Evaluation of a research mentorship program in community care

How does mentoring occupational therapists improve intervention fidelity in a randomised controlled trial? A realist evaluation

BACKGROUND

Integrating complex interventions within healthcare settings can be challenging. Mentoring can be embedded within a randomised controlled trial (RCT) to upskill and support those delivering the intervention. This study aimed to understand, from a realist perspective, how mentoring worked to support implementation fidelity for occupational therapists (OTs) delivering a vocational rehabilitation (VR) intervention within the context of an RCT.

METHODS

A realist evaluation using secondary data (emails, mentoring record forms, interviews) collected as part of an RCT. Three researchers coded the data following content analysis, focused on refining or refuting an initial programme theory by exploring the interactions between context, mechanisms, and outcomes. The research team met to further refine the programme theories.

RESULTS

Data from 584 emails, 184 mentoring record forms, and 25 interviews were analysed following a realist approach. We developed a programme theory consisting of two contexts (trial set-up, ongoing mentoring), nine mechanisms (collective understanding, monitoring, timely support, positive reinforcement, reflective practice, support data completeness, facilitation strategy, shared learning experience, management of research and clinical duties), and three outcomes (improved confidence, improved fidelity, reduced contamination).

CONCLUSIONS

Offering mentoring support to OTs delivering a VR intervention as part of an RCT improves intervention fidelity and reduces the risk of contamination. It improves OTs' understanding of the differences between their clinical and research roles and increases their confidence and competence in trial paperwork completion and identification of potential contamination issues.

Laying a Solid Foundation for the Next Generation of Evaluation Capacity Building: Findings from an Integrative Review

Evaluation capacity building (ECB) continues to attract the attention and interest of scholars and practitioners. Over the years, models, frameworks, strategies, and practices related to ECB have been developed and implemented. Although ECB is highly contextual, the evolution of knowledge in this area depends on learning from past efforts in a structured approach. The purpose of the present article is to integrate the ECB literature in evaluation journals. More specifically, the article aims to answer three questions: What types of articles and themes comprise the current literature on ECB? How are current practices of ECB described in the literature? And what is the current status of research on ECB? Informed by the findings of the review, the article concludes with suggestions for future ECB practice and scholarship.

Increasing research capacity in community organizations: Findings from the Community Research Scholars Initiative

Increasing research capacity in community-based organizations (CBOs) can equip the organizations to be more equal partners in academic/community partnerships and can help them be more accountable to their clients and funders. In this study, we report on findings from four years of data collected from the Community Research Scholars Initiative (CRSI) in Cleveland, Ohio. CRSI provided intensive research training over two years to two cohorts (N = 9) of frontline workers ("Scholars") from CBOs focused on health disparities. Scholars completed one year of didactic training and one year of mentoring to complete a research project based at their organization. Findings from surveys, focus groups with Scholars, and supervisor interviews indicated changes in Scholars' knowledge, confidence, and comfort with research concepts and skills. Scholars also demonstrated greater confidence in interacting with academic researchers, enhanced networks and career opportunities, and increased capacity for conducting community-based research. Scholar and organization engagement with community-based research was maintained after the program's end through a community-based research network (CBRN). Findings suggest that the intensive training program for community members with a broad curriculum, mentoring, and strong support helped changed how CBOs think about data and research and demonstrate the impact of their work.

Capacity building and mentorship among pan-Canadian early career researchers in community-based primary health care

AIM

To describe activities and outcomes of a cross-team capacity building strategy that took place over a five-year funding period within the broader context of 12 community-based primary health care (CBPHC) teams.

BACKGROUND

In 2013, the Canadian Institutes of Health Research funded 12 CBPHC Teams (12-Teams) to conduct innovative cross-jurisdictional research to improve the delivery of high-quality CBPHC to Canadians. This signature initiative also aimed to enhance CBPHC research capacity among an interdisciplinary group of trainees, facilitated by a collaboration between a capacity building committee led by senior researchers and a trainee-led working group.

METHODS

After the committee and working group were established, capacity building activities were organized based on needs and interests identified by trainees of the CBPHC Teams. This paper presents a summary of the activities accomplished, as well as the outcomes reported through an online semistructured survey completed by the trainees toward the end of the five-year funding period. This survey was designed to capture the capacity building and mentorship activities that trainees either had experienced or would like to experience in the future. Descriptive and thematic analyses were conducted based on survey responses, and these findings were compared with the existing core competencies in the literature.

