Mentoring in Pediatric Oncology: A Report from the
Children’s Oncology Group Young Investigator Committee
Adam S. Levy, MD,* Kimberly A. Pyke-Grimm, RN, MN,w Dean A. Lee, MD, PhD,z
Shana L. Palla, MS,y Arlene Naranjo, PhD,8 Giselle Saulnier Sholler, MD,z Eric Gratias, MD,#
Kelly Maloney, MD,** Farzana Parshankar, MD,ww Michelle Lee-Scott, CCRP,zz
Elizabeth A. Beierle, MD,yy Kenneth Gow, MD,88 Grace E. Kim, MD,zz Stephen Hunger, MD,**
Frank O. Smith, MD,##*** and Terzah M. Horton, MD, PhDwww
Summary: A formal Mentorship Program within the Children’s
Oncology Group (COG) was established to pair young inves-
tigators (mentees) with established COG members (mentors).
Despite the American Academy of Pediatrics policy statement
promoting mentorship programs, there are no publications
describing and evaluating national mentorship programs in
pediatric subspecialties. In this study, a series of internal program
evaluations were performed using surveys of both mentors and
mentees. Responses were deidentified and analyzed to determine
the utility of the program by both participant satisfaction and self-
reported academic productivity. Results indicated that mentees
were generally satisfied with the program. Mentor-mentee pairs
that met at least quarterly demonstrated greater academic pro-
ductivity than pairings that met less frequently. This formal men-
torship program appeared to have subjective and objective utility
for the development of academic pediatric subspecialists.
Key Words: mentorship, pediatric oncology, cooperative group
(J Pediatr Hematol Oncol 2013;35:456–461)
research.1In addition to stressing the need for mentorship
during medical school and residency training, the need for
mentors throughout an academic pediatrician’s career was
highlighted. The Committee recommended that professional
organizations establish programs to foster continued research
training for academic faculty and suggested that oppor-
tunities to participate in research activities be expanded.
Likewise, the US Institute of Medicine and the National
Institutes of Health suggested that improving mentorship is
important to reverse a trend of fewer physician investigators
leading research studies.2,3The best way, however, to prepare
physicians for patient-oriented research careers remains to be
defined.4There are limited publications describing mentor-
ship programs in medical research and even fewer reports
describing the outcomes of such programs.3,5–10Some studies
suggest that active mentorship enhances an investigator’s
academic productivity and career satisfaction.4,11,12Despite
the American Academy of Pediatrics policy statement pro-
moting mentorship programs, there are no publications
describing and evaluating national mentorship programs in
Because of the rarity of childhood cancers, most chil-
dren with cancer in North America are treated in tertiary
care academic institutions. A majority of these patients are
enrolled on National Institutes of Health-funded National
Cancer Institute-sponsored pediatric oncology clinical tri-
als. The Children’s Oncology Group (COG) is the largest of
these cooperative groups and includes over 200 treating
institutions and has over 7000 members. The COG is div-
ided into 30 disease and subspecialty committees. Given the
number of COG members and the inherent bureaucratic
structure of such large organizations, learning how to
become active an participant in COG-sponsored research
can prove challenging for junior COG members.
In 1996, a Young Investigator Program was established
within a predecessor group of the COG, the Children’s
Cancer Group. Upon merger of 2 pediatric cooperative
groups, the Young Investigator Program continued as the
Young Investigator Committee (YIC) with the following
goals: (1) to provide support and guidance for collaboration
and to facilitate the interaction of young investigators in basic
n 2001, The American Academy of Pediatrics published a
policy statement promoting mentorship in pediatric
Received for publication October 16, 2012; accepted May 7, 2013.
