Gender Differences in Self-reported Faculty Developmental Networks.

Scholars have long recognized gender variation in social relationship dynamics. However, how gender shapes developmental networking relationships for career advancement, particularly among university faculty members, is understudied. This area of research is important since women comprise an increasing proportion of faculty and yet report receiving less mentoring and lower career satisfaction, productivity, and advancement than their male counterparts. This cross-sectional study assessed gender differences in self-reported dimensions of faculty participants' developmental networks by collecting information on relationships with developers, who are people who have taken concerted action and offered professional and personal guidance to help participants advance in their careers over the past year. The investigators used egocentric network data from an electronically administered Mentoring Network Questionnaire collected from 159 faculty involved in a mentoring intervention during the pandemic. Faculty were from multiple Southwest and Mountain West institutions. Statistical analyses were performed using the Chi-squared test, Wilcoxon rank-sum test, and unadjusted multilevel regression. Female faculty chose developers of lower gender diversity than male faculty (p=0.01). Compared to male faculty, female faculty reported receiving more psychosocial support from individual developers (p=0.03). Female faculty members' developers were more often characterized as friends and less often described as sponsors and allies than male faculty, based on relative levels of career and psychosocial support that individual developers provided (p<0.001). No gender differences were found in other network characteristics. Female faculty build developmental networks that have different factors compared to male faculty. Greater levels of psychosocial support and fewer allies and sponsors for female faculty may have long-term implications for differential career advancement for women vs. men in academic careers. Strategies to enhance networking should address gender differences and include a structured framework for assessing network gaps.

Inter-Rater Reliability of the Mentor Behavioral Interaction Rubric.

An objective assessment of a mentor's behavioral skills is needed to assess the effectiveness of mentor training interventions in academic settings. The Mentor Behavioral Interaction (MBI) Rubric is a newly developed, content-valid, observational measure of a mentor's behavioral skill during single-episode interactions with a mentee. The purpose of this study was to assess the inter-rater reliability (IRR) of the MBI Rubric when used to assess video-recorded mentor-mentee interactions. Three of a pool of four faculty raters with expertise in mentor training synchronously rated 26 videos of mentor-mentee interactions using structured guidelines. The MBI Rubric includes six items (Part 1), each with ratings on a 3- or 4-point scale, and ten yes/no items (Part 2) that characterize the content of the interaction. After initial individual ratings were completed, the three raters met, reviewed disagreements, and reached decisions about final item scores by either consensus or majority vote. Mean total Part 1 scores ranged between 1.42-2.69. IRRs ranged from good (Part 1 IRR=0.67) to excellent (Part 2 IRR=0.83). No training effects were observed, with no decrease (i.e., showing less variability) in inter-rater standard deviations over time. Rater effects in initial individual scoring were observed, with a significant difference between one vs. the other three raters on Part 1 individual scores, with no effects for Part 2 scores. Raters tended to score lower on initial individual scores than the final score for both Part 1 and 2. The MBI Rubric is the first observational measure to assess single episodes of video-recorded mentor-mentee interactions and has demonstrated content validity, and now inter-rater reliability. It may be used in parallel with other instruments to measure the efficacy of mentor training. Limitations include possible ceiling effects, and resource-intensive administration in terms of rater expertise and time. Future work will assess the responsiveness of the Rubric to change in mentor skill and construct validity.

Mentoring Network Questionnaire Support Scales Reliable and Valid with University Faculty.

The Developmental Network Questionnaire (DNQ) is used in business to self-assess relationships with developers, or people who support one's career. The Mentoring Network Questionnaire (MNQ) is an online modification of the DNQ and includes two scales that rate developer's contributions to career or psychosocial help. The psychometrics of these scales for different populations are unreported. This study analyzed the construct validity and reliability of the two scales measuring support provided by developers of university faculty. Mentors and mentees (G=156) from multiple Southwestern and Mountain West universities rated 741 developers on the MNQ's five-item career- and psychosocial-support scales. Participants responded on a seven-point scale ranging from "never, not at all" to "to the maximum extent possible." Multilevel confirmatory factor analysis (MCFA) using Mplus and the multi-level reliability coefficient omega assessed construct validity and internal consistency reliability, respectively. Results supported the validity of two latent constructs of career- and psychosocial support, each measured by the established five-item scale: Comparative fit index (CFI)=.93, Tucker-Lewis Index (TLI)=.91, root mean square error of approximation (RMSEA)=.06, standardized root mean square residual (SRMR): W=.09, B=.10. The measurement model was improved when the "removes barriers" item was removed from the career-support scale (CFI=.96, TLI=.95, RMSEA=.05, SRMR: W=.06 B=.09. Factor loadings at both the within- and between-levels were strong and statistically significant. Reliability omegas ranged from .85 to .92. Career and psychosocial support provided to university faculty by developers in their networks may be validly and reliably measured at both the within- and between-levels by a modified four-item career support scale and the original five-item psychosocial support scale from the DNQ and the modified MNQ. Limitations include reduced statistical power due to small sample size and lack of testing at the university level. Future work will assess the responsiveness of these scales to measuring change over time in the amount of support provided.

