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SDR 11-439 – HSR&D Study

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SDR 11-439
Phase II Evaluation of VA Research Career Development Program: Mentoring Processes and Relationships
Ruth C. Cronkite PhD MS
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: April 2013 - September 2015

BACKGROUND/RATIONALE:
Since 1990, the Health Services Research and Development Career Development Award (CDA) Program has fostered the career development of over 250 health services researchers. The goals of the CDA Program are to: (1) build future capacity for research contributions and knowledge translation geared toward enhancing quality of care of Veterans in the Veterans Health Administration (VHA), and (2) retain recipients as VA researchers via organizational integration and leadership opportunities. The CDA Program supports these goals by providing salary, training, and especially mentoring to Career Development Awardees (CDAs). A Phase I evaluation of this program was recently completed, where the retention in VA research and research productivity of HSR&D CDAs were assessed. A key feature of the HSR&D CDA Program that is presumed to be critical to accomplishing its aims - an effective mentoring process and mentoring relationship - is treated as a "black box" in the Phase I evaluation. Phase II of the CDA Program evaluation presents an in-depth look at the mentoring component of the HSR&D CDA program.

OBJECTIVE(S):
The objectives of Phase II are to: (1) examine aspects of the mentorship and their associations with subjective and objective mentee and mentor outcomes, and (2) obtain input from VA stakeholders (CDAs and mentors) on how to enhance the HSR&D CDA Program mentorship and on innovations in mentorship models.

METHODS:
For Objective 1, 133 CDAs (84% response rate) and 119 mentors (82% response rate) completed an online survey covering mentee characteristics, mentor characteristics, format and structure of the mentorship, aspects of the mentoring relationship (mentoring functions, quality of mentoring, and similarity between mentee and mentor), institutional context (infrastructure, support), and subjective outcomes such as effectiveness of and satisfaction with mentors. CDA respondents whose awards were currently active in late 2013 and their mentors also completed a follow-up survey. Planned analyses will focus on identifying aspects of mentorships that are related to subjective and objective outcomes. For Objective 2, we conducted semi-structured interviews of awardees and mentors on how mentorships within the HSR&D CDA Program could be enhanced. These interviews supplemented interviews conducted during Phase I with CDA program stakeholders, for a total of 47 interviews.

FINDINGS/RESULTS:
A report summarizing the interviews with awardees, mentors, and other stakeholders has been completed. Generally, awardees and mentors were very satisfied with their CDA experience and its value to their careers. Suggestions for enhancements included:

(1) Offering more professional networking opportunities that could lead to collaborative relationships or career guidance,
(2) Increasing the diversity of CDA awardees and mentors,
(3) Offering supplemental distance mentors to provide additional expertise and mentoring,
(4) Setting goals and clarifying expectations at the beginning of a mentorship,
(5) Providing opportunities to interact with other members of the HSR&D CDA community and share research ideas, increasing recognition for outstanding mentoring,
(6) Including mentoring in performance expectations and evaluations, and
(7) Offering protected time for mentoring.

A report summarizing descriptive findings, bivariate associations, and multivariate predictive relationships among the key domains of a mentorship has been completed. Key findings include:
Awardee Characteristics. Awardees comprise a highly selected group of researchers with a passion and commitment to health services research, and high levels of career motivation, grit, conscientiousness, and research preparation. The proportion of awardees from underrepresented groups is low, suggesting a need to diversify the pipeline of qualified candidates. The number of publications with the awardee's primary mentor prior to the CDA is linked to subsequent research productivity, suggesting a potentially useful selection criterion.
Format and Structure of Mentorship. The average number of submissions before a CDA is funded has increased over time. This has the benefit of giving applicants a third chance, but the lengthy review process runs the risk of promising applicants seeking non-VA career development programs or positions. The trend toward more mentors in each mentee's mentoring team, selected via a mutual-input process, reflects the Developmental Network model. Awardees and mentors interact frequently and the primary mentor is usually co-located at the same facility as the awardee.
Mentoring Relationship. Both career and psychosocial mentoring functions are associated with positive outcomes. We identified specific mentoring functions as "best practices."

