Objectives. Mentorship and Knowledge Translation. What is mentoring? Mentorship. Does it currently happen? Why should we care?

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1 Objectives Mentorship and Knowledge Translation Sharon E. Straus MD MSc FRCPC LiKaShing Knowledge Institute St. Michael s s Hospital To enhance our understanding of the impact of mentorship To explore the mentor-mentee mentee relationship To provide a framework for mentorship in knowledge translation What is mentoring? The mentoring relationship is one of the most complex and developmentally important in a person s s life. The mentor will act as teacher, sponsor, guide, exemplar, counselor, moral support-- but most important is to assist and facilitate the realization of the dream. Levinson DJ: The Seasons of a Man s s Life. New York, Alfred A Knopf, 1978 Mentorship help getting resources, provide opportunities, protect, and advise Does it currently happen? Less than 50% of medical students have a mentor In some settings, less than 20% of faculty members in academic medicine have a mentor There is a perception that women have more difficulty finding a mentor than men Why should we care? Systematic review of literature identified 39 studies 34 cross sectional self-report surveys Median sample size 219 Median response rate 62% 3 before and after case series 1 case control study 1 cohort study JAMA 2006;296:

2 Why should we care? Mentorship influenced: Personal development Career guidance Career choice Discipline selected Academic vs. non-academic position Research productivity Retention and recruitment Why should we care? In Academic Medicine: 4 studies explored the influence of a mentor on career choice Participants included radiologists, primary care clinicians and emergency physicians Having a mentor influenced the selection of an academic career Why should we care? Impact on research productivity and success 13 studies identified including medical students, residents, fellows and staff physicians Associations found between having a mentor and: Completing a thesis Completing a research project Number of publications Likelihood of obtaining a grant Lack of a mentor associated with inability to complete a project or obtain a grant Where are the gaps? Only 5 studies provided details on mentorship relationship 4 studies reported if mentor assigned vs. self-identified Role of mentor and content of mentorship varied greatly Little mention of potential adverse outcomes associated with mentoring or on effect of mentorship for those interested in education-based careers Consider your own mentorship experiences What were barriers to the mentorship experience? What contributed to the success of the mentorship i.e. what where facilitators? What next?

3 Integrated KT Researchers and research users working together to shape the research Collaboration on setting the research question through to completion of the study and dissemination of its results It should produce research findings that are more likely relevant to and used by the end users Objective To explore and characterise the phenomenon of the mentor-mentee mentee relationship for academic clinician scientists who are at various stages of their career (early and mid) and who have obtained career support Acad Med Jan;84(1):135-9 Methods Population Health and Clinical Investigators who obtained funding from AHFMR since 1996 were invited to participate in semi- structured telephone interviews Stratified purposive sampling was used A sample of mentors identified on the AHFMR applications and during the mentee interviews was invited to participate Grounded theory Mentee Interviews What is their experience of mentorship? How and when did they identify their mentor(s)? What is the function of their mentor? What do they discuss with their mentor? What do they perceive as the elements of a successful mentoring relationship? Of a failed mentoring relationship? Results: Mentees As the data was analysed, additional questions were added including: What mentorship strategies would they recommend be implemented by their organisation? At funding agencies? Where there any barriers to receiving mentorship? What could be done to overcome these barriers? Should mentors be matched on gender, culture or other factors? 21 Population Health or Clinical Investigators 4 were female 12 were basic science researchers Participants were equally distributed between the University of Calgary and the University of Alberta All identified themselves as mentors to residents, fellows or junior faculty

4 Results: Mentors 7 senior mentors completed the interview All were men None of the mentees identified a female mentor 3 were from the University of Alberta and 4 from the University of Calgary Themes Experience with mentorship Self-identification of a mentor vs. assigning mentors Roles of a mentor Characteristics of a good mentoring relationship Barriers to mentorship Possible mentorship strategies Roles of AHFMR Experience with mentorship All participants believed good mentorship to be vital to career success 9 mentees described difficulties with mentorship including: Lack of mentorship Perceived competition with mentor Having research stolen by mentor I don t know if I would perceive much mentoring during the time I have been on faculty. I had a mentor who really didn t discuss things with me, was not interested in spending time on actually discussing issues, and was far too different from me to actually approach them with problems. Finding mentors I didn t seek out their mentorship because I didn t want to share all my ideas with that person because they were in the same area of research as me. All mentees had to have mentor as part of their AHFMR application Some mentees were assigned mentors by the University Department Chair All mentees expressed concern that assigned mentorship could have a negative impact on the relationship