From the *Department of Pediatrics, Children’s Hospital at Montefiore,
Albert Einstein College of Medicine, Bronx, NY; wOncology and
Stem Cell Transplant, Bass Center Day Hospital and Clinics, Lucile
Packard Children’s Hospital, Stanford; zzDepartment of Pathology,
zDivision of Pediatrics; yDepartment of Biostatistics, University of
Texas MD Anderson Cancer Center; wwwDepartment of Pediatrics,
Division of Hematology-Oncology, Baylor College of Medicine,
Houston, TX; 8Department of Biostatistics, Colleges of Medicine and
Public Health & Health Professions, University of Florida, Gaines-
ville, FL; zVan Andel Research Institute; #Division of Pediatric
Hematology/Oncology at the University of Tennessee College of
Medicine, Chattanooga, TN; **Center for Childhood Cancer and
Blood Disorders, University of Colorado and Children’s Hospital,
Denver, CO; wwPediatric Hematology/Oncology, Yale University,
New Haven, CT; zzDepartment of Hematology/Oncology Hospital
for Sick Children, Toronto, ON, Canada; yyDepartment of Surgery
88Department of Surgery, University of Washington, Seattle, WA;
##Department of Medicine and Pediatrics, University of Cincinnati
Cancer Institute; and ***Division of Hematology/Oncology, Uni-
versity of Cincinnati College of Medicine, Cincinnati, OH.
A.S.L. and K.A.P.-G. contributed equally.
Supported by the Children’s Oncology Group.
Each listed author made substantive intellectual contributions to this
manuscript using the following criteria: (1) substantial con-
tributions to conception and design, acquisition of data, or analysis
and interpretation of data; (2) drafting the article or revising it
critically for important intellectual content; and (3) final approval
of the version to be published.
The authors declare no conflict of interest.
Reprints: Adam S. Levy, MD, Department of Pediatrics, Children’s
Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY 10467
Supplemental Digital Content is available for this article. Direct URL
citations appear in the printed text and are provided in the HTML
and PDF versions of this article on the journal’s Website,
Copyrightr2013 by Lippincott Williams & Wilkins
456|www.jpho-online.comJ Pediatr Hematol Oncol?Volume 35, Number 6, August 2013
science and clinical research fields; (2) to identify successful
investigators to serve as mentors for young investigators; and
(3) to facilitate involvement of young investigators in COG
administrative, disease and study committees. “Young
investigators” were self-defined, but participants were usually
within 10 years of completing their subspecialty training. A
formal Mentorship Program was established in an effort to
pair young investigators (mentees) with mentors involved in
COG activities. In this report, we describe the COG Men-
torship Program (Fig. 1), a series of internal program eval-
uations, and the utility of the program as determined by both
the satisfaction its participants and their self-reported aca-
As part of a quality improvement exercise, participants
in the COG YIC Mentorship Program were asked to
complete a confidential survey assessing the mentorship
program (Supplemental Digital Content 1, http://links.lww.
com/JPHO/A42). Individual surveys were distributed to the
mentors and mentees in 2005, 2007, 2008, and 2009. These
surveys assessed whether the mentorship relationship was
active, whether the mentor and/or mentee found the rela-
tionship satisfactory, and whether the relationship was
productive. Surveys also assessed what each individual
hoped to gain from the mentorship experience. Participants
were asked if they had already identified a niche within
pediatric oncology, and whether they believed it was
important that the mentor have the same career focus.
Finally, participants were asked to provide qualitative
comments on the strengths and weaknesses of the mentor-
ship program. Surveys were returned via email to YIC
leadership and were deidentified for analyses. The data were
gathered following the provisions of the Declaration of
Helsinki and according to local Institutional Review Board
For this analysis, we considered the group of mentors
and mentees with a single questionnaire time point (2005)
as “cohort 1” and the group from 2007 to 2009 (3 ques-
tionnaire time points) as “cohort 2.” Cohort 1 included 48
mentees and 44 mentors (some mentors had more than
1 mentee). Cohort 2 included 31 mentees and 29 mentors.
Four individuals were mentees in both cohorts such that
overall there were 75 mentees and 73 mentors in the pro-
gram over the course of time discussed in this manuscript.
Data were collected from cohort 2 over three years
(2007-2009). If more than one survey was returned over the
mentoring period, results from each mentee were summar-
ized as one data point per mentee using the highest reported
frequency of meeting and highest reported fit scores
between the mentor and mentee. Likewise, all reported
mentor roles were condensed from multiple surveys for
each mentee, as the roles in mentoring frequently evolved
over time. For correlative data regarding productivity, data
from surveys of all 75 mentees from both cohorts were
included in the analysis. For descriptive data regarding
productivity, only surveys reporting productivity were
considered. Mentees who did not respond to the questions
regarding productivity or did not return a survey were
considered to have had no productivity. Each positive self-
report of productivity indicated on the survey was assigned
a value of one and total productivity summed.
