NOTES FROM THE ASSOCIATION OF
MEDICAL SCHOOL PEDIATRIC DEPARTMENT CHAIRS, INC.
The “Cs” of Mentoring: Using Adult Learning Theory and the Right Mentors
to Position Early-Career Investigators for Success
Tina L. Cheng, MD, MPH, and Jamilah M. Hackworth, EdD
E
ffective mentorship of early-career investigators is one
of the most important determinants of success in aca-
demic career development and productivity.1-3 A suc-
cessful mentoring relationship relies on trust, support,
communication, clear goals, skill development, and a pro-
ductive relationship for both parties.4 Although much has
been written on how to be an effective mentor, less has
been written about what mentees can do to develop and
strengthen mentee-mentor relationships. This article reviews
the tenets of adult learning theory that are relevant to men-
toring early-career investigators and outlines the types of
mentors needed (the “Cs”) for success. This article may
have relevance for mentee-mentor relationships starting as
early as high school, but it is most relevant for investigators
beginning in professional school and continuing through
junior faculty ranks.
Although traditional mentoring relationships connote a
single, dyadic, hierarchical relationship, they should be
viewed as partnerships characterized by sharing and mutual
respect.5 The multiple demands faced by faculty members
within academic medicine necessitates mentees’ ability to
manage their own development.6 This requires that mentees
understand how generational differences in mentor and
mentee values, expectations, and ethos may influence the
relationship and be self-directed and purposeful in establish-
ing and maintaining effective relationships with their men-
tors.7 To this end, Knowles outlined 6 main characteristics
of adult learners that can inform mentees’ approaches to
building relationships with their mentors and provide guid-
ance for what mentees can do to facilitate their own career
success8:
Adult Learning Is Self-Directed/
Autonomous: Mentees Should Seek out
Mentors
Mentees are actively involved in their learning process and
must be empowered to seek out mentors to reach their
learning objectives. Mentees should be proactive in inter-
viewing potential mentors, choosing their mentoring team,
and formalizing the relationship(s). Some suggest that adults
who choose their mentors have stronger relationships than
those who are assigned.9 Existing literature outlines the char-
acteristics of successful mentoring relationships including
having the “right chemistry”10; mentoring scale11; as well as
reciprocity, mutual respect, clear expectations, and shared
values.12
6
Once a mentee identifies a potential mentor, there should
be explicit discussion about the mentee’s and mentor’s inter-
ests and goals and alignment with the dyad’s available time to
help facilitate these goals. Focus groups with early career re-
searchers have found that common challenges in mentoring
relationships include compatibility, finding time, establish-
ing patterns, and agreeing to goals.13 Explicit discussion at
the inception of the relationship may help the mentee and
mentor avoid some of these common challenges. Many men-
tors and mentees advocate for the use of mentorship com-
pacts or agreements as a means to outline goals/objectives
for the mentoring relationship, periodicity, and duration of
meetings, as well as other rules for engagement.
Adult Learning Utilizes Knowledge and Life
Experiences: Mentees Should Build on Past
Relationships
Mentees and mentors have past experiences, knowledge, and
opinions that shape their work and their views on the direc-
tion of their careers. Strong mentor-mentee relationships
openly share and build upon this. Strong relationships often
involve discussions about science but also about career and
personal life experiences and work/life integration.
Adult Learning is Goal-Oriented: Mentees
Should Map out and Revisit Short- and Long-
Term Learning, Research, and Personal
Goals
Mentoring involves the provision of guidance for mentees to
identify and acquire knowledge and skills for success. Pur-
poseful assessment of competencies and sharing of one’s
learning, research, and personal missions is needed as specific
goals are developed. Competencies, learning activities, and
outcomes should be explicit, relevant, and time-bound as
should research milestones and outcomes.14 Regular review
of learning and research goals and timelines should be part
of the mentoring process.
From the Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; and
University of Cincinnati College of Medicine, Cincinnati, OH
The authors declare no conflicts of interest.
0022-3476/$ - see front matter. ª 2021 Elsevier Inc. All rights reserved.
https://doi.org/10.1016/j.jpeds.2021.03.023

Adult Learning is Relevancy-Oriented:
Mentees Should Develop Timelines Mapped
to Activities and Goals
The motivation to learn is increased when the relevance of
the work and relevance to one’s career are clear. Adults learn
by relating the assigned tasks to their own learning goals.
