All right, well, thank you for that introduction. And thank you to the American College of Critical Care Medicine for the invitation and the SCCM planning committee for inviting me. When I was inducted as a fellow of the college in 2017, I would find it hard to imagine that I'd be speaking at the ACCM town hall. So thank you to the college and to SCCM for the invitation. And so in the brief time that we have remaining, I'll spend a few moments talking about the value of mentorship and how we can use it to implement an advanced diversity within all of our institutions. So before we begin, I just want to highlight, and when we talk about mentorship, just want to walk a little bit through my journey and so you can understand where I've been and how mentorship has impacted my career. So beyond a mentorship that we've all received at home between our families and friends and high school teachers and such, many of our beginning mentorship experiences begin when we go to college. And so for me, that was at Florida A&M University in Tallahassee, Florida, which is a historically black college and university. And so I was really privileged to attend that university. And that's really where I learned the importance of mentorship and bringing others along in the journey. And then when I was graduating from pharmacy school, I went on to pursue critical care residency training at Tampa General Hospital, where I learned the value of mentorship in terms of being engaged in the profession and being engaged in professional societies such as SCCM. And further have gone on to institutions such as Auburn University, Harrison College of Pharmacy, and my current institution, the University of Florida College of Pharmacy, where I receive and continue to receive mentorship in terms of becoming a better researcher, teacher, and clinician every day. And so that's the lens in which I view a mentorship. I encourage each of you to think about mentors along the way that have helped you throughout your careers. So as we begin, I have no relevant conflicts of interest to disclose, but I do have a strong bias that mentoring is vital to the career success of trainees and health professionals. And I would venture to say that mentorship doesn't just stop when one leaves their training. Mentorship can be influential when we talk about early stage investigators, mid-career investigators and clinicians, or administrators and later stage practitioners. And so I have a strong bias that mentoring is something that's valuable to all of us. And so when I was putting together this presentation, I asked the organizers, what do you want me to talk about? And so the session objective that was related to my discussion was by the end of the presentation, folks would be able to apply mentorship skills to advance diversity and develop education leaders. And so in order to achieve that particular objective, here's an outline of where we're gonna go in the next few minutes. So I'd love to spend a few moments talking about where we are in terms of diversity in the workforce specific to critical care, and where have we been historically? Why is mentoring an important component of diversifying the critical care workforce? And then lastly, we'll talk about some strategies that perhaps you can take home to your own institutions and apply to facilitate a diverse faculty workforce. And so really briefly, I won't spend too much time here, but when we talk about concepts and definitions, I always like to set the stage when we talk about DEI. And so in the context of the discussion today, when we talk about mentorship, that really is about a collaboration, a working alliance, which individuals work together over time to see the professional growth of traditionally a junior colleague, and that's traditionally supported by a more senior colleague. But in a few slides, we'll talk about some examples where it can be different levels of mentor and mentee experience levels. When we talk about diversity, I'm talking about in this instance, differences, whether they be psychological, physical, and social differences that occur amongst all of us. And really, if I could sum it down and boil it down to one word, that word would be difference. When we talk about equity, we're talking about the guarantee of fair treatment, access, and opportunity for advancement. And working to eliminate barriers. And so one word that I would boil that down to is access. And then in the aspect of inclusion, it really is about the act of creating environments in which individuals and groups can feel welcome, respected, and supported. And so if I were to boil that down to, in this case, two words, it's what is your institution doing to make folks feel valued? In the context of this presentation, I'll spend the majority of the discussion focusing on underrepresented minority individuals, which in the context of this lecture, is when we talk about medicine and healthcare in general, those include those individuals that identify as black or African American, Hispanic or Latino, American Indian, Alaska Native, or those that identify as Native Hawaiian and Pacific Islander. Now, I do wanna acknowledge that much of the discussion that we talk about with respect to URMs can also apply to other historically marginalized groups, such as people with disabilities and such. But the focus of the discussion today will focus on those that come from underrepresented backgrounds. And so when we talk about faculty diversity, it remains elusive when we talk about different health disciplines. And so I present to you a paper that was recently published in the pharmacy literature from Hope Campbell and colleagues out of Nashville. And essentially, they wanted to evaluate the respective diversity that was seen in pharmacy, medicine, and dentistry faculty. And so despite making up nearly a third of the U.S. population, and nearly a third of those that are age 20 to 34, which would represent the number of students or college-age individuals that would be pursuing or considering careers in healthcare, despite making nearly a third of those populations, you can see the statistics that illustrate that pharmacy, medicine, and dentistry, in this case, are still grossly underrepresented when we talk about underrepresented minorities. In pharmacy, it's 8.5% of all faculty come from URM backgrounds. In medicine, it's about 7%. And our dentistry colleagues