The Mann-Whitney test was applied to determine
significance of pair-wise comparisons. The Kruskal-Wallis
test was applied to determine significance of meeting
frequency, in discrete categories as reported, for measures
of fit, productivity, and satisfaction. The Spearman corre-
lation coefficient was used to determine the correlation of
fit, productivity, and satisfaction measures with meeting
frequency as a continuous variable. P values for a 1-tailed
test are reported under the assumption that increased
meeting frequency would have a positive effect on outcome
measures. Figures and statistics were performed with Prism,
Macintosh version 5.0c.
FIGURE 1. Young Investigator Committee mentorship program overview.
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Descriptors of the Mentoring Relationships
Two groups of mentee/mentor pairs were assessed.
Forty-eight mentor/mentee pairs (cohort 1) were surveyed
during 2005, 2 years after their pairing. A second cohort of
31 mentor/mentee pairs (cohort 2) were surveyed in 2007,
2008, and 2009. Twenty-nine of the 48 mentees enrolled in
cohort 1 of the program answered the survey (response rate
60%). Twenty-eight of 31 mentees in cohort 2 responded to
at least one survey over the course of their mentorship
experience (response rate 90%).
In cohorts 1 and 2, the YI mentees ranked what they
hoped to gain from the program in the following order: (1)
navigation into and within specific COG disease committees,
(2) guidance on specific research projects, (3) collaborations
to assemble manuscripts for publication, (4) general career
guidance, and (5) aid in obtaining job contacts.
Roles performed by the mentors were not prospectively
defined in this mentoring project. Mentees were encouraged
to identify specific professional goals for the mentoring
period in an open-ended manner. The survey asked mentees
to retrospectively identify the roles that mentors had served
in working toward those goals. Some mentees attributed
multiple roles to their mentors. Pooling responses from both
cohorts, mentees reported that “advisor” (75%) and
“resource” (60%) were the most common roles for mentors
in these relationships (Fig. 2A). Mentees reported the
frequency of interactions with their mentors as shown
in Figure 2B.
For cohort 1, 22 of 29 (76% of respondents) were
satisfied with the program. The mentee satisfaction rate for
cohort 2 was 90% in 2007, 60% in 2008, and 80% in 2009.
Similar themes regarding satisfaction and dissatisfaction
were noted by both cohorts. Satisfied mentees noted that
the COG YI mentorship program was a starting point for
their careers as COG junior investigators, allowing them to
become more involved in COG and to build ties to allow
for future collaborative work. They also commented on the
advantages of having a mentor to guide them in accessing
COG tissue resources and COG clinical data.
Dissatisfied mentees also reported common factors
that impeded the success of their mentor/mentee relation-
ship. Some mentees commented that their assigned mentors
were extremely busy and often did not have time for men-
toring. They also commented that there were no defined
goals, and that significant effort was needed by both the
mentee and mentor to forge a productive mentee/mentor
relationship. Other suggestions included allowing mentees/
mentors to have a voice in their pairings, and funding for
YI’s travel to COG meetings to promote more personal
interactions with their mentors. Dissatisfied members sug-
gested that the YIC should keep track of their relationships
and intervene early (within the first 3 to 6mo) to help or
change suboptimal mentor/mentee assignments.
In cohort 1 in which 48 mentor/mentee pairs were
assessed, 8 of the mentees presented abstracts at national
meetings, 9 published papers in peer-reviewed journals, and
4 mentees became involved in active COG committee work.
In cohort 2, 16 of 31 pairings were objectively productive.
Seven pairings resulted in a publication, 10 pairings resulted
in a presentation, and 10 pairings resulted in active COG
committee work. In cohort 2, 7 pairings resulted in 2 areas
of productivity, and 2 pairings resulted in productivity in all
3 defined productivity areas (abstracts, publications, and
active COG committee work).
