Mentoring in Clinical ResearchAssociate Vice Provost, Faculty Mentoring University of California,...

A Guidebook for Mentors in Japan

St. Luke`s International UniversityCenter for Clinical Epidemiology

Mentoring in Clinical Research

Health Labour Sciences Research Grant 2015（循環器疾患・糖尿病等生活習慣病対策総合研究事業）

「研究マインドを持つ臨床医に対する疫学教育プログラムの開発と基盤整備」主任研究者高橋理

Forward…………………………………………………………………………………………………… 02

Research members………………………………………………………………………………… 37

References……………………………………………………………………………………………… 38

1Section What is mentoring and why is it important?……………………………………………………………………………………………… 04

2Section What is clinical research mentoring?……………………………………………………………………………………………… 09

3Section Characteristics of Good Mentoring……………………………………………………………………………………………… 14

4Section Alignment……………………………………………………………………………………………… 19

5Section Cultivation……………………………………………………………………………………………… 34

Contents



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Clinical research training relies on transference of critical knowledge, skills and attitudes

from experienced to emerging generations. Traditionally, in Japan and elsewhere, this

transference of knowledge and skills was expected to take place through an

apprenticeship like arrangement between the senior teacher and his or her protégé.

Clinical research mentorship was not taught or even explicitly articulated; there was an

assumption that mentoring came naturally, and the process of mentoring was not

formally discussed.

Over the past few years, however, there has been increasing interest in the theory and

practice of mentorship in academic medicine. Research has shown that formal

mentorship is integral to a productive and successful career in the academic health

sciences, particularly for clinical researchers. Formal, structured, mentorship supports

the success of junior researchers in publishing first authored papers and in obtaining

funding, while also improving their sense of professional satisfaction. Yet, many clinical

researchers report that they do not currently have a mentor, and this number is

significantly lower for women. Recent research conducted in Japan has shown that while

many researchers report having a mentor, the understanding of the role of the mentor is

still evolving and more training of both mentors and mentees is needed. As the clinical

and translational science workforce in Japan continues to expand, we need to rethink the

manner in which mentors are trained and evaluated.

The good news is that mentor training works. As a result, many large academic

medical centers in the U.S. have implemented new mentor development programs and

opportunities for mentor training continue to expand in Japan. Resources such as this

Mentoring Guidebook are critically important to help support mentor development in

Japan. Faculty members, clinical researchers and others who participate in mentor

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training and have the opportunity to reflect on their own mentoring practices while

engaging in conversation with respected peers become more skilled mentors and derive

more satisfaction from mentoring. This often translates into more productive mentees

which is good for science and ultimately for society.

The materials found in this Mentoring Guidebook build on a set of core competencies

and learning objectives for mentors that will help them to be more successful in their daily

interactions with their mentees. It is aimed at clinical research mentors at all levels of

training and working with mentees at different levels of professional development. The

format is designed to promote peer learning guided by discussion of mentoring

challenges intended to promote reflection of one’s mentoring philosophy and practices.

The concepts that underpin research mentor training materials such as this Guidebook

for Mentors in Japan are in fact the basic building blocks for all human relationships—

clear communication, assessing understanding, establishing mutual expectations, and

making it adaptable to many different situations and audiences. Mentoring matters, and

for those who are serious about elevating the level of mentorship and supporting a culture

of mentoring in Japan, the “Mentoring in Clinical Research: A Guidebook for Mentors in

Japan” will prove to be an indispensable resource.

Mitchell D. Feldman, MD, MPhil, FACPProfessor of Medicine and Interim Chief, Division of General Internal Medicine

Associate Vice Provost, Faculty MentoringUniversity of California, San Francisco

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A small plant grows. It needs air, sunshine, clean water, and the correct environment for it to grow optimally into a tree that has strong roots, bears abundant fruit, and eventually produces its own seeds of the next generation. A small plant may grow in the absence of one or more of these factors, but it will be stunted—perhaps it will be easily toppled in some future storm, perhaps it will yield little crop, or perhaps it will cease to bear seed early and wither. Manipulation of water content or direction of sunlight can also alter a plant`s natural course of growth into a variety a new shapes and forms.

Similar to the sapling, young trainees across a variety of professional disciplines require a complex interaction of external forces to optimize their own professional productivity, career trajectory, and ability to influence future generations. An abundance of research suggests that an effective environment for clinical research trainees includes adequate and accessible mentorship.

Roles of a mentorThe word “mentor” encompasses many varying roles that satisfy a variety of functions

in the raising of trainees. In general, however, the idea of mentorship consistently includes the following key components.

Guidance: The mentor serves as a guide for the mentee as they progress through their training. Rather than through orders or directives (as would be given by a boss), the mentor can guide their mentee in a positive way through a longitudinal series of discussions and “back and forth” interactions that often allows the mentee to consider various pathways, and subsequently choose the best direction to achieve their goals.

Advice: In order to guide the mentee in the best way, the mentor serves as a constant and reliable source of advice, drawing on both personal and professional experience, including expert and/or specialty knowledge, and familiarity with the research and/or academic environment. In the ideal mentoring relationship, the mentor does not hesitate to share this advice with mentees, and the mentee does not hesitate to seek this out from his/her mentor.

Skill-building: The mentor is invested in ensuring that his/her mentee gains the necessary skills required to achieve their goals. If the mentor is also a clinical colleague/supervisor, this may include clinical knowledge or patient-care skills. If one is acting in the capacity of a research mentor, this may include passing on skills in clinical questioning, research design, or data analysis. When the mentor does not himself possess the necessary knowledge, he will share his resources with the mentee in order to get them the best available skills. Teachable skills may also include interprofessional skills including networking, relationship-building, professionalism, and supportive counselling.

Facilitation of mentee s professional goals: In essence, all of the above roles of mentors serve to prepare and facilitate the mentee to independently achieve his/her professional goals. In addition to the goals of mentee, a mentor may also consider the

Mentoring in Clinical Research A Guidebook for Mentors in Japan

What is mentoring and why is it important?What is mentoring and why is it important?

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“bigger picture” —the goals of the department, institution, and society— but these are considered secondary to the needs of the mentee and distinguish the mentor from the supervisor. The primary purpose of a supervisor is to facilitate the goals of the institution/department, even if those goals are counter to the growth and development goals of the mentee. If these goals are aligned, the supervisor may also be acting as a mentor. However, if the goals of the mentee and the department are poorly aligned, the mentor must choose to play either a supervisory role or a mentoring role, as both may be difficult. Similarly, serving one`s own goals may lead to conflicts of interest and should probably be consciously placed as a lower priority in the mentoring context. Mentoring should not be approached as free labor by subordinates to achieve the mentors own goals!

Why is mentoring important?A large and continually growing body of research has shown that mentoring is an

effective modality to facilitate the development of trainees in a variety of ways and contexts. In a seminal 2006 JAMA article, Sambunjak summarizes this well: “Mentorship has an important influence on personal development, career guidance, career choice, and research productivity, including publication and grant success.” This conclusion has been echoed in several subsequent papers.

Personal growth of mentors and mentees: Mentorship serves a critical role in human development, and specifically in academic relationships. Mentoring relationships are, in fact, so important that they have been described as “vital” to satisfaction and professional success of not only mentees, but mentors as well. (Straus 2013) Optimal satisfaction among both staff and trainees can have lasting benefits in other areas as well including human resource recruitment and retention (goals with which many institutions struggle) as well as institutional reputation and future funding.

Research productivity: Numerous qualitative and quantitative studies of mentoring have shown that optimal mentoring relationships increase research productivity. Especially in the busy clinical environment of academic hospitals, mentors can serve as a point of focus for young trainees to concentrate on their research goals, which are often prohibitively difficult without faculty support. In addition to moral support, mentors provide concrete clinical and research skills that allow trainees to (1) best consider clinical questions, (2) design fulfilling projects around research questions, (3) obtain and analyse institutional data, (4) and present and publish their findings to colleagues and peers.

