The POD: A New Model for Mentoring Underrepresented Minority Faculty

Abstract

Mentoring, long recognized as a catalyst for successful careers, is particularly important to the career development of underrepresented minority (URM) faculty. In academic medicine, mentor-protégé relationships are seriously threatened by increased clinical, research, and administrative demands and an emphasis on scholarship over citizenship. New mentoring models are needed, and they should be adaptable to a medical school's unique structure and mission. The Peer-Onsite-Distance (POD) model, developed in 2002 by the authors and introduced at the College of Medicine at the University of Arkansas for Medical Sciences, is a targeted, multilevel mentoring prototype that is built on a solid research foundation and tailored to the unique needs of URM medical school faculty. The mentee's individual needs for guidance related to career goals, resources, and the content and interaction skills that are known to be critical to successful academic careers are targeted for development. The multilevel approach provides a unique network of peer and faculty mentors who provide site-specific career guidance. Also in the network are leaders in their fields who can provide access to accurate information, cautions, predictions, and announcements of future resources or potential restrictions in academic medicine. Mentor commitments are clearly defined and time contributions are maximized. The POD model aims to promote retention and advance the careers of URM faculty by wrapping them in a protective cushion of interpersonal and intrapersonal support. The flexibility of the design allows for adaptation to any institution's unique structure and mission.

Full text

Faculty
The POD: A New Model for Mentoring
Underrepresented Minority Faculty
Charlotte Lewellen-Williams, MPH, Virginia A. Johnson, EdD, Linda A. Deloney, EdD,
Billy R. Thomas, MD, MPH, Apollos Goyol, PhD, and Ronda Henry-Tillman, MD
Abstract
Mentoring, long recognized as a catalyst
for successful careers, is particularly
important to the career development of
underrepresented minority (URM) faculty.
In academic medicine, mentor–prote´ge´
relationships are seriously threatened by
increased clinical, research, and
administrative demands and an emphasis
on scholarship over citizenship. New
mentoring models are needed, and they
should be adaptable to a medical
school’s unique structure and mission.
The Peer-Onsite-Distance (POD) model,
developed in 2002 by the authors and
introduced at the College of Medicine at
the University of Arkansas for Medical
Sciences, is a targeted, multilevel
mentoring prototype that is built on a
solid research foundation and tailored to
the unique needs of URM medical school
faculty. The mentee’s individual needs
for guidance related to career goals,
resources, and the content and
interaction skills that are known to be
critical to successful academic careers are
targeted for development. The multilevel
approach provides a unique network of
peer and faculty mentors who provide
site-specific career guidance. Also in the
network are leaders in their fields who
can provide access to accurate
information, cautions, predictions, and
announcements of future resources or
potential restrictions in academic
medicine. Mentor commitments are
clearly defined and time contributions
are maximized. The POD model aims to
promote retention and advance the
careers of URM faculty by wrapping
them in a protective cushion of
interpersonal and intrapersonal support.
The flexibility of the design allows for
adaptation to any institution’s unique
structure and mission.
Acad Med. 2006; 81:275–279.
The importance of mentoring, long
recognized as a catalyst for successful
careers, is receiving renewed attention in
academic medicine. Benefits of the
mentor–prote´ge´ relationship are well
documented, and a positive correlation
between mentoring and academic success
and productivity has been frequently
reported.
1–10
Faculty who have been
successful in their careers are known to
have benefited from the counsel of one or
more mentors
11
across their professional
lifespan, especially during periods of
transition.
3,4,12
In particular, junior
faculty who have research mentors have
reported greater productivity and career
satisfaction.
7,10
Although having a faculty mentor and
being part of an active network of peers
are known to be essential elements of
successful careers in academic medicine,
the lack of mentoring is a pervasive
problem.
5,13
Mentor–prote´ge´
relationships are seriously threatened by
increased clinical, research, and
administrative demands, while traditional
support structures (e.g., the faculty club,
the doctors’ “mess”) have been eroded or
lost.
