Mentoring The Mentor
Mentoring The Mentor
DOI 10.1007/s10461-016-1364-3
ORIGINAL PAPER
Abstract Given the diversity of those affected by HIV, October 2013 and May 2015) with plans for annual train-
increasing diversity in the HIV biomedical research ing. Mentoring competency was measured using a vali-
workforce is imperative. A growing body of empirical and dated tool before and after each workshop. Mentoring
experimental evidence supports the importance of strong competency skills in six domains of mentoring—specifi-
mentorship in the development and success of trainees and cally effective communication, aligning expectations,
early career investigators in academic research settings, assessing understanding, fostering independence, address-
especially for mentees of diversity. Often missing from this ing diversity and promoting development—all improved as
discussion is the need for robust mentoring training pro- assessed by a validated measurement tool for participants
grams to ensure that mentors are trained in best practices pre- and -post the ‘‘Mentoring the Mentors’’ training
on the tools and techniques of mentoring. Recent experi- workshops. Qualitative assessments indicated a greater
mental evidence shows improvement in mentor and mentee awareness of the micro-insults and unconscious bias
perceptions of mentor competency after structured and experienced by mentees of diversity and a commitment to
formalized training on best practices in mentoring. We improve awareness and mitigate these effects via the
developed a 2-day ‘‘Mentoring the Mentors’’ workshop at mentor–mentee relationship. Our ‘‘Mentoring the Mentors’’
UCSF to train mid-level and senior HIV researchers from workshop for HIV researchers/mentors offers a formal and
around the country [recruited mainly from Centers for structured curriculum on best practices, tools and tech-
AIDS Research (CFARs)] on best practices, tools and niques of effective mentoring, and methods to mitigate
techniques of effective mentoring. The workshop content unconscious bias in the mentoring relationship. We found
was designed using principles of Social Cognitive Career quantitative and qualitative improvements in mentoring
Theory (SCCT) and included training specifically geared skills as assessed by self-report by participants after each
towards working with early career investigators from workshop and plan additional programs with longitudinal
underrepresented groups, including sessions on uncon- longer-term assessments focused on objective mentee
scious bias, microaggressions, and diversity supplements. outcomes (grants, papers, academic retention). Mentoring
The workshop has been held three times (September 2012, training can improve mentoring skills and is likely to
improve outcomes for optimally-mentored mentees.
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investigators in academic research settings [1–7]. For that offer faculty the opportunity to develop skills and
example, an observational study found that institutions incorporate best practices. Mentoring training programs
with strong mentoring programs demonstrated greater should allow for standardization of mentorship tech-
research productivity among early career faculty than niques, increase the validity of mentoring as an academic
institutions without such programs [2]. A comparative activity on par with research or teaching, lead to curricula
study examined time to promotion among faculty members and guides on training mentors, and fundamentally result
in the Department of Medicine at a large research univer- in better outcomes for mentees in the area of scholarship
sity pre- and post-establishment of a formal mentoring and promotion. However, although some forums for short-
program and among mentored and non-mentored faculty term training on mentorship skills exist, longitudinal
matched for other characteristics [8]. Time to promotion mentoring programs with formal evaluation and long-term
was significantly decreased both in the era of the mentoring monitoring of both mentor and mentee outcomes and
program (by 1.2 years) and among faculty members who successes, assessed both by self-report and by objective
were mentored (by 1.0 year). Moreover, recent surveys parameters, especially for HIV researchers, require
from academic medical centers showed that faculty satis- development.
