|Year : 2022 | Volume
| Issue : 1 | Page : 15-19
Cardiovascular research mentorship platforms: Productivity, diversity, inclusion, and equity
Yuki Ka Ling Shum1, Gary Tse2, Tong Liu3, Adrian Baranchuk4, Sharen Lee1
1 Medical Education Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China
2 Medical Education Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong; Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury CT2 7FS, UK
3 Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
4 Division of Cardiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
|Date of Submission||23-Feb-2022|
|Date of Decision||27-Mar-2022|
|Date of Acceptance||07-Apr-2022|
|Date of Web Publication||30-Jun-2022|
Division of Cardiology, Kingston General Hospital, Queen's University, Kingston, Ontario
Medical Education Unit, Cardiovascular Analytics Group, Hong Kong
Source of Support: None, Conflict of Interest: None
Background: There has been increasing awareness on the issue of underrepresentation in academic cardiology. However, to date, most mentorship programs are not designed specifically tailored for future careers in cardiology or cardiovascular medicine. We present our 6-year experience in running two research mentorship platforms, the International Health Informatics Study Network and the Cardiovascular Analytics Group. Objective: To study the underrepresentation in academic cardiology. Methods: Researchers were prospectively recruited into the mentorship programs between September 2015 and September 2021. A combination of online mentorship approaches was employed, including one-to-one mentoring (between faculty and students and between peers), group mentorship, and teaching sessions. Outcomes included the number of publications related to cardiovascular medicine, including those with student members in key authorship positions, and students serving as mentors. Female representation was assessed. Results: A total of 117 researchers from 19 countries were recruited between September 2015 and September 2021, leading to the successful publication of 164 research articles on cardiovascular medicine or epidemiology. Students participated in 80% of the articles (n = 131). At least one student served as the first author in 34% of the articles (n = 56; at least one female student as the first author in 48% of the 56 articles; n = 27), as the senior author in 7.3% of the articles (n = 12), and as a mentor in 15% of the articles (n = 26; at least one female student served as a mentor in 42% of the 26 articles; n = 11). Female researchers occupied one of the four key authorship positions in 43% of the articles (n = 70; 47 female first authors; 10 female co-first authors; 6 female co-corresponding authors; and 17 female last authors). There was a 12% increase in the percentage of females in key authorship positions between the periods 2016–2018 and 2019–2021, from 47% (n = 33) and 53% (n = 37) of the 70 publications having at least one female in key authorship positions, respectively. Conclusions: Online-based mentorship programs can promote the development of independent research and leadership skills in students, with a positive impact on diversity, gender equity, inclusion, and productivity in cardiovascular research.
Keywords: Diversity, equity, gender, mentorship, virtual
|How to cite this article:|
Ling Shum YK, Tse G, Liu T, Baranchuk A, Lee S. Cardiovascular research mentorship platforms: Productivity, diversity, inclusion, and equity. Ann Clin Cardiol 2022;4:15-9
|How to cite this URL:|
Ling Shum YK, Tse G, Liu T, Baranchuk A, Lee S. Cardiovascular research mentorship platforms: Productivity, diversity, inclusion, and equity. Ann Clin Cardiol [serial online] 2022 [cited 2022 Sep 30];4:15-9. Available from: http://www.onlineacc.org/text.asp?2022/4/1/15/349338
| Introduction|| |
Over the past years, there has been increasing awareness on underrepresentation in academic cardiology, with different groups facing barriers to entering research, promotions, and representation in leadership roles. For example, female talents in academic cardiology are significantly underrepresented. In addition, while women have a slightly higher frequency of attaining first authorships, it has been reported that women are 50% less likely to hold a senior authorship position for cardiovascular research. The drop in female representation in senior ranks of academic cardiology may be contributed by a lack of female talent engagement, particularly during their early career advancement, in high-impact journals and leadership roles. The development of membership programs represents an option to provide support and guidance for successful careers, with positive effects on capacity building for mentees. Of the different types of programs, remote mentorship has previously been shown to be effective and can improve access in underrepresented groups and reduce gender inequalities. However, to date, these programs are not specific designed for mentorship in cardiovascular medicine.