12
As a professional activity, the time
that is needed to build mentoring
relationships is typically uncompensated,
difficult to fit into busy schedules, and
undervalued by the medical school.
8,11,14
Promotion and tenure criteria in most
academic health centers emphasize
scholarship, not citizenship.
11
The need for mentoring may be even
greater for faculty from minorities
underrepresented in medicine.
Underrepresented minority (URM)
groups—African Americans, Hispanics,
American Indians, and Pacific
Islanders—are severely underrepresented
on medical school faculties
5,13,15–18
and at
the doctoral level in the sciences.
19
Compared to white faculty, URM
medical school faculty are promoted at
lower rates
15,17,20,21
and report lower
career satisfaction.
16,18
URM faculty, who
traditionally choose primary care
specialties and frequently have greater
debt burdens than do other faculty, have
been reported to spend more time in
patient care and less time in research than
their white counterparts.
16,20
Most
medical schools have few URM faculty to
mentor medical students.
9,17,22
One key way that physicians are
socialized to medical faculty roles is
mentoring. As stated above, this may be
particularly important to the career
development of URM faculty
3,13,15
because URM physicians are less likely to
have mentors.
5,23
Research in corporate
America has shown that people of color
who have a strong network of mentors to
cultivate their professional development
advance the furthest.
24
Mentoring must
be encouraged and rewarded if URMs are
to achieve and maintain positions of
influence and leadership in academia.
5
Ms. Lewellen-Williams is director of faculty
diversity for the University of Arkansas for Medical
Sciences College of Medicine, Little Rock, Arkansas.
Dr. Johnson is an educational evaluator, the
Academic Affairs Office of Educational Development,
University of Arkansas for Medical Sciences, Little
Rock, Arkansas.
Dr. Deloney is the graduate medical educator for
the Department of Radiology, University of Arkansas
for Medical Sciences College of Medicine, Little Rock,
Arkansas.
Dr. Thomas is the associate dean of diversity affairs
in the College of Medicine, University of Arkansas
for Medical Sciences, Little Rock, Arkansas.
At the time of the study, Dr. Goyol was a program
evaluator, Academic Affairs Office of Educational
Development, University of Arkansas for Medical
Sciences, Little Rock, Arkansas.
Dr. Henry-Tillman is director of cancer control for
the Arkansas Cancer Research Center, University of
Arkansas for Medical Sciences, Little Rock, Arkansas.
Correspondence should be addressed to Ms.
Lewellen-Williams, UAMS College of Medicine,
Center for Diversity Affairs, 4301 West Markham,
#820, Little Rock, AR 72205; telephone (501) 526-
6630; fax (501) 526-6620; e-mail:
具lewellencharlottef@uams.edu典.
Academic Medicine, Vol. 81, No. 3 / March 2006 275

In the institutional climate, structured,
visible systems make connections
between potential mentors and mentees
easier.
14
Although available research on
mentoring in medical environments is
limited, the variety and intensity of
reported mentoring activities at U.S.
medical schools suggest the difficulty of
implementing successful formal
mentoring programs.
5,7
Tested
mentoring models are lacking, as is
expertise in mentoring newer categories
of faculty such as clinician educators.
5
New models are needed, and it has been
suggested that each medical school
should design a mentoring program that
is appropriate for its unique structure
and mission.
5,15
In this article, we
describe the development of a unique
targeted, multilevel mentoring model, the
Peer-Onsite-Distance (POD) model, now
being used at our medical school. This
model is designed to promote retention
and career development among our
URM medical school faculty, but the
flexibility of our design allows for
adaptation to any institution’s unique
structure and mission.