FINDINGS

Since 2013, nine webinars and three online workshops were hosted by trainees and senior researchers, respectively. Many of the CBPHC Teams provided exposure for trainees to innovative methods, CBPHC content, and showcased trainee research. A total of 27 trainees from 10 of the 12-Teams responded to the survey (41.5%). Trainees identified key areas of benefit from their involvement in this initiative: skills training, networking opportunities, and academic productivity. Trainees identified gaps in research and professional skill development, indicating areas for further improvement in capacity building programs, particularly for trainees to play a more active role in their education and preparation.

When east meets west: a qualitative study of barriers and facilitators to evidence-based practice in Hunan China

Background

Research into evidence-based practice has been extensively explored in nursing and there is strong recognition that the organizational context influences implementation. A range of barriers has been identified; however, the research has predominantly taken place in Western cultures, and there is little information about factors that influence evidence-based practice in China. The purpose of this study was to explore barriers and facilitators to evidence-based practice in Hunan province, a less developed region in China.

Methods

A descriptive qualitative methodology was employed. Semi-structured interviews were conducted with staff nurses, head nurses and directors (n = 13). Interviews were translated into English and verified for accuracy by two bilingual researchers. Both Chinese and English data were simultaneously analyzed for themes related to factors related to the evidence to be implemented (Innovation), nurses’ attitudes and beliefs (Potential Adopters), and the organizational setting (Practice Environment).

Results

Barriers included lack of available evidence in Chinese, nurses’ lack of understanding of what evidence-based practice means, and fear that patients will be angry about receiving care that is perceived as non-traditional. Nurses believed evidence-based practice was to be used when clinical problems arose, and not as a routine way to practice. Facilitators included leadership support and the pervasiveness of web based social network services such as Baidu (百度) for easy access to information.

Conclusion

While several parallels to previous research were found, our study adds to the knowledge base about factors related to evidence-based practice in different contextual settings. Findings are important for international comparisons to develop strategies for nurses to provide evidence-based care.

Electronic supplementary material

The online version of this article (10.1186/s12912-018-0295-x) contains supplementary material, which is available to authorized users.

Mentoring as a Knowledge Translation Intervention for Implementing Nursing Practice Guidelines: A Qualitative Study

An interpretive descriptive qualitative study was conducted to explore the characteristics and outcomes of mentoring used for implementing nursing practice guidelines. We interviewed six mentees, eight mentors, and four program leaders who were involved in the Registered Nurses' Association of Ontario fellowship program in Ontario, Canada. Inductive content analysis was used and study rigor was verified using triangulation of findings and member checking. Mentors were described as accessible, dedicated, and having expertise; mentees were described as enthusiastic, self-directed, and having mixed levels of expertise. The mentoring process included building relationships, developing learning plans, and using teaching and learning activities guided by learning plans to support development of mentees. Mentoring was described as positively impacting mentoring relationships, mentees, mentors, and organizations. A central feature of this fellowship program was the learning plan used to identify mentees' needs, guide mentoring activities, and monitor measureable outcomes.

The Community Research Scholars Initiative: A Mid-Project Assessment

Community organizations addressing health and human service needs generally have minimal capacity for research and evaluation. As a result, they are often inadequately equipped to independently carry out activities that can be critical for their own success, such as conducting needs assessments, identifying best practices, and evaluating outcomes. Moreover, they are unable to develop equitable partnerships with academic researchers to conduct community-based research. This paper reports on the progress of the Community Research Scholar Initiative (CRSI), a program that aims to enhance community research and evaluation capacity through training of selected employees from Greater Cleveland community organizations. The intensive 2-year CRSI program includes didactic instruction, fieldwork, multiple levels of community and academic engagement, leadership training, and a mentored research project. The first cohort of CRSI Scholars, their community organizations, and other community stakeholders have incorporated program lessons into their practices and operations. The CRSI program evaluation indicates: the importance of careful Scholar selection; the need to engage executive leadership from Scholar organizations; the value of a curriculum integrating classwork, fieldwork, and community engagement; and the need for continual scholar skill and knowledge assessment. These findings and lessons learned guide other efforts to enhance community organization research and evaluation capacity.

