Mentoring Programs

Steven R. Lowenstein, MD, MPHProfessor of Emergency MedicineAssociate Dean for Faculty Affairs

November 3, 2010

Departmental benefits

Faculty career satisfaction & success

Faculty retention Success of the department Departmental and institutional

loyalty Development of the next generation

of leaders

Guiding principles Mentoring programs are important Mentoring is time-sensitive

Quick start Address mentoring needs before hire

Clinician-educators need mentoring, too External connections are vital

Productive colleagues National exposure SOM courses and programs

Guiding principles

Required: Knowledgeable mentors Career-building skills Promotion & tenure

Required: Departmental leadership Required: Investments Required: Mentors with time

Departmental ProgramInfra-structure

•Assignment

•Team mentoring

•Monitoring

•Resources

•Time for scholarship

•Departmental expertise

•Performance reviews

Network of productive colleagues

Effective use of SOM resources

•TSP, AME

•OFA

•Clinical Scholars

•Tailored course-work, training

National involvement

Mentoring Pairs

Case Study

The Misguided Mentor

MAJORS & MINORS

MERITORIOUS* IN ALL Teaching Clinical/service Scholarship

*Praiseworthy…deserving of merit

EXCELLENT* IN ONE Teaching Research Clinical activity

*Outstanding…of exceptional merit

M E

Promotion & Tenure Approval Rates2002 - 2009

Associate Professor (n = 462): 97% Clinician-educators (114; 2002-2005):

97% Professor (226): 96% Tenure (105): 88%

Publication Totals2000-2005

Clinician Educators (Promotion to Associate Professor; n = 114)

1st/Sr. Peer

Other Peer

All Peer Chapter, etc.

Total Publicatio

ns

Minimum 0 0 0 0 1

Maximum 36 64 85 55 92

Mean 6.5 7.3 13.7 7.3 20.9

Median 4 5 11 6 18

25th Percentile

2 2 5.5 2 10

Scholarship: Required by Rules

All faculty are required to participate in scholarship

The products of scholarship must be in a format that can be evaluated, which would normally mean in a written format

Scholarship: Broadly Defined Discovery, application, integration

and education Products that can be reviewed:

Publications, CDs, educational syllabi, web sites, chapters, case reports, reviews, residency training manuals, policy “white papers,” clinical guidelines, evidence-based pathways.

Alternative Forms of Scholarship

Case Study

Publish, perish and the teaching scholar

Should she opt out of the intern coordinator position?

How will she find time for grants? How can she ever get promoted? What about her “isolation?” Please help …

MAJORS & MINORS

MERITORIOUS* IN ALL Teaching Clinical/service Scholarship

*Praiseworthy…deserving of merit

EXCELLENT* IN ONE Teaching Research Clinical activity

*Outstanding…of exceptional merit

M E

Meritorious vs. excellent

Active participation in teaching activities of the department, including (2 or more): presenting series of lectures, coordinating a course, advising students, attending on inpatient or outpatient service, mentoring students/fellows, seminar or laboratory group leader)…

Meritorious teaching evaluationsDevelopment, revision of

teaching materials for students, CME courses…

Invitations to present courses, lectures outside of department, give grand rounds

Greater than average share of teaching duties (e.g., course or fellowship director) …

Consistently receives outstanding teaching evaluations or teaching awards …

Develops innovative teaching methods, such as educational software, videotapes..

Provides educational leadership by writing syllabi, or assuming administrative roles

Consistent participation in national educational activities (RRC’s, board examiner)

Invitations to be Visiting Professor

TEACHING

Excellence: Using the matrices

Teaching Excellence

Provides educational leadership by writing syllabi or textbooks or assuming administrative roles

Developed “Sports Medicine” module for residents

Wrote 84-page evidence-based syllabus

Developed 6 web-based patient encounters demonstrating knee examination and approach to common knee injuries

Co-director of multi-disciplinary CME course, “Sports Medicine for Primary Care Clinicians”

Co-chair, departmental Medical Student Education Committee

Meritorious vs. Excellent

Active & effective participation in clinical activities of the unit

Board certification Support from internal

peers at practice site Invitations to speak on

clinical topics on campus

Participation on institutional clinical care committees

Development of new therapies or health care delivery systems that have improved health care

Active participation in evaluating effectiveness, access, utilization

Recognition of clinical excellence at regional or national level (through requests to write reviews, speaking invitations, awards, letters of reference)

Clinical leadership (practice director, head of inter-disciplinary team that creates and evaluates a pathway)

National leadership activities (e.g., chairing national meetings or committees, editorial role, officer of national organization)

CLINICAL PRACTICE

Promotion Matrices

Use them to guide career planning Concrete examples to distinguish

“meritorious” vs. “excellent” Excellence:

