MEO 1087-2981 Medical Education Online, Vol. 15, No. 0, April 2010, pp. 1–8 sici xxx PUBMED Abbreviation MitchellD.Feldman

*Mitchell D. Feldman Faculty Mentoring University of California 400 Parnassus Ave Box 0320San FranciscoCA94143-0320USA+1 (415) 476 7964

PatriciaA.Arean SallyJ.Marshall MarkLovett PatriciaO'Sullivan Faculty Mentoring University of California

San FranciscoCAUSA

Department of Psychiatry University of California

San FranciscoCAUSA

Office of Academic Affairs, Department of Preventive and Restorative Dental Sciences, Division of Biomaterials and Bioengineering, Faculty Development and Advancement University of California

San FranciscoCAUSA

Office of Educational Technology, School of Medicine University of California

San FranciscoCAUSA

Office of Medical Education and Department of Medicine, School of Medicine University of California

San FranciscoCAUSA

Medical Education Online RESEARCH ARTICLE Does mentoring matter? Background: To determine the characteristics associated with having a mentor, the association of mentoring with self-efficacy, and the content of mentor–mentee interactions at the University of California, San Francisco (UCSF), we conducted a baseline assessment prior to implementing a comprehensive faculty mentoring program. Method: We surveyed all prospective junior faculty mentees at UCSF. Mentees completed a web-based, 38-item survey including an assessment of self-efficacy and a needs assessment. We used descriptive and inferential statistics to determine the association between having a mentor and gender, ethnicity, faculty series, and self-efficacy. Results: Our respondents (n=464, 56%) were 53% female, 62% white, and 7% from underrepresented minority groups. More than half of respondents (n=319) reported having a mentor. There were no differences in having a mentor based on gender or ethnicity (p≥0.05). Clinician educator faculty with more teaching and patient care responsibilities were statistically significantly less likely to have a mentor compared with faculty in research intensive series (p<0.001). Having a mentor was associated with greater satisfaction with time allocation at work (p<0.05) and with higher academic self-efficacy scores, 6.07 (sd = 1.36) compared with those without a mentor, 5.33 (sd = 1.35, p<0.001). Mentees reported that they most often discussed funding with the mentors, but rated highest requiring mentoring assistance with issues of promotion and tenure. Conclusion: Findings from the UCSF faculty mentoring program may assist other health science institutions plan similar programs. Mentoring needs for junior faculty with greater teaching and patient care responsibilities must be addressed. mentoring faculty development program evaluation self-efficacy Prior research has shown that mentorship in the academic health sciences has an important influence on academic productivity, personal development, and career guidance for students, fellows, and junior faculty 12345. As a result, there has been growing interest in developing mentoring programs for protégés at all levels of career development 678 in a variety of health professional settings 910111213 and for diverse mentors and mentees 141516. Most of these programs have been modest in scope, informally organized, and have faced challenges to long-term sustainability, in part due to increased clinical and administrative demands on mentors and mentees 117.The University of California, San Francisco (UCSF) recently established what we believe to be the largest and most comprehensive mentoring program in the USA for health sciences faculty (http://acpers.ucsf.edu/mentoring/). Junior faculty members from the professional Schools of Dentistry, Medicine, Nursing, and Pharmacy are eligible for participation in the program. The primary goal of the UCSF faculty mentoring program is to promote the careers of junior faculty members by facilitating and supporting their relationship with a career mentor who can help guide their professional development. At the time of the launch of the faculty mentoring program in 2006–2007, we conducted a comprehensive baseline survey of all potential mentees to assess if UCSF faculty were currently receiving mentoring, the characteristics associated with having a mentor, the association of mentoring with self-efficacy, and the content of mentor–mentee interactions. All junior faculty members (below the Associate Professor rank) in the Schools of Medicine, Nursing, Dentistry, and Pharmacy were considered eligible to receive the baseline survey. Eight hundred and fifty-two junior faculty with appointments of greater than 50% were invited by e-mail between October 2006 and January 2007 to complete a web-based 38-item mentoring survey. To maximize recruitment, we contacted the faculty by e-mail a total of five times over the course of three months, inviting them to participate in the survey. No incentives were offered. The UCSF Committee on Human Research approved the research.The study investigators created the survey after extensive review of prior research in mentoring program evaluation for academic