread across two workshops. We describe the salient points of program implementation that were recorded through mentor meetings and participant feedback.

The challenges faced in module 1 included few software glitches, participants needing more time refining their data collection tools, the translation of participant information sheet and consent form was not possible within the workshop time.

Challenges faced in module 2 were that a lot of time in plenary sessions was spent on language correction on the manuscripts. In both modules, the participants felt that more time was needed for individual work on their projects.

Participants suggestion was to include the topic ‘how to choose a journal’ in module 1. They also wanted topics such as ‘advanced statistics’ and ‘grant writing’ to be included in this module. They mentioned the ratio of mentor:mentee to be optimal and not to be altered.

Product

Number of participants achieving program outcomes

The numbers of participants achieving the outcomes are presented in Fig. 2. At end of module 1, all participants submitted the final versions of the protocols within the stipulated time and also submitted and processed it through the ethics committee. The clinical trial protocols developed under this program were registered in the Clinical Trial Registry of India.

Fig. 2.

Flowchart of participants achieving outcomes along the program.

This was followed by a one-year period of data collection. Except for two participants who could not complete the data collection of their projects, all the others came with collected data for the module 2 on manuscript writing. Thus, six participants attended module 2. In module 2, a total of five of six participants completed a draft manuscript and submitted it to a peer-reviewed journal. All five initial submissions were to journals included in PubMed. We allowed two participants to directly attend module 2 to maintain the batch size of eight participants.

External assessment of the protocols after module 1

The mean (±SD) score on assessment of post-training version of protocols by external experts was improved to 71 (+3.6) from 30 (±17.8) of 100.

Global satisfaction by participants

Module 1 was rated ‘excellent’ by seven participants and ‘good’ by one of them. Six participants rated module 2 as excellent and two rated it as good.

Participants’ self-perception of learning specific skills

There was a gain in skills after attending the respective modules, as evident from Fig. 3. The median pre-training score ranged from 1 to 5, while the median post-training score ranged from 6.5 to 8.5 of 10 on protocol writing skills. Participants felt that they had a marked gain in skills related to formulating research question, preparing data entry tool, analysis plan, timeline of project, managing references and choosing study design.

Fig. 3.

Comparison of the pre and post self-assessment scores of individual skills for module 1 (n = 8).

As shown in Fig. 4, the median pre-training score ranged from 3 to 6, while the median post-training score ranged from 5 to 8 of 10 on skills related to manuscript writing. Participants felt that there was a marked gain in skill of choosing a journal for publication, writing introduction, abstract and title, communicating with reviewers and building a research career.

Fig. 4.

Comparison of the pre and post self-assessment scores of individual skills for module 2 (n = 8).

Participants’ reflections on their learning experience

We received two sets of 8 reflections each, one from each participant, under this project. On an average, the reflections were detailed, with the word count ranging from 220 to 520 words and spanning more than one to two typed A4 size pages.

The emerging themes from the analysis of reflections with verbatim responses are presented in Table 2.

Table 2.

Thematic analysis of reflections by participants.

Theme	Category	Verbatim responses
What they felt before the program	Research phobia	“Research was like a big scary mountain which you know that you have to climb one day, but you just go to it and come back. But, to my surprise, our facilitators transformed the big scary mountain into a lush green field … “ “I always turned a blind eye to all the CMEs that flashed ‘RESEARCH’ in the fifteen years long journey of my academic career. Today, I really don't regret my hatred because I would not have learned better had it not been for this need-based hands-on experience”
	Difficulty in identifying a researchable topic	“I found it a bit tough, because I was getting very few research ideas applicable to our setup”
	Usefulness of preparing a draft protocol	“Good part was submission of protocol before the workshop. So I did my ground work properly and I knew what I actually wanted to do in my research”
What specific skills learnt	Use of reference management software	“Being from the bygone era of typewriting, ‘Mendeley’ was magical. Goodbye to manual referencing”
	Use of PICOT format for research question	“Now I know what type of information I should be looking for. …. . I will gather only that information which is needed”
	Focus on analysis at the beginning	“Most interesting part, I felt preparing Dummy tables. It was like, we almost finished building up our house; now only interior left!” “At the end of workshop, I could FEEL the importance of Stephen Covey's concept- Begin with end!”
	Use of Dropbox and online teamwork	“I learnt a very useful property of Dropbox to do an online teamwork! It was really very motivating to work in time by seeing each others' submissions in dropbox.. (Other things)”
What they felt about training methodology	Appreciated dedicated time for individual work during the training	“The beautiful part of each and every session was that after every lecture there was a “hands on” session …. ….. that every time, during each lecture we kept on thinking that how this information would be applicable to our research work.”
	Appreciated the peer feedback on their protocols	“ …. not only facilitators but we were getting very essential stuff of feedback from our peers also.”
	Timelines helped to stay focused	“… deadlines set that actually helped as complete the task on time”
Participants' feeling at training completion	Research made interesting	“Research seems an interesting aspect of current employment. And can make working environment worth to work.”
	A sense of accomplishment, confidence and joy	“While writing the final protocol, I was impressed with myself. Everything in the protocol was properly defined and specific.” “A tender new born- A PROTOCOL- feeling great to have it in our hands!”
	Overcoming of fear and research phobia	“it's an amazing feeling to overcome your fears and move ahead.”
	Clarity gained on time commitment and procedure for research	“I also have a clear Idea about the procedure and total time required for the protocol preparation”
	Learned to work in a systematic way	“Learnt a lot in systematic way and changed my style of working …”
What are plans for next steps?	Use of skills gained in future research	“Excited to start my study after presentation in Ethics committee” “Looking forward to do at least one research per year.” “I am going to try to apply all this knowledge for my other project also, which is waiting for manuscript writing”
	Sharing the gained knowledge with others	“As we will share this knowledge with friends and colleagues, they will also be benefited”

At start of the program, the participants expressed a feeling of research phobia and difficulty in identifying a researchable topic.