are doing a little bit better at 14%, but still under what we would expect relative to their representation in both the U.S. as well as the age-appropriate population. Now, let's explore that a little bit further. Campbell and colleagues looked at this, and they looked at it through the lens of pharmacy. And so one of the things that they wanted to highlight was understanding what are some of the differences with respect to pipeline considerations. And so this figure here just illustrates a pipeline for what a traditional role would be for a pharmacy faculty. So traditionally, you get your PharmD, then you go pursue residency training, and then you join faculty. And so you can see that for non-URM individuals, you can see that pipeline expands, where essentially they make up 66% of the population in the census, but account for nearly 81% of practice faculty within colleges of pharmacy. Now, conversely, looking at that same pipeline figure for URM faculty, you can see that the pipeline narrows over time. So despite making up a third of the population, you can see that by the time it gets to a faculty position, URMs only make up about 8.5% based on the work that they had done in 2021. And so I briefly highlight here some examples of where mentorship along the way can have an impact. So we talk about making the choice to pursue college, college recruitment and retention, interest in STEM, interest in a health discipline. I want you to think about in your own stories, how did you get to where you are, and who are the folks that maybe influenced you? Or when we talk about retention and academic success within a college or within your experience, think about folks that have helped you along the way. And certainly when we talk about deciding to pursue different specialties in terms of academia, think about folks that have influenced you or even into clinical practice. Now, some theories have been hypothesized around this and largely centered around lack of support and mentorship and role modeling for individuals that come from URM backgrounds. And so you may be thinking, looking at that, well, that's not critical care, we're not that way. And so let's bring it a little bit closer to critical care. And so I wanna highlight a study that was done by Lanefall and colleagues in 2017. This is a little bit older study, but they looked at data from the ACGME from 2004 to 2014 and wanted to explore the demographics of critical care fellows over that time, which included surgical, pulmonary, as well as anesthesia critical care fellows. For context, during that timeframe, that 10-year time period, the absolute number of fellows increased from 1,600 to about 2,500 over that same time. So I wanna provide that as context. And so I wanna orient you a little bit to these figures here, and let's see if I can make this work, all right. So this figure to the left represents individuals who identified as white. This figure in the middle is identifying those that identified as Hispanic, and on the right is those individuals that identified as black. The yellow bars here represent the U.S. Census and their percentage over the 10-year timeframe. The major point that I wanna highlight from this is that when we look at individuals that identify as white, their representation in terms of critical care fellows, which is represented by the black lines, I know it's a little bit busy, but it's very similar to the demographics of the U.S. Census. However, when you look at Hispanic and individuals that identify as black, you can see that the numbers are below the yellow line, which represents the representation. And so what they looked at and identified is that among black and Hispanic individuals, the absolute numbers increased over time, but I just told you that the number of fellows increased as well. We actually saw in black fellows a decrease in percentage over that 10-year timeframe. Now, that wasn't statistically significant, but this should be alarming to us as healthcare professionals and our deeper understanding of health disparities and health equity, how impactful it might be to include, to try to increase diversity amongst the critical care workforce. See if I can get it to go, all right. And so I've given you all these statistics, but let's think about what we can do next, right? I personally wouldn't have been where I am today without the help of mentors, so let's talk about what that could look like moving forward. And so we talk about mentors, and I asked you to consider your own mentorship journeys. Mentors can fill a number of different roles, and it's likely that one mentor is not gonna fill all of them. For time's sake, I won't read or go through all of the different roles, but I just want you to think about in your own experiences, in your own career, what roles has a mentor taken for you, from being an advisor where they can give you a career experience, to being a sponsor where they can provide source of information about different opportunities, such as speaking opportunities, to serving as a role model in terms of trying to be the best academic or best clinician that one can be. And so really briefly, and I won't read this to you, just for time's sake, but mentees, the benefits to mentees are numerous. I think I'm speaking to a, I'll say biased audience in the sense that I'm sure we've all received mentorship along the way and can speak to the importance of it in terms of our own professional development as well as our own career journeys. And so I wanted to do a deeper dive and look at what do successful mentorship programs look like when we talk about instituting them at our own institutions. And so Bonifacio and colleagues completed a systematic review of mentorship programs in medicine that were designed for underrepresented minority individuals. And so in their paper, they found several different models that have been explored, and there is no one size fits all model. When we talk about mentorship, typically we're thinking of this dyad model where it's one mentor and one mentee. And so that's when we historically think about that, that's usually one senior mentor and one junior mentee. So this is easy to implement because it involves less complex scheduling and communication purposes. But there are other models which include kind of a offshoot of this dyad model is a peer model or horizontal model where two individuals that are at the same