health professionals. It was then reviewed and pilot tested by experts in medical education and professional development at UCSF to assure relevance and wording.The survey consisted of 10 demographic questions about the respondent, eight questions about current mentoring relationships, if any, and their mentoring needs, and six questions about academic self-efficacy. In addition to baseline demographic information, we asked faculty to identify in which of the five UCSF faculty series they held an appointment. [The faculty series consist of Ladder Rank, In Residence, Clinical X, Health Sciences Clinical (the ‘Health Sciences’ designation was added to distinguish it from the title given to volunteer clinical faculty), and Adjunct.] In general, faculty in the Ladder Rank, In Residence, and Adjunct series are expected to spend most of their time engaged in research and their advancement and promotion is mainly linked to accomplishments in this domain, while faculty in the two clinical series (Clinical X and Health Sciences Clinical) are evaluated for promotion on the basis of their teaching and clinical competence. In addition, respondents were asked to indicate (in intervals of 20%) the amount of time they spent teaching, providing patient care, conducting research, and doing administrative tasks.Respondents were also queried about their academic self-efficacy. The self-efficacy questions were derived from a previously validated survey reported in prior research on faculty development 218. The six self-efficacy items were rated on a scale from weak 1 to strong 9 for level of confidence in key academic skills such as identifying their professional goals and interests and identifying the requirements for advancement and promotion at UCSF. These items formed a single factor in a principal components factor analysis, and the scale had an internal consistency reliability of 0.84.We also asked the faculty members to indicate which of 20 topics, if any, were discussed with a mentor. These same topics were rated on a scale of “no interest in assistance” 1 to “strong interest in assistance” 5.Descriptive statistics were used to characterize respondent faculty and their mentorship experiences at UCSF. Associations of gender, ethnicity, and faculty series with having a mentor were assessed with chi-square tests and odds ratios. A t-test was used to determined differences in self-efficacy between mentored and non-mentored faculty. Fifty-six percent of the faculty members we contacted responded to the survey (n=464). The majority of respondents (84%) were in the School of Medicine, 53% were women, 62% white, 27% Asian-American, 3% African-American, and 4% Latino. Our respondents were very comparable to those eligible who were 89% from the School of Medicine, 54% female, 61% white, 29% Asian, 2% African American, and 3% Latino.About two-thirds (n=319) of the respondents reported that they currently had a mentor; of these, 67% said they found the mentor themselves and 20% had the mentor assigned to them. Overall, 28% of faculty reported they needed help finding a mentor. Those with a mentor were younger (m = 38.7, sd = 5.7) than those without a mentor (m = 40.8, sd = 7.1, p=0.004). Table 1 shows the association with having a mentor by various demographic variables. Faculty series was associated with having a mentor (p<0.001). When examining the association, we found that faculty in both of the clinical series were significantly less likely to have a mentor compared to the other series (p values ranged from <0.001 to 0.022). There was an association between time for teaching and having a mentor (p=0.001), with those teaching less than 60% time more likely to have a mentor than those junior faculty members who reported spending more time teaching. Likewise, time spent engaged in research and the likelihood of having a mentor were associated (p<0.001); faculty with 20% or less time for research were significantly less likely than all other levels of protected time for research to have a mentor. Likewise, patient care was associated with having a mentor (p<0.001); those who reported spending 20% or less of their time in patient care were more likely to have a mentor than those who reported spending a higher percentage of their time at work in patient care activities. Finally, having a mentor was associated with being more satisfied with the time allocations at work (p=0.026). We found no association with having a mentor and gender, ethnicity, or school. Variable/value Have a mentor, n (%) p* *p values determined by chi-square analyses. Significant chi-squares were followed up with pair-wise comparisons to determine which categories were significantly different from each other. Note: Due to missing data, responses do not always total to 319. Gender  Female 154 (51.7) 0.50  Male 144 (70.2) Ethnicity  White 186 (68.1) 0.57  Asian 83 (70.9)  African-American/Latino 24 (72.7)  Other 10 (55.6) School  Dentistry 20 (64.5) 0.68  Medicine 266 (83.4)  Nursing 14 (66.7)  Pharmacy 19 (79.2) Series  Ladder rank 30 (76.9) <0.001  Clinical X 41 (49.4)  Adjunct 105 (82.0)  In