In most productive pairings, relationship strengths
included a mentor that actively participated in the mentor-
mentee relationship throughout the project. Reported
mentor participation included giving start-up ideas for
navigating through COG or Institutional Review Board
approval systems and assisting with interactions with COG
Effects of Mentee Gender
Mentees reported “active” mentoring relationships
and satisfaction with mentoring relationship at similar rates
regardless of gender (Fig. 3A), with perhaps a slight trend
among women toward more frequent interactions with their
mentors (Fig. 3B). There were also no significant differences
between genders in reported productivity resulting from the
mentor-mentee relationship (Fig. 3C).
Predictors of Interaction Frequency and of
Productivity as a Measure of Successful
The frequency of interactions correlated with the per-
ceived degree of “fit” between the mentee’s needs and the
mentor’s qualities (Fig. 4A) and how well the mentor’s time
expectations matched the mentee’s (Fig. 4C). Importantly,
the frequency of interactions did not simply correlate with
mentee perceptions of fit, matching time expectations, and
program expectations, but correlated strongly with reporting
FIGURE 2. A, Roles served by mentors as reported by mentees. B, Meeting frequency reported by mentees.
Levy et alJ Pediatr Hematol Oncol?Volume 35, Number 6, August 2013
r2013 Lippincott Williams & Wilkins
the achievement of objective outcomes of the mentoring
relationship (Figs. 4B, D).
In cohort 1, 21/44 (48%) mentors responded to the
survey. Of the responding mentors, 13/21 (62%) felt the
pairing was active. The mentors were asked to rank in order
of important 5 areas that they might help a mentee. The
majority of the mentors ranked guidance on specific
research projects as the top reason for being a mentor. The
second most important area was specific COG disease
committee advice and introduction of mentees to COG
committee leadership. The third most important area was
general career guidance. Serving as a contact to obtain a job
and collaborating to write papers for publication were rated
as least important. The majority of the mentors felt it was
important for the mentee to be differentiated toward a
certain career niche within pediatric oncology. Although
not universal, the majority of mentors also felt that they
and their mentee should be in the same niche.
Mentors in 2005 indicated that strengths of the men-
tor/mentee relationship were generally encompassed in 3
themes: the opportunity to encourage future investigators
and leaders, to ensure the future of COG, and to provide
career opportunity for mentees. Perceived challenges in the
program included the limited number of mentors, lack of
funding, and lack of formal guidelines for the program.
Many mentors hoped that the program would continue
with more formality and official COG-sponsored events.
The mentors in cohort 2 were asked how they had
assisted their mentees. As reported by cohort 1 mentors,
assistance on specific research projects was the most common
response. Cohort 2 mentors also noted program strengths
and weaknesses similar to those outlined in cohort 1.
The current study is the first comprehensive assess-
ment of a mentorship program within a pediatric clinical
trials consortium. We show here that a structured program
of prospective mentor-mentee matching on the basis of
interests resulted in successful mentoring. Mentees in both
groups were productive, resulting in a total of 16 pub-
lications, 18 presentations, and 14 mentees becoming active
in COG committee work. Of note, since clinical trial data
may need many years to mature before publication, this
assessment of productivity within the group may actually
underestimate the ultimate productivity of these pairings.
The importance of mentorship in an individual’s
career development is widely believed to be self-evident.
However, there is limited evidence that mentor programs
provide benefits to participants or organizations in medi-
cine,13–15nursing,16,17or business.18Of note, literature
suggests that many mentorship programs do not establish a
clear definition of mentorship nor clear guidelines or goals
for program participants (mentees).
One recent systematic review examined the prevalence of
mentorship and its effect on career development in medi-
cine.14There was an apparent positive impact of mentorship
on research development and productivity. Mentorship
FIGURE 3. A, Relationship of gender to mentor-mentee interaction frequency. B, Mentee gender and reported frequency of inter-
actions. C, Mentee gender and reported productivity.
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relationships are quite common in medicine,19,20with 19% to
93% of individuals reporting a mentor-mentee experience.21
The perceived value of mentorship is notable in some spe-
cialties. For example, 95% of Adolescent Medicine faculty
described their mentor as important.21A recent study deter-
mined that academic general pediatrics division chiefs
acknowledge the benefits of mentoring relationships, and
suggested that pediatric societies could facilitate this area of
The influence of gender on the mentorship relationship
may also be important. A recent survey of pediatric sur-
geons determined that nearly one-half of female respond-
ents believed inadequate mentoring limited their career
development as compared with 36% of male respondents.23
However, in our study we found no significant differences
in the mentor-mentee relationship based on gender.