Curriculum-based Faculty Training in Networking: Knowledge and Self-efficacy Outcomes.

Although the advantages of developmental networks are well-known, most faculty do not know how to participate in such networks actively. Additionally, institutions face challenges in teaching faculty the best practices of networking. This deficiency constitutes a critical gap in the literature, which may slow career advancement for faculty, particularly from underrepresented groups. The study's purpose was to examine the effectiveness of a curriculum-based faculty training in developmental networks, utilizing the Extension for Community Health Outcomes (ECHO) platform. In this pre-post study, 33 faculty members participated in the intervention utilizing eight modules involving four competencies. Each module followed a standard format, including a short didactic, two facilitated case study discussions based on real-life scenarios, and self-reading of selected literature. Outcomes included (i) change in knowledge scores obtained from two questions per module and (ii) self-efficacy scores measured on a scale of 0-100. Paired student's t-test and mixed model regression analyses were used. A significant increase in knowledge score was documented using mixed model regression for 4 of the eight modules (mean change score 0.4-0.8, p≤0.03 for all analyses). The proportion of faculty participants reporting correct knowledge items for all modules increased from 49.8% (pre) to 64.3% (post), which was statistically significant (p<0.001). Significant increases in paired self-efficacy scores were reported for each of the eight modules (mean change score 17-37, p<0.05 for all analyses). This study highlights the importance of curriculum-based training in networking. Participants showed a significant increase in pre-post networking self-efficacy and knowledge scores. Our ECHO-based curriculum, facilitator training, and manual enable easy implementation in other institutions, ensuring scalability and adaptability. Our analysis provides the evidence basis for examining the impact of a developmental network intervention in enhancing individual career networks.

Faculty Retention at a School of Medicine, 2010-2022.

Faculty retention at academic health centers is a concern with about one-fifth of physicians reporting intentions to leave. We studied factors affecting faculty at risk for attrition, defined as women, racial/ethnic underrepresented minorities (URM), and clinical faculty. Identification of factors predicting retention of at-risk faculty may help mentors and minority-serving institutions devise novel targeted retention strategies. Our study site was a minority-serving institution in a majority-minority state in the US Southwest where at-risk faculty constitute the majority group. Faculty characteristics and departure dates were extracted from an institutional database maintained by the University of New Mexico (UNM) School of Medicine (SOM) for 2,427 participants employed from July 2009 through June 2022. Annual attrition rates and relative risk (RR) of attrition were estimated by discrete-time hazard rate models assuming a Poisson distribution. The overall annual attrition rate was 11.5%, which projects to 50% attrition in 6.0 years. Time to 50% attrition was 4.6 years for assistant professors, 8.9 years for associate professors 7.2 years for full professors. Faculty with a PhD degree had lower attrition (7.2%, RR=0.69, 95% CI 0.60, 0.79) compared to faculty with an MD degree (10.5%) in adjusted analyses. Clinician educators had a higher attrition rate (8.9%) compared to tenure track (6.4%, RRtenure track=0.72, 95% CI 0.61, 0.85). Black faculty had a higher risk of attrition compared to White faculty (RR=1.56, 95% CI 1.09, 2.25), and non-Hispanic White faculty had a lower risk of attrition (RR=0.83, 95% CI 0.71, 0.98). Annual attrition rates increased over the study period with most of the increase before about 2016. We did not detect significant differences in attrition due to sex or URM status.

Why Faculty Leaders Leave a School of Medicine?

