Advancing the Science of Mentorship: Future Directions for Sustainable Implementation and Evaluation of Mentorship Education for the Clinical and Translational Science Workforce.

The Advancing the Science of Mentorship: Future Directions for Sustainable Implementation and Evaluation of Mentorship Education for the Clinical and Translational Science Workforce conference was held in Madison, Wisconsin, in April 2023. The conference provided an engaging and scholarly forum for clinical and translational researchers from diverse backgrounds and career stages (including leaders at Clinical and Translational Science Award (CTSA) hubs and affiliated institutions) with a professional interest and commitment to improving and diversifying workforce development and fostering a climate of inclusive excellence through best practices in mentorship. Outcomes from the conference include an online resource and a new Community of Practice.

The impact of inclusive mentoring and identity work on self-efficacy in career advancement and career commitment among underrepresented early-career faculty and post-doctoral fellows.

Objective: Researchers from underrepresented groups leave research positions at a disproportionate rate. We aim to identify factors associated with self-efficacy in career advancement and career commitment among underrepresented post-doctoral fellows and early-career faculty. Methods: Building Up is a cluster-randomized trial with 25 academic health institutions. In September-October 2020, 219 Building Up participants completed the pre-intervention assessment, which included questions on demographics, science identity, mentoring, self-efficacy in career advancement (i.e., advancement is open to me, confidence in career progression, confidence in overcoming professional barriers), and career commitment (i.e., intent to continue research training or studying in a field related to biomedical sciences). Using logistic and multinomial logistic regression, we identified characteristics independently associated with self-efficacy in career advancement and career commitment. Results: The cohort is 80% female, 33% non-Hispanic/Latinx Black, and 34% Hispanic/Latinx. Having mentors that address diversity was significantly associated with the belief that advancement is open to them (OR = 1.7). Higher science identity (OR = 4.0) and having mentors that foster independence (OR = 1.8) were significantly associated with confidence in career progression. Higher science identity was also significantly associated with confidence in overcoming professional barriers (OR = 2.3) and intent to continue studying in a field related to biomedical sciences (OR = 3.3). Higher age (OR = 2.3) and higher science identity (OR = 4.2) were significantly associated with intent to continue research training. Discussion: Science identity and mentoring play key roles in self-efficacy in career advancement and career commitment. These factors may contribute to retention of underrepresented early-career biomedical researchers.

Diversity supplements: An underutilized opportunity to improve the diversity of the health sciences research workforce.

Purpose: This paper describes the process developed at the University of Pittsburgh to increase the number of NIH-funded Diversity Supplements. Method: The authors formed a Diversity in Academia Workgroup where we created the infrastructure and process to increase the number of Diversity Supplements. Each year, the Office of Sponsored Programs provided a list of grants that would be eligible to submit a Diversity Supplement. We surveyed the Principal Investigators inquiring about their interest in working with a trainee on a Diversity Supplement. If yes, we included their information in a database we built so that trainees could search for eligible research studies. The Diversity Deans then identified underrepresented faculty and postdoctoral researchers. We invited Program Officers from NIH to participate in a panel presentation for trainees, which was well attended. Results: The number of Diversity Supplements awarded to Pitt researchers has significantly increased from 7 in 2020 to 10 in 2021 and to 15 in 2022. Six more have been awarded in the first half of 2023. Conclusions: We created the Diversity in Academia Workgroup with the goal to increase the number of Diversity Supplements at the University of Pittsburgh and in so doing, increase the diversity in the biomedical research workforce. While challenging, we know the critical importance and benefits of increased diversity at the University, and we have made significant strides toward this goal.

Time to act: A rubric-based approach for institutionalizing justice, equity, diversity, and inclusion.

Attacks on minoritized communities and increasing awareness of the societal causes of health disparities have combined to highlight deep systemic inequities. In response, academic health centers have prioritized justice, equity, diversity, and inclusion (JEDI) in their strategic goals. To have a sustained impact, JEDI efforts cannot be siloed; rather, they must be woven into the fabric of our work and systematically assessed to promote meaningful outcomes and accountability. To this end, the University of Pittsburgh's Institute for Clinical Research Education assembled a task force to create and apply a rubric to identify short and long-term JEDI goals, assess the current state of JEDI at our Institute, and make recommendations for immediate action. To ensure deep buy-in, we gathered input from diverse members of our academic community, who served on targeted subcommittees. We then applied a three-step process to ensure rapid forward progress. We emerged with concrete actions for priority focus and a plan for ongoing assessment of JEDI institutionalization. We believe our process and rubric offer a scalable and adaptable model for other institutions and departments to follow as we work together across academic medical institutions to put our justice, equity, diversity, and inclusion goals into meaningful action.