Residence 57 (67.9)  Health sciences clinical 86 (66.2) Percentage of time – teaching  0–20 168 (72.7) 0.001  21–40 90 (62.9)  41–60 26 (78.8)  61–80 3 (25)  81–100 2 (33.3) Percentage of time – patient care  0–20 129 (80.1) <0.001  21–40 65 (73.0)  41–60 44 (56.4)  61–80 22 (44.9)  81–100 8 (47.1) Percentage of time – research  0–20 63 (50.8) <0.001  21–40 55 (73.3)  41–60 36 (69.2)  61–80 97 (87.4)  81–100 37 (72.5) Satisfaction with time allocation  Yes 231 (77.5) 0.026  No 67 (22.5) We found that those with a mentor had an average self-efficacy score of 6.1 (sd = 1.4), which was statistically significantly higher than the self-efficacy scores of those without a mentor, 5.4 (sd = 1.4, p<0.001). This corresponds to a modest effect size for having a mentor of 0.5 19. Table 2 indicates the topics that the mentees reported discussing with their mentor and their level of interest in seeking assistance about these topics from the new faculty mentoring program. As seen in Table 2, the topic most often discussed with mentors was obtaining funding (57% discussed with their mentor) and the least common topic was computer and statistical skills (11%). Teaching was discussed by 34% of mentees. Surprisingly, only 28% reported that they discussed their merit and promotion packet with their mentor. Yet, while obtaining funding was the topic that mentees most frequently talked to mentors about, mentees indicated that they most wanted assistance from the new faculty mentoring program on issues related to promotion and tenure. There were no differences in topics discussed based on gender or ethnicity. However, there were differences in what was discussed based on series. Generally, issues related to funding, grant writing, presentation, research design, and delivering presentations and manuscripts were less frequently discussed in the clinical series compared to the other series. Would like assistance from Faculty Mentoring Program^a Topic Percent discussed with any mentor (n=464) n Mean sd ^aAssistance rated from no interest 1 to strong interest 5. Obtaining funding 57 441 3.72 1.43 Manuscript preparation and publishing 51 440 3.09 1.44 Grant writing 49 443 3.48 1.44 Research design 44 439 3.22 1.41 Long-term career planning 41 441 3.72 1.43 Understanding promotion and tenure 40 442 3.12 1.29 Presentation/posters 39 437 2.49 1.29 Time management 36 439 3.01 1.46 Networking nationally and internationally 34 441 2.67 1.35 Teaching 34 436 2.40 1.40 Curriculum vitae 33 441 3.69 1.26 Networking on campus 32 442 3.65 1.33 Clinical care 32 443 3.09 1.40 Balancing personal/professional demands 31 446 3.60 1.25 Communicating effectively with colleagues 31 437 2.94 1.35 Review promotion/merit packet 28 444 3.95 1.30 Developing a research portfolio 28 441 3.04 1.42 Translational research skills 15 437 3.09 1.39 Developing an educator’ portfolio 12 441 3.08 1.36 In this study, we examined the processes and content of mentoring relationships and the mentoring needs of junior faculty in a large academic health sciences university prior to the implementation of a structured mentorship program. We found that at baseline, faculty who focus more heavily on teaching and clinical responsibilities are less likely to have a mentor and that faculty with a mentor have higher academic self-efficacy. While our findings are limited by the fact that we surveyed faculty members only at a single institution, we believe that these observations make an important contribution as this is the largest such survey reported in the peer-reviewed literature. We expect that our results will not only inform the development of the faculty mentoring program at UCSF, but will also help guide the development of similar programs at other health sciences universities. While a majority of junior faculty at UCSF reported having a career mentor, one-third said that they could not identify a mentor. Of these, most faculty members stated that they needed assistance in finding an appropriate mentor. The mentorship literature suggests that organically derived mentoring relationships are generally more satisfying and productive than those based on assignments but supports an assigned mentor as superior to none at all 21. In fact, junior faculty without mentors are at risk for isolation, do not feel as closely tied to their department or institution, and may rely too much on a risky strategy of trial and error for information about the institution and as a career-building strategy 22. In the new UCSF faculty mentoring program, junior faculty who cannot identify a career mentor are contacted by their departmental mentoring facilitator and together they identify an appropriate mentor for the academic year. We found that women and underrepresented minority faculty at UCSF were as likely to have a career mentor as other faculty. This finding is contrary to some previous research in the area. A systematic review of mentorship in academic medicine found that women report more difficulty in finding mentoring compared with men, though they found mixed results regarding sex concordance and satisfaction with mentoring