Involvement in those goal-setting activities and clarity on
the timing and relevancy of tasks contribute to success. For
example, taking a class on scientific writing is more relevant
and influential if the mentee has a manuscript upon which to
work while taking the course.
Adult Learning Highlights Practicality:
Mentees Should Envision Translational
Impact and Next Steps
Learning is facilitated when the translational impact of dis-
covery is understood and when the next logical research
question can be envisioned. Similarly, learning is facilitated
when career discussions are related to knowledge of the prac-
tical steps necessary for employment, promotion, or
advancement. It should be noted that millennials are known
to value purpose. They also tend to expect accessibility, rapid
response and turnaround, and frequent short meetings.7
Adult Learning Encourages Collaboration:
Mentees Should Be Collaborators with Their
Mentors in Synergizing Discovery
It is known that adult learners thrive in collaborative rela-
tionships with their educators, the foundation of the strong
mentor-mentee relationship and successful science. When
mentor and mentee have shared scientific interests and goals,
they become more productive and put forward their best
work. Teamwork and giving credit to contributions of all
team members furthers success. Explicit discussion of the
mentor and mentees’ goals, tasks, and future collaborative
endeavors strengthens team science. For millennials, collabo-
ration, innovation, and team science are motivating.
Shea has outlined 7 special mentee skills: (1) ask produc-
tive questions, (2) develop key listening skills, (3) use trust-
building behaviors, (4) overcome the awe factor, (5) resolve
differences, (6) capture the essence of your mentor’s help,
and (7) internalize your mentor’s input.6 These skills are crit-
ical when it comes to establishing and maintaining produc-
tive mentoring relationships—the cornerstone for success
for early-career investigators.
The Cs of Mentoring
Mentors, mentoring teams/career development committees,
and individualized development plans are often required
for training programs; however, the types of mentors needed
by early-career investigators is often not clearly delineated.
What types of mentors do early-career investigators need to
Volume 238  November 2021
be successful? Below, we present 8 types of mentors as the
“Cs of mentoring” (Table; available at www.jpeds.com).
Occasionally a single mentor successfully guides a mentee
in all of these “Cs,” but because of the complexities
associated with the multiple demands that exist in
contemporary academic medicine as well as the time
constraints that exist for mentors, alternatives to traditional
dyadic mentoring relationships including mentoring teams
or developmental networks are necessary.15 These
mentoring teams or networks empower mentees to seek
personalized developmental relationships that provide
them with diverse perspectives, exposure, mentorship,
sponsorship, and psychosocial support. Early-career
investigators should reflect on whether their mentoring
teams address all of these “Cs.” If not, they should actively
seek out additional mentorship.
Content Mentor
This is the mentor who shares an interest in the mentee’s
research area, knows the literature, and can guide the devel-
opment of the mentee’s study question. A great candidate for
content mentor would be a more senior faculty member who
has ongoing projects in which the mentee can participate.
This could create a mutually beneficial partnership where
the mentor’s research is furthered while simultaneously
enhancing the skills of the mentee—a win-win situation for
both parties.
Connecting Mentor
This mentor has a vast network and can extend that network
to mentees as they seek to get connected both inside and
outside of their institutions. These networks and the ability
to leverage them are critical to career success as they aid in
the development of research collaborations, and expansion
of one’s own developmental network, and ultimate career
success.16 In addition, the connecting mentor often serves
as an advisor and may model techniques for properly interact-
ing with and leveraging one’s professional network both in
formal and informal settings. The connecting mentor may
also function as a sponsor by recommending mentees for
important committees and other leadership opportunities.17
Coaching Mentor
Coaching is thought to be distinct from mentoring in em-
ploying “methods that help the learners gain insights into
their own assumptions, clarify meaning about relevant out-
comes, and help identify specific actions needed to achieve
a desired result.”18 Coaching is learner-driven in helping
mentees gain insight into assumptions, processes, and out-
comes into actions needed to achieve goals. Coaching helps
to develop skills, which may include abstract or manuscript
writing, presentation skills, grant writing, laboratory tech-
niques, biostatistical analytic skills, or self-monitoring and
lifelong learning skills. Coaches help to identify strategies to
manage challenges, improve academic performance, and
further professional identity development.19
7
THE JOURNAL OF PEDIATRICS  www.jpeds.com
Cheerleader Mentor
The journey to becoming a successful clinician investigator
will have ups and downs. Amid manuscript or grant rejec-
tions, failed experiments, research delays, an encouraging
cheerleader mentor is needed to help keep mentees focused
on their long-term career goals.