Shut Up & Write!® builds writing self-efficacy and self-regulation in early-career researchers.

Introduction: High writing self-efficacy and self-regulation are tied to publication and grant submission. Writers with these attributes are more productive. We investigated whether participating in a Shut Up & Write!®-style intervention (SUAW) would produce statistically significant gains in writing self-efficacy and self-regulation when comparing pre-post-participation surveys. Methods: Forty-seven medical students, TL1/KL2, and early-career faculty from across the USA expressed interest in participating, with 37 completing the pre-survey. We conducted (on Zoom) a 12-week SUAW series and measured the effect using a pre-post survey adapted from the Writer Self-Perception Scale. Paired t-tests (α = 0.05) were conducted on three subscales to test for significant differences between pre- and post-test means. The subscales reflected writing attitudes, writing strategies, and avoiding writing distractions. Subscales showed acceptable internal consistency with Cronbach's alphas of 0.80, 0.71, and 0.72, respectively. Results: Twenty-seven participants attended at least one session. Of these, 81% presented as female, and 60% were from NIH-defined Underrepresented Backgrounds and/or were from Minority-Serving Institutions. Twenty-four completed both the pre- and post-surveys. Sixty percent previously participated in an activity similar to SUAW. We found significant improvements in writing attitudes (p = 0.020) and writing strategies (p = 0.041) for those who previously participated. For those who had not previously participated, we found improved writing strategies (p = 0.002). Eighty percent were very satisfied/satisfied with SUAW. Discussion: Researchers have tied writing self-efficacy and self-regulation to timely publication and grant submission. We found significant gains in self-efficacy and self-regulation, suggesting that participation in a SUAW-style intervention may increase writing productivity.

Perseverance and consistency of interest in underrepresented post-doctoral fellows and early-career faculty.

Introduction: Underrepresented researchers face more challenges than their well-represented counterparts. Perseverance and consistency of interest are associated with career success in well-represented physicians. Therefore, we examined associations of perseverance and consistency of interest with Clinical Research Appraisal Inventory (CRAI), science identity, and other factors related to career success among underrepresented post-doctoral fellows and early-career faculty. Methods: This is a cross-sectional analysis of data collected from September to October 2020 among 224 underrepresented early-career researchers at 25 academic medical centers in the Building Up Trial. We used linear regression to test associations of perseverance and consistency of interest scores with CRAI, science identity, and effort/reward imbalance (ERI) scores. Results: The cohort is 80% female, 33% non-Hispanic Black, and 34% Hispanic. The median perseverance and consistency of interest scores were 3.8 (25th-75th percentile: 3.7,4.2) and 3.7 (25th-75th percentile: 3.2, 4.0), respectively. Higher perseverance was associated with a higher CRAI score (ß = 0.82; 95% CI = 0.30, 1.33, p = 0.002) and science identity (ß = 0.44; 95% CI = 0.19, 0.68, p = 0.001). Higher consistency of interest was associated with a higher CRAI score (ß = 0.60; 95% CI = 0.23, 0.96, p = 0.001) and higher science identity score (ß = 0.20; 95% CI = 0.03, 0.36, p = 0.02), while lower consistency of interest was associated with imbalance favoring effort (ß = -0.22; 95% CI = -0.33, -0.11, p = 0.001). Conclusions: We found that perseverance and consistency of interest are related to CRAI and science identity, indicating that these factors may positively influence one's decision to stay in research.

Leading Emerging and Diverse Scientists to Success: Results from LEADS alumni.

Purpose: In 2015, the University of Pittsburgh partnered with several Minority Serving Institutions to develop the Leading Emerging and Diverse Scientists to Success (LEADS) Program. LEADS was designed to provide skills development, mentoring, and networking support to early career underrepresented faculty. Method: LEADS included three components: skills training (e.g., grant and manuscript writing and team science), mentoring, and networking opportunities. Scholars completed a pre- and post-test survey and an annual alumni survey that included measures on burnout, motivation, leadership, professionalism, mentoring, job and career satisfaction, networking, and an assessment of their research self-efficacy. Results: Scholars demonstrated a significant increase in their research self-efficacy having completed all the modules (t = 6.12; P < 0.001). Collectively, LEADS scholars submitted 73 grants and secured 46 grants for a 63% success rate. Most scholars either agreed or strongly agreed that their mentor was effective in helping to develop their research skills (65%) and provided effective counseling (56%). Scholars did experience increased burnout with 50% feeling burned out at the exit survey (t = 1.42; P = 0.16) and 58% reporting feelings of burnout at the most recent survey in 2020 (t = 3.96; P < 0.001). Conclusions: Our findings support the claim that participation in LEADS enhanced critical research skills, provided networking and mentoring opportunities, and contributed to research productivity for scientists from underrepresented backgrounds.