Gathering Information
Literature review
We conducted an online Medline search
to identify research from a 25-year period
(1978 to 2002) on the impact of
mentoring on faculty in medical
professions. The reported studies were
analyzed to identify critical variables
associated with mentoring success in
environments where time and work
demands on potential mentors preclude
the use of a traditional mentor–prote´ge´
relationship. Alternative approaches were
examined to compare benefits of using
traditional “definite mentoring” by only
one mentor with “diffuse mentoring” by
several mentors.
25,28
We also examined
success strategies, problems, and
solutions for implementing and
maintaining mentor programs and
mentor training. Review findings were
summarized and used to develop a
structured interview that was intended to
identify current practices at other
medical schools (as described below) as
well as to structure the new URM
mentoring program.
Structured interviews
During a doctoral mentoring institute at
Arizona State University, we conducted
structured interviews with administrators
representing the 11 higher education
institutions that comprised the Minority
Graduate Education at Mountain States
Alliance. The institute, sponsored
(among others) by the White House
Office of Science and Technology Policy
and the National Science Foundation
Alliance for Graduate Education and
Professoriate Programs, was designed to
enhance knowledge and best practices of
mentoring for URM faculty.
26
It provided
a natural environment for us to collect
detailed input from 30% of the attendees
regarding success strategies, problems,
and solutions related to initiating and
maintaining a mentoring program.
Structured interviews provided a unique
opportunity to investigate current
practices not yet published in the
literature. The interview format focused
on critical ingredients and the benefits of
mentoring in each respondent’s medical
setting. Specifically, the interview focused
on barriers to mentoring at the
respondent’s institution, as well as
outcomes and success strategies used with
junior faculty.
Inventory development
Based on findings from the literature
review and the structured interviews
described above, we designed two
inventories, the Mentee Need Inventory
and Mentor Readiness Inventory, as tools
for matching mentees’ needs with
mentors’ expertise. The inventories
comprised nine professional interaction
skills and 12 content skills (see Table 1).
The inventory was pilot-tested with a
focus group, and then parallel versions of
the needs assessment (one for peer
mentors, one for potential mentees) were
finalized as self-administered paper-and-
pencil questionnaires taking only ten to
20 minutes to complete. Permission to
conduct human subjects research was
granted by the institutional review board
at the University of Arkansas for Medical
Sciences (UAMS). University rules
required that all information remain
confidential.
We compiled a list of URM faculty,
housestaff, graduate students, and
medical students in the UAMS College of
Medicine as of Fall 2002 and invited all of
them to participate in the mentoring
project on a voluntary basis. Information
packets were distributed to a total of 31
interested participants—nine potential
peer mentors and 22 potential mentees—
during the Spring 2003 semester. The
packet consisted of a cover letter and a
copy of the appropriate needs assessment
inventory. The cover letter introduced
the investigators, the reason for the
project, the benefit of the study to the
participant, and the time frame for return
of the questionnaire (within two weeks).
All participants returned their completed
inventories (100% response rate).
What We Learned
Findings from the literature and
interviews
Our review of the literature confirmed
that faculty mentors and peer networks
Table 1
Content and Skills Critical to Academic Career Success*
Content areas Interaction skills
Career goals Coaching
.........................................................................................................................................................................................................
Clinical skills Decision making
.........................................................................................................................................................................................................
Conducting research Goal setting
.........................................................................................................................................................................................................
Confidence building Guiding
.........................................................................................................................................................................................................
Curriculum vitae development Listening
.........................................................................................................................................................................................................
Grant writing Problem solving
.........................................................................................................................................................................................................
Negotiating Providing feedback
.........................................................................................................................................................................................................
Organization and committee participation Reinforcing
.........................................................................................................................................................................................................
Professional networking Role modeling
.........................................................................................................................................................................................................
Promotion/tenure
.........................................................................................................................................................................................................
Publishing your work
* Based on findings from the literature, two inventories were designed as tools for matching mentees’ needs with
peer mentors’ expertise. The inventories, shown in the table, comprise 12 content skills and nine professional
interaction skills.