Career mobility: In addition to the important concrete skills outlined above, mentors also play an important role in teaching the characteristics and qualities (“soft skills”) needed for a successful career trajectory. (Kashiwagi 2013) From fostering inter-professional relationships to teaching grantsmanship for obtaining grant funding, these soft skills are vast and are likely equally important as the concrete skills as trainees develop into their career roles. Role-modeling likely plays an important role in conveying of these skills, as does introduction of the mentee to a mentor`s established professional networks.

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What is “Team-Based Mentoring”?Mentoring works best when mentors have adequate time and skills to properly guide

their mentees for future success. In the busy clinical environment, it is not realistic to assume that a single person can adequately fulfill all the various needs of their mentees, despite their best intentions. In the same way that it “takes a village” to raise a child —i.e., a loosely-knit team of parents, siblings, teachers, community leaders, and peers all contributing to the growth and development of an individual— there are many manifestations of mentorship (Figure 1).

Often times, a lead mentor plays the role of choreographer to the numerous other mentors with whom the mentee may be interacting. The lead mentor may be the person whom the mentee knows best, trusts the most, or has the longest relationship. It is reasonable to expect that the lead mentor will have a level of parental intimacy with the mentee. Deep knowledge of, as well personal and professional investment in, a mentee can help the lead mentor organize other types of mentorship that will further the mentee`s goals. Department chief

A career mentor is likely to be a senior researcher or clinician who can help the mentee with decision-making that will further his/her career goals. The career mentor may or may not know the mentee on a deep, personal level, but —possibly at the behest of the lead mentor— will be best positioned to facilitate the mentee`s professional (occupational) goals. It is reasonable to assume that the lead mentor will often also be the career mentor in Japan. Hospital President, or Professor

An important role of the lead mentor is to introduce one or more co-mentors to the mentee. A co-mentor may be a younger senior clinician interested in taking a new mentorship role and with adequate time and enthusiasm to do so. The availability and need for co-mentorship will be largely based on available resources and needs of individual mentees. Co-mentors may eventual “evolve” into lead mentors as they become more skilled. Senior colleague

A research mentor or project mentor may be the same person, or their tasks may be divided. In Japan, we often find that the project mentor (often a clinical supervisor in the specialty department) supplies clinical knowledge and support necessary to successfully complete a research project, while the research/scholarly mentor supplies mainly expertise stemming from research experience and teachable skills (epidemiology, biostatistics, data analysis, etc.). Depending on the level of continuity that the research mentor has with the mentee, he/she may be considered a tutor. In general, tutors have contact with mentees for shorter, limited periods of time —often just enough to teach a particular research skill— while research mentors, while of course playing a role in teaching skills, typically maintain a long-term relationship with a mentee throughout the duration of an ongoing project and often over multiple project-years. Epidemiologist,

Biostatistician

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Co-mentor

Lead mentor

Career mentor Project mentor

Research/Scholarlymentor

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Figure 1. Many types of mentors, working together in a team-based approach, can serve the various needs of a mentee.Image courtesy of Dr. Mitchell Feldman

©2012 Regents of the University of California

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Career mentor Project mentor

Research mentor

Figure 2. In Japan, expect significant overlap in roles of different mentors.

Figure 1 represents a theoretical model in an ideal situation in which academic resources are plentiful and enthusiasm abundant. As such, it may have little reflection on reality. There can be, should be, and will be significant overlap in these roles based on the resources available in any given institution, the skills of mentors, and most importantly the needs of mentees (Figure 2). This being said, it is crucial that team mentors have early communication about their respective roles in the development of the mentee, so as to (1) make the mentoring process more efficient for all and (2) prevent misunderstandings of “territory” between mentors.

caution!

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In Japan, we often find that several of these roles —lead mentor, career mentor, and sometime even research mentor— may be assumed by a single, trusted senior physician, who may also be a clinical supervisor. While this can be an efficient way to deliver a unified message in an efficient way through a single trusted source, a less-than-optimal relationship can leave a mentee with nowhere to turn for other sources of information, guidance, or respite. While it is often not feasible or helpful to have multiple mentors interacting on a daily basis (“too many cooks in the kitchen”), mentees should be encouraged to find suitable co-mentors, who can provide additional consultation, advice, and a different and valuable perspective. Especially for Japan, mentors should be warned against treating mentees like property, to be held and protected within a certain territory, but rather as adult children who should be guided to explore the research environment around them.

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Roles and Functions of the Clinical Research MentorFollowing from the above scheme, this guidebook will focus on the role of the research

mentor and, within this, to the clinical research mentor (CRM) specifically. While there is significant overlap between the roles of a basic science mentor and a clinical research mentor, we anticipate several key differences—for example, those pertaining to laboratory hierarchy and workflow structures; an examination of these differences, while important, is beyond the scope of this guidebook.

In the most basic terms, the primary purpose of the CRM is to shepherd the mentee`s research goals to fruition via (1) discussion and development of the mentee`s clinical and research question(s), (2) understanding of and filling in of any gaps in skills and knowledge that might prevent a mentee from achieving research productivity, and (3) encouraging the mentee to disseminate his work to the scientific and academic communities. To this end, we can regard the CRM has having two basic functions, each with sub-roles:

I. Advisory functions: Seeing research through to a successful end

a. Clarification of research questions: The most fundamental step in the research process for any clinical researcher is to decide on a research question that is appropriate and feasible for a clinical research project. Mentees should first consult with specialty supervisors and colleagues in the patient care setting in order to identify valuable clinical questions that warrant investigation. Nonetheless, as some clinical questions, while interesting, may not be amenable to rigorous methodologic study, the CRM plays an important role in refining (and often simplifying) these questions into a feasible research question. Rather than relying on specialized knowledge of the research topic or medical specialty, shaping a feasible research question will draw upon the CRM`s expert knowledge of epidemiological methods, institutional databases, and available administrative and statistical support structures, as wel as his/her experience with manuscript writing and submission.

b. Research organizer: As a research project begins, the mentee will undoubtedly become focused on the small, often laborious, administrative tasks involved in protocol writing, IRB approval, and data collection and management. Using a variety of tools that will be discussed below, the CRM may help the mentee by keeping him/her on a regular schedule that takes into account the “big picture,” administrative deadlines, individual progress goals, and time limits for abstract and manuscript submissions. As previous reports suggest that only 44% of research abstracts are eventually published, the importance of this role should not be underestimated (Scherer 2007).


2 What is clinical research mentoring?

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c. Network facilitator: Success as a clinical researcher often goes beyond data collection and analaysis, requiring a network of skilled experts in a variety of fields that can contribute to a research project. In fact, this is probably necessary, as a single mentor cannot realistically (or successfully) provide all the needed resources for a mentee to be a productive researcher. For example, a clinical research mentor might share his knowledge of online resources during a literature review, or may provide the mentee with an introduction to another researcher interested in the same methodology. The experienced research mentor will also share his/her personal network of colleagues and collaborators with the mentee, in order to develop future research projects that enhance knowledge, science, project, and career. The clinical mentor should also facilitate a young researcher`s access to clinical databases at both the home institution, other domestic organizations, and even open access international data sources.