and mentee productivity 1. It is critical that we better understand the work experiences of minority and women faculty in academic health settings and provide outstanding mentoring to ensure that we recruit, retain, and support a diverse health professions workforce 23242526. While some research has found that gender and/or ethnic concordance in mentoring relationships may be preferable 27, given the current workforce in academic medicine this is often not feasible and in fact has not been found to be critical to mentee satisfaction with mentoring 328. A national survey of US medical schools found that women and minority faculty felt that such matching was not important, though this research was limited by the lack of diversity in the study participants 29. What seems clear, however, is that mentor training and mentoring programs that specifically address the needs of women and minority faculty can be effective in improving recruitment of similar faculty and trainees to that institution 3031. We found that clinical and clinician educator faculty were significantly less likely to be mentored than research intensive faculty. This is a disturbing though perhaps not surprising finding, since traditional mentorship models at academic health sciences settings focus on career development in research-oriented faculty. Prior research has suggested that mentoring programs for clinician educator faculty members may enhance productivity and job satisfaction, but few mentoring and faculty development programs explicitly target these faculty 3233. This may explain, in part, why retention of clinician-educator faculty is often a challenge in academic health sciences institutions despite the fact that these faculty members are highly valued as educators. Enhanced mentorship may offer an opportunity to improve retention of clinician-educator faculty members. Our results indicate that faculty with mentors were more likely to be satisfied with the distribution of their work and had higher self-efficacy than those who were not mentored. Self-efficacy is defined, in part, as a belief in one's ability to accomplish specific goals and tasks 343536. Because of the cross-sectional nature of our data, we cannot say with confidence that mentorship necessarily leads to enhanced self-efficacy and positive academic outcomes, as those who have high self-efficacy may be more likely to seek out mentoring. However, other research suggests that protégés with more exposure to mentoring report higher levels of self-efficacy 215181920343738, and results from a faculty development program for medical faculty found a positive correlation between mentorship, improved self-efficacy, and enhanced research and leadership skills necessary for academic advancement and retention 218. As seen in Table 2, mentees report discussing a broad variety of topics with their mentor. Given the current funding climate, it is not surprising that junior faculty report that they need assistance with funding issues from their mentor and from the overall program. Conversely, it is interesting that several key topics are reportedly discussed infrequently with mentors although mentees indicate that they need assistance with them. For example, while only 28% of mentees reported reviewing their promotion/merit packet with their mentor, it was the top-rated topic that mentees said they wanted assistance with. Likewise, only 31% reported discussing issues of personal–professional balance with their mentor, but it was in the top five topics for which mentees reported wanting assistance. It is not clear what underlies this disconnect between what faculty mentors and mentees discuss in mentoring meetings and what areas mentees say they need assistance. Perhaps mentors define their mentoring relationships more narrowly (to assist with funding, grants, and manuscripts) than most mentees do, and mentees do not have the communication tools or confidence needed to broaden the agenda. Future research should address these barriers. The UCSF Faculty Mentoring Program targets all junior faculty in the four health sciences professional schools at UCSF (Medicine, Nursing, Pharmacy, and Dentistry). The Graduate Division supports its own mentoring program and similar programs are being developed for medical students and other trainees at the university. The program is led by the Director of Faculty Mentoring along with the Mentoring Program Coordinator, and the Vice Provost Office of Academic Affairs and Faculty Development and Advancement. Senior faculty ‘mentoring facilitators’ were appointed in each department to help facilitate the matching of mentor–mentee pairs and to help disseminate mentoring best practices across the campus (Figure 1). In addition, to underscore the importance of mentoring, UCSF recently stipulated that mentoring activities must be documented on the CV to be evaluated at the time of promotion, along with competence in teaching. Numerous awards have been established to recognize and promote outstanding mentorship, and mentor development activities have been initiated along with mentoring resources.