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Academic Medicine, Vol. 81, No. 3 / March 2006276

were critical ingredients of a successful
academic medicine career.
5,9,15,20,27
Importantly a positive relationship was
found to exist between having a mentor
and professional development
(conference participation, research,
teaching, grantsmanship, and
publishing).
1–10,28
Studies suggested that
successful mentoring programs should be
unique and developed according to the
setting and environment.
5
An
understanding of the cultural parameters
and unique needs and issues of different
minority groups was found to be
important. Essential characteristics of
successful mentor–mentee relationships
that were identified in the literature were
interpersonal (i.e., common research
interests and life experiences, trust,
honesty, and mutual respect) and
intrapersonal (i.e., similar values, ability
to motivate/inspire, recognition of
personal strengths and limitations, and
ability to give constructive
criticism).
1,4,8,10,13
Previous research and outcomes from the
structured interviews helped define
specific content areas to address during
mentoring such as professional
networking, publishing, committee
participation, teaching skills, grant
writing, promotion, and tenure. Specific
interaction skills critical to professional
performance, such as problem solving,
decision making, goal setting, and
feedback were also identified. This
information was consistent across
different medical school settings.
Findings from the inventories
When we had received the 31 completed
inventories, we used descriptive statistics
to quantify (1) mentee needs in the
content areas, (2) the interaction skills of
members of both groups, and (3) mentor
readiness. In addition, we developed an
evaluation plan and data collection
process to assess program outcomes in
these targeted areas.
The content skills for which the 22
potential mentees reported the most need
were networking (21; 95%), clinical skills
(19; 86%), curriculum vitae (CV)
development (18; 82%), establishing
career goals (17; 77%), and confidence
building (16; 73%). Although the nine
potential mentors (faculty and
community physicians) reported
readiness to mentor in all of these
content areas, mentor readiness was
strongest for clinical skills (7; 78%),
career goals (7; 78%), and confidence
building (7; 78%). A majority of potential
mentors (5; 55%) also agreed they could
assist with both developing a CV and in
networking.
Interaction skills for which the 22
potential mentees reported the most need
were problem solving (19; 86%), career
guidance (19; 86%), role modeling (18;
82%), providing feedback (18; 82%), and
coaching (15; 68%). Again, the nine
potential mentors reported readiness to
mentor in all of these areas. Mentor
readiness was strongest for problem
solving (8; 89%). Most potential mentors
(7; 78%) also agreed they could give
feedback and role model, as well as guide
(6; 67%) and coach (5; 55%).
Formal mentor preparation is known to
increase the frequency and effectiveness
of mentoring activities,
8
and outcomes of
the needs assessment verified a need for
some mentor training. Of the potential
mentors, one-third requested basic “how
to mentor” training. While two-thirds
indicated readiness to mentor, they
requested brief refresher sessions in
specific skills: CV preparation,
publishing, and negotiating. Interestingly,
four members (44%) of the group
requested a refresher session in how to
mentor teaching skills.
Both potential mentees and mentors
perceived the primary benefit of being
mentored as a means to develop a
professional network (mentees 11; 58%;
mentors 4, 44%). Secondarily, both
believe mentoring facilitates decision
making about career goals (mentees 6;
32%; mentors 3; 33%).
A New Mentoring Model
Overview
We developed the POD model in 2002
after the research described above. The
POD is a targeted, multilevel mentoring
model (illustrated in Figure 1) built on a
solid research foundation and tailored to
the unique needs of minority medical
school faculty. Furthermore, the POD
model is based on the belief that people
have value as individuals and as members
of groups. The model provides a
protective structure to orient new faculty
to the culture of academic medicine and
offers interpersonal and intrapersonal
support to nurture the mentee’s
professional development. It targets the
individual’s needs for guidance related to
career goals, resources, and content and
interaction skills (see Table 1). Channels
of support and communication are
developed within and between a network
of mentors to convey general success
strategies as well as site-specific guidance.