Engage in several activities in area of focus

Demonstrate leadership in one or more Document these accomplishments

Lesson: Focus on documentation

Quality, importance, impact, reach C.V. – not enough Teaching evaluations – not enough Reprints of articles – not enough Chair’s letter – not enough

Supporting evidence Clinical and teaching portfolios Narratives Annotated bibliographies

Junior faculty must build a dossier --- starting now

Dr. Jones could … Develop and own the intern rotation Think about leadership and scholarship “Curriculum innovation”

Critical principles of pathophysiology at bedside

End-of-life care Evidence-based mgt of respiratory failure Professionalism Bedside teaching as a technique Develop simulations, PBL, manuals, syllabi

Document learner outcomes

•Clear objectives•What need did course fill•Preparation

•Background, literature•Development of content•Teaching methods used

•Significant results (impact)•Who took it•Dissemination, presentation•Products that can be reviewed•Clear description of faculty role

External connections-Teaching

Teaching Scholars Program Academy of Medical Educators Course work and training Involvement in undergraduate medical

education and residency program Simulation center Leadership opportunities--SOM,

national

External connections - Clinical

SOM , UCH, Denver Health initiatives: Patient safety and quality Inter-professional ethics Electronic health records Team-based practice Practice and teaching opportunities

LEADS, global health, women’s health, rural CU-UNITE (Colorado Urban Underserved

Interdisciplinary Health Training and Education)

Building a successful program

MentoringFaculty Development

Faculty development essentials

Mentoring programs are a component of faculty development

Performance feedback Annual reviews by chair Mid-course comprehensive reviews

Support and rewards for teaching & clinical service

Support & time for scholarship

Responsibilities of the chair SOM Rules: Mandatory assignment Facilitate process by which junior faculty

identify & approach mentors Whom they admire After learning about their career interests and

observing their teaching, clinical, scientific and personal styles

Common “match points” During recruitment Initiation of joint research, clinical or teaching projects

Assist in identifying mentors outside department Message to new Assistant Professor …

Responsibilities of chair Communicate in writing to mentors

and mentees Remind them of their responsibilities

to one another Consult regularly with junior faculty to

gauge mentoring needs Monitor process, evaluate

outcomes, identify gaps, suggest new pairings

Limitations to pairs Requires time … Senior faculty report they are

“near mentoring capacity” Some senior faculty members are reluctant Senior mentors cannot know it all Protégés are short on time Challenges of “mentoring across differences”

Generational differences Many minority faculty members leave their jobs early,

because of feelings of isolation and “benign neglect” Newer models need to save time,

improve efficiency & expand reach of mentoring

Newer mentoring models Workshops

Present information that all faculty members need In collaboration with other departments

Mentoring consultations Enable a faculty member to request a specific consult for a

particular area (course supervision, academic writing, time management, preparing a grant, presenting research abstract)

Co-mentoring Match junior faculty with 2-3 mentors (broader expertise) Results in a department of medicine:

Provided a better experience for mentees and for co-mentors Less demanding than being a sole mentor

Lackhaupt, 2005

Collaborative mentoring Groups of peers and senior mentors Visible, quick and efficient means to share knowledge +

academic skills Promotion process and preparing dossiers Career planning Negotiation skills, work-life balance, time management Mentor-mentee responsibilities Scientific and grant writing

Harness energy & knowledge of senior faculty & peers Suggest influential colleagues and national connections Help mid-career faculty gain mentoring skills Build collegiality, break down barriers Especially helpful in first 1-2 years

External connections:SOM Faculty Development Resources

Comprehensive web site www.medschool.ucdenver.edu/faculty Faculty development seminars Links to Newsletter, Diversity, Academy of

Medical Educators, AAMC resources, FAQ Articles on time management,

mentoring, demonstrating scholarship, teaching skills, curriculum design, grant-writing, managing a lab, others

Other ingredients Incorporate mentoring programs into

departmental strategic planning Director participates in departmental leadership Recognition of mentoring as official part of

senior faculty members’ duties Investments in faculty

TSP and Clinical Scholars Program Monetary support for mentor-mentee pairs

Seed grants for projects Recognition of teaching and clinical service Rewards, celebrations, rituals

Outcome metrics Faculty participation as mentors Successful mentor-mentee activities (feedback) Faculty retention Research and academic productivity Promotion and tenure success Inter-disciplinary collaborations Local and national leadership positions Development as a teacher Clinical program building Successes of investments in faculty Exit interviews

Summing up Each department should develop a strong

mentoring & faculty development program Welcome, coach and support junior faculty Good for junior faculty & good for department

and School of Medicine Helps build a “community” of teachers,

scholars and clinicians Promotes faculty success, leadership

development and loyalty to the department & SOM