Measuring the effectiveness of mentoring as a knowledge translation intervention for implementing empirical evidence: a systematic review

BACKGROUND

Mentoring as a knowledge translation (KT) intervention uses social influence among healthcare professionals to increase use of evidence in clinical practice.

AIM

To determine the effectiveness of mentoring as a KT intervention designed to increase healthcare professionals' use of evidence in clinical practice.

METHODS

A systematic review was conducted using electronic databases (i.e., MEDLINE, CINAHL), grey literature, and hand searching. Eligible studies evaluated mentoring of healthcare professionals responsible for patient care to enhance the uptake of evidence into practice. Mentoring is defined as (a) a mentor more experienced than mentee; (b) individualized support based on mentee's needs; and (c) involved in an interpersonal relationship as indicated by mutual benefit, engagement, and commitment. Two reviewers independently screened citations for eligibility, extracted data, and appraised quality of studies. Data were analyzed descriptively.

RESULTS

Of 10,669 citations from 1988 to 2012, 10 studies were eligible. Mentoring as a KT intervention was evaluated in Canada, USA, and Australia. Exposure to mentoring compared to no mentoring improved some behavioral outcomes (one study). Compared to controls or other multifaceted interventions, multifaceted interventions with mentoring improved practitioners' knowledge (four of five studies), beliefs (four of six studies), and impact on organizational outcomes (three of four studies). There were mixed findings for changes in professionals' behaviors and impact on practitioners' and patients' outcomes: some outcomes improved, while others showed no difference.

LINKING EVIDENCE TO ACTION

Only one study evaluated the effectiveness of mentoring alone as a KT intervention and showed improvement in some behavioral outcomes. The other nine studies that evaluated the effectiveness of mentoring as part of a multifaceted intervention showed mixed findings, making it difficult to determine the added effect of mentoring. Further research is needed to identify effective mentoring as a KT intervention.

Standing on the shoulders of giants: results from the Radiation Oncology Academic Development and Mentorship Assessment Project (ROADMAP)

PURPOSE

To analyze survey information regarding mentorship practices and cross-correlate the results with objective metrics of academic productivity among academic radiation oncologists at US Accreditation Council for Graduate Medical Education (ACGME)-accredited residency training programs.

METHODS AND MATERIALS

An institutional review board-approved survey for the Radiation Oncology Academic Development and Mentorship Assessment Project (ROADMAP) was sent to 1031 radiation oncologists employed at an ACGME-accredited residency training program and administered using an international secure web application designed exclusively to support data capture for research studies. Data collected included demographics, presence of mentorship, and the nature of specific mentoring activities. Productivity metrics, including number of publications, number of citations, h-index, and date of first publication, were collected for each survey respondent from a commercially available online database, and m-index was calculated.

RESULTS

A total of 158 academic radiation oncologists completed the survey, 96 of whom reported having an academic/scientific mentor. Faculty with a mentor had higher numbers of publications, citations, and h- and m-indices. Differences in gender and race/ethnicity were not associated with significant differences in mentorship rates, but those with a mentor were more likely to have a PhD degree and were more likely to have more time protected for research. Bivariate fit regression modeling showed a positive correlation between a mentor's h-index and their mentee's h-index (R2=0.16; P<.001). Linear regression also showed significant correlates of higher h-index, in addition to having a mentor (P=.001), included a longer career duration (P<.001) and fewer patients in treatment (P=.02).

CONCLUSIONS

Mentorship is widely believed to be important to career development and academic productivity. These results emphasize the importance of identifying and striving to overcome potential barriers to effective mentorship.

Nursing student participation in mentoring programs to promote adolescent health: practical issues and future suggestions

The purpose of this study was to explore the practical issues encountered by nursing students who participated in three mentoring programs to promote adolescent health as well as to suggest future mentoring program options for promoting healthy adolescent behavior. The principal investigator and the nursing students recorded practical issues as they arose and prepared memos on these issues offering suggestions for future programs. The written records and memos were reviewed and analyzed using a content analysis process. The content analysis revealed a number of issues and suggestions for future mentoring programs. These issues included the general advantages of mentors, growth in professional capability, progress in professional socialization, and the acquisition of health promotion strategies. Discussion on these issues allows us to assess the potential of nursing students as mentors in a mentoring program to promote adolescent health. Future program development includes program delivery within longer, more regularly structured periods of time while using a multifaceted collaborative approach that can then be evaluated with an appropriate scale to maximize the effects of the program.