We believe the POD acronym connotes a
protective environment that nurtures the
junior faculty member, just as a family or
social group cares for its members or the
fruit of a plant protects its new seeds.
The model’s components
The model has five parts:
Figure 1 The Peer-Onsite-Distance (POD) model used to mentor underrepresented medical
school faculty at the University of Arkansas College of Medicine. The figure illustrates how
individual mentees’ needs can be met, either simultaneously or in sequence, by three different
types of mentors. Typically, peer mentors are junior faculty, onsite mentors are senior faculty, and
distance mentors are private-practice physicians, state and national legislators, and other health
care professionals.
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Academic Medicine, Vol. 81, No. 3 / March 2006 277

Mentee. A mentee is a junior URM
faculty member who is the recipient of
teaching and relationship-building
activities that are critical to career
advancement in the academic medicine
environment.
Content and interaction skills. Content
and interaction skills are themes that
have been identified in the literature as
critical for successful academic careers
across medical environments. The model
integrates specific content areas and
interaction skills that can be applied to
the mentoring relationship (see Table 1).
Peer mentors. Faculty who are advancing
in the academic environment and are
close to the mentee in rank are peer
mentors. They are prepared to offer
advice from their own experiences that is
appropriate for and effective in the
particular site. These mentors socialize
mentees to the medical faculty role and
provide collegial support that includes
empathy, warmth, and genuineness.
Onsite mentors. Onsite mentors are
senior faculty, including researchers, full
professors, and department chairs, who
provide information in targeted content
areas. They serve as the mentee’s
advocates, liaisons, or coaches and
provide support, guidance, authentic
feedback, “real world” examples, and
alternatives. They serve a number of
mentees in a timely and efficient manner
that is congruent with their busy
schedules.
Distance mentors. Distance participants
are leaders who emerge from health care,
business, academia, or governmental
and political settings and accept a
clearly defined responsibility to make a
once-a-year contribution in their area
of expertise, frequently conducted as
part of their ongoing public information
activities. These mentors share accurate
information, cautions, predictions, and
announcements of future resources or
restrictions in academic medicine.
Application of the model
The application process is self-directed
and initiated when a URM faculty
member completes a Mentee Need
Inventory (described earlier). Peer and
onsite mentors who indicated readiness
to give support and instruction in the
needed content and interaction skills
areas are identified and asked to provide
targeted mentoring. These mentors are
offered training in coaching and guidance
strategies, feedback and reinforcement
techniques, and evidence-based
instructional methods that enable
mentees to learn quickly and efficiently in
the environment in which they will have
to respond.
Contact is initiated when mentoring
strategies, selected by the mentor to meet
the mentee’s targeted needs, are applied
individually or as a set of sequential and
cumulative steps. For example, the
mentee may need instruction in one or
more targeted content areas (e.g., CV
development) and interaction skills (e.g.,
providing feedback to residents). The
instruction may be enriched by shared
examples of successful career experiences,
and/or extended by recommended
materials for further study. The mentee
may arrange opportunities to observe
persons who are proficient in specific
information or skills in the academic
environment. The mentee may also
shadow the mentor to observe the skill
being modeled in practice or view
examples on video or other media.
Having learned a skill and seen it applied
(e.g., networking), the mentee should
practice in a variety of increasingly
complex environments under the
guidance of the mentor. For example, the
mentor might first have the mentee
network at a departmental meeting, next
at a college-wide event, and then at a
national professional meeting. After each
practice activity, the mentor reinforces
the elements of successful performance
and provides specific guidance as to how
performance might be improved in the
next practice activity. Upon successful
acquisition of the skill, the mentee should
reflect on the learning experience and
discuss the experience with the mentor.
On a continuous basis, mentors will share
emerging success strategies with each
other for the benefit of future mentees.