level mentor each other. And so that's one that's been explored in the literature. There are others which include a triad type of models which are two mentors and one mentee. And other models include two mentees and one mentor. And they serve as kind of a mentoring group to each other. For time's sake, I won't spend too much time here, but when we talk about another model which is this collective or group model, this includes where there's actually a network of individuals that are serving as a mentor. And earlier I showed you the slide that talks about some of the roles of mentors. There's very few people that are gonna be able to check every box for you, all right? I know that I have professional mentors, personal mentors in research, clinical practice. And so looking outside of just one person is one way to advance mentorship. Now in their systematic review, they identified some barriers to successful mentorship programs. And some of those include program logistics. And so earlier I talked about those network programs. They can be helpful, but they can also be more complex. Think about it, the more people that you add to the meetings and mentor committees, you can see different challenges in terms of implementing those. Mentor matching and just making sure that folks fit the same type of interest can be a barrier. And then communication, just like any other type of relationship can be a challenge. Some facilitators include, facilitators of what a good mentorship program might look like include institutional support, and strong institutional support has been demonstrated to be helpful. Mentor training, as well as mentors or role models from similar gender or cultural backgrounds. Now, I do wanna highlight that that doesn't necessarily mean that there needs to be racial concordance with the mentorship, but it was shown to be a facilitator of good relationships. I'll have to say that in my own institution, my biggest mentor right now is, we talk about interprofessional education, is a colleague, a nursing educator, and has helped me immensely as I pursue NIH funding. And so mentorship doesn't just have to be in our silos of our specific professions. Really briefly, themes that good programs have or the more impactful programs include aligning mentorship programs with institutional goals and resources. It has to be a part of what the institution lives every day. And also training of mentors has been shown to ensure program effectiveness. Really briefly, in terms of just mentorship, relationship principles in general, I'll leave this here on the screen for a moment, but a couple of things that I wanna highlight are effective communication, and just making sure that we're engaging and active listening with our mentees and providing constructive feedback. Modeling ethical behavior and making sure that we are providing the type of role model that we want our mentees to grow into. And then lastly, I'll say here, nurture well-being. So that's something that I take very seriously with my mentees is just ensuring that they are taking time to practice self-care, taking time to not, to do things outside of critical care. I often tell them that an empty cup can't pour into others. And so being able to get your refill, whatever that looks like, is so impactful in terms of being able to help others. So really briefly, this is a model that was described by Lusant and colleagues in terms of very specific actions to promote successful URM mentorship. And it was written through the lens of gastroenterologists, but many of the principles apply to the critical care discipline. And so first is establishing mentor-mentee relationships and assuring equity in mentorship opportunities. And so making sure that mentors are engaged in implicit bias training and that mentors have a responsibility to seek folks out that may be different from their own discipline or their own background. Oftentimes we engage with folks that are similar to us, but I think as a mentor, we have the opportunity to engage with others. For time's sake, I won't go through all of these, but in terms of some of the actions to enrich mentor-mentee relationships, include just including very respectful dialogue about life experiences and culture. When we talk about maximizing the success of the relationship, defining goals and progress and monitoring progress towards those goals can be successful. Talking about sponsorship, we talked about it earlier, but mentors should leverage their experiences and knowledge of an institution to help early career faculty and clinicians. And sponsorship activities include recommending them for speaking at presentations like this at SCCM and others. And lastly, when we talk about specific actions, mentorship and mentoring the next generation includes exposure of folks that aren't currently in the field of critical care. So this is high school, undergraduates, things of that sort to expose them to the field of critical care. This is gonna be helpful because they will know more about the profession at an earlier time point in their career. Too much to explain in a 15 minute talk, but here's some additional resources if you wanna learn more about different mentoring, particularly to underrepresented minorities. One, I wanna draw your attention, or two, is the Center for the Improvement of Mentored Experiences and Research. And then also the National Academy of Sciences has a program, the Science of Effective Mentoring in STEM, which can be helpful. And so I encourage you to review that. So in conclusion, we talk about some of these challenges. There have been longstanding in terms of representation, but mentorship is fundamental to achieving and working to build a diverse workforce. And we certainly need to take deliberate approaches to maximize those experiences. I'll leave you with this, and I thought this was a very powerful quote. And I thought it would engender goodwill from the audience. Who doesn't love Oprah? I mean, Oprah is great. But she said, a mentor is someone who allows you to see the hope inside yourself. And I hope that, no pun intended, I hope that you consider your role as a mentor and how you can pour into others and allow them to see the hope inside them. And so with that, I'll pause, and thank you for your attention and staying.

mentorship

diversity

critical care medicine

career development

underrepresentation

mentorship programs