Critiquing, Challenging Mentor
Aside from cheerleader mentors, clinician investigators also
need mentors who will give critical feedback and will chal-
lenge ideas. Mentors are needed to help develop and word-
smith study aims, closely read multiple drafts of
manuscripts and grant applications, and offer constructive
criticism and ways to improve.
Career Mentor
Early-career investigators need mentors who are actively
thinking (along with them) about the long-term develop-
ment of their careers. This could be a division director or
department chair. The career mentor will ensure that
much-needed discussions about what is needed for promo-
tion as well as issues of balancing career and personal life
occur on a regular basis.
Colleague Peer Mentor
Teaming with colleagues who are in a similar stage of develop-
ment can enrich early-career investigators’ work. Peer mentor-
ing partnerships or groups can provide enhanced engagement,
collaboration, social support, and intellectual input. This might
include writing accountability groups, writing partners, social
groups or other mechanisms for peer support.
Clinical Mentor
Early-career clinician investigators (eg, physicians, nurses,
psychologists, etc) will need clinician mentors to work closely
with them to provide guidance and support regarding patient
management and the navigation of clinical systems at your
organization. Mentees’ clinical skill development will also
benefit tremendously from having an experienced clinical
mentor and will ensure that they are able to achieve and sus-
tain high-quality clinical outcomes for all patients.
8 Cheng and Hackworth
Volume 238
It is rare that the types of mentors described above can be
found in one person. Therefore, early-career investigators
should assess their mentoring networks to determine which
mentors fulfill each of the 8 Cs and seek out mentors to fill
any gaps that they identify in the process.
Shopping for Mentors
For new trainees and junior faculty, the first step is to shop
for mentors and form a mentoring team. Focus group studies
and commentaries have outlined steps for “managing up” to
create successful relationships with mentors.1,20,21 Once the
mentee has clarified her or his values, knowledge/skills
gaps, and goals, it is important to meet with many potential
mentors to discuss common interests, learn about projects
underway, and available resources. Once early-career investi-
gators have selected potential mentors for their mentoring
teams, it is important to formalize the relationships by asking
the question, “Will you be my mentor?” Discussion of expec-
tations and parameters of the relationship is necessary. To
clarify and formalize the responsibilities of the mentor and
mentee, some faculty may choose to use mentoring com-
pacts/agreements, formalized agreements between mentors
and mentees used to outline parameters for their mentoring
relationships including the establishment of expectations/
goals for the relationship, meeting frequency, plan for evalu-
ating relationship effectiveness, etc.
Effective mentorship is critical to success in academic
medicine. Mentees who take personal responsibility for
developing goal-oriented, collaborative developmental net-
works that include mentors fulfilling each of the Cs of men-
toring outlined above will be well-positioned to have
impactful, rewarding careers in academic medicine. n
Reprint requests: Jamilah M. Hackworth, EdD, Cincinnati Children’s Hospital
Medical Center, 3333 Burnet Ave MLC 4000, Cincinnati, OH 45229. E-mail:
Jamilah.Hackworth@cchmc.org
References available at www.jpeds.com
November 2021 NOTES FROM THE ASSOCIATION OF MEDICAL SCHOOL PEDIATRIC DEPARTMENT CHAIRS, INC.
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THE JOURNAL OF PEDIATRICS  www.jpeds.com Volume 238

Table. The “Cs” of mentoring clinician scientists

 Content Mentor
 Connecting Mentor
 Coaching Mentor
 Cheerleader Mentor
 Critiquing Mentor
 Career Mentor
 Colleague Peer Mentor
 Clinical Mentor

8.e2 Cheng and Hackworth