Faculty attrition at academic health centers (AHCs) is significant at about 11% nationally, with one in five physicians intending to leave, and replacement costs averaging $500,000 per physician. Attrition among AHC faculty leaders is inadequately studied. This study compares reasons to leave between exiting faculty leaders and faculty non-leaders at the University of New Mexico School of Medicine (UNM SOM). The SOM deans interview all exiting faculty using a structured exit survey. 329 faculty non-leaders and 58 faculty leaders left UNM SOM between July 2017 and June 2022. Distributions of each variable were analyzed for statistically significant differences between the two groups using Fisher's 2-sided exact test. Text comments by leaders were analyzed qualitatively for content using a team-based, iterative process. As compared to non-leaders, exiting faculty leaders were more likely to be professors (51.7% vs 16.7%, p<0.001), and hold tenure (32.8% vs. 12.2%, p=0.001). Faculty leaders were more likely than non-leaders to cite high-level leadership as a reason to leave (41.4% vs. 24.3% p=0.01) and better leadership as a critical issue in development and retention (51.7% vs. 36.8% p=0.04). Qualitative analyses of textual leader comments showed a similar distribution of themes as the quantitative variables when examining open text related to the survey questions related to reasons to leave and the most critical issues. In addition, when asked what would need to change for them to return, qualitative data showed open-ended responses by exiting faculty leaders were twice as frequent to include leadership comments than those by non-leaders (34.2% vs. 16.2%). Exiting faculty leaders disproportionately cite high-level leadership as a reason to leave. The mediatory factors for this association are not known. Investigations to determine the causes for the study findings, and data-driven intervention strategies to retain faculty leaders at SOMs are needed.

Organizations' Mentoring Culture is Associated With Mentoring Climate and Involvement.

Organizational culture is the shared, often unspoken, basic values, beliefs, and assumptions. Underlying culture influences organizational climate, the observable policies, practices, and procedures that faculty experience. Yet little is known about mentoring culture and climate in higher education. The purpose of this study was to a) conduct a psychometric evaluation of the 4-item Organizational Culture Mentoring Values (OCuM-V) scale and b) determine if organizational culture, operationalized as values related to mentoring, is associated with organizational mentoring climate (OMC) and involvement with mentoring. 298 [55 under-represented minority (URM)] faculty from University of New Mexico and Arizona State University completed a cross-sectional survey, including the OCuM-V scale and the 15-item OMC Availability (OMCA) scale. Items for both scales were rated No (1), Don't know (0), or Yes (1). Faculty reported if they were being mentored or providing mentoring. Exploratory factor analysis (EFA) and Cronbach's alpha were used for scale evaluation. Spearman correlation and logistic regression were used to assess OCuM-V association with climate and mentoring involvement, respectively. Overall, 24% of faculty were being mentored (27% for URM), and 43% were mentoring (38% for URM). OCuM-V items loaded on a single factor in EFA (Cronbach's alpha=0.84 for all; 0.88 for URM). OCuM-V was positively correlated with OMCA (including institutional expectations, mentor-mentee relationships, and resources subscales) for both all and URM faculty (r>0.4 p<.001 for all). Greater OCuM-V was associated with an increased odds of being mentored (OR=1.75±1.19-2.61) and providing mentoring (OR=1.83±1.30-2.58). Mentoring culture is associated with mentoring climate. Faculty who perceive stronger OCuM-V report a stronger OMC (available structure, programs/activities, policies/guidelines) and are being mentored or providing mentoring more often. Limitations include a small sample size for the URM group and cross-sectional data collection. Organizational leaders should explicitly promote values related to mentoring to strengthen both mentoring culture and climate at their institutions.

The Pandemic Effect on Faculty Attrition at a School of Medicine.