In light of these findings, we present an accessible distributed research team model to help raise the female representation and tackle the challenges faced by female academics in the field of cardiovascular medicine. We present our 6-year experience in running two closely connected research mentorship platforms, the International Health Informatics Study (IHIS) Network and the Cardiovascular Analytics Group (CVAG), for meta-analysis and original studies, respectively.
| Methods|| |
Description of mentorship platforms and recruitment
The IHIS network was established for systematic reviews and meta-analyses and CVAG provided supervision for original studies, reviews, case reports, and other article types. Capacity building was achieved using blended learning, one-to-one, and small group mentoring. Research skills training was provided by standardized teaching in large group sessions on project management for original studies (including study design, database handling, propensity score methods, regression analysis, calculation of accuracy metrics, and study write-up), systematic reviews and meta-analysis (introductions to different databases, creation and optimization of search terms, heterogeneity, different effect estimates, and methods of pooling, meta-regression and trial sequential analysis), and complemented by the availability of offline learning materials. Twenty-four-h advice can be sought from the large group messaging platform. Both mentees and mentors are encouraged to use any communication platform preferred, including electronic mails and messaging apps.
Recruitment of participants and outcomes
All participants provided informed consent in joining our mentorship programs. Aspiring researchers were recruited into either mentorship program, or both, between September 2015 and September 2021. They were matched with more experienced colleagues who provided mentorship regarding different aspects of the research project management. Smaller groups were created based on research themes. Outcomes included the number of publications, including those with student members in key authorship positions, those with students serving as mentors, and those where female members have occupied key authorship positions. They are presented as count (percentage).
| Results|| |
Over a 6-year period between September 2015 and September 2021, a total of 117 researchers from 19 countries joined the mentorship programs. Of these, 91 (78%) were from medicine, 15 (13%) from biological or biomedical sciences, 7 (8%) from pharmacy, 2 from data science or computing backgrounds (2%), and 1 (1%) was from social sciences. A total of 164 research articles were published between January 1, 2016, and October 1, 2021.
Students participated in 80% of the articles (n = 131; 1 student author in 34 articles; 2 student authors in 26 articles; 3 student authors in 41 articles; 4 student authors in 18 articles; and >5 student authors in 12 articles). There was at least one student as the first author in 34% of the articles (n = 56; at least one female student as first author in 48% of the 56 articles; n = 27) and at least one student as senior author in 7.3% of the articles (n = 12). Moreover, at least one student served as a mentor in 15% of the articles (n = 26; at least one female student served as a mentor in 42% of the 26 articles; n = 11). There is at least one female in one of the four key authorship positions in 43% of the articles (n = 70; 47 female first authors; 10 female co-first authors; 6 female co-corresponding authors; and 17 female last authors). There was a 12% increase in the percentage of females in key authorship positions between the periods 2016–2018 and 2019–2021, from 47% (n = 33) and 53% (n = 37) of the 70 publications having at least one female in key authorship positions, respectively.
| Discussion|| |
The IHIS network was created by a senior faculty member (AB) and junior faculty member (GT) at the time of conception, specifically designed to facilitate the conducting of systematic reviews and meta-analyses in 2017. By contrast, the CVAG started as a local research group in 2015 for conducting original research in Hong Kong, China, which has promptly expanded to include mentors and mentees globally. The main findings of this study are that over a 6-year period, of all publications produced from the mentorship programs, 80% had student representation, 34% of first authors were students, and 43% had female members occupying a key authorship position.