This process, facilitated by the POD
program administrator, enables mentors
to expand their menu of places to
practice, models to observe, and media
and materials to review, as well as to
endorse or reaffirm that certain activities
are more effective in generating rapid
performance of new skills. In addition,
mentors will discuss any obstacles and
barriers encountered by mentees and
work together to formulate solutions.
A Program Based on the Model
A URM mentoring program based on the
newly developed POD model was
introduced to faculty at the UAMS
College of Medicine in 2002 using a
grand rounds session in conjunction with
individual departmental presentations.
The POD model was immediately
accepted by all stakeholders— university
administration, potential peer and onsite
mentors, and potential mentees—and
supported by College of Medicine faculty.
Ten senior and nine junior URM faculty
immediately decided to participate. These
mentors represented a wide variety of
departments in the college.
Basic or refresher training assures
mentors have effective advising, teaching,
and leadership skills appropriate for the
medical environment. Mentor training
on guidance and coaching strategies was
offered to peer and onsite mentors at the
onset of the project.
The program was initiated with 22
mentees, nine peer, and ten onsite
mentors. Distance mentors were alumni
in private practice, a state senator, a U.S.
Congressman, and a former U.S. Surgeon
General. They provide accurate
information, cautions, predictions, and
announcements of future resources or
potential restrictions in academic
medicine. Distance mentors are expected
to present one “Lunch and Learn” on
campus annually, designed specifically
for program participants and targeting
topics identified in the needs assessment.
This will provide a unique opportunity
for URM faculty to network and connect
with distance mentors to facilitate career
progression. Ongoing recruitment
activities target individuals who have
unique access to information and
resources on a national level.
While the primary outcome of this
project was the creation of the POD
mentoring model, a second outcome was
the transition of the URM mentoring
program from a time-limited grant-
funded activity to an ongoing activity
supported by the College of Medicine.
Traditionally, URM faculty mentoring in
the UAMS College of Medicine had been
facilitated by the Office of Minority
Affairs. Introduction of the POD model
contributed to a new Center of Diversity
Affairs with a full-time director position.
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Academic Medicine, Vol. 81, No. 3 / March 2006278

Conclusion and Discussion
Targeted multilevel mentoring is an
innovative approach to providing URM
faculty with faculty mentors and an active
network of peers, both known to be
essential elements for successful academic
medicine careers.
1–10
As stated earlier, the
literature suggests that successful
mentoring programs be unique and
appropriate to the medical school’s
setting and environment.
5
Although
successful faculty careers are known to
benefit from the counsel of one or more
mentors,
11
there is ample evidence that
mentor–mentee relationships are
seriously threatened by increased clinical,
research, and administrative demands.
The time required to build mentoring
relationships is typically uncompensated,
difficult to fit into busy schedules, and
undervalued by the medical school.
8,11,14
The POD model is designed to increase
the likelihood that mentors with limited
time will participate in mentoring
activities. In the three-level POD model,
peer mentors provide guidance and
support while busy senior faculty focus
on specific and generally more
challenging tasks on a professional level.
The mentees are further supported by a
network of academic, corporate, and
government and political leaders.
The POD’s multilevel approach parallels
findings of a recent study that identified
three important domains of successful
mentorship: the relationship between
mentor and mentee (such as guidance
and support), the professional attributes
of the mentor (such as reputation), and
the personal attributes of the mentor
(such as availability and caring).
10
While
our informal evaluation activities to date
have provided evidence of the efficacy of
the POD model, future studies will assess
the productivity and career satisfaction of
mentees who are mentored by this new
approach.
Acknowledgments
This work was supported in part by a grant from
the National Cancer Institute to Reduce Cancer
Health Disparities, 5U01 CA86081-04, Arkansas
Special Populations Access Network. Preliminary
findings, “Needs and Resources for Developing a
Targeted Approach to Mentoring for Minorities
in Professional Medical Careers,” were presented
at the 2003 Annual Meeting of the Association of
American Medical Colleges, Washington D.C.
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