II. Tutor functions: Helping the mentee gain concrete skills and knowledge

a. Study Design Skills: The foundation of world-class clinical research lies in the first stages of its conception, particularly with the overall design of the study. As medical students in Japan are only beginning to gain this type of learning in the medical school curriculum, clinical mentors may be unable to offer help with this important, foundational step. Perhaps the most important role for a CRM is to help the mentee to understand the basic elements of thorough research. This may involve training the mentee at the elemental level including types of study (e.g., retrospective versus prospective, case-control versus cohort), or may involve higher level teaching such as helping the mentee calculate an appropriate sample size or rigorously consider sources of bias in his/her study. Often, the CRM will help the mentee improve his/her study by considering new patient populations, suggesting additional exclusions to minimize bias, or to change the study design altogether to better fit the existing data. Whether training a novice or advanced mentee, adequate time and dedication at this step is crucial for virtually all CRMs.

b. Analytic Skills: All data requires some form of analysis and it is likely that most mentees will feel rather lost at the outset of their research careers in terms of comfort with data analysis, none of which is currently taught in the medical school curriculum. Nonetheless, an important point to remember is that the role of CRM does not equate to biostatistician nor a data analyst. This is often a point of misunderstanding in Japan and should be made clear at the outset of the mentor-mentee relationship. As true excellence with data analysis, both quantitative and qualitative, can take years of formal education to master, it is unlikely that most CRMs will feel expert in all the myriad analytic methods available in modern clinical research. As such, the wise mentor will maintain familiarity with the basic analytic methods that can help their mentee in the early phases of their project; these might include univariate analysis, bivariate comparisons, regression analysis, as well as survey design. Beyond this, the crucial function of the CRM will be to guide the mentee towards the resources from which he/she can gain the knowledge needed to complete a successful and thorough analysis. These resources may include online classes (ex. free, Web-based EDX lecture series), textbooks, and —most importantly— research colleagues and collaborators.

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Before becoming a clinical research mentor, one should consider realistically whether one has obtained the basic skills in study design and data analysis needed to shepherd a young and inexperienced trainee through a research project. Passion for mentorship, while important, is insufficient to facilitate productive research. CRMs should take adequate time to hone their own skills prior to consenting to become a mentor for others.

Caution!

c. Writing and Presentation Skills: Presentation of research at meetings, with subsequent publication, is the ultimate definition of success in modern clinical research. In order to maximize publication, good writing skills are important. An important, and often overlooked function of the CRM is as an editor for abstracts, posters, and manuscripts. It is likely that the CRM has the most experience than any other type of mentor in terms of having submitted a volume of both successful and unsuccessful manuscripts and abstracts; mentees stand to gain much from having access to this important well of experience. At centers of excellent clinical research in the United States, some high-power mentors will only accept mentees who can prove excellent (or at least adequate!) writing skills at the outset of their relationship. While this is overly severe and not appropriate to the Japanese context, CRMs should emphasize mentees to work on their writing skills early and often. While it may be easier for a mentor, for the sake of efficiency, to do the writing for the mentee, this should be avoided! Instead, the CRM should encourage the mentee to share their written work —protocol, abstract, poster, and manuscript— often with the CRM. In this way, useful feedback can be given to improve writing skills. For situations in which the mentor feels uncomfortable giving feedback on writing, for either Japanese or English, appropriate research colleagues and collaborators should be sought.

Benefits of Clinical Research MentoringAvailable literature on the efficacy of mentoring strongly suggests that mentoring pays a

plethora of benefits, to both individuals and institutions, in the form of research productive and career satisfaction, reputation, and success. While there is substantial overlap, we have divided beneficiaries into three groups: mentors, mentees, and institutions.

I. Benefits to Mentors

a. Despite being a time-consuming endeavor when appropriately done, mentorship pays a multitude of rewards to mentors. Personal rewards include satisfaction with the role of shepherding a trainee through the system, and has been likened by numerous experts as similar to the rewards of parenting. Many mentors express a sense of joy at training a new generation of young professionals who will carry the science of medicine forward, often carrying on a legacy of themselves. Mentors may find that mentorship inspires them to be more productive with their own unfinished projects. [Frei 2010]

Benefits to mentors also include more concrete professional rewards. Research productivity —along with clinical care and education— continues to be the primary benchmark for promotion at most academic medical centers in the United States and Europe. In the United States, research productivity helps both mentor and mentee in

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promotion from Assistant Professor to Associate Professor, Associate Professor to Full Professor, as well as in tenure decisions. As it is typical for the CRM to be included in the authorship of a project, the success of the mentor is tied in a tangible way to the success of the mentee. In addition to job promotion, many research universities such as Harvard and University of California at San Francisco (UCSF) also recognize excellent mentorship with prestigious faculty awards.

Finally, mentors may gain significant financial rewards from good mentorship, apart from those monetary awards obtained via job promotion and faculty recognition. In the United States, National Institute of Health (NIH) grant recipients are evaluated not only on their proposed projects, but also on success of past publications. Furthermore, several grant types are tied to appropriate mentorship, asking directly for past mentorship activities on the application. As the NIH considers research mentorship as a serious component of funding eligibility, demonstrable mentorship in research has become an important component of financial survival in the research arena. While this is perhaps less applicable to the Japanese context at the present time, the recent establishment of the Japan Agency for Medical Research and Development (AMED), which is anticipated to follow the NIH funding model, may suggest similar funding considerations in the future.

II. Benefits to Mentee

a. Expanded knowledge and skills: The most clear and obvious benefit to mentees is the knowledge and many skills that they can acquire from a skilled mentee. This includes elements outlined above, including the fundamentals of clinical epidemiology and clinical effectiveness research, as well as skills in data collection and management, data analysis (both basic and advanced), as well as training in manuscript writing and presentation. The CMR can also bequeath their network of knowledge resources and collaborators to the mentee, a gift that can potentially contribute to the mentee`s success for years to come.

b. Upward career mobility through research: Numerous previous qualitative studies of mentees have suggested that research mentors not only convey concrete skills to mentees, but also act as cheerleaders—an ongoing source of energy, motivation, and guidance that enhances research productivity through support and confidence-building. While this is difficult to quantify, virtually all previous studies regarding mentorship have shown a relatively strong correlation after adjustment for other relevant factors between career success (most often faculty positions at academic medical centers) and past mentorship during the formative years of training.

c. Broader work-life perspectives: Similarly, the guidance of a mentor may help a young and busy trainee see a broader perspective of life. This may, in turn, help trainees make better choices in the pursuit of family, career, position, and occupational specialty. As Japanese clinical trainees enter the workforce with relatively little real-world work experience, they likely have little perspective about career direction, career options, and so forth. A mentor on the clinical wards may give them a specifically, and perhaps falsely, narrow perspective on occupational trajectory. An enthusiastic and dedicated CRM has the potential to convey a more balanced perspective that focuses

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on broader opportunities in clinical research, academia, international careers, and public health.

III. Benefits to Institutions

a. Reputation: Throughout the world, centers of clinical excellence typically build their reputation on the quality of research they produce. Influential clinical research —research that is rigorous, thorough, and innovative— has the potential to build a strong reputation both domestically, as well as internationally, for the institution that produces it. Reputation as a supportive place for research undoubtedly leads to more productivity, as more and better researchers seek to join the organization, creating a virtuous cycle. The potential fruits of this virtuous cycle include benefits in (1) patient catchment, as patients often seek the “best” healthcare institutions based on reputation; (2) patient quality of care, as clinical research leads to healthcare advancement on the local level before dissemination on the national or international level; and (3) increasing opportunities for government funding, as national-level funding agencies are typically biased towards institutions with a proven track-record of research productivity.

b. Recruiting and retention (of trainees and staff): The virtuous cycle described above also has concrete benefits on the local level that extend beyond patient care. Especially for the rural community hospital, which might be struggling with trainee (junior and senior resident) recruitment and faculty retention, institutions that provide a supportive research training environment may find a benefit in recruiting and retention. While protected time for research, opportunities for research funding, and other interventions are also important, numerous case studies have shown that active mentorship programs may be a cost-effective and relatively easy way for institutions to build a support environment for clinical research.