Mentors at Academic Health Centers (AHC) are challenged by mentee attrition, with one in five physicians reporting an intent to leave in 2020. AHCs struggle with physician replacement costs, which are exorbitant. Data-driven efforts to mitigate attrition during the pandemic require an understanding of reasons to leave. This study compares characteristics of exiting faculty at the University of New Mexico School of Medicine (UNM SOM) two years before to two years after April 1, 2020. Demographic and reason to leave variables from exit interviews of 168 faculty that left UNM SOM between April 2018-to-March 2020 and 151 faculty that left between April 2020-to-March 2022 were compared. Exiting faculty were stratified into those resigning vs. retiring. Distributions of each variable were analyzed for statistically significant differences using a chi-square or Fisher's 2-sided exact test. The pandemic was associated with an approximately three-fold higher proportion of retirement contributing to total attrition than before (25.8% vs. 8.9%; p<0.001). Among those who resigned, the pandemic was associated with a higher proportion of physicians than before (84.3% vs. 72.8%; p=0.03). Hispanic faculty may be more likely to resign during the pandemic than before (p=0.06). Those who resigned during the pandemic may be significantly less likely to cite "inadequate adherence to FTE" or a "challenging work environment" (p= 0.048 and 0.053 respectively) but more likely to cite personal family matters (p=0.06) as reasons to leave than before the pandemic. The increased proportion of retirees during the pandemic presents challenges for AHCs by exacerbating the current shortage of mentors while providing leadership opportunities for those retained. Mentors need to be aware of the top reasons for faculty leaving (which have not materially changed during the pandemic): challenging work environment, personal/family matters, inadequate work-life balance, greater career opportunities, and inadequate salary.

Mentoring Award: Importance, Availability and Association With Mentoring Outcomes.

Intrinsic and extrinsic awards may motivate mentors and thus strengthen the organizational mentoring climate (OMC). Several institutions offer extrinsic awards for mentoring to recognize exceptional mentorship by individuals who support junior faculty in their career development. Mentees, peers, or institutions may nominate mentors for these awards. However, the faculty's perception of the importance of these awards and the association between their availability and mentoring outcomes remain unclear. We conducted secondary data analysis of a cross-sectional survey of 298 individuals (5%) from a pool of 6,152 faculty from the University of New Mexico (Main Campus and Health Sciences Center) and Arizona State University. The mentoring award's importance to faculty subgroups and the relationship of its perceived availability with providing/receiving and confidence in mentoring was determined. Participants completed the online OMC importance and availability draft scales, containing one item each on the award. Of all participants, 60.4% rated an award as very or somewhat important. Only 7% reported award availability (reaching 19% for ASU faculty). Women and Hispanic faculty rated the award as more important than their respective counterparts. Although availability was not associated with providing mentorship, faculty reporting unavailability were less likely to be receiving mentorship than others. Mean self-reported confidence in mentoring was higher among those reporting availability than in other groups. University faculty, particularly women and Hispanic, rate a mentoring award as important, yet few report their availability. Although availability is not associated with providing mentorship, it is associated with receiving mentorship and confidence in mentoring. The study's cross-sectional nature, low participation rate, and inability to independently confirm award availability limit its findings. Organizations need to establish and raise awareness of a faculty mentorship award as part of efforts to strengthen the OMC.

A Qualitative Review of Comments by Faculty Who Cite Work-Life Balance as a Reason to Leave.

Despite growing evidence for the need for work-life balance (WLB) for faculty at academic health centers, mentors frequently do not know how to advise their mentees on this topic. WLB impacts job satisfaction and intent to stay, and physicians are particularly at risk. In this study, we explored exit survey comments of faculty of the University of New Mexico School of Medicine citing work-life balance as a reason to leave (WLB-ARTL). Between July 2017 and December 2020, 59 faculty provided open-ended survey responses related to reasons for leaving, what they liked and disliked about being faculty, mentorship, and more. Using a qualitative descriptive design, we analyzed open-ended responses using a systematic, iterative, thematic approach via NVIVO software. We classified themes using Shanafelt's drivers of engagement and burnout: workload/job demands; efficiency/ resources; meaning in work; culture/values; control/flexibility; social support/community at work; and work-life integration. While there were numerous quotes across all themes, we chose to summarize emergent codes with the most faculty representation and those that can most easily be addressed through mentorship: career development, culture and people, and hours and schedule (related to themes of meaning in work, culture and values, community at work, work-life integration, and control and flexibility). To improve faculty retention, institutional leaders should focus on developing mentors' career coaching and mentoring skills. Additional focus should be placed on training mentors to discuss and address WLB among their faculty mentees.

Factors Related to Faculty Work Life Balance as a Reason to Leave a School of Medicine.

