Mentorship is critical for career-satisfaction, faculty retention, scholarly productivity, and confidence in professional development skills; yet many academic physicians note a lack of mentorship.¹ Forming effective mentoring relationships can be challenging, especially in a large division of General Internal Medicine comprised of predominantly junior faculty. At the time this initiative was launched, formal mentorship practices for new and junior faculty entailed annual progress meetings with section heads, seminars on mentorship, and meetings with the director of the faculty development program for incoming faculty. Based on conversations with colleagues and division leaders, these measures seemed inadequate for fostering durable mentorship connections. In this article, we describe an innovative project-based mentorship model to bolster mentorship knowledge and increase mentorship connections across our division.

Our idea was to use a book-writing project to connect junior and senior faculty not only as co-authors of a book chapter but also as mentorship dyads. The book, entitled Chalk Talks in Internal Medicine—Scripts for Clinical Teaching², comprises teaching scripts for common clinical scenarios in internal medicine. The book editors started by creating a list of salient inpatient and outpatient clinical teaching topics and invited all faculty in our division to sign up for chapters of interest. We designated authors as junior or senior based on number of years on faculty, then paired junior (mentees, n=48) and senior (mentors, n=46) faculty based on mutual clinical teaching interests. We prioritized connecting co-authors who in our estimation would not have met otherwise given multiple campuses and settings in our large division. Two mentors wished to work with two mentees each and were therefore assigned two chapters.

Participants were given instructions on creating a teaching script on the clinical topic they selected. In addition, all participants were given copies of a one-page Project-Based Mentorship Guide³ which provided guidance for mentor- and mentee-ship.^4,5 Author dyads were encouraged to meet at least once to plan their chapter and use the opportunity to discuss career development as outlined in the guide. We sent e-mail reminders to follow the steps outlined in the guide and highlighted positive comments from participants engaged in mentorship.

The project launched in January 2017 and ended in March 2019 with the submission of the chapters to the publishers. We surveyed participants in October 2020 after publication of the book. We queried prior mentorship experience and impact of the project-based mentorship approach on the writing process, quality of the chapter, and enjoyment of the process. We asked participants to rate the overall benefit of the initiative for themselves and their partner using a 5-point “strongly disagree” to “strongly agree” Likert scale. We also asked whether they had remained engaged with their co-author around either career development, additional joint scholarship, writing letters of support, or networking, and invited other comments about the overall project.

We received 69 responses to the survey: 43/46 (93%) of mentors (MO) and 26/48 (54%) of mentees (ME) responded. Twenty-three dyads had responses from both members. We examined differences in the distributions of responses by group (mentor v. mentee) using chi square tests. For surveys with matched data from both co-authors, we repeated the analyses using only data from matched pairs to assess potential response bias given different response rates between the two groups.

All respondents reported that they had met at the start of the project and 75% of mentors and 94% of mentees reported that career advice was reviewed in the initial meeting. Only 13% of mentees reported any prior structured mentorship relationship.

Mentors and mentees generally agreed that the approach enhanced the writing process (MO=78%, ME=65%), the quality of the chapter (MO=70%, ME=61%) and their enjoyment of the process (MO=83%, ME=70%); results were similar for the 23 matched dyads. Most mentors and mentees reported personally benefiting from the experience. Interestingly, the groups differed with half as many mentees (31%) as mentors (65%) perceiving benefit for their paired colleague (p=0.006). Ten mentees (38%) and 20 mentors (47%) endorsed some form of ongoing engagement after the book project; examples included sharing occasional pleasantries on clinical service to a mentor recruiting their mentee to work in an educational role.

We identified three themes in the written comments:

1. mentorship worked best when the dyad had similar academic interests and clinical practices;
2. the project-based format was an effective faculty development tool to teach mentorship skills; and
3. mentors and mentees described challenges in evenly distributing the writing effort and keeping to deadlines.

Several lessons from this project can inform future efforts to foster mentorship. First, formal integration of mentorship guidance can have a positive and enduring effect on career development as long as 18 months after completion of a project. This approach should be considered as part of any comprehensive strategy of fostering mentorship in an academic group.

Secondly, we learned that assigning mentorship dyads is challenging, even in a project-based model. In this project, the book editors assigned authors to work together based on their understanding of the authors’ content expertise, stated interest in specific chapters, and perception of whether the authors would have otherwise had a chance to work together. Several comments raised the possibility that this approach may have hindered the mentorship aspect of the project extending beyond the authorship work as the authors’ career goals or research interests were not necessarily aligned. The matching process could have been improved by surveying faculty to learn more about their career focus or allowing mentees to select from a pool of potential mentors.

Lastly, effective mentorship while co-authoring a manuscript proved to be a complex process. Greater foundational teaching may be required than a concise one-page project-based mentorship guide. For example, mentees tended to believe that their mentors received fewer benefits from project-based mentorship than they did, suggesting the need to highlight what mentors receive back from mentoring relationships. Greater awareness of the mutual benefits of mentorship might enhance mentees’ comfort with reaching out to mentors to initiate or perpetuate relationships. In addition, comments referencing imbalances in the distribution of work highlighted that not specifically articulating the ground rules of co-authorship can distract from positive mentoring experiences.

Overall, the project was useful for teaching mentorship skills to mentors and in enhancing the writing experience for both mentors and mentees. The use of a structured guide to promote mentorship and career development conversations paired with a clearly defined scholarly product resulted in benefits to both junior and senior faculty.