faction, not just productivity, improved with formal and
informal mentoring [9, 10]. These observational studies, Effective Mentoring of Investigators
among others, argue that a culture of formal mentoring from Underrepresented Groups is Likely to Require
enhances the success of academic faculty as measured by Mentoring Training Programs Geared Towards
productivity, advancement, and job satisfaction. The fast- Enhancing Specific Skills
moving field of HIV/AIDS research is one in which men-
toring may be particularly critical to the success of the next Given the diversity of those affected by HIV, increasing
generation of clinical and translational researchers. diversity in the HIV clinical and biomedical research
Often missing from the discussions of the need for workforce is imperative. The benefits of effective men-
academic mentorship programs is the need for robust toring specifically for early career investigators from
mentoring training programs to ensure that mentors are underrepresented backgrounds are well-documented [17–
trained in best practices on the tools and techniques of 26]. Historically, there has been a disproportionately and
mentoring [6, 11–13]. A recently-published randomized dismally low percentage of racial and ethnic minority
controlled trial by Pfund et al. conducted at 16 academic faculty members in U.S.-based academic institutions, with
health centers randomized mentors in the intervention arm retention rates of minority faculty falling at higher levels of
to an 8-hour case-based curriculum focused on mentoring academic rank [27, 28]. Minority recruitment and retention
competencies, and compared mentor and mentee reports of in HIV research has not been an exception. Moreover, there
mentors’ competency skills post-training to those from an is evidence that scientists from underrepresented groups
untrained control group [6]. Importantly, besides experience significantly lower success rates in obtaining
improvements in the mentors’ perceptions of mentoring funding from the National Institutes of Health (NIH) [15,
competency after receiving the training intervention, 29], despite controlling for possible confounders to this
mentees of trained mentors also reported improvements in finding. For example, African American investigators were
the mentoring skills of their mentors, even though the 10 % less likely to be awarded R-level NIH research
mentees were blinded to mentor assignment. Although this funding than white investigators even when controlling for
trial was limited in its ability to assess longer-term out- educational background, country of origin, training, pre-
comes with more objective parameters of mentee success, vious research awards, publication record, and employer/
such as manuscripts and grants, this study, among others university characteristics [29]. These data launched an NIH
[14], suggests that designated mentorship training may initiative to increase representation of individuals from
improve mentoring competencies in specific areas such as typically underrepresented groups in the biomedical
maintaining effective communication, aligning expecta- research workforce [30], such as individuals from certain
tions, assessing understanding, addressing diversity, fos- racial and ethnic groups, from disadvantaged backgrounds,
tering independence, and promoting professional or with disabilities [31]. The importance of increasing
development [15]. diversity among researchers underscore the need to train
Successful mentoring requires skilled mentors. Mentor- mentors to employ tailored and effective mentoring
ship matters and mentoring mentors matters. Despite a approaches that take into account the background,
growing understanding that faculty can benefit from strengths, and needs of each mentee.
training on mentoring [14, 16], there are limited formal Potential barriers to NIH-funding success rates and
mentorship training programs for academic researchers in academic progress of racial/ethnic minorities have been
any field, including HIV research, in the U.S. or elsewhere identified and include inadequate research training and
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mentees of diversity (Fig. 1). Our ‘‘Mentoring the Mentors’’ outlines the steps and structure of the Mentor Consulta-
training program focused on fostering early career investi- tion Clinic.
gators of diversity is the first of its kind reported in the lit- The second and third ‘‘Mentoring the Mentors’’
erature and holds promise for expanding the pool of expert workshops for HIV researchers were held in October 2013
and peer mentors well trained to provide robust academic and May 2015, respectively, with findings describing the
mentorship in the field of HIV research and beyond. implementation and findings from the second workshop
subsequently published [56]. Briefly, after recruiting
Curriculum of ‘‘Mentoring the Mentors’’ through national CFAR programs and HIV-related
Workshops research networks, we accepted a total of 67 mid- and
senior-level investigators from a wide range of universi-
The development and implementation of the first ‘‘Men- ties and research institutions across the US for these two
toring the Mentors’’ training for HIV researchers held in workshops. Attendees represented multiple disciplines in
September 2012 at UCSF has been described [12]. Briefly, HIV research, including medicine (42 %), social and
after recruiting through multiple national Centers for behavioral sciences (21 %), public health (13 %), epi-
AIDS Research (CFAR) programs and the eight CFAR demiology (10 %), and nursing (8 %). About half (51 %)
Networks of Integrated Clinical Systems (CNICS) sites, were at the full Professor level, 37 % at the Associate
we eventually accepted 26 faculty participants from 16 Professor level, and 11 % were at the senior Assistant
universities into our first training program. Of note, the Professor level. The majority (66 %) reported currently
initial applicant pool was much larger, but we restricted serving as primary mentor for mainly 1–3 mentees, with
participation to allow for more personalized training and 33 % mentoring 4 or more mentees. We administered the
to encourage interactive discussion. The main selection validated Mentoring Competency Assessment tool
criteria for trainees to participate in the workshops was (MCA) [15] before participants arrived and again
academic rank at the mid-level (advanced Assistant Pro- 1–2 weeks after the workshops were completed. Based on
fessor; Associate Professor) or senior (Full Professor) a [95 % evaluation completion rate, we were able to
level and having an active role in mentoring early stage document statistically significant increases in attendees’
investigators at the time of the training. Table 1 summa- self-ratings of mentoring skills, including skills related to
rizes qualitative data showing the participants’ self-de- communication, fostering independence, and, importantly
scribed strengths as mentors, areas for improvement, and for this report, addressing diversity in the mentoring
lessons learned from the mentoring workshop that could relationship.