Mentoring can help promote faculty retention at academic health centers (AHCs). Faculty retention is important to optimize patient care and reduce replacement costs. Nationally "work life balance" (WLB) is identified by faculty as a reason to leave (ARTL) AHCs (Alexander & Lang, 2008). To help mitigate faculty attrition at AHCs, we examined work life balance as a reason to leave (WLB-ARTL) and other associated factors at the University of New Mexico School of Medicine (UNM SOM). Faculty responses from 255 faculty that left UNM SOM between July 2017 and December 2020 were analyzed using logistic regression with the outcome WLB-ARTL. Distributions of each variable were tabulated. Odds ratio associations from logistic regression between WLB-ARTL and each variable were obtained. Multivariate logistic regression modeling was performed with backward selection at p<0.05. Of the 255 faculty who exited the University of New Mexico School of Medicine (UNM SOM), 25% had WLB-ARTL, 48% were women, 72% were physicians, 58% were clinician-educators, and 13% were from racial/ethnic underrepresented minorities (URMs). Multivariate modeling found four factors associated with increased WLB-ARTL: compensation, time for academic pursuits, spousal and family support, and dislike of patient care conditions and environment. Two factors associated with lower WLB-ARTL were better leadership and periodic reviews addressing job satisfaction. Gender, URM, and physician status were not found to be significant. Similar to previous studies (Whittaker et al., n.d.), we found that WLB-ARTL at UNM SOM was associated with specific "work" and "life" factors. Faculty retention efforts should focus on "work" factors such as providing protected time for academic pursuits and improving patient care conditions, and "life" factors such as addressing compensation and supporting families.

Faculty Rating of the Importance and Availability of Organizational Mentoring Climate.

Organizational climate is the shared perception of and the meaning attached to the policies, practices, and procedures employees experience. University faculty can assess their organizational mentoring climate (OMC) using recently published, reliable, and valid OMC importance (OMCI) and availability (OMCA) scales. Factors affecting the OMC's importance and availability are, however, not known. By studying these factors, organizational leaders can determine whether and how to change the OMC to improve faculty mentoring outcomes. In this cross-sectional study, 300 faculty from the University of New Mexico (Main, Health Sciences Center [HSC] and branch campuses) and Arizona State University (a non-HSC campus) completed the online OMCI and OMCA scales, each with three subscales: Organizational Expectations, Mentor-Mentee Relationships, and Resources. OMCI scale items were rated from very unimportant (1) to very important (5); and, for OMCA, -1 (no), 0 (don't know), 1 (yes). The study used linear regression analysis after normalizing the scales to M=0 and SD=1. Although not explicitly targeted for recruitment, the respondents were predominantly women, non-Hispanic White, senior, tenure-track faculty members who were neither providing mentoring nor receiving mentoring. In the multivariable models, women faculty attached greater importance to mentoring climate components than men. HSC faculty and those receiving mentoring reported greater availability of mentoring climate components than their respective counterparts. Underrepresented minority (URM) faculty did not rate OMCI or OMCA differently than non-URM faculty. Faculty subgroups in this study attached varying levels of importance to the OMC and rated the availability of climate components differently. Factors impacting the importance of the OMC differed from those affecting the perceived availability of the climate components. Based on their relative importance and lack of availability, organizational leaders should create, modify and implement structures, programs, and policies to improve organizational mentoring expectations, mentor-mentee relationships, and mentoring resources, thereby strengthening their OMC.

Developmental Networks Among Mentors and Mentees Involved in a Mentoring Intervention.

The growing application of social network-based theories and methods (Burt et al., 2013) in scholarship on mentoring illustrates that mentoring goes beyond dyadic relationships comprising a senior mentor and a junior protégé (Higgins & Kram, 2001). However, limited data exist on the state of developmental networks of university faculty. This study examines developmental network characteristics among mentors and mentees participating in an ongoing intervention that aims to enhance career success through improved mentoring. Cross-sectional data come from 81 faculty mentors and mentees at three universities in the Southwestern United States. Using the online Modified Mentoring Network Questionnaire (MNQ), participants provided information on relationships with developers, who are people that have taken concerted action, and provided professional and/or personal guidance to help participants advance in their careers. An individual's developmental network comprises relationships with developers. We conducted exploratory analyses examining key characteristics of mentors' and mentees' developmental networks. Participants received psychosocial and career support from an average of 4.9 developers (4.8 and 5.1 for mentors and mentees respectively) from 2.3 arenas (2.2 and 2.4 arenas for mentors and mentees, respectively). While the most common arena was the respondents' current job/position (62%, 64% and 59% for all participants, mentors, and mentees respectively), developers were from graduate school (11%, 6% and 17%); prior jobs/positions (13%, 16% and 9%) and family (8%, 5% and 11%). Our preliminary findings suggest that developers are important for university faculty and that methods and insights from social network analysis can be applied to examine their support networks. As our study is part of an ongoing longitudinal intervention, these findings will inform future analyses that will examine changes in developmental network characteristics and its impact on participants' careers.