UCSF Faculty Mentoring Program organizational chart.

The Faculty Mentoring Program aims to pair every junior faculty member (up to the Associate Professor rank) with a career mentor. We encourage junior faculty members to assemble a mentoring team consisting of a career mentor, scholarly mentor, and co-mentor with clear roles and responsibilities (Table 3). The junior faculty member is responsible for arranging meetings of the mentoring team on an annual basis to review career progress toward promotion. Additional meetings of the team are essential for faculty engaged in research. The career mentor is a senior faculty member usually in the mentee's home department, who is responsible for overall career guidance and support for their mentee, including a minimum of twice yearly meetings to review the mentee's CV and Individual Development Plan (IDP) The faculty mentee is expected to complete an IDP semi-annually and send it to the mentor with an updated CV prior to each meeting. The career mentor is also responsible for reviewing advancement and promotion issues, helping the mentee to set short- and long-term professional goals, assisting with networking in the institution and nationally, and reviewing issues of personal/professional balance as they arise. To avoid any real or potential conflicts of interest regarding job responsibilities, we recommend that the career mentor should not be the mentee's direct supervisor, department chair, division chief, or laboratory head. While these leaders are expected to provide career advice to their junior faculty members and can effectively serve as a research or scholarship mentor, other senior faculty should be tapped to fill the role of career mentor in the faculty mentoring program. Types of mentors Characteristics Career mentor A senior faculty member primarily responsible for providing career guidance and support May not have expertise in the mentees’ scholarly or research area Assigned by the Faculty Mentoring Program, Mentoring Facilitator in each department or school Expected to meet with the mentee at least every six months to review overall career goals and advise them on issues related to advancement and promotion Should not be a mentee's direct supervisor, but will usually be in their home department Scholarly mentor Must be expert in the scientific or scholarly area of the mentee Able to guide mentees in the following areas: Professional research and academic skills Develop a feasible, coordinated research plan Provide resources: databases, access to space, research staff, access to funding and potential funding sources (campus and national) Collegial networking: national, international Assist with communication of findings including oral presentations, writing of abstracts, manuscripts, and development of grants Co-mentor Responsible for working with the lead mentor on overall mentoring responsibilities (as outlined above) for the mentee and for providing particular guidance in their area of expertise We believe that the UCSF Faculty Mentoring Program is the largest and most comprehensive program for academic health sciences faculty in the nation. Lessons learned from this program should help to inform similar faculty developments efforts at other medical and health sciences universities. The authors have not received any funding or benefits from industry to conduct this study. Dr. Feldman had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Feldman is responsible for the conception and design of the research, data collection, analysis and interpretation of data, drafting and/or editing and final review of the manuscript. Drs Arean, O'Sullivan, and Marshall are responsible for analysis and interpretation of data, drafting and/or critical revision of the manuscript, and administrative support. Mark Lovett is responsible for analysis and interpretation of data, critical revision of the manuscript and statistical analysis. The authors thank Sarah Zins and Viverly Maniago for their assistance. AmbunjakDStrausSEMarusicA. 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