Underrepresentation in academic medicine has been an ongoing issue in various specialties, with a negative impact on gender,, ethnicity,, and those from low-income countries. A range of successful mentorship programs has hitherto been described, many of which have a positive effect on gender equity. The evaluation of mentorship programs can be achieved using different outcome measures, including satisfaction levels of mentees and mentors, vitality and active participation levels, program growth, knowledge and skills acquired, productivity, and recognition. The success of mentorship programs was evaluated by assessing the satisfaction and experience of mentees and mentors alike through the analysis of survey data and thematic analysis of interviews, as well as quantifying productivity.,,
There are two strategies that our research platforms have adopted: accessible and distributive [Figure 1]. To allow accessibility, an effective collaboration is essential, where female mentees can openly take counsel from senior members and principal investigators. Open communication is also encouraged by accepting feedback and concerns from mentees through various platforms, such as e-mails, real-time messaging apps, or monthly video conferences. In the monthly video conference, members of our group are empowered to propose research ideas publicly, after which all members are able to discuss the feasibility, design, and execution of proposed ideas. A supportive learning environment is created; accessible research guidance and inspiration are empowered under the decentralized management. Thereby, female mentees' interest in cardiovascular academic medicine is raised, and institutional barriers are broken down for early-career female talents who lack prior experience in mentorship. Students are accredited to lead projects of their choice and be involved in all phases from study idea inspiration, formulating proper research questions, systematic search and appraisal of literature, data collection and analysis and to manuscript writing and submission. The early development of complimentary independent research skills equips students to become principal investigators and mentors in the future.
|Figure 1: Distributed global network of junior and senior investigators (top panel). Accessibility is enhanced by interactions between group members and principal investigators (bottom panel). This system allows gender equity to be achieved by breaking down institutional barriers and provides support and opportunities for students with no prior experience to enter biomedical research. Copyright Cardiovascular Analytics Group 2021. Reproduced with permission|
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The decentralized research approach demonstrates the distributive element of our research platforms meaning that individual female talents at individual aspects of the project, such as protocol development, data collection and review, statistical analysis, and drafting as well as the finalization of manuscripts. Implementing the distributive strategies to projects increases the flexibility and adaptability of individual involvement, which allows student talent to rapidly gain new skills and engage in mentorship. Furthermore, it increases the efficiency and productivity of the research group and hence promotes early career development and advancement into leadership roles. Moreover, the mentorship platforms have fostered an environment to promote gender equity. This is evidenced by female colleagues represented in 43% of all publications on key authorship positions.
Our mentorship programs focus predominantly on peer-to-peer (horizontal) mentoring. The combination of both vertical and horizontal mentorship has previously been shown to produce positive results on deliverables in other settings. In our programs, group mentoring involves different group sizes (from one to one to the whole group). Previous studies have found that large group mentoring is an efficient and productive training model, allowing strong outputs with relatively few mentors. A key component of this strategy is the bidirectional concept: the mentee will learn from the mentor and vice versa.
The positive impact of the mentorship programs is evidenced by the achievements of a female undergraduate student (Sharen Lee [SL]), who completed high school in 2017. She was new to academic research without prior training when she joined the team in October 2018 as a 3rd-year undergraduate student and is currently in her final year of the undergraduate medical program in China. She has since published more than 50 publications, most of which have been published in Science Citation Index (SCI)-indexed journals in quartiles 1 and 2 in the respective fields, as well as two chapters in academic texts. Moreover, she has over five published articles as a corresponding or co-corresponding author and has been leading junior mentees as a senior author of upcoming manuscripts from the team. She is also an active member of the International Society of Electrocardiology Young Community, where she is involved in leading international, multi-center studies on the effects of coronavirus disease 2019 on the cardiovascular system., Furthermore, she has led several projects on congenital ion channelopathies,,,,,, cardiovascular effects of anti-diabetic drugs,,, and cardiovascular outcomes in diabetes mellitus,,,, and cancer. Interestingly, the mentor (GT) is of a different gender, suggesting that same-gender mentorship is not a prerequisite for success. Indeed, successful mentorship of women can be achieved when all of the attributes are present, including accessibility, active listening, be affirmative, and a catalyst for excellence. However, we nevertheless acknowledge that the presence of a successful role model can project a positive image to aspiring trainees. Indeed, we strongly believe that “Great mentors inspire others to become mentors.” Mentorship can promote intergenerational learning where knowledge is passed down from one generation of researchers to the next. Our focus on experiential learning through active participation has supported the next generation of researchers, with elements of interprofessional learning, mixed-learning approaches supported by a range of mentorship modalities.