Factors Related to Faculty Retention in a School of Medicine: A Time to Event Analysis.

National data indicate that 50% of assistant professors leave a School of Medicine (SOM) within eight years of hire. At-risk for attrition in some studies are women, racial/ethnic underrepresented minorities (URM), and clinical faculty. Retention of faculty is not adequately studied in the Southwestern US, where at-risk faculty constitute the majority group. The study hypothesized that at-risk faculty have lower retention rates than those not at-risk. Identification of factors predicting retention of at-risk faculty may help institutions devise novel and targeted retention strategies. Prospective time to event analyses studied assistant professors hired at the University of New Mexico's (UNM) SOM from 2008-2019. Eight factors, measured at the time of hire, included: rank, race/ethnicity, gender, MD degree, academic track, department type, salary, and fiscal year of hire. Univariate analyses included graphical analysis of Kaplan-Meier analysis and Cox proportional hazard ratios with years to departure measuring the main event to resignation. 844 full-time junior faculty included 50% women, 81% physicians, 42% clinician educators, and 18% racial/ethnic URM. Compared to non-Hispanic Whites, Black faculty (HR = 2.24, 1.25-4.03) and faculty with non-US degree (1.53, 1.19-1.94) had a higher risk of leaving. Faculty in clinician educator (2.01, 1.06-3.82) or visiting research tracks (2.41, 1.20-4.84) both had higher risk of leaving than tenure track faculty. Although URM faculty did not have an overall higher risk of departure, male faculty had higher risk of leaving than women when they are URM or unknown-URM status. In our analysis of junior faculty, we showed that faculty who were Black, had an international education, and in clinician educator or visiting research tracks were at greater risk of leaving, but women and Hispanic faculty had similar retention rates as their respective counterparts at UNM SOM. The differential retention rates among several at-risk subgroups of junior faculty may indicate the need to refocus the existing diversity and faculty development programs at UNM SOM.

Exiting Medicine Faculty Want the Organizational Culture and Climate to Change.

National data indicate about 50% of junior faculty leave a School of Medicine (SOM) within eight years of hire. The long-term goal of the study was to determine innovative strategies for promoting SOM faculty retention. The study objective was to determine factors influencing SOM faculty to exit, and what would encourage them to stay or return. All faculty exiting the University of New Mexico (UNM) SOM were surveyed and their responses analyzed to the following items: (a) If something could have been done differently that might have resulted in staying at UNM, what would it have been? (b) What would need to change at UNM SOM for you to return? and (c) general comments offered. Qualitative analysis of open-ended responses used an iterative process and systematic thematic approach and NVivo software. 173 faculty respondents surveyed between July 2017 and June 2019 included 86 women, 33 non-Caucasians, and 14 Hispanics. A total of 110 faculty reported an MD degree and 117 were assistant professors. Seventy-eight faculty were on clinician educator track. The 367 responses to the three questions were categorized into 10 themes. The most common themes included (a) people (leadership and others) and workplace culture (25.1% of responses); (b) extent of career support and resources (15.3%); (c) organizational systems and administration (13.6%); and (d) faculty feelings of autonomy and value (10.9%). Exiting faculty frequently discussed the need for a change of leadership and changes in organizational climate and culture, which may have influenced their willingness to stay or to return to UNM SOM. To retain faculty, SOM leaders need to strengthen and/or modify organizational climate and culture components. Innovative strategies for this purpose may include organizational interventions followed by evidence-based leadership training programs, and the use of exit surveys for monitoring interventions.

Assigning mentors for new HSC faculty hires: A preliminary policy evaluation.

Effective practices for selecting mentors for new faculty at academic health centers (AHC) are currently unknown. The University of New Mexico's School of Medicine assigns a mentor to all new faculty at the time of hire. The effectiveness of this policy measure has not been previously evaluated. The research question was to determine the proportion of new faculty mentees who meet with their assigned mentors before their mandatory orientation held within their first year of hire. At the orientation, faculty are surveyed about their response to the institutional policy of assigning mentors upon their hire. The proportion of new faculty mentees who met their assigned mentors prior to the orientation event constituted the primary study outcome. Of the 289 new faculty surveyed, 79.9% met their assigned mentors prior to the orientation - most meetings were weekly (48.8%) or monthly (27.9%). Among those who had not yet met their mentors, 65% planned to meet them within the month of the survey. 5.5% of all faculty reported a change of mentor from their initial assignment and 2.8% stated that they needed a different mentor. Physicians were less likely to meet with their assigned mentors than non-physician faculty (p=0.02). The preliminary policy evaluation demonstrates that most new faculty either meet or plan to meet their assigned mentors. Most participants stated that they did not need to be assigned a different mentor. Assigning mentors for new faculty hires may be considered a best practice at an AHC.