Continued impact of COVID-19 pandemic on clinical and translational science early-career researchers.

The COVID-19 pandemic had an immediate impact on the lives and work of early-career researchers. We leveraged a cluster-randomized trial and compared survey data collected over two timepoints to explore whether these impacts persisted. Although more than a year had passed, 74% of participants reported that their research was affected in multiple ways in both 2020 and 2021. These data suggest that the effects of the pandemic on early-career researchers may be prolonged. Our findings additionally serve as an impetus to identify and implement solutions to early-career challenges that undoubtedly existed before the pandemic, but which COVID-19 brought into the spotlight.

Reducing tensions and expediting manuscript submission via an authorship agreement for early-career researchers: A pilot study.

Authorship can be a source of tension on research teams, in academic/industry collaborations, and between mentors/mentees. Authorship misconduct is prevalent among biomedical researchers, and disputes about authorship can generate tensions that have the potential to disrupt professional relationships and damage careers. Early-career researchers may experience particular challenges navigating authorship both because of inexperience and power differentials; in effect, they lack the language and confidence to have these conversations and may feel unwilling to challenge the status quo. The authors implemented an Authorship Agreement for use when collaborating on a manuscript and hypothesized that using this agreement would reduce authorship tensions and speed time to manuscript submission by helping early-career investigators manage authorship conversations more effectively. The authors surveyed trainees (n = 65) on the prevalence of authorship-related tensions and compared the results from the first survey in 2017 to the final survey in 2020. The decrease in tensions around meeting deadlines was significant (z = 2.59, p = 0.010). The authors believe the effect of an Authorship Agreement on authorship-related tensions has not previously been investigated. This work extends what is known about the prevalence of commonly cited authorship tensions, and provides evidence of the effectiveness of steps that can be taken to alleviate them.

Customized Career Development Platform (CCDP) for clinical and translational researchers: A pragmatic cluster-randomized controlled trial.

Introduction: Early-stage clinical and translational researchers who set and track career goals, milestones, and progress are successful in career development. We aimed to determine the effectiveness of the Customized Career Development Platform (CCDP), an online individual development plan (IDP), versus the traditional IDP template in improving research success and career satisfaction. Methods: We conducted a pragmatic cluster-randomized controlled trial of 340 scholars and trainees at 27 US academic healthcare institutions. The primary outcome was number of published manuscripts 24 months post-intervention. Secondary outcomes included the number of grant proposals submitted and funded, job satisfaction, and level of communication with mentors. An analysis of CCDP participants assessed proficiency level for the 14 Clinical and Translational Science Award (CTSA) competencies. Data were analyzed using intention-to-treat. Results: Participants were mostly female (60.3%) and Caucasian (67.2%); mean age was 34 years. Twenty-four months following the intervention, the CCDP versus traditional IDP groups showed a similar number of publications (9.4 vs 8.6), grants submitted (4.1 vs 4.4) and funded (1.3 vs 2.0), and job satisfaction score (3.6 vs 3.7). The CCDP group had higher odds of discussing communication (OR = 2.08) and leadership skills (OR = 2.62) and broadening their network (2.31) than the traditional IDP group. The CCDP arm reported improvements in 9 of the 14 CTSA competencies. Conclusion: The CCDP offers CTSA hubs an innovative alternative to traditional IDP tools. Future studies are needed to elucidate why the CCDP users did not fully appreciate or adopt the functionality of the online platform.

A Mixed-Methods Analysis of Gender and Career Status Differences in the Impact of the COVID-19 Pandemic on Underrepresented Postdoctoral Fellows and Early-Career Faculty.

