Attachment 17 NRMN Faculty Mentor Core Followup Survey

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Attachment 17:
NRMN Faculty Mentor Core Follow-up Survey
Revised 7.31.17

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NRMN Annual Follow-up Survey
You have previously participated in a program associated with the National Research
Mentoring Networks (NRMN), perhaps through mentoring, training regarding mentorship or grant-writing, or affiliated programs such as IRACD or ROCC.
NRMN programs are part of a large National Institutes of Health (NIH) funded initiative for those pursuing biomedical, behavioral, clinical, and social science research
careers. This effort, the NIH Diversity Program Consortium (DPC), has been tasked
with understanding what programs and strategies benefit those interested in these
careers.
The University of California, Los Angeles (UCLA) is collecting information about these
programs on behalf of the Consortium and NIH.
NRMN has provided UCLA your name and contact information because you have
participated in activities that are part of the NIH Diversity Program Consortium’s work.
All of the information you provide will be protected and secured to the extent permitted
by law.
Through this survey, we will gain understanding of your professional activities, including any mentoring/coaching practices, research, scholarly productivity, and other
academic activities.
Public reporting burden for this collection of information is estimated to average 25
minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this burden estimate
or any other aspect of this collection of information, including suggestions for reducing
this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974,
Bethesda, MD 20892-7974, ATTN: PRA (0925-0747). Do not return the completed
form to this address.

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Professional Development/Training

1. In the past year, have you participated in any professional development or training of
4 hours or longer not through NRMN to improve your skills as a biomedical researcher? This can include training to be a mentor, a mentee, about grant writing, or about other
research skills.
No

Yes

a. What was the focus of the training (Select all that apply)
Mentoring relationships
Conducting research
Grant writing
Other career development topics (e.g., applying to graduate school, publishing,
gaining tenure)
Other (specify):
b. Mode of training (Select all that apply)
In-person
On-line that occurs in scheduled, real-time method (synchronous)
On-line or other virtual that you can take at any time that provides feedback or interaction with others (asynchronous)
Self-study (by any means, but no interaction or feedback)
Other (specify):

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Mentoring
This next section concerns your experiences with mentoring in a variety of contexts.
A mentor is someone who provides guidance, assistance, and encouragement on professional and academic issues. A mentor can be either someone who is more experienced (or
senior) than you or someone who is at a level similar to you (a “peer”). It can also be someone who serves as an academic “coach.”
A mentee is someone who receives guidance or assistance from a mentor. A
mentee can be someone less experienced (or junior) than you or someone
who is your peer.

A mentoring relationship can be formal (with established responsibilities and perhaps arranged by your institution) or informal.

2. Have you ever regularly mentored students, post-docs or fellows, junior researchers,
junior faculty, or peers on biomedical career or research issues?
No

Yes

3. How many different people do you regularly mentor currently? (Enter 0 if you do not
mentor anyone in a category.)
a.
b.
c.
d.
e.
f.

Undergraduate Students:
Post-baccalaureate Students:
Graduate Students:
Post-docs:
Faculty:
Others:

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4. Which of the following do you help your mentees with? (choose all that apply)
Research related to grant writing and funding
Specialized research issues (e.g., statistics or instrumentation, writing for publication)
Research in general (e.g., general advice/supervision in a lab or project)
Educational choices and strategies (e.g., guidance in selecting coursework, other
educational opportunities)
Career planning (e.g., giving advice, helping network, linking to opportunities)
Personal support (e.g., listening to personal concerns, work-life balance, diversity
issues)
Other (specify):

5. There are a variety of ways to connect (that is, matched or linked) with mentees, For
each of the methods below, please indicate about how many of your mentees you connected with in this way.
We were matched / Iinked
through an NRMN program
We were matched / linked
through some other formal
program
We were matched or connected through other ways

None

25% or less

26-50%

51-75%

76-100%

N/A

6. Please tell us how frequently you communicate with your mentees with each of these
approaches:
In-person
Phone/ Skype/Zoom
Email/ Text
Other

Weekly or
more often

Monthly

Every 2-3 A few times
months
a year

Annually
or less

Never

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7. We would like to understand more about your mentoring relationship. For the two mentees with whom you work most closely on research who are from under-represented groups,
please use the following private weblink to provide their names and emails. If you do not
have any mentees who are from under-represented groups, please indicate the two
mentees with whom you work most closely on research.
Weblink will not allow anyone to view their names or email addresses. The information will
be used to email a request to these mentees to complete a brief survey regarding their mentored experience.
Mentees’ names and emails are only available to our research office if the mentees respon
to the email request by going to the website and completing the survey. Their information will
be deleted from the system after 3 months if they do not respond to the requests to participate.