be applied to each mentor’s personal action plan over the Figure 1 shows attendees’ pre-workshop means (grey
coming year. bars) and post-workshop means (black bars) for the men-
Each 2-day workshop (Table 2) focuses on a series of toring competencies assessed by the MCA. As a reference,
topics designed to enhance general mentoring techniques, MCA scores from a normative sample of senior mentors
(e.g., communication strategies, use of individual devel- drawn from a national Clinical and Translational Science
opment plans, setting goals and expectations for the men- Award (CTSA) sample are shown with stripes [15]. Of note
tor–mentee relationship, how to teach time management, is that the normative group (striped bars) included more
life-work balance, mentor and mentee evaluation tools, senior faculty (i.e., more full professors with extensive
how to give and receive feedback, etc.). Topics specifically mentoring histories than our group), which likely accounts
related to diversity (e.g., unconscious bias, microaggres- for their higher scores compared to our mentors at baseline
sions, description of diversity supplements to NIH spon- (grey bars). However, after our workshop, our mentors’
sored grants and other foundation grants geared towards scores (black bars) surpassed their own baseline scores (in
minority applicants, resiliency, self-awareness, etc.) are grey; all p values \ .0001) and almost all of those of the
also addressed, all via didactic presentations, break-out more senior comparison group (striped bars).
sessions, role-play exercises and small-group brainstorm-
ing sessions.
Toward the end of the training curriculum, we conduct Discussion
a Mentor Consultation Clinic (Fig. 2), in which partici-
pants break into groups of 5–6 and provide input on a The urgent need for training programs to inculcate best
current mentoring challenge identified by one of the practices of effective mentoring for HIV research mentors
mentors. In this exercise, participants are instructed to is evident, especially for mentors working with mentees
apply the workshop’s training content (e.g., active lis- from underrepresented groups. We have instituted an
tening, awareness of bias) to a specific mentoring situa- annual ‘‘Mentoring the Mentors’’ workshop at UCSF to
tion before offering advice and recommendations. Table 3 train mid-level and senior HIV researchers from across
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Table 1 Mentoring the mentors workshop (September 2012, UCSF) learning points
the country on tools and techniques of successful men- whether intensive mentor training such as the program
toring. We have demonstrated that our program can result described in this paper or others [11] results in an increase
in increased confidence across a range of mentoring in the likelihood that mentees will remain in academic
competencies, including competency in addressing topics research careers. Improvements in self-efficacy around
related to diversity in the context of the mentoring research skills have been reported in early stage learners
relationship. with designated training programs [59, 60], but the impact
While these scores on a validated measure of mentoring of mentorship training on mentee self-efficacy has not been
competency [15] are an important indicator of the impact assessed. This is particularly important for researchers
of this program, more comprehensive evaluation over the from underrepresented backgrounds, in which attrition at
long-term is needed [58]. This includes documenting each step of the pipeline is disproportionately higher than
whether changes in perceived mentoring competency for non-minority academic researchers [27, 28]. Thus,
results in improved quality of mentoring and improved documenting immediate perceived improvements in men-
outcomes for both mentors and mentees. Such metrics toring competency is important, but insufficient to fully
include number of mentees, frequency and quality of evaluate the impact of mentor training. Although self-re-
mentor–mentee contact, routine use of specific mentoring ported improvements in mentoring practices are likely to
tools such as the Individual Development Plan (IDP), improve long-term mentee outcomes, these studies are yet
mentee productivity (e.g., published papers, funded grants), to be conducted, require investment, and the authors are
and mentor–mentee satisfaction with the mentoring rela- actively seeking funding for a longitudinal program with a
tionship. Eventually, it will be important to document robust monitoring and evaluation component.