PURPOSE: The lack of racial and ethnic diversity in the biomedical workforce is pronounced and those from underrepresented backgrounds encounter more challenges than their majority counterparts. The extent of the impact of the COVID-19 pandemic on early-career investigators from underrepresented backgrounds is not yet fully understood. To examine the impact of the pandemic on underrepresented early-career biomedical researchers, this study evaluated differences in productivity, research, and psychological well-being by gender and career status. METHOD: This was a cross-sectional analysis of preintervention data, collected in September-October 2020, from 220 participants enrolled in the Building Up a Diverse Biomedical Research Workforce study. Participants were from 25 academic medical centers in the United States and were underrepresented early-career researchers. The primary outcomes were agreement on a 5-point Likert scale with pandemic impact statements (e.g., "The COVID-19 pandemic has impacted my ability to conduct research"). Thematic analysis was conducted on responses to 2 open-ended questions assessing the pandemic's impact. RESULTS: Most participants were female (79.9%), of non-Hispanic/Latinx/Spanish origin Black/African American (33.2%) or Hispanic/Latinx/Spanish origin (34.1%), and early-career faculty (53.4%). Over half of participants agreed or strongly agreed that the COVID-19 pandemic impacted their ability to work (55.7%) and conduct research (70.7%). Themes from qualitative analysis suggested lower research productivity, concerns about the academic job market and funding, and psychological distress due to the pandemic. Women were more likely to attribute lost productivity and psychological distress to homeschooling and childcare responsibilities. Postdoctoral fellows were concerned about more competition for fewer academic positions. CONCLUSIONS: In this study of early-career underrepresented biomedical researchers, the impact of the COVID-19 pandemic was widely felt by participants, varying by gender and career status. For those postdoctoral fellows and early-career faculty who are underrepresented, it is critical for institutions to offer flexibility in their positions.

The impact of social unrest due to systemic racism on underrepresented post-doctoral fellows and early-career faculty.

Introduction: Social unrest tied to racism negatively impacted half of NIH-funded extramural researchers underrepresented (UR) in science. UR early-career scientists encounter more challenges in their research careers, but the impact of social unrest due to systemic racism in this group is unclear. We used mixed methods to describe the impact of social unrest due to systemic racism on mentoring relationships, research, and psychological well-being in UR post-doctoral fellows and early-career faculty. Methods: This is a cross-sectional analysis of data collected in September 2021-January 2022 from 144 UR early-career researchers from 25 academic medical centers in the Building Up Trial. The primary outcomes were agreement on five-point Likert scales with social unrest impact statements (e.g., "I experienced psychological distress due to events of social unrest regarding systemic racism"). Thematic analysis was conducted on responses to one open-ended question assessing how social unrest regarding systemic racism affected participants. Results: Most participants were female (80%), non-Hispanic Black (35%), or Hispanic (40%). Over half of participants (57%) experienced psychological distress as a result of social unrest due to systemic racism. Participants described direct and indirect discrimination and isolation from other persons of color at their institutions. Twice as many participants felt their mentoring relationships were positively (21%) versus negatively (11%) impacted by social unrest due to systemic racism. Conclusions: Experiences with racial bias and discrimination impact the career and well-being of UR early-career researchers. Mentoring relationships and institutional support play an important role in buffering the negative impact of racial injustice for this population.

Evaluation of two longitudinal faculty leadership training programs: behavioral change and institutional impact.

PURPOSE: Building leadership skills among faculty in academic medicine is essential, yet professional development programs focused on leadership are not always attentive to the needs of faculty on diverse career pathways or at differing career stages-nor are they often rigorously assessed. Evaluations commonly focus on participant satisfaction and short-term learning but not behavior change and institutional impact, which are difficult to assess but arguably more meaningful. Given the substantial time and money invested in these programs, more rigorous evaluation is critical. DESIGN/METHODOLOGY/APPROACH: The authors evaluated an intensive, shared leadership-focused training program for early-career and mid-career faculty, offered by the University of Pittsburgh's School of Medicine over the course of a year. They administered a pre/post-program assessment of confidence in key skill areas, and conducted semi-structured interviews with 21 participants between 1-4 years after program completion. FINDINGS: Participants in both programs showed statistically significant improvement (p < 0.001) on every item measured in the pre/post-test. Analysis of the interviews revealed indications of substantial behavior change as well as institutional impact. The evaluation also suggested particular benefits for female professionals. ORIGINALITY/VALUE: The authors conducted a long-term assessment of leadership training focused on career pathway and career stage and found that it (a) prompted both positive behavioral change and institutional impact and (b) suggested benefits for female faculty in particular, which could potentially help to eliminate gender-based disparities in leadership in academic medical centers.