C. Mentor Development ProgramsInstitutions considering starting a program or curriculum (either formal or informal) in

clinical research might consider a program for training mentors. This may be especially important at institutions for whom this is a “first foray” into clinical research and at which a core of skilled mentors does not already exist. Several institutions in the United States and Europe have, over the last two to three decades, developed mentor training programs. These modalities range from online “e-seminars” to single-day mentoring events to serialized workshops. Perhaps the best example of a formalized mentor training program is the Mentoring Development Workshop (MDP) at UCSF. Held every year over a course of 5 months, this series of 5 monthly seminars is required for all mid-level (Associate Professor) researchers, most of whom are also CRMs, prior to beginning mentorship of junior faculty (Assistant Professor or below). Each seminar includes 2 1-hour lectures plus discussion; lectures consist of a variety of topics including optimal mentor characteristics, mentee selection techniques, introduction to funding pathways and institutional support systems, team management, diversity training, and time/goal management.

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A. What are the ingredients for a successful mentoring relationship?When we imagine the characteristics of an ideal mentor, it is natural to think about

excellent teachers and colleagues that we have experienced in our own lives and careers. From there, we often —through the veil of memory— attempt to dissect why or how they were a good teacher, often coming up with typical phrases such as, “He was kind” or “She was an excellent teacher.” However, as mentoring is a dyad relationship, when attempting to optimize the mentoring relationship, it is equally important to consider the characteristics and responsibilities that must be shared by the mentee as well. While most people can agree on a very basic set of human characteristics that lead to mentoring success such as kindness, responsibility, and dedication to learning, a review of the existing literature provides a more detailed set of descriptors that may help predict successful mentoring relationships. Based on data extracted from a series of semi-structured interviews, Straus et al. (2013) describe these basic tenets as follows:

1. Reciprocity: The dyad nature of the mentoring relationship should be respected in terms of recognizing that both mentor and mentee must have something to gain —whether personal reward or more concrete gains such as research publications— from agreeing to enter into the relationship. An unbalanced relationship in which either the mentor or the mentee is the sole recipient of benefit can lead to unsuccessful outcomes.

2. Mutual respect: Good mentoring takes time. For most busy clinician-researchers, time is in short supply. Similarly, mentees may be equally pressed for time, juggling research goals with the demands of clinical training and patient care. As such, each party must respect the other`s time and effort—for example, expressed as showing up prepared for discussions, meeting deadlines for previously set goals, and returning emails in a timely fashion.

3. Clear expectations: The best mentoring relationships are ones in which confusion, miscommunication, and misunderstandings are minimized. In order to do this, both the mentor and mentee should freely communicate their expectations at the beginning of the relationship. A number of tools are available to facilitate this (and will be discussed in the next section), including mentoring contracts and the Individual Development Plan (IDP).

4. Personal connection: While mentoring is foremost a professional relationship, great mentoring relationships are enhanced when a personal friendship can also be formed. As mentors often play a parental role to mentees as well, optimal mentoring occurs when mentees feel that their mentor cares deeply about their personal and professional well-being. While many mentoring relationships develop organically,


Characteristics of Good Mentoring

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mentor-mentee matching —by age, gender, specialty, research or career goals— can play a useful role in facilitating optimal connections.

5. Shared values: Similarly, it is helpful if both mentor and mentee have a common base of thinking, from which to expand their mentoring relationship. While exactly matching values is difficult to find, probably unnecessary, and perhaps even deleterious due to absence of challenge, a “fairly common ground” has been reported to be useful in terms of professional and personal background. Again, mentor-mentee matching may be a helpful way to optimize this goal.

B. Are you prepared for being a mentor?Why are skilled mentors skilled? Certainly a few individuals —those of exceptional

collegiality, exceptional empathy, etc.— inherently possess a nature that lends itself to great mentoring. However, a far greater number become excellent mentors by strengthening their skill set, often through long experience in teaching and research. Ramani et al. (2006) offer twelve tips for developing effective mentors. The following list summarizes these in addition to those found in other literature.

1. Communication skills: Perhaps the single most important factor in being a good mentor is communication. A mentor should ask himself, “Do I like to talk to other people and can I be an active listener?” Can you teach and convey ideas in a positive and motivational way? In addition to teaching concrete skills, can you deeply and earnestly listen to the needs of your mentee, providing sensitive counselling and guidance to help him/her find the best way forward? Can you redirect a wayward resident in a positive way? Prior to mentoring, mentors will want to consider their own skills in this area and work to improve themselves so as to be the best mentor possible.

2. Commitment: As noted by Bettmann (2009) interest is essential to mentoring. Mentors should ask themselves “Do I have enough interest in being a mentor?” While mentors may be scarce in the current Japanese research environment, forcing disinterested staff to serve as mentors can lead to poor outcomes and drive mentees away from clinical research. Serving as a mentor is generally voluntary, and mentees are guided to seek out the most dedicated and passionate mentors.

However, passion is not enough. Prior to embarking on a mentoring relationship, mentors will need to ask themselves “Do I have enough time to be a mentor?” and then answer that question realistically, taking into account their own research, patient care, and administrative and personal responsibilities. Mentors should perhaps best think about their mentoring obligations as not “add on” work, but an important and integrated part of their professional commitments. As not all mentees are alike, mentors will also need to assess the work involved with a particular individual. Advanced trainees will generally require less time commitment, while those new to clinical research typically require more. Highly motivated mentees may require less time if relatively independent, but paradoxically more time if they seek considerable additional knowledge and guidance from you.

Though the desire to become a mentor may start out as noble and altruistic, lack of commitment can lead to dissatisfaction and burnout for both mentor and mentee.

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Prevent burnout by realistically assessing why you would like to be a mentor. Ask yourself “What benefits do I expect for being a mentor?” As noted above, professional rewards such as compensation or protected time should be discussed with your institutional administration. Rewards such as publications or analysis of a dataset should be discussed openly with your mentee at the outset of the relationship.

Conflict of Interest: Mentors should be clear with themselves and their mentees about potential conflicts of interest, asking themselves, “Am I in competition with my mentee?” In the clinical research environment, potential conflict most often arises when dealing with issues of promotion, recognition, and authorship. For example, junior faculty who need more first author publications may feel resentful when a mentee takes charge of a project and takes first authorship. Bettmann notes that being able to subjugate personal interests to those of the mentee is an important characteristic of a good mentor. These are difficult situations to deal with and should be discussed as early as possible to avoid later misunderstandings.

3. Clinical Research Experience: Even if a mentor has adequate time and great passion, he/she should ask “Do I have enough knowledge and experience to be an effective mentor?” Experience is broad and may be defined as research experience, including publication and presentation; managerial experience and time management skills; and interpersonal experience and network, both inside and outside the institution. Clinical research experience is best gained by conducting studies at one`s institution, and gaining additional skills through formal programs, such e-learning skill development courses and Masters of Public Health (MPH) programs geared towards clinical research. Younger mentors, who still wish to actively contribute to mentees, may find that having a more senior “mentor advisor” is helpful in learning how to be an optimal mentor.

New researchers should generally not be put in the role of being a research mentor, but rather a “peer mentor.” Those with little experience should not be paired with mentees with equally little experience.

Caution!

C. Strive for a “Best-fit” Mentoring RelationshipDifficult issues in mentoring, including dysfunctional mentoring relationships are well-

described in the literature (Sambunjak 2006; Bickel 2011). This highlights the need for an adequate framework or strategy for mentor-mentee matching in environments that allow for this type of pairing. Based on the current work environment in Japan, we recommend that consideration be given to the following dynamics when matching mentors with mentees.

1. Gender: Gender remains an active issue in professional life in Japan. Despite recent efforts by the government to address this, we must respect the reality that, in Japan, women face unique challenges and barriers in their professional lives. These include special difficulties in work-family balance, child-rearing, and promotional opportunities.

17

Section3C

haracteristics of G

oo

d M

entoring

Gender-sensitive matching may help young female trainees better find mentors, male and female, that reflect the shared values and career goals that may be unique to women in the clinical research and practice arena.