Our experience is not free from different types of bias. Language barriers have not been acknowledged; inherited cultural bias can be a limitation to proper communications; one-in-one encounters were not recorded systematically or supervised by the coordinators of the different programs.
| Conclusions|| |
Online-based mentorship programs can promote the development of independent research and leadership skills. This is evidenced by the number of students represented in subsequent publications and increasing numbers as first authors on publications related to cardiovascular medicine. They have also produced a positive impact on female representation. The taking up of leadership roles is encouraged, allowing undergraduate students to supervise projects successfully, who subsequently served as senior authors in the publications.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Balasubramanian S, Saberi S, Yu S, Duvernoy CS, Day SM, Agarwal PP. Women representation among cardiology journal editorial boards. Circulation 2020;141:603-5.
Burgess S, Shaw E, Zaman S. Women in cardiology. Circulation 2019;139:1001-2.
Ransdell LB, Lane TS, Schwartz AL, Wayment HA, Baldwin JA. Mentoring new and early-stage investigators and underrepresented minority faculty for research success in health-related fields: An integrative literature review (2010-2020). Int J Environ Res Public Health 2021;18:432.
Burgos LM, Farina J, Sauce Perez AL, Ortiz Lopez HI, Gupta SD, Baranchuk A, et al.
Gender equity imbalance in cardiology scientific sessions in the Americas. Curr Probl Cardiol 2021;46:100785.
Lerchenmüller C, Lerchenmueller MJ, Sorenson O. Long-term analysis of sex differences in prestigious authorships in cardiovascular research supported by the national institutes of health. Circulation 2018;137:880-2.
Vasylyeva TL, Díaz-González de Ferris ME, Hains DS, Ho J, Harshman LA, Reidy KJ, et al.
Developing a research mentorship program: The American Society of Pediatric Nephrology's experience. Front Pediatr 2019;7:155.
Wong RK, Vanderpuye V, Yarne J, Ndlovu N, Lasebikan N, Szumacher E, et al.
Clinical research mentorship programme (CRMP) for radiation oncology residents in Africa-building capacity through mentoring. Ecancermedicalscience 2021;15:1210.
Vulpe H, Vanderpuyne V, Yarney J, Tosoni S, Ringash J, Kassam Z, et al.
Design and implementation of a distant-learning clinical research mentorship program: The Accra-Toronto Collaboration. JCO Glob Oncol 2020;6:919-28.
Bonifacino E, Ufomata EO, Farkas AH, Turner R, Corbelli JA. Mentorship of underrepresented physicians and trainees in academic medicine: A systematic review. J Gen Intern Med 2021;36:1023-34.
Seldon C, Wong W, Jagsi R, Croke J, Lee A, Puckett L. Remote mentorship in radiation oncology: Lessons to share. Adv Radiat Oncol 2021;6:100686.
Tse G, Liu T, Roever L, Lee S. The women's leadership gap in diabetes: A call for equity and excellence. Diabetes 2021;70:1623-1633. Diabetes 2022;71:e1-2.
Clarke Whalen E, Xu G, Cygankiewicz I, Bacharova L, Zareba W, Steinberg JS, et al.
Gender equity imbalance in electrocardiology: A call to action. J Electrocardiol 2017;50:540-2.
D'Armiento J, Witte SS, Dutt K, Wall M, McAllister G; Columbia University Senate Commission on the Status of Women. Achieving women's equity in academic medicine: Challenging the standards. Lancet 2019;393:e15-6.
Yeung C, Baranchuk A. Gender equity trends in academic productivity and influence by subspecialties of cardiology. J Am Coll Cardiol 2018;72:3228-9.