Surveillance of CKD epidemiology in the US - a joint analysis of NHANES and KEEP.

Chronic Kidney Disease (CKD), is highly prevalent in the United States. Epidemiological systems for surveillance of CKD rely on data that are based solely on the NHANES survey, which does not include many patients with the most severe and less frequent forms of CKD. We investigated the feasibility of estimating CKD prevalence from the large-scale community disease detection Kidney Early Evaluation and Program (KEEP, n = 127,149). We adopted methodologies from the field of web surveys to address the self-selection bias inherent in KEEP. Primary outcomes studied were CKD Stage 3-5 (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2, and CKD Stage 4-5 (eGFR <30 mL/min/1.73 m2). The unweighted prevalence of Stage 4-5 CKD was higher in KEEP (1.00%, 95%CI: 0.94-1.05%) than in NHANES (0.51%, 95% CI: 0.43-0.59%). Application of a selection model that used  variables related to demographics, recruitment and socio-economic factors resulted in estimates similar to NHANES (0.55%, 95% CI: 0.50-0.60%). Weighted prevalence of Stages 3-5 CKD in KEEP was 6.45% (95% CI: 5.70-7.28%) compared to 6.73% (95% CI: 6.30-7.19%) for NHANES. Application of methodologies that address the self-selection bias in the KEEP program may allow the use of this large, geographically diverse dataset for CKD surveillance.

Unplanned pregnancy on a direct oral anticoagulant (Rivaroxaban): A warning.

Direct oral anticoagulants (DOACs or NOACs -non-vitamin K oral anticoagulants), as the name suggests, are oral anticoagulants with a direct inhibitory action either against factor X or factor II (thrombin). Pregnant women were excluded from participating in all the large trials of the DOACs and they are considered contra-indicated in pregnancy and breast feeding. We present a case of inadvertent exposure to rivaroxaban in a woman who presented at 25 weeks' gestation. The management of her pregnancy and delivery is described, and the previous published case reports are reviewed with a discussion about the use of DOACs in woman of childbearing age.

Comparative efficacy and safety of intravenous ferric carboxymaltose (Ferinject) and iron(III) hydroxide dextran (Cosmofer) in pregnancy.

BACKGROUND: Iron-deficiency anaemia is common in pregnancy, with well-described maternal morbidities. When oral iron therapy has failed, intravenous (IV) preparations are considered. Ferric carboxymaltose (ferinject) is a new IV preparation which can be given quickly. There are no published data on Ferinject use in pregnancy. This study analyses historical data from women given Cosmofer, compared with those given Ferinject in pregnancy, to assess comparative efficacy and safety. METHODS: Pregnant women treated with Cosmofer and Ferinject, were identified from pharmacy records. Records for all cases were reviewed and those which fulfilled inclusion criteria selected. The inclusion criteria included: symptomatic iron-deficient anaemia unresponsive to oral iron; age ≥18; second to third trimester; full blood count taken at least once at two, four and/or six weeks post-infusion. Data were collected on the pre-treatment Hb, ferritin, and same data collected at two, four and six weeks after the infusion. Side-effects or adverse reactions were noted for both the Cosmofer and Ferinject patients. RESULTS: Results were obtained for 92 women (44 received Ferinject and 48 Cosmofer). Pre-infusion Hb and ferritin levels were comparable in the two groups. At two weeks, the mean Hb rise in the Ferinject group was 1.73 g/dL and 1.34 g/dL in the Cosmofer group. At four weeks, the total rise in Hb was 2.57 g/dL Ferinject, 2.34 g/dL Cosmofer. At six weeks the rise was 3.01 g/dL and 3.2 g/dL respectively. No serious adverse events were reported in either group. CONCLUSION: Both preparations appear effective and safe, with low risk of serious adverse effects and side-effects.