2. Age: Despite changes over the last several decades, Japan remains a seniority-based

hierarchical structure. Many people find it difficult to interact with individuals of significantly different age, when the age gap does not conform to traditional conventions. To minimize the confusion and awkwardness that might come from mismatched pairing, in general, mentors should be older in age compared to their mentees.

3. Cultural and language: As Japan continues to globalize, cultural and language differences may should be considered when pairing mentors with mentees. In general, mentees who wish to produce research in English, or who wish to present their work internationally, should be paired with a mentor competent in English and culturally aware of international standards in the topic of research.

D. General Advice for MentorsThere is wide consensus from numerous experts on the basic tenets of successful

mentoring. Zerzan (2009) notes that “Good mentors value mentoring as part of their professional role and avoid focusing on their own professional needs and agendas, instead helping mentees develop theirs” and that “Good mentors take an interest in the mentee, provide both professional and personal support, prompt a mentee to take risks, and help open doors to opportunities.” At the risk of repetition, some perspectives on how to achieve these goals are outlined below:

1. Creating a safe and welcoming environment: The fundamental goal of a mentor should be to create a space in which the mentee, though challenged to produce good work, feels comfortable seeking the advice, counseling, and guidance of a trusted mentor. Mentors should continually strive to achieve this important goal. Bettman (2009) and several other authors note that accessibility —being routinely available to your mentee— is a critical part of this environment. Betmann further notes that patience is an important skill for the mentor to develop, in order to create a safe and warm mentoring space.

2. Establishing a communication framework: Good communication can be a key to

excellent mentoring and increasing productivity of your mentee. Several methods are available to enhance communication, such as the PEARLS checklist (Partnership, Empathy, Acknowledgment, Respect, Legitimization, and Support). In particular, the idea of empathy is echoed by several other experts; Betmann describes this as having “personal insight into what the trainee is experiencing,” and using this special insight to guide and counsel. Acknowledgement, respect, and legitimization is summed up by some authors as “open-mindedness,” defined as respect for a mentee`s needs as an individual, including working styles and career goals, even when they differ from the mentor`s.

18

3. Enhancing organization: As time is limited, meetings should be useful and conducted efficiently. Having a meeting plan with regularly scheduled appointments, reviewing goals of meetings, and ensuring that each meeting has a set agenda can be extremely helpful to keeping a project on track. When the mentor or mentee is unavailable to meet frequently “in person”, regular e-mail or telephone contact should be pursued between scheduled meeting times.

Similarly, Cho (2011) summarizes the overall characteristics of the ideal mentor well, as a person who: 1) Exhibits admirable personal qualities, including enthusiasm, compassion, and

selflessness.2) Acts as a career guide, offering a vision but purposefully tailoring support to each

mentee.3) Makes strong time commitments with regular, frequent, and high-quality meetings.4) Supports personal/professional balance.5) Leaves a legacy of how to be a good mentor through role modeling and instituting

policies that set global expectations and standards for mentorship.

E. Advice for Institutions There is wide consensus that, while optimal mentoring starts with individuals (both

mentor and mentee), that institutions can make an important and lasting difference by helping to create excellent mentoring environments (Keyser 2008; Ramani 2006). This can be done without a large investment in time or money by creating programs and practices to promote the characteristics of effective mentors and mentees (Table 1). Institutions can: 1. Offer faculty and trainees training in mentoring (ex. communication) skills2. Address the demand for flexibility and less-than-full-time career options3. Create mentor-mentee matching programs4. Offer faculty rewards and recognition programs for excellence in mentoring

Table 1. Institution-level mentoring support by ease of implementation

Implementation Development Support Reward

Easy Mentor development courses Peer support Academic recognition

Education/training on boundaries Mentors for mentors Non-financial reward

ChallengingHeightened awareness of

biases (gender, age) Referral Skills Resources Protected timeFinancial reward

(Adapted from Ramani 2006)

19

Section4Alig

nment

Once a mentor prepares for the characteristics that can optimize a good relationship, and a most optimal match has been made with a mentee, the process of mentoring a trainee through a clinical research project may begin in earnest. “Alignment” refers to the various strategies that allow for maximal efficiency in keeping a project on track, and helping to ensure that both mentors’ and mentees’ time is spent in the best way possible. There are many ways that this can be done, however there appears to be wide consensus among experts that these strategies should should be discussed and implemented early in the mentoring relationship, both to maximize time, as well as avoid later confusion. This section will highlight some of these alignment strategies.

1. Shaping a good menteeThe attitudes and characteristics of a good mentee are perhaps second only to the

characteristics of a good mentor. Ideally, a good mentee has an enthusiastic attitude, is a self-starter, focuses on his/her own self-improvement (knowledge, skills, etc.), and seeks guidance proactively. It is reasonable to assume, however, that a young mentee who has little prior clinical research experience may not have all of these characteristics in the beginning. As such, mentors have a unique opportunity to shape trainees into good mentees early in the relationship.

According to Straus et al., mentees should be expected to have the following five characteristics. As mentees cannot reasonably be expected to possess all of these characteristics in the beginning, we suggest that mentors explicitly discuss these points with their mentees at the beginning of the relationship.

i . Active listening: Active listening requires trainees to be “present in the moment,” taking in mentor guidance and immediately translating this into next steps in the research project. Active listening also entails active question-and-answer in order to optimize one`s own understanding. Trainees should be open to feedback and discussion, taking these with a positive attitude towards self-improvement. As mentors are also encouraged to be active listeners, discussions that employ active listening skills should be lively and interesting!

ii. Respect for mentor’s efforts: Mentors are often busy and volunteer their time to work with mentees; mentoring is typically a “labor of love.” It should be made clear to mentees in the beginning of the relationship that advice and input is given to the mentee from this standpoint. Nonetheless, it may not be reasonable for a mentee to follow all of a mentor`s suggestions. If a mentee disagrees with some piece of advice, he/she should not become defensive, but rather should formulate a thoughtful, polite, and articulate response as to why he/she thinks differently. In return, the mentor should respect the mentee`s own respectfully-presented arguments, as well.


Alignment Alignment 44Section

20

iii. Responsibility: Ultimately, the mentee should understand that the clinical research project is theirs, and not the mentor’s. As such, the ultimate responsibility to bring the project to fruition lies with the mentee. This requires paying attention to time schedules, both short- and long-term, and taking responsibility for driving the relationship forward. If a mentor is very busy, he/she should explain that the mentee should proactively schedule discussion meetings and approach the mentor with questions.

iv. Preparation: The mentee should ALWAYS be prepared for meetings and discussions. Items that are agreed upon to have been completed (ex. bivariate data analysis, completion of a section of manuscript, etc.) should be completed and brought to the meeting for discussion. If the mentee is unable to adequately and professionally complete the item, he/she should honestly tell the mentor and the meeting should be postponed. The mentee should prepare an agenda for each meeting and send this to the mentor prior to the meeting, which will allow the mentor to prepare as well. In respect for the mentor`s time and schedule, the mentee is expected to always show up to scheduled meetings and inform the mentor as early as possible for scheduling changes.

v. Respect for mentor`s competing demands: Mentors will occasionally have to miss scheduled meetings in order to accommodate their own busy demands. Though it is the responsibility of the mentor to minimize this, it is sometimes unavioidable. If a mentor is very busy with other duties, this should be explained clearly to mentees at the beginning of the relationship in order to prevent bad feelings or misunderstandings.

2.Mentoring Contracts: Over the last several years, the mentoring process at some high-power research

institutions in Europe and the United States has become increasingly formalized. This formalization helps to ensure good mentee behaviors by standardizing expectations for mentees, while also standardizing guidance given from mentors. Mentor contracts (also called “Partnership Agreements”) have gained popularity among some programs as way to ensure that mentors and mentees are “on the same page” regarding the items outlined above. They also ensure that both mentors and mentees are complying with the expectations layed out by the department or institution. These types of contracts should be tailored to the needs of specific institutions, mentees, and mentors. The sample shown below allows for multiple mentors (team-based mentoring) to be included in the contract.