The specific skills that participants learned were use of reference management software, use of PICOT format for refining research question, keeping a focus on analysis and end point from the beginning, and online teamwork. The participants appreciated the dedicated time allotted during the training hours to work individually to build the components of their protocols. They also appreciated constructive feedback received from peers during plenary sessions.

At training completion, the participants overcame the fear of research and felt it to be interesting. They also felt a sense of accomplishment and confidence and learnt the systematic research process. They wished to use the skills gained future research and share the knowledge with others.

Discussion

Summary and comparison

The novelty of this article is reporting of a structured mentorship experience for research training to medical college faculty in India.

During our earlier research methodology workshops, the faculty had expressed a need for guidance and hand-holding during a research project. This was also reflected in receipt of more applications than we could accommodate in this program. The assessment of pre-training versions of the protocols also indicated a substantial need for improvement.

Efforts at training the faculty in research are underway for a long time, mainly in form of research methodology workshops in India. Recently the medical education regulatory body made the ‘Basic course in biomedical research’ compulsory as an eligibility criteria for faculty in medical colleges.¹³ Consequent to this the Indian Council of Medical Research has launched an online course offered through the Swayam platform.¹⁴ Other initiatives reported in the literature are support units with part-time or full-time staff mainly aiming at helping the faculty in statistical or administrative support.^15,16

Earlier reports of evaluation of such research methodology workshops have mainly remained restricted to measuring knowledge gain.^17,18 The limitations to the theory-driven training programs are that the knowledge gain is transient and fails to translate into a project because of inertia in initiating research studies.⁵ The need for close guidance in form of mentorship is reported earlier.^5,19 A systematic review and qualitative exploration has identified mentoring and participatory experiential learning as important success strategies for faculty development in research.^20,21 Our program is one such effort at a functional mentorship program involving a participatory learning element through a research project. The key characteristic of such functional mentorship is that the mentor is chosen with specific skills to match the needs of the mentee (research skills here), and the relationship is focused on a tangible outcome in form of a project.⁸

Other unique features of our program were utilization of local experts as mentors, deliberately splitting the curriculum into multiple spaced workshops, giving refinement periods to the participants, having defined outcomes, and a small group with limited mentees per mentor and peer support. The participants consulted respective mentors through the course of program including the refinement period. This mentoring relationship has continued beyond the program.

All participants completed the first outcome of submission of protocol to the ethics committee. Five of eight participants could reach the second outcome of submitting the manuscript of project within two weeks of module 2. One participant could not complete the data collection because of the clinical workload. For the second participant, inadequate pilot testing lead to underestimation of the data collection task and subsequent difficulty in achieving sample size. The third participant who could not submit the manuscript with 15 days of workshop 4, could finally do it later. Similar to our training experience, an earlier study evaluating the outcome of the SORT-IT program found that 89% of participants completed all modules.²²

The compulsory element of working on a project helped the faculty overcome the initial inertia to start a research project in this program. Our experience suggests that the presence of the mentor, defined milestones and a community of practice of peers motivated the faculty to stay on track with projects. Earlier literature suggests that perceived lack of time is a barrier to research output by the faculty.⁵ Similar to the study by Wadhwa et al²¹, our program also helped faculty secure protected time for research amid their otherwise busy schedules. Splitting of the training into multiple workshops with refinement periods gave breathing space to the faculty to absorb the knowledge and translate it into their projects. The mentors were from departments other than the faculty's department in our program. Earlier literature recommends such an arrangement of keeping mentors from other departments.¹⁹ We also observed the role of peers in this workshop: they provided constructive feedback to each other's projects and also created a social support group in form of a learning community of practice which we later found to have been described in the literature.^15,21

The participants reported a gain in specific skills in protocol preparation and manuscript writing. Participants’ reflections suggests an attitudinal change from research phobia to an interest in research. They also reported overall satisfaction with the content and organization of the program. As another by-product, our training program also served as a platform for interdepartment communication among the pre-para and clinical departments.

Implications for next batches

We have identified a few modifications for this program from the next batches. Earlier literature has identified the need to extend such training to senior teachers,¹⁵ and we plan to extend our program to senior teachers in the coming batches. We will include more hands-on training on how to deal with statistics and shift the topic on choosing the journal to module 1. We also intend to split the workshops into shorter duration. We plan to have monthly progress meetings during the data collection phase for hand-holding. We want to take two participants from this batch as mentors for the next batch.

Potential replication

We believe that our model of a mentorship program is potentially replicable at other medical colleges also. We purposefully utilised locally available mentors to ensure the sustainability of the program. We believe that interested and experienced faculty from community medicine, pharmacology and other departments would be available in medical colleges who can take up such programs. Epidemiology and biostatistics being a core component of community medicine teaching, the faculty of community medicine already have background knowledge about a large part of the research methodology. The software and online tools used during this training were all open access, free to use tools.

Limitations

We could include only eight participants in this first batch to maintain the quality of training. Topics of advanced statistics and grant writing could not be covered during this training.

Conclusion

We could locally develop a structured mentorship program for faculty on health research and implement it successfully for the first batch. Five of eight participants could successfully take their research from the protocol to the manuscript stage. The program helped the participating faculty to gain substantial knowledge and attitude towards research.

Disclosure of competing interest

The authors have none to declare.

Appendix A. Supplementary data

The following is the Supplementary data to this article: