Mentoring Ethics: - Johns Hopkins Medical Institutions

THE RESPONSIBLE
CONDUCT OF RESEARCH
MENTORING RELATIONSHIPS:
THE GOOD, THE BAD AND THE
UGLY
Cynthia Rand, Ph.D.
Professor of Medicine

DISCLOSURES
Financial: Merck Childhood Asthma Network
(Scientific Advisory Board-Chair); TEVA
(Scientific Advisor); Vertex (Scientific Advisory
Board)
Research: National Institutes of Health (NIH)
Legal Consult/Expert Witness: None
Organizational: None
Gifts: None
Tobacco: None

OVERVIEW
Why care about mentoring
The link between mentoring relationships and
the responsible conduct of research
The hallmarks of good and bad mentoring
relationships
Mentor-Mentee Vignettes: You‟re the Judge
Institutional role in enhancing the quality of
mentoring relationships

WHY CARE ABOUT MENTORING
RELATIONSHIPS?

WHY CARE?
Mentoring is the primary process for formal research
training of the next generation of scientists.
• Knowledge- what content domains do you need to
master?
• Skills –what you need to be able to do (techniques,
procedures, methodologies)
• Critical thinking- how do you generate hypotheses?
• Observation- how do you interpret data?
• Communication –how do you present data, write
papers?
• Collaboration- how do you collaborate within and
across teams and networks?
• Rules –what are the rules for the responsible
conduct of research?

WHY CARE?
Mentors also serve as role models and informal
guides to the “society” of science and academic
medicine
• Formal and informal networks and collegiality
• Career guidance and advocacy
• Prioritization and time-management
• Professionalism, values and attitudes
• Passion, curiosity and fun
The nature and quality of mentoring of new
academic medical researchers will determine the
future culture and success of science for years to
come

But why care about mentoring relationships and the
responsible conduct of research?

How Many Scientists Fabricate and Falsify Research?
2% of scientists
admitted to have
fabricated, falsified or
modified data or results
at least once
From G. Dover with permission, Fanelli D (2009) How Many Scientists Fabricate and Falsify Research?
A Systematic Review and Meta-Analysis of Survey Data. PLoS ONE 4(5): e5738.

MENTORING AND RESEARCH MISCONDUCT:
WRIGHT ORI REVIEW OF TRAINEE MISCONDUCT
Closed ORI cases of trainee misconduct 1990-2004
33 post docs, 10 graduate students and 2 additional
trainees
All but three cases involved either or both
fabrication and falsification
77% admitted to misconduct
• most signed a Voluntary Exclusion Agreement with ORI
precluding them from receiving federal funds for
research from 3-5 years
• 63% required retractions of publications
• 41% fired or dismissed, 43% resigned
By permission from T. Cheng. Wright DE et al. Sci Eng Ethics 2008
14:323-336

MENTORING AND RESEARCH MISCONDUCT: RESULTS
In review of 33 cases in which trainees were found
guilty of scientific misconduct:
• 90% involved fabrication, falsification or both
• Over half first reported by someone other than
mentor
• 63% led to retractions of published papers
• 73% mentors did not look at raw data
• 62% mentors did not have set standards for
recording data
From G. Dover by permission Wright DE et al. Sci Eng Ethics 2008 14:323-336

MENTORING AND RESEARCH MISCONDUCT
53% of cases described their stress levels as a
factor that caused or contributed to their
misconduct
• 62% felt pressure to perform well
• 38% felt time-related stress such as submitting a
grant, publication or publication deadline or complete
dissertation
• 17% felt unreasonable pressure from the mentor to
get desired or quick results
By permission from T. Cheng. Wright DE et al. Sci Eng Ethics 2008 14:323-336

“Even though I had already secured a position…and
had 18 publications, an NIH fellowship and several
awards for my prior work, I believed myself to be a
complete failure as a scientist…I think that was going
through my mind, and led me to believe that, if I could
just show one piece of „promising‟ data at a group
meeting, my supervisor would let me continue working
on the problem and produce real data that could be
presented and published…”
By permission from T. Cheng. Wright DE et al. Sci Eng Ethics 2008 14:323-336

DID INADEQUATE MENTORING CONTRIBUTE
TO/FAIL TO PREVENT MISCONDUCT?

WHAT WOULD CONSTITUTE
INADEQUATE MENTORING?
Failure to review trainee raw data at regular intervals
Failure to establish clear standards for:
• Keeping lab books
• Managing and retaining data
• Authorship
Failure to adequately support trainee career
development
• Unsupportive work environment for trainees
• Undue pressure to produce results quickly
• Unreasonable expectations as to productivity
• Failure to monitor and be alert to stress levels of trainees
Adapted from J. Freischlag with permission

SO WHAT IS GOOD MENTORING?

CHARACTERISTICS OF SUCCESSFUL
MENTORING RELATIONSHIPS
Reciprocity: bidirectional
nature of mentoring,
including consideration of
strategies to make the
relationship sustainable
and mutually rewarding
Mutual respect: respect
for the mentor and
mentee‟s time, effort, and
qualifications
Shared values: around
the mentor and mentee‟s
approach to research,
clinical work, and personal
life
Clear expectations:
expectations of the
relationship are outlined
at the onset and revisited
over time; both mentor and
mentee are held
accountable to these
expectations
Personal connection:
connection between the
mentor and mentee
Strauss et al . Acad Med. 2013;88:82–89.

WHEN MENTORING FAILS
Poor communication:
including lack of open
communication, failure
to communicate
tactfully, and inability
to listen
Lack of commitment:
lack of time committed
to the relationship or
waning interest over
time
Perceived (or real)
competition
Personality differences:
different personal
characteristics between
the mentor and mentee
Conflicts of interest:
competing agendas
between the mentor and
mentee
Lack of experience:
mentor may not have
relevant knowledge, skills,
or experience
Strauss et al . Acad Med. 2013;88:82–89.

VIGNETTE 1
Mei is a Ph.D international postdoctoral fellow
hired to work on Dr. X‟s exciting new proteomics
grant. Mei‟s spoken English skills are poor,
however, other fellows and technicians in the lab
speak Chinese so she has had no problems working
in her lab setting. She has worked long hours and
her research has yielded a number of important
new findings , however, Dr. X has refused to allow
Mei to take first authorship on any publications.
Mei is increasingly stressed that her work in Dr.
X‟s lab is not advancing her career, but she is
anxious and uncertain about what she should do.

POTENTIALLY VULNERABLE MENTEES
International scholars may be fully reliant on
their mentor for visa status and/or salary
Limitations in English skills may contribute to
misunderstandings and isolation from the
broader academic community
Cultural differences may exist related to
expectations about mentee/mentor relationships,
lab practices, expectations for performance
Mentoring International PostDocs http://ori.hhs.gov/rcr/CHOP_VideoGuide.pdf

VIGNETTE 2
Dr. B. is a Division Director of a busy clinical division in
Medicine. He is under increased pressure to meet clinical
demands of a newly opened service at Greenspring Station.
To meet these needs he recruits Dr.T, straight out of
fellowship at UNC Chapel Hill, to join the faculty. Dr. T is
very excited to come to Hopkins because of the opportunity to
develop a clinical researcher career. Dr. B. has assured Dr. T
that Hopkins is a wonderful environment for a budding
clinical researcher. In the offer letter Dr. B notes that he will
serve as Dr. T‟s mentor and that they will meet regularly to
review progress toward academic goals. After one year, Dr. T
has found it difficult to get a research program going with his
7 clinics a week and the conversion to EPIC. At the time of
his annual review, Dr. B. says that Dr. T has been a
wonderful addition to the Division, and he would therefore
like him to take on the role of co-director of the fellowship
program. Dr. T is worried that this will further retard his
research career.

CONFLICT OF INTEREST MENTORING?
“a division chief may find conflict of interest in his or
her roles as both guardian of the division and
facilitator of a junior faculty member's professional
aspirations”
Pololi and Knight J Gen Intern Med. 2005 September; 20(9): 866–870.

WHICH HAT?
Manager
Mentor
Directs the work of the
individual
Focused on performance,
professional development and
career development
Based on organizational
needs
Driven by learning agenda
influenced by organizational
needs
Inside the hierarchy of direct
reporting relationships
Sometimes, but not always
confidential
Guide and support the
individual
Focused on professional
and personal development
Based on mentee‟s
expressed needs
Driven by specific learning
agenda identified by the
mentee
Outside the hierarchy of
direct reporting
relationships
Confidential
Adapted from M. Feldman, UCSF Faculty Mentoring Toolkit
http://academicaffairs.ucsf.edu/ccfl/media/UCSF_Faculty_Mentoring_Program_Toolkit.pdf

VIGNETTE 3
Dr. Y is a very prominent and very successful
researcher. He prides himself on his mentoring
skills and his unbroken record of NIH funding.
He therefore attracts many fellows and junior
faculty eager to work with him. Trainees learn
quickly that they will need to impress Dr. Y with
their data if they want to get his time and
attention. For the smartest and most successful
trainees, Dr. Y can open many doors. And Dr. Y
is just as willing to tell the less successful
trainees that they don‟t have what it takes to
succeed. He believes it‟s important to be blunt.
Dr. Y has won several mentoring awards.