KL2 scholars' perceptions of factors contributing to sustained translational science career success.

Introduction: Identifying the most effective ways to support career development of early stage investigators in clinical and translational science should yield benefits for the biomedical research community. Institutions with Clinical and Translational Science Awards (CTSA) offer KL2 programs to facilitate career development; however, the sustained impact has not been widely assessed. Methods: A survey comprised of quantitative and qualitative questions was sent to 2144 individuals that had previously received support through CTSA KL2 mechanisms. The 547 responses were analyzed with identifying information redacted. Results: Respondents held MD (47%), PhD (36%), and MD/PhD (13%) degrees. After KL2 support was completed, physicians' time was divided 50% to research and 30% to patient care, whereas PhD respondents devoted 70% time to research. Funded research effort averaged 60% for the cohort. Respondents were satisfied with their career progression. More than 95% thought their current job was meaningful. Two-thirds felt confident or very confident in their ability to sustain a career in clinical and translational research. Factors cited as contributing to career success included protected time, mentoring, and collaborations. Conclusion: This first large systematic survey of KL2 alumni provides valuable insight into the group's perceptions of the program and outcome information. Former scholars are largely satisfied with their career choice and direction, national recognition of their expertise, and impact of their work. Importantly, they identified training activities that contributed to success. Our results and future analysis of the survey data should inform the framework for developing platforms to launch sustaining careers of translational scientists.

The Virtual CTSA Visiting Scholar Program to Support Early-Stage Clinical and Translational Researchers: Implementation and Outcomes.

In addition to restrictions on conducting research, COVID-19-related travel bans and scientific meeting cancellations have negatively affected scholars in the Clinical and Translational Science Award (CTSA) Mentored Career Development Award (KL2) program. In response, a national virtual visiting scholar program was developed to provide opportunity for KL2 scholars to be virtual visiting professors at another CTSA hub, meet faculty and scholars, and expand networks and build collaborations. This article describes the design and short-term outcomes of the virtual CTSA Visiting Scholar Program. In 2020, a working group designed core program elements and developed an application and selection process. Anonymized surveys were sent to scholars post visit and to scholars and program directors 6 months post visit to evaluate their experience and solicit suggestions for improvements. Between November 2020 and May 2021, 56 KL2 scholars and 27 hubs participated. Forty-five (80.4%) participating scholars responded to the initial survey. Nearly all scholars (44, 97.7%) agreed their experience was valuable. All respondents indicated they would recommend the program to other KL2 scholars. For the 6-month survey, the response rate was 87.5% (49/56). Within 6 months of their visit, 36 (73.5%) respondents had contacted at least one person at the host hub and for 17 (34.7%) respondents, new collaborations with the host hub ensued. Twenty-five of 27 (92.6%) host hubs responded to the survey. Most (21, 84.0%) agreed that hearing visiting scholar talks was valuable to their own scholars and 23 (92%) indicated likelihood of their hub participating in future round of the program. The virtual Visiting Scholar Program provided KL2 scholars an opportunity to virtually visit another CTSA hub, present their research, and meet with faculty and other scholars to expand their networks. Although geared to KL2 scholars, this model is potentially generalizable to other nationally coordinated career development programs.

Recruiting underrepresented individuals in a double pandemic: Lessons learned in a randomized control trial.

The Building Up Trial is a cluster-randomized trial that aims to address the issue of the leaky career pathway for underrepresented (UR) faculty in biomedical fields. Regulatory approval and recruitment for the Building Up Trial took place during the COVID-19 pandemic and the anti-racism movement. The pandemic and anti-racism movement personally and professionally impacted the target population and made recruitment challenging at both the institution and participant level. The target sample size for this study was 208 postdoctoral fellows or early-career faculty across 26 predominately white institutions. Challenges and adaptations are described. The Building Up Trial was delayed by 3 months. In total, 225 participants from 26 institutions were enrolled. Participants are predominately female (80%), Hispanic/Latinx (34%) or non-Hispanic/Latinx Black (33%), and early-career faculty (53%). At the institution level, obtaining Institutional Review Board (IRB) approval through a single Institutional Review Board (sIRB) posed the biggest challenge. We adapted to COVID-19-related challenges through simplifying sIRB forms, modifying study practices, and increasing communication with institutions. Recruiting UR postdoctoral fellows and faculty during the COVID-19 pandemic and anti-racism movement was challenging but not impossible. Studies should be prepared to modify study and recruitment policies to overcome additional barriers posed by the pandemics.