21

Section4Alig

nment

From https://www.icre.pitt.edu/mentoring/contracts.html, accessed December 14, 2015.

22

From https://www.icre.pitt.edu/mentoring/contracts.html, accessed December 14, 2015.

23

Section4Alig

nment

3. Individual Development PlanAnother strategy for alignment that has become very popular over the last several years

is the Individual Development Plan (IDP). Reflecting this popularity, as of October 2014, an IDP is now required for all graduate students and post-doctoral researchers participating in National Institute of Health (NIH) grants. IDPs are considered effective tools for facilitating communication between mentors and mentees regarding the research planning process, as well as individual mentees` growth and development into successful research scientists.

While formats may vary by institution from narratives to questionnaires/checklist-templates, the purpose of the IDP is to identify a mentee`s (1) short-term research goals, (2) long-term career goals, and (3) strengths and weaknesses in concrete research skills.Both online, as well as paper-based versions are used. The IDP is first created through introspection by the mentee, and then further refined through discussion with the mentor. Once an IDP is in place for a mentee, it is periodically reviewed and revised in a longitudinal manner, typically every 6 to 12 months, in order to continuously reflect the mentee`s goals under the mentor`s guidance.

The IDP presented below is adapted from various sources including the University of California at San Francisco and the University of Wisconsin. Mentors will find other IDP templates easily discovered on the internet via browser search on “IDP template” or similar.

242020

ステップ1：自己評価以下、研究の広い分野でご自分の得意とする分野および苦手とする分野についてお尋ねします。この評価は、ご自身の一連のスキルについて包み隠さず正直にお答えいただて初めて最も有効に活用できるものであり、「正解」や「不正解」はありません。研究分野が異なれば、質問の定義や解釈も異なるかもしれませんが、評価はあなた自身の内省を目的としたものです。また、「自分に関係ない」と思われる質問はスキップしてかまいません。

個別キャリアプラン

パートA：研究スキル� 1 ＝改善の必要がある　　　5＝大変優れている

1 2 3 4 5

創造性／新しい研究命題の創出

研究デザイン

文献のレビューと批判的評価

問題解決法

統計解析法

データと分析結果の解釈

コンピュータ・スキル（Excel、統計解析ソフトウェアなど）

自分の分野特有の技術的スキル：（具体的に書いてください）

自分の分野特有の知識：（具体的に書いてください）

記録保存とデータ管理

口頭発表スキル

ポスター発表スキル

論文執筆スキル

助成金／申請書作成スキル

IDP.indd 20 2016/03/25 22:42

2121

� 1 ＝改善の必要がある　　　5＝大変優れている

1 2 3 4 5

指導力（マンツーマン）

指導力（グループ／教室）

地域サービス／一般に対する教育普及

他者の知的貢献を認め尊重する

良いロールモデルとなる

メンターを見つけて効果的に活用する

他者へのメンタリング

メンタリングや指導力で自分が得意とする分野、改善の余地があると考えているところ、1年後あるいは2年後までに達成したい授業やメンタリングの目標をお書きください。

技術的知識や専門スキルで自分が得意とする分野、改善の余地があると考えているところ、1年後あるいは2年後までに達成したい研究／学術活動をお書きください。

パートB：指導法とプロフェッショナリズム

IDP.indd 21 2016/03/25 22:42

25

Section4Alig

nment

2020

ステップ1：自己評価以下、研究の広い分野でご自分の得意とする分野および苦手とする分野についてお尋ねします。この評価は、ご自身の一連のスキルについて包み隠さず正直にお答えいただて初めて最も有効に活用できるものであり、「正解」や「不正解」はありません。研究分野が異なれば、質問の定義や解釈も異なるかもしれませんが、評価はあなた自身の内省を目的としたものです。また、「自分に関係ない」と思われる質問はスキップしてかまいません。