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Communication Active listening, having difficult conversations, giving feedback (positive and negative),
setting and aligning expectations, understanding different communication styles
Leadership skills and emotional Types of leadership, emotional intelligence, mindfulness in mentoring
intelligence
Diversity in the mentoring Disparities in academic research, unconscious bias, microaggressions and discriminations,
relationship mentoring across differences
Professional skills Time management, teaching writing skills to mentees, public speaking/presentation skills
Life–work balance Life–work balance and self-care, priority management matrix
Mentoring roles Defining categories of mentoring roles, clarifying the role of the lead mentor, stressing
interdisciplinary and team mentorship
Mentoring resources and tools Individual development plans (IDPs), rewards and challenges of mentoring, NIH grant
mechanisms (e.g., F, T32, K, and diversity supplements), tools and structure for effective
mentoring sessions, distance mentoring, team mentoring, developing an IDP for mentoring
skills (M-IDP)
Professional ethics Boundaries in the mentor–mentee relationship, authorship issues, managing professional
disputes, responsible conduct of research training opportunities for mentees, research
misconduct
Integrating and applying mentoring Mentor consultation clinic, developing a network of mentoring support
skills
Fig. 2 Participants at the first workshop (September 2012, UCSF) Fuchs, Associate Professor of Medicine, UCSF; Becky White,
during the Mentor Consultation Clinic. Photo used with permission Assistant Professor of Medicine, University of North Caroline
from the participants. Clockwise from left: Michael Saag and Director (UNC); Monica Gandhi, Professor of Medicine, UCSF; Richard
of CFAR, University of Alabama, Birmingham (UAB) receives Haubrich, Professor of Medicine, University of California, San Diego
advice from peers during the Mentor Consultation Clinic; Jonathan (UCSD)
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The ‘‘Entering Mentoring’’ Curriculum developed by teaching in promotion decisions. On the other extreme,
the University of Wisconsin Mentoring Program, like ours, some participants reported that their institutions implicitly
employs Social Cognitive Career Theory in its approach or explicitly discouraged faculty from devoting much time
and aims to improve the same six research mentoring to mentoring by not acknowledging such efforts in pro-
competencies: (1) maintaining effective communication; motion and tenure decisions and not allowing relief from
(2) aligning expectations; (3) assessing understanding; (4) clinical, administrative, or teaching activities to allow time
addressing diversity; (5) fostering independence; and (6) for mentoring. Given the empirical evidence of the
promoting professional development. The University of importance of quality mentoring on a range of outcomes,
Wisconsin program is focused mainly on case-based structural factors must be addressed to encourage and
learning for each of the 6 objectives and the set curriculum empower researchers to devote time and effort to mentor-
is typically implemented in four 2-hour sessions, led by ing early career investigators.
two trained facilitators. The curriculum of the HIV In summary, mentor training is an important element in
researcher ‘‘Mentoring the Mentors’’ workshops is, by a comprehensive approach to optimize outcomes for early
contrast, delivered over two 8-hour days and, although career investigators, and may be particularly influential in
case-based learning is also emphasized, our curriculum is countering the challenges faced by scholars from under-
delivered mainly through rotating didactic sessions, small represented backgrounds. We describe here a model for an
group exercises, group discussions, peer-to-peer advice intensive ‘‘Mentoring the Mentors’’ training program
sessions, and role playing sessions. Our curriculum is, by designed to incorporate best practices in mentoring for HIV
design, more fluid and less systematically delivered than researchers and plan longitudinal studies and supplemental
the University of Wisconsin program as the mentors in our mentee training programs to ultimately change mentoring
programs were all mid-level and senior HIV researchers practices and improve outcomes.
with typically long histories of mentoring experience. We
aimed to maximize the expertise of the group in our pro- Acknowledgments Funding provided by National Institutes of
Mental Health/NIH R24MH094274.
gramming with a peer-based approach while simultane-
ously teaching some core principles around the individual
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