“TOR(MENTORS)”
"[a]t the same time we proffer kudos upon
outstanding mentors, it behooves us to call
attention to those who engage in actively
negative mentoring, which for want of a better
term we shall refer to as 'tormenting.' Perhaps an
award should be given to 'Tormentor of the Year”
Silen, "In Search of the Complete Mentor," in Mentations, Volume 5-Fall 1998
http://ccnmtl.columbia.edu/projects/rcr/rcr_mentoring/foundation/#9

Williams et al. Education for Primary Care (2012) 23: 56–8
TOXIC MENTORS
1) “Destroyers or criticizers” – mentors who focus on
inadequacies
2) “Dumpers” – mentors who force novices into new roles and
let them “sink or swim”
3) “Blockers” – mentors who continually refuse requests,
withhold information, take over projects, or supervise too
closely
4) “Avoiders” – mentors who are neither available nor
accessible

VIGNETTE 4
Dr. D is an ambitious Assistant Professor in the
last year of her K award who feels that her
productivity is slow because she has never had a
postdoctoral fellow work with her in her research
program. She is very pleased when an incoming
fellow selects her to serve as his primary mentor.
She gives the fellow a project to complete, however,
after nine months the fellow seems to be
floundering. Dr. D is uncertain how to help.

JUNIOR OR SENIOR FACULTY MENTOR?
Junior
More available
Fewer other
mentoring
commitments
More time
May be more
personally engaged
Senior
More resources
More experience
More influence
More competitive as a
K mentor
Consider a duo- Junior + Senior Mentor
.

THE MULTIPLE MENTOR STRATEGY
Few mentors can provide all necessary
mentoring support
Keeps the novice from setting out on the
often futile search for the “perfect mentor”
Gives the mentee the opportunity to
evaluate advice from several different
perspectives
Makes it more likely that the mentee will
have access to diverse mentors of the
same and other gender/race and in
various positions 28
Adapted from Hall, 1983, AAMC

VIGNETTE 5
Mary is a postdoctoral fellow in Pediatrics. She is in year
three of her fellowship and is hoping to be offered a position
on the faculty. At the beginning of her fellowship her
mentor Dr. A had offered to meet with her every two weeks
to review her progress, however, Mary frequently ended
up canceling meetings at the last minute because she still
had clinical commitments to finish up. Dr. T. had helped
her initiate a small clinical study, however, it had taken a
long time to learn the e-IRB system and the data collection
was going slowly because she kept getting interrupted by
her other commitments. Last year, Dr. T. provided her
with a data set that she could use to write a secondary
analysis paper and gave her access to her biostatistician,
however, she was not really done with all the analyses and
was having trouble getting started on the draft. She has
asked Dr. T. to be her mentor for a K award and is shocked
that Dr. T says that she does not believe she can serve as
Mary‟s K mentor.

THE TEAR-YOUR-HAIR-OUT MENTEES:
WHAT JHSOM MASTER MENTORS SAID
Brilliant, but not working to potential
Highly distracted, not focused
Passive
Passive-Aggressive
Arrogant or disinterested in being mentored
Not a team player or exhibiting poor behavior
Poor time management
Unreliable
Not listening to you
Doesn‟t appreciate mentoring
30

PROACTIVE MENTEESHIP
Agree on the structure and objectives of relationship
Respect your mentor‟s time
Plan and set the meeting agenda
Asks for and be receptive to feedback
Clarify mentor‟s expectations regarding authorship,
intellectual property, team responsibilities
Follow through on assigned tasks/projects/papers
Set and regularly review mutually determined goals,
milestones and expectations
Be responsive and flexible
Show appreciation

INSTITUTIONAL ROLE IN ENHANCING THE
QUALITY OF MENTORING RELATIONSHIPS
Does the Institution:
• Assure that all trainees and junior faculty have
identified mentors?
• Provide training for mentoring skills?
• Provide resources and support for mentoring diverse
faculty?
• Have guidelines for “best practices” mentoring?
• Monitor the quality of mentoring relationships?
• Provide regular opportunities for informal and/or
cross-departmental mentoring?
• Recognize and reward excellence in mentoring?

PAY IT FORWARD: GOOD MENTORING IS
GOOD FOR THE WORLD!
"If we are to have faith that mankind will survive
and thrive on the face of the earth, we must
believe that each succeeding generation will be
wiser than its progenitors. We transmit to you,
the next generation, the total sum of our
knowledge. Yours is the responsibility to use it,
to add to it, and transmit it to your children.“
(Rosalyn Yalow, 1977, Stockholm)

PANEL DISCUSSION
Jessica L. Bienstock, M.D.
Thomas Koenig, M.D.
Carolyn Machamer, Ph.D.
Sheila Garrity, J.D., M.P.H., M.B.A.
• Moderator