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8. Do you have a faculty member or someone else who is more senior than you who you
consider a mentor?
No

Yes

9. How many different mentors do you regularly work with?

10. Which of the following does your primary mentor help you with? (choose all that apply)
Research related to grant writing and funding
Specialized research issues (e.g., statistics or instrumentation, writing for publication)
Research in general (e.g., general advice/supervision in a lab or project)
Educational choices and strategies (e.g., guidance in selecting coursework, other educational opportunities)
Career planning (e.g., giving advice, helping network, linking to opportunities)
Personal support (e.g., listening to personal concerns, work-life balance, diversity issues)
Other (specify):

11. Please tell us how frequently you communicate with your primary mentor with each of
these approaches:
In-person
Phone/Skype/Zoom
Email/Text
Other

Weekly or
more often

Monthly

Every 2-3
months

A few times
a year

Annually
or less

Never

12. How did you find this mentor

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They sought you out
You sought out your mentor independently
They were assigned in some other way by your department or campus
You were matched/linked through the National Research Mentoring Network (NRMN)
Matched/linked through some other formal program
Other (specify):

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We would like to get information about your current position.
13. What is your current primary position? (Please indicate all that apply)
Working (including internships and significant volunteer positions
Retired
Unemployed, looking for work
Otherwise not in labor force
Other (specify):
a. Paid Employment (check all that apply):
Full Time
Part Time
Internship or student placement
Seasonal (full-time or part-time)
No paid employment
Position:
Institution or Company:

b.Is this paid position related to biomedical research?
No

Yes

c. Volunteer / Unpaid
Position:
Institution or Company:
No volunteer position
d. Is this volunteer position related to biomedical research?
No

Yes

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14. During the past year, did you complete any certificate program
No

Yes

If yes, please indicate the following:
a. certificate
b.Major / area of study:
d. From which institution or school:
d. Date awarded

/

15. To allow us to follow your professional accomplishments, please provide any of the
following identifiers that you have and use
ORCID ID

I do not have or use

NIH eRA Commons ID

I do not have or use

LinkedIn ID

I do not have or use

My NCBI (PubMed or SciEnv)
Publications list (URL):

I do not have or use

Any other public listing with your updated publications
Site name (e.g. research gate,
academia.edu, etc.
ID

I do not have or use

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16. Please attach your most recent academic vita (such as a CV). Later in the survey we
ask about publications and grants. Uploading your CV may allow you to skip those items.
Upload now

Defer for now

I do not want to upload my CV

Below is a list of all grants and submissions you have provided to us in the past.

17. Have you applied for any grant funding or other financial support for your research (e ther as Principal Investigator or as Co-Investigator or other paid position) in the past year?
No

Yes

18. Please complete or update information for each grant or proposal:

NOTE: if this information is already provided in your CV that you uploaded, you do not complete this
item.

Please check here if you want us to refer to your CV.

a. Funding Agency Type:
NIH
Other federal (e.g. NSF)
Nonfederal governmental
Nonprofit (e.g. foundations
For-profit/Industr
Other (specify):
b. Agency/Foundation/Company Name:
c. Project Title:
d. Role:
Principal Investigator
Co-PI
Investigator
Other (specify):
e. Your percent effort:

% or

calendar months

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f. Submission status:
Submitted (first time for this proposal)
Re-submitted with revisions
Impact score (if applicable):
Not funded
NIH Impact score (if applicable):
Funded
g. Grant funding mechanism:
K (any type)
P (any type)
R01
R03 or R21
Other R series
T (any type)
U (any type)
Other (e.g., supplements, etc.) (specify):
h. Annual direct cost (average across all years of entire project award, even if you are associated only with a subcontract):
Less than $50,000
$50,000-$99,999
$100,000-$249,999
$250,000-$499,999
$500,000 or more
i. Full grant number if available
e.g., 10

e.g., K01

e.g., AG

j. Start Date (e.g., 07/2015)

/

k. End Date (e.g., 07/2015)

/

e.g., 000000 (6 digits)

l. What was the main purpose of the funding?
Research
Training of others (e.g., students, peers, workforce)
Your career development
Other (specify):

optional

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19. Have you conducted research that is not covered by the grants listed above, whether it is
your own research or under the direction of someone else?
No

Yes

a. What type of research was this? (select all that apply)
Literature review, synthesis of existing knowledge, and/or conceptual (ie., not involving
data analysis)
Analysis of existing (secondary) data
Analysis of data you collect (primary analysis)
Collection of data, either in the lab or elsewhere
b. What was your role? (select all that apply)
PI /Co-PI or Project Lead
Investigator or collaborator
Other (specify):

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20. Do you have any peer-reviewed publications that you have had accepted to add to this list?
This may include peer-reviewed abstracts included in conference proceedings.
No

Yes

If yes, please answer the following questions:
NOTE: If this information is already provided on your CV that you uploaded, you do not complete this
item.

a.
b.
c.
d.
e.