Following the completion and evaluation of the 2005
cohort survey (cohort 1) and the 2007 cohort survey (cohort
2), changes were instituted to improve the program. The
mentoring commitment was increased from 2 to 3 years in
order to encourage a longer lasting, productive mentor-
mentee relationship and to give time for project completion.
Participants in the program were also encouraged to define
goals with their mentors early in their relationship. The YI
mentorship program was broadened to all members of the
COG including physician members in pathology, radiation
oncology, and surgery, as well as nonphysician members in
allied health fields including nursing, pharmacy, psychol-
ogy, and social work.
Based on feedback from the 2005 cohort, mentees were
encouraged to suggest a mentor for their pairing and the YIC
leaders had discussions with both the mentee and mentor
before pairings to ensure that interests were similar and that
each person had the time to commit to the pairing. Closer
monitoring of the pairings was initiated by the YIC, with
communication with the mentee 3 months after the pairing to
ensure that the pair had made contact and that they had
defined goals for their pairing. The program also allowed for
early re-pairing if the initial pairing was not a good match.
We believe that the changes implemented strengthened the
program and encouraged future young investigators in
pediatric oncology interested in COG investigative research.
FIGURE 4. Relationship of the frequency of mentor-mentee interactions with reported predictors and productivity outcome measures.
P-values shown are for Kruskal-Wallis analysis of the entire data set for each figure. Correlation of meeting frequency (and P-values for
Spearman nonparametric correlation) with (A) the mentee’s perceived degree of “fit” with their mentor (P=0.0094), (B) the mentee’s
perceived match of program expectations with the mentor’s (P=0.0027), (C) the mentee’s perceived match of time expectations with
the mentor’s (P=0.0092), and (D) the mentee’s reported productivity (P=0.0059).
Levy et al J Pediatr Hematol Oncol?Volume 35, Number 6, August 2013
r2013 Lippincott Williams & Wilkins
Although not the only goal, one major goal of the YI Download full-text
mentorship program is to facilitate academic productivity
for mentees, defined as publications, a presentations, and/
or active participation in COG committee work. Within a
mentoring program, it is important that the program pro-
spectively address areas that impact the success of men-
toring relationships. We found, as might be expected, that
productivity—one of our objective measures—correlated
with both a perceived match in mentor/mentee objectives,
and adequate time commitments from both participants,
and the needs/skills of the mentor-mentee pair. In general,
the more frequent the interactions, the more likely the
relationships were identified as active. Most importantly,
the frequency of interactions did not simply correlate with
mentee perceptions of fit and match, but correlated most
strongly with mentee productivity. It is clear that mentoring
programs should prescribe and encourage frequent inter-
actions to maintain momentum and structure.
This study has several limitations as a retrospective
survey. Surveys were done via questionnaires, creating a
potential selection and reporting bias. To reduce the risk of
reporting bias we assumed that those who did not respond
to the survey had no productivity, thereby eliminating the
risk of reporting overly positive results. The response rate,
however, was relatively good for both mentors and ment-
ees. The cohorts were also relatively small, limiting formal
statistical analysis to common events between groups.
There are some confounding issues that must also be con-
sidered. For example, individuals who are more persistent
and engaged in the mentoring program may be more self-
motivated than those who were less active in the program.
Thus, attributing productivity to the program per se cannot
be proven. On the other hand, those who did not respond to
the survey may be those individuals who were least satisfied
or found the program least effective.
In summary, this is the first comprehensive assessment
of a mentorship program within a pediatric clinical trials
consortium over time. Although mentees perceive that men-
tors play a variety of roles, the mentors stated the key roles
were guidance on specific research projects, COG disease-
committee activities, and collaboration on manuscripts.
Mentees described the relationship as “active” if the mentor
and mentee met at least quarterly. Furthermore, mentor-
mentee pairs that met at least quarterly demonstrated greater
academic productivity than pairings that met less frequently.
Importantly, the YI mentorship program was not intended to
replace mentorship that occurs within training programs or
academic centers. Rather, it should complement such the
local mentorship junior colleagues receive. These findings will
help direct future oversight and guidance for this and other
pediatric mentoring programs.
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