Attachment 18 NRMN Student Mentee Followup Survey

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Attachment 18:
NRMN Student/Mentee Follow-up Survey
Created 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 IRACDA 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. Do you have a faculty member or someone else who is more senior than you who you
consider a mentor?
No

Yes

8. How many different mentors do you regularly work with?
9. For the mentor you work with most closely (your primary mentor), please provide the
following information:
Position:
Institution/ Company:
Discipline:
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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13. Indicate to what extent the following statements are true of you:
Strongly
disagree

Disagree

Neutral

Agree

Strongly
Agree

I choose not
to answer

a. I have a strong sense of
belonging to the community
of scientists
b. I derive great personal
satisfaction from working on
a team that is doing important research
c. I have come to think of
myself as a ‘scientist’
a. I feel like I belong in the
field of science
14. Indicate to what extent you are confident that you can complete the following tasks:
Not at all
confident

a. Use technical science
skills (use of tools, instruments, and/or techniques)
b. Generate a research
question to answer
c. Figure out what data/
observations to collect and
how to collect them
d. Create explanations for
the result of the study
e. Use scientific literature
and/or reports to guide research
f. Develop theories (integrate and coordinate results
from multiple studies)

A little
confident

Somewhat
confident

Very
confident

Absolutely I choose not
confident to answer

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15. Indicate the importance to you personally of each of the following:
Not
important

a. Obtaining recognition from colleagues for contributions to my special
field.
b. Making a theoretical contribution to
science.
c. Becoming an authority in my field.

Somewhat
important

Very
important

Essential

I choose not
to answer

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We would like to get information about your current position.
16. 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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17. Have you been enrolled in school at any time during the past year?
No
Yes and I am still enrolled
Yes, but I am not still enrolled

a. Expected completion date (year):
Expected degree:
b. Status:
Full time
Part time
c. Institution:
d. Major:

e. Please tell us your current status
I graduated from my previous institution
I did not graduate but do have plans to attend school in the next 2 years
I did not graduate and do NOT have plans to attend school in the next 2 years
f. Please indicate the following:
Degree / certificate:
Major / area of study:
From which institution or school:
Date awarded

/

18. 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

/

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19. During the past year, did you apply to any degree or certificate program?
Note: If you completed a program above, please indicate here any other program applications.
No

Yes

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

/

e. Status of application:
Accepted and will attend
Accepted and will not attend
Waitlisted
Pending
Not accepted
20. During the past year, did you receive any scholarships or grants for education expenses
that you do not need to repay?
No

Yes

a. Name of scholarship/grant:
b. Amount (total value including value of any fee/tuition waivers):
Less than $1,000
$1,000-$4,999
$5,000-$9,999
$10,000 or more
c. Period of award:
d. Was this award based on:
Need
Merit
Need and Merit
Other (specify):

to

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21. Do you have any education debt?
No

Yes

a. Total amount that you owe:
Less than $5,000
$5,000-$9,999
$10,000-$19,999
$20,000 or more
I don’t know how much i owe
b. How much you borrowed during the past year:
None
Less than $1,000
$1,000-$4,999
$5,000-$9,999
$10,000 or more

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22. 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.

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

Yes

24. 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/Industry
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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25. 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):
Worked in a laboratory in a college/university
Worked on research in a non-academic location
Designed your own research experience
Conducted research that had an unknown outcome
Contributed to research that advanced knowledge (even if it was a very small advancement)
None of the above
26. Do you have any peer-reviewed publications accepted, in-press, or published in the past
year? This may include peer-reviewed abstracts included in conference proceedings.
No

Yes

Below is a list of publications you have provided to us in the past.

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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:

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

Yes

29. 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
30. 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:

31. 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 year.
If you provided this information already on your CV, you may skip this item:

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32. 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:

33. 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:

34. Please indicate if any of the following are an ongoing or long-term situation for you:
Yes

Are you deaf or do you have serious difficulty hearing?
Are you blind or do you have serious difficulty seeing, even when
wearing glasses?
Because of a physical, mental, or emotional condition, do you
have serious difficulty concentrating, remembering, or making
decisions?
Do you have serious difficulty walking or climbing stairs?
Do you have difficulty dressing or bathing?
Because of a physical, mental, or emotional condition, do you
have difficulty doing errands alone such as visiting a doctor’s
office or shopping?

No

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35. Do you have someone at a similar educational level as you (i.e. a peer)
who you consider an academic/career mentor?

No
Yes
a. How many different peer mentors do you have? _________
b. Which of the following do your peer mentors help you with?
(Choose all that apply)
Research issues
Social and emotional needs (e.g. sharing concerns about school)
Tangible help (e.g. advice about faculty and classes, 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): ________________________

c. How do you usually communicate with your primary peer mentor?
In-person
Phone/Skype
Email/Text
Other (specify): ______________
d. How often do you usually communicate with your primary peer
mentor?
Weekly
Montly
Several times a year
Annually or less
e. How did you find this mentor?
They were assigned in some other way by your department or
campus
You were matched through the National Research Mentoring Network (NRMN)
Matched through some other formal program
You sought out your mentor independently
Other (specify): ______________

36. Do you have anyone who you currently mentor about academic issues
who is junior to you?

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No
Yes
a. How many different people to your regularly mentor currently?
b. At what education level are the people you mentor? (Choose all that
apply)
College students
High school students
Middle or elementary school students
c. Which of the following do help your mentees with? (Choose all that apply)
Research issues
Social and emotional needs (e.g. sharing concerns about school)
Tangible help (e.g. advise about faculty and classes, 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): ___________________________
d. How do you communicate with your mentees?
In-person
Phone/Skype
Email/Text
Other (specify): ______________
e. On average, how often do you usually communicate with your mentees?
Weekly or more often
Monthly
Several times a year
Annually or less
f. How did you first connect with your mentees? (Choose all that apply)
They were assigned in some other way by your department or campus
You were matched through the National Research Mentoring Network) (NRMN)
Matched through some other formal program
They sought you out independently
Other (specify): _________________