5 the relationships that were most productive were those that were spontaneous and not due to a requirement. a forced relationship could lead to failure. Assigned mentorship could lead to an artificial or superficial relationship. Many reported difficulty in identifying mentors No formal mechanism to find a mentor not a whole lot of selection available at their institution Recommendations Department chair provide a list of potential mentors Mentees should meet with various mentors and speak with other mentees Mentor should not be someone the mentee is dependent on for resources, should not be their post-doc supervisor Mixed recommendations on whether there is a need for gender matching Role of a mentor Reviewing grants (especially for AHFMR process) Networking Preparing manuscripts and presentations Advising on achievement of career milestones Advising on time management Advising on navigating the university bureaucracy Providing role model for good mentorship Providing guidance vs. facilitating decision making The role of the mentor was to help me to do my job, push me to do my job. I don t need somebody to say you are wonderful, I need someone to kick my butt once in awhile. the mentoring provided me profoundly changed my career path and determined what I did for the rest of my life and he did that in the space of a total of 2 meetings for 3 minutes each.

6 Barriers to mentorship ensure that the research is appropriate for the mentee and not just what the mentor believes is necessary to enhance the bigger research agenda. Clarifying what intellectual property belongs to the mentee it was a disaster when there was a blurring around academic work and the mentor tried to take my work Time Lack of mentors Lack of academic recognition One of the major barriers to this process is that people are mentors basically as a hobby. They do not consider it part of the job that they do and that influences the time available to do it. Under our current system I don t know that anybody views mentoring as a priority. Recommendations: Possible mentorship strategies Mentorship at a distance?provide funding to visit mentor regularly Academic and scientific mentorship?team mentorship Recommendations: Mentorship education Only 1 mentee suggested that no mentorship education or support for mentorship was needed, believing that mentorship can t t be taught it is like a lot of things in academic medicine. Nobody teaches you how to do it, you are just expected to do it. Mentorship Education Educational interventions to include workshops for facilitators - 'train the trainer' workshops for mentors and mentees mentorship tool kit '1 minute mentor' Checklist for mentors/mentees Individual development plan Mentorship cases Consider the following: You supervise Dr. Smith who is a fellow in orthopedics and enrolled in the MSc program in clinical epidemiology Together, you discussed implementing a program to prevent and manage delirium in older patients admitted with hip fractures Dr. Smith wrote a proposal outline You believe the proposal lacks focus and is too ambitious for a masters thesis. You provided feedback to Dr. Smith and urged him to further refine his research question and plan. In the subsequent meeting held 1 month later, there is no evidence that progress has been made and he seems overwhelmed with clinical work and course requirements. What should you do?

7 Mentorship as a strategy for enabling the science and practice of KT We haven t been able to identify any rigorous studies that have evaluated mentorship as a strategy to enhance capacity for KT research and practice But it shouldn t be seen as something different from mentorship in other scholarly activities Science of KT May focus on Creation of knowledge tools/products Assessing gaps Adapting knowledge Understanding determinants of knowledge use Selecting, tailoring and implementing KT strategies Monitoring outcomes of KT strategies Assessing Sustainability MRC framework for assessing complex interventions Phase 1: Defining the intervention Theoretical basis for the intervention, components Phase 2: Exploratory Phase Acceptability and feasibility of delivering the intervention Phase 3: Explanatory Phase Rigorous evaluation Phase 4: Pragmatic Phase Post-implementation surveillance Practice of KT Putting knowledge into action By various stakeholder groups Across different settings Knowledge-to to-action Cycle Select, Tailor, Implement Interventions Assess Barriers to Knowledge Use Adapt Knowledge to Local Context Monitor Knowledge Use KNOWLEDGE CREATION Knowledge Inquiry Synthesis Products/ Tools Identify Problem Tailoring Knowledge Evaluate Outcomes Sustain Knowledge Use Mentorship in KT CIHR Summer Institute 30 students Focus on KT and mentorship Identify, Review, Select Knowledge Graham et al., 2006

8 Dr. Smith Part 2 You see Dr. Smith 2 weeks later to review the proposal for the delirium project. Dr. Smith isn t sure how to handle the research question which is: What is the impact of a delirium prevention strategy on older patients admitted with hip fractures? What is your approach? KT Canada Creating new knowledge about how best to achieve KT across different decision maker groups; Advancing the theory and methods of KT; Developing, testing, and commercialising tools and services aimed at sustaining KT; and Working with partners across the continuum of care to effect KT. Training Initiative Provide outstanding, innovative training centres and laboratories for trainees from various research disciplines to develop skills in KT and KT research; Link trainees and mentors to collaboratively advance the science and practice of KT; and, Partner with other national and international research groups to promote KT research and training Resources National KT Seminar Series KT Consultation Service This service will serve 3 different categories of participants: Decision makers and knowledge users who are interested in enhancing their knowledge and skills for practising KT; Researchers interested in developing a KT research project that is focused on advancing the science of KT; and, Researchers from other fields who are interested in learning how to apply the basic principles of the practice of KT to their own work. Submit your name and a description of the KT question you are trying to tackle including the rationale for this question.