Mentoring Research

 

A critical part of faculty success in academic medicine is publishing impactful research. In my experience, the way most faculty perform research is by supervising trainees who are responsible for collecting most of the experimental data, doing a preliminary analysis, and writing a rough draft of the manuscript.

Faculty who can demonstrate the leadership to reliably get their trainees to be productive with these tasks tend to have stronger research productivity, and this is one of the foundations of their career success. Of course, productive trainees also tend to go on to have happy, successful careers. Mentoring trainees can also be a highly enjoyable part of academic medicine for a faculty member. Watching them develop meaningful and impactful long-term careers, in part because of the skills they learned from you, is very satisfying.

For this Viewpoint, I’m focusing on how faculty can productively mentoring medical student, resident, and clinical fellow trainees. Simply put, productive mentoring of a trainee on a research project means 1) helping the trainee achieve their goals and 2) getting them to complete a research project that you want done.

Understanding Trainee Motivations

Although occasionally a trainee will design their own research project, more commonly the faculty mentoring should be the person conceptualizing the project. The faculty member understands the field better and can design a more impactful study. Thus, a key role of the faculty member is to assign the trainee a project that the trainee is interested in, and that will help them move toward achieving their career goals.

To do this, the mentor must understand the skillset, background, time commitment, and interests of the trainee. For many trainees, research isn’t something that they plan on doing in the future. They may even consider research as being one more hurdle that they need to overcome so that they can then move toward their real long-term goals, such as getting into a good residency or clinical fellowship. The faculty mentor should think from the trainee’s perspective and select a project accordingly.

Preventing Trainee Burnout

Trainees are always excited at the start of a new research project, but at some point in the middle of the project, their enthusiasm wanes. They might have other commitments come up, or perhaps they have found that collecting the data isn’t as easy as anticipated. Moving past these points where progress has stalled is critical.

Mostly, it depends upon the grit of the trainee and their determination to work through difficulties. However, the principal investigator can provide important support. As part of this support and to help inspire trainees to continue to work on their projects as they experience the inevitable multitude of problems, I often explain my concept of how all research can be broken down into three phases. Each phase needs to be completed in sequence to result in a publication.

Mentoring trainees can also be a highly enjoyable part of academic medicine for a faculty member. Watching them develop meaningful and impactful long-term careers, in part because of the skills they learned from you, is very satisfying.—John S. Oghalai, MD

Phase 1. Developing a new experimental setup or materials. You have developed a hypothesis that you want to test. Because it’s research, it has never been done before. To do it, you need to create a new experiment. For a basic science lab, this might mean designing and building a new experimental rig that lets you measure something that could not previously be measured. For clinical research, this might mean developing a new survey that lets you assess outcomes in a new way.

No matter what it is, you’ll spend a lot of time thinking about how to create this new experiment so that it lets you answer the question under study. You will then develop the experimental methodology, and then you will need to test and validate it.

Every step of the way, there are risks. The new methodology might not work. It may be expensive to create. Thus, the concern is always that you’re potentially wasting a lot of time doing something that may never lead to a publication. However, if it works as you expect, you’ll be able to study something in a way that nobody else has ever been able to do. Thus, phase 1 is the key to producing impactful research of high significance. It’s fun because it requires creativity and innovation.

Medical students shouldn’t typically be assigned a research project that’s still in phase 1. They’ll be unlikely to finish it within their allotted time with you. Residents and fellows might have enough ability and time, but probably not. In my experience, it’s usually up to the faculty member to create the new experimental methodology, often by collaborating with other faculty who have different, but synergistic, expertise.

Phase 2. Preliminary hypothesis testing. You’ve finished creating your unique experimental method and now you need to collect some data to see if your hypothesis is correct or not. This phase of research is what most people commonly think research is. Sometimes, your hypothesis is completely wrong, and you need to decide if it’s worth continuing along this line of research at all. More commonly, your hypothesis is partially correct, and so more data will need to be collected to understand the mechanism behind the effect you found.

This phase of research is fun because there are always new data coming in that can be discussed and interpreted. All trainees do very well on research projects that are in phase 2. Yes, there’s a moderate risk that the hypothesis is wrong, but this is what research is all about. Frankly, even if the hypothesis is wrong, data collected using a unique experimental method are likely to identify something novel that could be developed into a paper.

Phase 3. Developing statistical rigor. You’re pretty sure you know the answer to your research question at this point. Now, you just need to collect enough data to write a paper. This means you need adequate power for your study to have the statistical rigor to prove or disprove your hypothesis. For basic science, this means repeating the experiment many times for every condition. For clinical research, this means enrolling enough subjects so that you have enough data to support your conclusions with the appropriate power.

Many people find this phase of research boring, and it can be quite repetitive. This work is nearly guaranteed to lead to a publication, however, so that can make it fun. The key to this phase is to come in early, do many experiments all day long, and leave late in the evening. Medical students and residents love phase 3 research projects because they have limited time, and they want things to work immediately. These are often projects that another trainee started but never finished.

This explanation of how a research project naturally progresses through the three phases is helpful in many ways. Trainees need to know which phase they’re in currently and what it will take to get to the next phase. The scariest part of research for many trainees is thinking they’re on the wrong path because they were put on a bad project. Trainees also want to impress their faculty mentors, and they’re worried about their long-term future if their experiments aren’t working. Recognizing that everybody who does research must struggle through similar difficulties as they move through the three phases is helpful.

Showing Empathy

A faculty mentor must always remember that every trainee deserves our empathy. Accomplishing anything meaningful in research is hard and stressful. Demonstrating enthusiasm and confidence that the project is moving forward appropriately, despite the challenges, goes a long way toward helping the trainee feel good that they will ultimately achieve both their goals and ours. This role modeling can stimulate trainees to finish their projects. Furthermore, a good experience on a research project can often get trainees to reevaluate their long-term career plans, and perhaps even stimulate them to change subspecialties or decide to enter academic medicine. Research mentoring of medical students, residents, and clinical fellows is a privilege for the faculty member because it has the power to alter the course of a trainee’s career.   

Dr. Oghalai is chair of the Caruso Department of Otolaryngology–Head and Neck Surgery and a professor of otolaryngology–head and neck surgery at the Keck School of Medicine and a professor of biomedical engineering at the Viterbi School of Engineering, both at the University of Southern California in Los Angeles.