Choi AM, Rustgi AK. Diversity in leadership at academic medical centers: Addressing underrepresentation among Asian American faculty. JAMA 2021;326:605-6.
Nivet MA. Minorities in academic medicine: Review of the literature. J Vasc Surg 2010;51:53S-8S.
Sumathipala A, Siribaddana S, Patel V. Under-representation of developing countries in the research literature: Ethical issues arising from a survey of five leading medical journals. BMC Med Ethics 2004;5:E5.
Farkas AH, Bonifacino E, Turner R, Tilstra SA, Corbelli JA. Mentorship of women in academic medicine: A systematic review. J Gen Intern Med 2019;34:1322-9.
Gusic ME, Zenni EA, Ludwig S, First LR. Strategies to design an effective mentoring program. J Pediatr 2010;156:173-4.e1.
McGuire CM, Riffenburg K, Malope S, Jack B, Borba CP. Mixed-methods evaluation of family medicine research training and peer mentorship in Lesotho. Afr J Prim Health Care Fam Med 2020;12:e1-17.
Nocco MA, McGill BM, MacKenzie CM, Tonietto RK, Dudney J, Bletz MC, et al.
Mentorship, equity, and research productivity: Lessons from a pandemic. Biol Conserv 2021;255:108966.
Cohen JG, Sherman AE, Kiet TK, Kapp DS, Osann K, Chen LM, et al.
Characteristics of success in mentoring and research productivity – A case-control study of academic centers. Gynecol Oncol 2012;125:8-13.
Muschallik J, Pull K. Mentoring in higher education: Does it enhance mentees' research productivity? Educ Econ 2016;24:210-23.
Balandya E, Sunguya B, Gunda DW, Kidenya B, Nyamhanga T, Minja IK, et al.
Building sustainable research capacity at higher learning institutions in Tanzania through mentoring of the Young Research Peers. BMC Med Educ 2021;21:166.
Manabe YC, Nambooze H, Okello ES, Kamya MR, Katabira ET, Ssinabulya I, et al.
Group mentorship model to enhance the efficiency and productivity of PhD research training in Sub-Saharan Africa. Ann Glob Health 2018;84:170-5.
Chung CT, Bazoukis G, Radford D, Coakley-Youngs E, Rajan R, Matusik PT, et al.
Predictive risk models for forecasting arrhythmic outcomes in Brugada syndrome: A focused review. J Electrocardiol 2022;72:28-34.
Haseeb S, Gul EE, Çinier G, Bazoukis G, Alvarez-Garcia J, Garcia-Zamora S, et al.
Value of electrocardiography in coronavirus disease 2019 (COVID-19). J Electrocardiol 2020;62:39-45.
Garcia-Zamora S, Lee S, Haseeb S, Bazoukis G, Tse G, Alvarez-Garcia J, et al.
Arrhythmias and electrocardiographic findings in Coronavirus disease 2019: A systematic review and meta-analysis. Pacing Clin Electrophysiol 2021;44:1062-74.
Lee S, Li KH, Zhou J, Leung KS, Lai RW, Li G, et al.
Outcomes in Brugada syndrome patients with implantable cardioverter-defibrillators: Insights from the SGLT2 registry. Front Physiol 2020;11:204.
Lee S, Wong WT, Wong IC, Mak C, Mok NS, Liu T, et al.
Ventricular tachyarrhythmia risk in paediatric/young vs. adult Brugada syndrome patients: A territory-wide study. Front Cardiovasc Med 2021;8:671666.
Lee S, Zhou J, Jeevaratnam K, Wong WT, Wong IC, Mak C, et al.
Paediatric/young versus adult patients with long QT syndrome. Open Heart 2021;8:e001671.
Lee S, Zhou J, Li KH, Leung KS, Lakhani I, Liu T, et al.
Territory-wide cohort study of Brugada syndrome in Hong Kong: Predictors of long-term outcomes using random survival forests and non-negative matrix factorisation. Open Heart 2021;8:e001505.