The impact of the COVID-19 pandemic on underrepresented early-career PhD and physician scientists.

Underrepresented minorities have higher attrition from the professoriate and have experienced greater negative impacts of the COVID-19 pandemic. The purpose of this study was to compare the impact of COVID-19 on the lives of 196 early-career physician-scientists versus PhD researchers who are underrepresented in biomedical research. Participants in the Building Up study answered questions on the impact of the COVID-19 pandemic on their personal and professional lives, and a mixed-methods approach was used to conduct the analysis. While most participants experienced increases in overall stress (72% of PhD researchers vs 76% of physician-scientists), physician-scientists reported that increased clinical demands, research delays, and the potential to expose family members to SARS-CoV-2 caused psychological distress, specifically. PhD researchers, more than physician-scientists, reported increased productivity (27% vs 9%), schedule flexibilities (49% vs 25%), and more quality time with friends and family (40% vs 24%). Future studies should consider assessing the effectiveness of programs addressing COVID-19-related challenges experienced by PhD researchers and physician-scientists, particularly those from underrepresented backgrounds.

Assessing the application of human-centered design to translational research.

INTRODUCTION: Human-centered design (HCD) training offers the potential to improve both team processes and products. However, the use of HCD to improve the quality of team science is a relatively recent application, and its benefits and challenges have not been rigorously evaluated. We conducted a qualitative study with health sciences researchers trained in HCD methods. We aimed to determine how researchers applied HCD methods and perceived the benefits and barriers to using HCD on research teams. METHODS: We conducted 1-hour, semi-structured interviews with trainees from three training cohorts. Interviews focused on perceptions of the training, subsequent uses of HCD, barriers and facilitators, and perceptions of the utility of HCD to science teams. Data analysis was conducted using Braun and Clarke's process for thematic analysis. RESULTS: We interviewed nine faculty and nine staff trained in HCD methods and identified four themes encompassing HCD use, benefits, challenges, and tensions between HCD approaches and academic culture. CONCLUSIONS: Trainees found HCD relevant to research teams for stakeholder engagement, research design, project planning, meeting facilitation, and team management. They also described benefits of HCD in five distinct areas: creativity, egalitarianism, structure, efficiency, and visibility. Our data suggest that HCD has the potential to help researchers work more inclusively and collaboratively on interdisciplinary teams and generate more innovative and impactful science. The application of HCD methods is not without challenges; however, we believe these challenges can be overcome with institutional investment.

Correlation of Coping, Mentorship, and Life Events with Burnout in Internal Medicine Residents.

Physician burnout is a widespread problem. We examined how coping, mentorship, and life events correlated with burnout in Internal Medicine Residents. We performed a cross-sectional study of survey data collected over multiple time points and used Spearman correlation of coping, mentorship, and life events to emotional exhaustion (EE) and cynicism (CYN). Burnout was assessed using the Maslach Burnout Inventory-General Survey (MBI-GS), coping skills were measured using the Brief COPE, mentorship with an institutional mentoring survey, and life events with a shortened Social Readjustment Rating Scale (SRRS). Two thousand one surveys were distributed to 616 residents from 2010 to 2015. There were 1144 cases of completion of both the Brief COPE and the MBI-GS (58%), 744 of the MBI-GS and the Mentoring survey (47%), and 1138 of the MBI-GS and Life Events Scale (57%). There were correlations between acceptance (ρ 0.1-0.24), denial (ρ 0.13-0.20), substance abuse (ρ 0.15-0.22), behavioral disengagement (ρ 0.18-.037), self-blame (ρ 0.27-0.45), self-distraction (ρ 0.18-0.32) and venting (ρ 0.15-0.47) and EE. There were correlations with acceptance (ρ 0.11-0.15), denial (ρ 0.18-0.26), humor (ρ 0.13-0.20), substance abuse (ρ 0.10-0.29), behavioral disengagement (ρ 0.19-0.40), self-blame (ρ 0.24-0.35), self-distraction (ρ 0.14-0.34) and venting (ρ 0.12-0.38) and CYN. There was a negative correlation between mentorship and EE (ρ - 0.15, - 0.18) and CYN (ρ - 0.30 to - 0.20). There were correlations between life events and EE (ρ 0.15-0.20) and CYN (ρ = 0.14-0.15). Maladaptive coping mechanisms, acceptance, and life stressors correlate with burnout in internal medicine residents and mentoring may be protective.