Institutional Context. Most awardees were co-located at an HSR&D CoE/COIN and benefited from the associated resources. Awardees reported moderate levels of opportunities for networking and peer mentoring, for mentor skills training, professional development, and support for conducting their research.
Outcomes. In general, awardees reported high levels of research self-efficacy, career satisfaction, effectiveness of their primary mentor and mentoring team, and intent to mentor. They also demonstrated substantial research productivity in terms of publications and grants. Among CDA alumni, 82% had a current VA position, 95% had a current research position, 94% had a current academic position, and 63% has a current tenure-track position.

IMPACT:
Overall, Phase II of the CDA Program evaluation has yielded valuable information on the most salient aspects of mentoring, and can be used by HSR&D Service and by CDAs and mentors to foster optimal mentorship experiences and outcomes. The multi-faceted information can be used to: (1) guide the CDA Program's selection and mentorship of future CDAs in a way that is adaptive to the career contexts of junior investigators, and (2) help VA HSR&D Service develop health services researchers who understand key issues relevant to the VA health care system and who have the knowledge, skills, and collaborative relationships to translate findings to enhance health care for Veterans.

The findings from the two reports helped to critically inform the now-ongoing CDA Enhancements Initiative (CDAei), which provides additional mentoring, networking, and peer mentoring opportunities, as well as supplemental training and resources on professional issues and fostering healthy mentorships.

PUBLICATIONS:

Journal Articles

  1. Richman I, Asch SM, Bendavid E, Bhattacharya J, Owens DK. Breast Density Notification Legislation and Breast Cancer Stage at Diagnosis: Early Evidence from the SEER Registry. Journal of general internal medicine. 2017 Jun 1; 32(6):603-609.
  2. Cannell MB, Weitlauf JC, Garcia L, Andresen EM, Margolis KL, Manini TM. Cross-sectional and longitudinal risk of physical impairment in a cohort of postmenopausal women who experience physical and verbal abuse. BMC women's health. 2015 Nov 11; 15(1):98.
  3. Blodgett JC, Del Re AC, Maisel NC, Finney JW. A meta-analysis of topiramate's effects for individuals with alcohol use disorders. Alcoholism, clinical and experimental research. 2014 Jun 1; 38(6):1481-8.
  4. Blodgett JC, Maisel NC, Fuh IL, Wilbourne PL, Finney JW. How effective is continuing care for substance use disorders? A meta-analytic review. Journal of substance abuse treatment. 2014 Feb 1; 46(2):87-97.
  5. Del Re AC, Maisel NC, Blodgett JC, Finney JW. Intention-to-treat analyses and missing data approaches in pharmacotherapy trials for alcohol use disorders. BMJ open. 2013 Nov 12; 3(11):e003464.
  6. Del Re AC, Maisel N, Blodgett JC, Wilbourne P, Finney JW. Placebo group improvement in trials of pharmacotherapies for alcohol use disorders: a multivariate meta-analysis examining change over time. Journal of Clinical Psychopharmacology. 2013 Oct 1; 33(5):649-57.
HSR&D or QUERI Publications

  1. Halvorson M, Finney JW, Cronkite RC, Amundson EO, Bi X, Cucciare MA, Finlay A, Hayashi K, Owens D, Maisel N, Timko C, Weitlauf J. Improving the VHA Health Services and Development Career Development Award Program: Interviews with Key Stakeholders. 2014 May 1.
VA Cyberseminars

  1. Asch S, Blonigen D, Cucciare M, Gellad WF, Keyhani S. Transitioning off CDA and Factors Influencing Retention. HSR&D Career Development Awardee Series [Cyberseminar]. HSR&D. 2016 Apr 12.
  2. Weitlauf JC. What does the Science say about Passion, Harmony, and Satisfaction at Work? An Empirical Approach to Work-life Balance. HSR&D Career Development Awardee Series [Cyberseminar]. HSR&D. 2015 Nov 10.
  3. Asch SM. Dancing with the Devil You Know. HSR&D Career Development Awardee Series [Cyberseminar]. HSR&D. 2015 Oct 13.
Conference Presentations

  1. Finney JW. Implementation of evidence-based mechanisms of change in alcohol-focused care. Presented at: Research Society on Alcoholism Annual Satellite Session on Research on Mechanisms of Behavior Change; 2015 Jun 20; San Antonio, TX.


DRA: none
DRE: none
Keywords: Career Development
MeSH Terms: none