個別キャリアプラン

パートA：研究スキル� 1 ＝改善の必要がある　　　5＝大変優れている

1 2 3 4 5

創造性／新しい研究命題の創出

研究デザイン

文献のレビューと批判的評価

問題解決法

統計解析法

データと分析結果の解釈

コンピュータ・スキル（Excel、統計解析ソフトウェアなど）

自分の分野特有の技術的スキル：（具体的に書いてください）

自分の分野特有の知識：（具体的に書いてください）


口頭発表スキル

ポスター発表スキル

論文執筆スキル

助成金／申請書作成スキル

IDP.indd 20 2016/03/25 22:42

2121


1 2 3 4 5

指導力（マンツーマン）

指導力（グループ／教室）

地域サービス／一般に対する教育普及

他者の知的貢献を認め尊重する

良いロールモデルとなる

メンターを見つけて効果的に活用する

他者へのメンタリング

メンタリングや指導力で自分が得意とする分野、改善の余地があると考えているところ、1年後あるいは2年後までに達成したい授業やメンタリングの目標をお書きください。

技術的知識や専門スキルで自分が得意とする分野、改善の余地があると考えているところ、1年後あるいは2年後までに達成したい研究／学術活動をお書きください。

パートB：指導法とプロフェッショナリズム

IDP.indd 21 2016/03/25 22:42

262222


1 2 3 4 5

期限を守る

目標の設定と結果の監視を独立して行う

効率的に仕事を進める（例：優先順位の決定、自分の仕事を片付ける、他の職務・責務を果たす時間を作るなど）

組織力

複数の仕事を同時にこなす能力�（例：同時に複数のプロジェクトに取り組む）

他者の意欲を引き出し、動機づけをする

使命（ミッション）、目標（ビジョン）、戦略を理解する

プロジェクト管理 :�全体（例：日程、優先順位の設定）

プロジェクト管理 :�予算

様々なチーム／グループと仕事をする。（例：訓練レベルや専門、文化的背景の違い）�

プロジェクト管理 :�人事（例：職責の委任、進捗状況の監督）

対立の解消（難しい会話、対立防止）

ミーティングを主導する（例：議題の設定、効率など）

プロジェクト管理とリーダーシップで自分が得意とする分野、改善の余地があると考えているところ、1年後あるいは2年後までに達成したいことをお書きください。

パートC：管理能力とリーダーシップ

IDP.indd 22 2016/03/25 22:42

2323


1 2 3 4 5信頼性（約束したことを最後までやり通す）

研究仲間との意思疎通を書面でうまく行う�

研究仲間との意思疎通を口頭でうまく行う�

仕事上の英語力

建設的な批判や意見（フィードバック）を伝えたり受け止めたりする能力

新しい研究仲間との人脈作りや会合

チームや組織で共同研究や作業を行う能力

仲間意識／他者に対する支援

自分の分野に特有の知識（具体的に書いてください）


対人スキルでご自分が得意とする分野、改善の余地があると考えているところをお書きください。

パートD：対人・コミュニケーション能力

IDP.indd 23 2016/03/25 22:42

27

Section4Alig

nment

2222


1 2 3 4 5

期限を守る

目標の設定と結果の監視を独立して行う

効率的に仕事を進める（例：優先順位の決定、自分の仕事を片付ける、他の職務・責務を果たす時間を作るなど）

組織力

複数の仕事を同時にこなす能力�（例：同時に複数のプロジェクトに取り組む）

他者の意欲を引き出し、動機づけをする

使命（ミッション）、目標（ビジョン）、戦略を理解する

プロジェクト管理 :�全体（例：日程、優先順位の設定）

プロジェクト管理 :�予算

様々なチーム／グループと仕事をする。（例：訓練レベルや専門、文化的背景の違い）�

プロジェクト管理 :�人事（例：職責の委任、進捗状況の監督）

対立の解消（難しい会話、対立防止）

ミーティングを主導する（例：議題の設定、効率など）

プロジェクト管理とリーダーシップで自分が得意とする分野、改善の余地があると考えているところ、1年後あるいは2年後までに達成したいことをお書きください。

パートC：管理能力とリーダーシップ

IDP.indd 22 2016/03/25 22:42

2323


1 2 3 4 5信頼性（約束したことを最後までやり通す）

研究仲間との意思疎通を書面でうまく行う�

研究仲間との意思疎通を口頭でうまく行う�

仕事上の英語力

建設的な批判や意見（フィードバック）を伝えたり受け止めたりする能力

新しい研究仲間との人脈作りや会合

チームや組織で共同研究や作業を行う能力

仲間意識／他者に対する支援

自分の分野に特有の知識（具体的に書いてください）


対人スキルでご自分が得意とする分野、改善の余地があると考えているところをお書きください。

パートD：対人・コミュニケーション能力

IDP.indd 23 2016/03/25 22:42

282424


1 2 3 4 5

利益相反を理解する

データ所有権について理解し問題を共有する

責任ある論文発表とオーサーシップ施行

研究上の不正行為を指摘し抑制する

ヒト被験者に対する責任ある行為

動物に対する責任ある行為

パート E：研究倫理と責任ある行動

ステップ2：IDPを書くパートA：スキル評価概要

ご自身について、少なくとも 3 つ「十分なスキルがある分野」あるいは「十分な訓練を受けている分野」（「得意分野」）、および「もっと訓練が必要と思われる分野」（「能力育成の必要がある分野」）を以下の表に記入してください。 3 つ以上記入してもかまいません。

得意分野能力育成の必要がある分野

IDP.indd 24 2016/03/25 22:42

2525

パート B：今後 6 ～ 12 カ月の目標

対象分野1. 開拓すべき目標ま

たは育成すべきスキル

2. 目標達成の手法／戦略

3. 期間 4. 達成したことを示す証拠（成果）

例：複数レベル混合モデルについて学ぶ

eCRNetを利用したオンライン講義の受講；メンターから個人指導を受ける

3カ月別個にDMデータセットを一人で解析し、原稿用データを準備する

研究(A)

指導力(B)

プロフェッショナル／キャリア(C)

リーダーシップ／メンタリング(D)

対人関係／コミュニケーション

(E)

IDP.indd 25 2016/03/25 22:42

29

Section4Alig

nment

2424


1 2 3 4 5

利益相反を理解する

データ所有権について理解し問題を共有する

責任ある論文発表とオーサーシップ施行

研究上の不正行為を指摘し抑制する

ヒト被験者に対する責任ある行為

動物に対する責任ある行為

パート E：研究倫理と責任ある行動

ステップ2：IDPを書くパートA：スキル評価概要

ご自身について、少なくとも 3 つ「十分なスキルがある分野」あるいは「十分な訓練を受けている分野」（「得意分野」）、および「もっと訓練が必要と思われる分野」（「能力育成の必要がある分野」）を以下の表に記入してください。 3 つ以上記入してもかまいません。

得意分野能力育成の必要がある分野

IDP.indd 24 2016/03/25 22:42

2525

パート B：今後 6 ～ 12 カ月の目標





例：複数レベル混合モデルについて学ぶ

eCRNetを利用したオンライン講義の受講；メンターから個人指導を受ける

3カ月別個にDMデータセットを一人で解析し、原稿用データを準備する

研究(A)

指導力(B)

プロフェッショナル／キャリア(C)

リーダーシップ／メンタリング(D)


(E)

IDP.indd 25 2016/03/25 22:42

302626

パート C：今後 3 ～ 5 年の目標





例 :�准教授就任自分の研究分野で年

に論文を3本発表する。研修医に教え始める

3年履歴書には、第 1・第 2著者の出版物が9本以上必要

研究(G)

指導力(H)

プロフェッショナル／キャリア(I)

リーダーシップ／メンタリング(J)


(K)

IDP.indd 26 2016/03/25 22:42

2727

パートD：目標の優先順位づけ上記の表では、ご自身の仕事の様々な面について短期・長期両方の視点から答えていただきました。

活動を整合させるには、目標達成にとっての最重要事項をはっきりさせることが重要です。以下の表に、上記の表の A ～ K を優先度の高い順に記入してください。

短期（6～ 12カ月）長期（5年以下）

優先順位が高い項目

優先順位が低い項目

IDP.indd 27 2016/03/25 22:42

31

Section4Alig

nment

2626

パート C：今後 3 ～ 5 年の目標





例 :�准教授就任自分の研究分野で年

に論文を3本発表する。研修医に教え始める

3年履歴書には、第 1・第 2著者の出版物が9本以上必要

研究(G)

指導力(H)

プロフェッショナル／キャリア(I)

リーダーシップ／メンタリング(J)


(K)

IDP.indd 26 2016/03/25 22:42

2727

パートD：目標の優先順位づけ上記の表では、ご自身の仕事の様々な面について短期・長期両方の視点から答えていただきました。

活動を整合させるには、目標達成にとっての最重要事項をはっきりさせることが重要です。以下の表に、上記の表の A ～ K を優先度の高い順に記入してください。

短期（6～ 12カ月）長期（5年以下）

優先順位が高い項目

優先順位が低い項目

IDP.indd 27 2016/03/25 22:42

322828

パートE：プロジェクトご自身の活動や学術活動についてよく考えてお書きください。必要であればページを足してもか

まいません。

I. 計画しているプロジェクトa. テーマ :

b. 共同研究者：

c. 日程／期限：

d. 予算：

II. 継続中のプロジェクト a. タイトル :

b. 共同研究者 :

c. 完了までの予定 :

d. 研究費の調達：

IDP.indd 28 2016/03/25 22:42

2929

ステップ 3: メンターとIDPの内容を確認する（必要に応じて書き直してください）

ステップ 4: 少なくとも年 1 回 IDPを見直し更新する

IDP.indd 29 2016/03/25 22:42

33

Section4Alig

nment

2828

パートE：プロジェクトご自身の活動や学術活動についてよく考えてお書きください。必要であればページを足してもか

まいません。

I. 計画しているプロジェクトa. テーマ :

b. 共同研究者：

c. 日程／期限：

d. 予算：

II. 継続中のプロジェクト a. タイトル :

b. 共同研究者 :

c. 完了までの予定 :

d. 研究費の調達：

IDP.indd 28 2016/03/25 22:42

2929

ステップ 3: メンターとIDPの内容を確認する（必要に応じて書き直してください）

ステップ 4: 少なくとも年 1 回 IDPを見直し更新する

IDP.indd 29 2016/03/25 22:42

34

Cultivation refers to the skills needed for a mentor to maintain and develop a productive mentoring relationship with a trainee during the project. All of the skills discussed above of course play a role in maintaining a fruitful relationship. This section, however, will focus on some of the concrete skills needed for a mentor to help foster independence in a mentee. What do we mean by fostering independence? It is perhaps best to image which skills the mentee will need (1) for successful completion of a publishable clinical research project, and (2) in their future, when they become a mentor to another generation of eager young learners. Thinking back on your own early career, what skills do you wish you had learned early on, that would have helped you to produce more independent clinical research and of higher quality? The options are many and may include specific research skills in epidemiology and biostatistics, data analysis, presentation, and manuscript writing. They may also include how to access large publically-available datasets. Other useful skills might include manuscript-writing and public speaking, as well as networking skills to find future collaborations.

1. Teaching Research Skills

Ideally, clinical research mentors should be familiar with the fundamentals of clinical epidemiology including:(1) how to formulate and refine a research question.(2) how to choose an appropriate study design (ex. retrospective vs. prospective, cohort

vs. case-control), as well guiding the mentee in the relative strengths and weaknesses of these approaches.

(3) how to help the mentee select an appropriate patient population, including thinking about relevant inclusion and exclusion criteria, and designate an appropriate sample size.