Please check here if you want us to refer to your CV.
Title:
PMID # if available:
List all Authors (Last FM, comma separated):
Journal Name:
Year Published (or indicate “in press” or “epub ahead”):

f.
g.
h.
i.

Volume:
Issue:
Page Numbers:
DOI or URL for epubs:

21. Are there other scientific publications of yours to add to this list? (e.g. book chapters
books, reports, non-peer reviewed journal articles, working papers, other)
No

Yes

a. Publication Type:
Chapter
Book
Other, (specify):
b. List all Authors (Last FM, comma separated):
Complete the applicable information below depending on publication type:
c. Book/Anthology Title:
d. Book Editors:
e. Year Published:
f. Edition:
g. Publisher:
h. City:
i. State:
j. Page Numbers:
k. DOI or URL for epubs:

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22. Have you presented at a scientific conference in the last year (including posters)
No

Yes

23. Have you had any of the following technology transfer activities completed since last
December?
Issued patents
Completed licenses
Drug, device, or diagnostic approvals
Result of basic research commercialized
in other ways

Yes
Yes
Yes
Yes

No
No
No
No

Below is a list of technology transfer activities (including issued patents, completed licenses,
and drug, device, or diagnostic approvals you have provided to us in the past.

Please review the list. Are there any to add to this list?
No

Yes

a. If yes, what type (check all that apply)
New patent issued
License completed
Drug, device, or diagnostic received regulatory approval
Result of basic research commercialized
24. In the past year, have you been formally recognized, honored, or awarded in recognition
of your teaching, research, or other professional activity?
No

Yes

If yes, please list any honors or awards you received in the past year in recognition of your
teaching, research, or other professional activity. If you provided this information already on
your CV, you may skip this item:

25. Have you held office in any professional organization in the past year
No

Yes

If yes, please list any offices you have held in professional organizations in the past yea .
If you provided this information already on your CV, you may skip this item:

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26. Have you provided service to any federal agencies (e.g. reviewer for NIH/NSF/CDC or
similar proposals, member of federal agency advisory council, etc.) in the past year? If you
provided this information already on your CV, you may skip this item:
No
Yes
If yes, please list any service to federal agencies you have performed in the past year (e.g.
reviewer for NIH/NSF/CDC or similar proposals, member of federal agency advisory council,
etc.): If you provided this information already on your CV, you may skip this item:

27. Have you provided service to any non-federal agencies such as state agencies or foundations in the past year?
No

Yes

If yes, please list any service to non-federal agencies you have performed in the past year: If
you provided this information already on your CV, you may skip this item:

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28. Do you have anyone you currently mentor who is at a similar career level
to yours (a peer)?
No
Yes

29. How many different peers do you mentor currently? ____
30. Which of the following do you help your peers with? (choose all that
apply)

Research issues
Social and emotional needs, e.g. sharing concerns about career and
work-life balance
Tangible help, e.g. advice about faculty colleagues and teaching, help
with writing
Networking assistance, e.g. helping you meet other people in your
field
Career planning (e.g. giving advice, helping find opportunities)
Other (specify): _________________
31. How did you first connect with these peers? (choose all that apply)

They were assigned by your department or campus
Through a NRMN mentorship program
Matched through some other formal program
They sought you out independently
Other (specify): _________________
32. How do you communicate with your peer mentees?
In-person

Phone/Skype
Email/Text
Other (specify): _____________________

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33. On average, how often do you usually communicate with these peers
about their research?
Weekly or more often
Monthly
Several times a year
Annually or less

34. For the two peers whom you mentor most, please use the following
private weblink to provide the name and email for those mentees.
Weblink will not allow anyone to view the name or email address.
Information will be used to email a request to these mentees to complete
a brief survey regarding their mentored experience. Mentee name and
email are only available to our research office if the mentee elects to
respond to the email request by going to the website and completing the
survey. Their information will be deleted from the system after 3 months
if they do not respond to the requests to participate.

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35. Do you have someone at a similar educational level as you (i.e. a peer)
who you currently consider a mentor?
No
Yes

36. How many different peer mentors do you have? ____

37. Which of the following do your primary peer mentors help you with?
(choose all that apply)
Research issues
Social and emotional needs e.g. sharing concerns about career and
work-life balance
Tangible help (e.g. advice about faculty colleagues and teaching, help
with writing)
Networking assistance ( e.g. helping you meet other people in your
field)
Career planning (e.g. giving advice, helping find opportunities)
Other (specify): _________________

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38. How did you find this primary mentor?

They were assigned by your department or campus
Through NRMN
Matched through some other formal program
You sought out your mentor independently
Other (specify): _________________
39. How do you usually communicate with your primary peer mentor?

In-person
Phone/Skype
Email/Text
Other (specify): __________________
40. How often do you usually communicate with your primary peer
mentor?

Weekly or more often
Monthly
Several times a year
Annually or less