Lee S, Zhou J, Liu T, Letsas KP, Hothi SS, Vassiliou VS, et al.
Temporal variability in electrocardiographic indices in subjects with Brugada patterns. Front Physiol 2020;11:953.
Lee S, Zhou J, Jeevaratnam K, Wong WT, Wong IC, Mak C, et al.
Paediatric/young versus adult patients with congenital long QT syndrome or catecholaminergic polymorphic ventricular tachycardia. Eur Heart J 2021;42 Suppl 1:ehab724.1870.
Lee S, Zhou J, Leung KS, Wai AK, Jeevaratnam K, King E, et al.
Comparison of sodium-glucose cotransporter-2 inhibitor and dipeptidyl peptidase-4 inhibitor on the risks of new-onset atrial fibrillation, stroke and mortality in diabetic patients: A propensity score-matched study in Hong Kong. Cardiovasc Drugs Ther 2022;[doi: 10.1007/s10557-022-07319-x].
Zhou J, Lee S, Leung KS, Wai AK, Liu T, Liu Y, et al.
Incident heart failure and myocardial infarction in sodium-glucose cotransporter-2 vs. dipeptidyl peptidase-4 inhibitor users. ESC Heart Fail 2022;9:1388-99.
Mui JV, Zhou J, Lee S, Leung KS, Lee TT, Chou OH, et al.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors vs. dipeptidyl peptidase-4 (DPP4) inhibitors for new-onset dementia: A propensity score-matched population-based study with competing risk analysis. Front Cardiovasc Med 2021;8:747620.
Lee S, Jeevaratnam K, Liu T, Chang D, Chang C, Wong WT, et al.
Risk stratification of cardiac arrhythmias and sudden cardiac death in type 2 diabetes mellitus patients receiving insulin therapy: A population-based cohort study. Clin Cardiol 2021;44:1602-12.
Lee S, Zhou J, Guo CL, Wong WT, Liu T, Wong IC, et al.
Predictive scores for identifying patients with type 2 diabetes mellitus at risk of acute myocardial infarction and sudden cardiac death. Endocrinol Diabetes Metab 2021;4:e00240.
Lee S, Zhou J, Leung KS, Wu WK, Wong WT, Liu T, et al.
Development of a predictive risk model for all-cause mortality in patients with diabetes in Hong Kong. BMJ Open Diabetes Res Care 2021;9:e001950.
Lee S, Zhou J, Wong WT, Liu T, Wu WK, Wong IC, et al.
Glycemic and lipid variability for predicting complications and mortality in diabetes mellitus using machine learning. BMC Endocr Disord 2021;21:94.
Lee S, Liu T, Zhou J, Zhang Q, Wong WT, Tse G. Predictions of diabetes complications and mortality using hba1c variability: A 10-year observational cohort study. Acta Diabetol 2021;58:171-80.
Zhou J, Lee S, Lakhani I, Yang L, Liu T, Zhang Y, et al.
Adverse Cardiovascular Complications following prescription of programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors: A propensity-score matched Cohort Study with competing risk analysis. Cardiooncology 2022;8:5.
Vasquez R, Pandya AG. Successful mentoring of women. Int J Womens Dermatol 2020;6:61-2.
Levinson W, Kaufman K, Clark B, Tolle SW. Mentors and role models for women in academic medicine. West J Med 1991;154:423-6.
Cole DC, Johnson N, Mejia R, McCullough H, Turcotte-Tremblay AM, Barnoya J, et al.
Mentoring health researchers globally: Diverse experiences, programmes, challenges and responses. Glob Public Health 2016;11:1093-108.
Rodríguez DC, Jessani NS, Zunt J, Ardila-Gómez S, Muwanguzi PA, Atanga SN, et al.
Experiential learning and mentorship in global health leadership programs: Capturing lessons from across the globe. Ann Glob Health 2021;87:61.