(4) how to write an appropriate IRB protocol, taking into account patient privacy and public health ethics.

Once the project has been implemented, the clinical research mentor should be familiar with basic analytics steps, and prepared to guide the mentee in the following:(1) how to best extract and organize obtained data into a functional and secure dataset.(2) how to conceptually think about the appropriate analysis including univariate, bivariate,

and advanced analytic strategies. Where the mentor`s own experience is insufficient, he should be prepared to help the mentee gain access to those with the right expertise to see the analysis completed correctly.

Finally, when all results have been finalized, the mentor should be prepared to stay involved as:


Cultivation 55Section

35

Section5Cultivatio

n

(1) a sounding board for discussion, helping the mentee to formulate a mature, coherent, and articulate Discussion that peer-reviewed journals would be interested in publishing,

(2) a writing coach that can, through the use of outlines and drafts, help the mentee produce a finished manuscript that is appropriate for publication

(3) a editor of all work, to ensure that abstracts, posters, and manuscripts meet a high standard of professional quality.

As noted above, a previous Cochrane review noted that less than half of research abstracts went on to manuscript publication, reflecting a potentially massive loss of data, and wasted hard work. To combat this inertia, mentors should remain enthusiastic cheerleaders, reminding and coaxing their mentees to see their projects to fruition.

As Japan`s mentor pool for clinical research is currently limited, it is not reasonable to assume that all mentors will feel comfortable teaching the breadth of skills outlined above. Mentors should actively seek out training opportunities for both themselves and their mentees. Opportunities for skill-building are available through a variety of venues in Japan:

a. International Masters of Public Health (MPH) degree: an MPH degree is likely the most comprehensive and complete way to gain all or most of the skills outlined above, in a limited period of time. The United States and European universities offer a large menu of Coucil for Education in Public Health (CEPH)-certified degree programs that welcome students from Japan. Several universities (Johns Hopkins, University of Liverpool and many more) offer online degree options that are convenient, though perhaps somewhat expensive, for international residents.

b. Domestic MPH programs: Japan currently has 4 MPH degree-granting, university-based programs in both East and West Japan. While more convenient than international programs, these the programs are as of yet not CEPH-certified and may vary in quality. In 2017, a fourth program at St. Luke`s International University will offer both classroom and mixed class/online tracks to meet the needs of a variety of working students. The majority of domestic programs offer limited exposure to international collaboration and expertise, with the St. Luke`s program being an exception.

c. Epidemiology and biostatics seminars and workshops: Several workshops focused on giving learners a hands-on experience in epidemiology and data analysis are available throughout the country, organized by universities, hospital organizations, and private enterprise. These 1- to 2-day courses are an excellent and cost-effective way to learn new skills or refresh old ones.

d. Writing and presentation classes: Several English schools offer classes focused on presentation skills for those interested in international conferences. Similarly, writing courses are offered through both private language schools, as well as university course offerings.

36

We hope that readers of this guidebook will find the topics outlined compelling and useful as they begin (or continue!) to mentor the next generation of clinical researchers in Japan. Mentoring is a human art, applied to clinical science. At the end of the day, much of the mentoring literature emphasizes and re-emphasizes the same basic set of guiding principles: that mentors should establish clear and open lines of communication with their mentees; that mentors should have a plan for effective mentoring, and stick to it; that mentors should strive to be caring and compassionate, taking an active role in the research lives of their trainees—as teachers, as guides, as parental surrogates, and as professional colleagues. These are not only research values, but human values as well. While much of the literature on mentoring derives from the US, we see these human values everywhere in the world where teachers and students interact, and very often in Japan. The task for Japan`s growing clinical research environment moving forward will be to optimize and formalize these processes wherever possible, in order to maximize their value on productivity in clinical research.

St. Luke's International University Center for Clinical EpidemiologyGautam A. Deshpande

Summary

37

Research members

Research members list(2015)

Name Affiliations

Primary Investigator Osamu Takahashi St. Luke’s International University

Co Investigator Takuro Shimbo Ohta General Hospital Foundation Ohta Nishinouchi

Hospital

Kunihiko Matsui Kumamoto University Hospital

Gautam A. Deshpande St. Luke’s International University

Sachiko Ohde St. Luke’s International University

Yasushi Ishida Ehime Prefectural Central Hospital

Seiji Bito Tokyo Medical Center

Kyoko Nomura Teikyo University School of Medicine

Honami Yoshida National Institute of Public Health

Kevin Urayama St. Luke’s International University



38

1. Sambunjak, D., Straus, S. E., & Marušić, A. (2006). Mentoring in academic medicine : a systematic review. JAMA, 296(9), 1103-1115.

2. Straus, S. E., Johnson, M. O., Marquez, C., & Feldman, M. D. (2013). Characteristics of successful and failed mentoring relationships: a qualitative study across two academic health centers. Academic medicine: journal of the Association of American Medical Colleges, 88(1), 82.

3. Kashiwagi, D. T., Varkey, P., & Cook, D. A. (2013). Mentoring programs for physicians in academic medicine: a systematic review. Academic Medicine, 88(7), 1029-1037.

4. Scherer, R. W., Dickersin, K., & Langenberg, P. (1994). Full publication of results initially presented in abstracts: a meta-analysis. JAMA, 272(2), 158-162.

5. Bickel, J., & Rosenthal, S. L. (2011). Difficult issues in mentoring: Recommendations on making the “undiscussable” discussable. Academic Medicine, 86(10), 1229-1234.

6. Zerzan, J. T., Hess, R., Schur, E., Phillips, R. S., & Rigotti, N. (2009). Making the most of mentors: a guide for mentees. Academic Medicine, 84(1), 140-144.

7. Cho, C. S., Ramanan, R. A., & Feldman, M. D. (2011). Defining the ideal qualities of mentorship: a qualitative analysis of the characteristics of outstanding mentors. The American journal of medicine, 124(5), 453-458.

8. Bettmann, M. (2009). Choosing a research project and a research mentor. Circulation, 119(13), 1832-1835.

9. Guberman, J., Shapiro, B., & Torchia, M. (2006). Making the right moves: a practical guide to scientific management for postdocs and new faculty. Maryland, North Carolina: Howard Hughes Medical Institute and Burroughs Wellcome Fund.

10. University of California, San Francisco, Mentor Development Program: https://accelerate.ucsf.edu/training/mdp-materials (Website Accessed 2016.3.28)

11. Ramani, S., Gruppen, L., & Kachur, E. K. (2006). Twelve tips for developing effective mentors. Medical teacher, 28(5), 404-408.

12. Keyser, D. J., Lakoski, J. M., Lara-Cinisomo, S., Schultz, D. J., Williams, V. L., Zellers, D. F., & Pincus, H. A. (2008). Advancing institutional efforts to support research mentorship: A conceptual framework and self-assessment tool. Academic Medicine, 83(3), 217-225.

13. Frei, E., Stamm, M., & Buddeberg-Fischer, B. (2010). Mentoring programs for medical students-a review of the PubMed literature 2000-2008. BMC medical education, 10(1), 1.

14. Cho, C. S., Ramanan, R. A., & Feldman, M. D. (2011). Defining the ideal qualities of mentorship: a qualitative analysis of the characteristics of outstanding mentors. The American journal of medicine, 124(5), 453-458.

15. Feldman, M. D. (2012). From the Editors’ Desk: Realizing the Dream: Mentorship in Academic Medicine. Journal of general internal medicine, 27(1), 1-2.

16. Jackson, V. A., Palepu, A., Szalacha, L., Caswell, C., Carr, P. L., & Inui, T. (2003). “Having the right chemistry”: a qualitative study of mentoring in academic medicine. Academic Medicine, 78(3), 328-334.

References


St. Luke`s International UniversityCenter for Clinical Epidemiology




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