Building a Productive Mentoring Partnership Across Disciplines and Institutions

Lori Daiello, PharmD, ScM, is the principal investigator of an NIH-funded study of postoperative delirium and persistent cognitive impairment among older adults undergoing major surgeries. But she didn’t start her career with the goal of becoming an independent researcher. After earning her PharmD in 1993, specializing in geriatric psychopharmacology, she built a successful clinical practice working with patients with dementia.

“Somewhere in the course of my career, I started becoming frustrated with the limited ability I had to make a difference larger than at the individual patient level. So I started to think about a research career,” she says. In 2006, she began a post-doctoral fellowship at Rhode Island Hospital’s Alzheimer’s Disease & Memory Disorders Center. When it ended, she says, “I was humbled by learning that I had a long path ahead if I wanted to be an NIH-funded researcher.”

Mentors are crucial to the success of everyone on the path from clinician to researcher. In Dr. Daiello’s case, mentors at Brown University from her post-doctoral program guided her to the next step, a K23 award. A few years later, one of her mentors, Rich Jones, ScD, introduced her to Sharon Inouye, MD, MPH. Jones brought Daiello to the first Center of Excellence for Delirium in Aging: Research, Training, and Educational Enhancement (CEDARTREE) Delirium Boot Camp, a two-day intensive course organized by Dr. Inouye.

That was the beginning of a mentoring relationship that was pivotal to Dr. Daiello’s research career development. She was at a point of needing to look outside her home institution for mentorship. And Dr. Inouye, renowned for her research on delirium and dementia at Harvard, was open to working with a researcher in pharmacology. “Sharon mentored me the same as she did physicians, and I think that had a lot to do with my being able to move forward and attain independent funding,” says Dr. Daiello. “To be able to learn from her was an unprecedented opportunity. She takes mentoring very seriously, and the devotion she has to advancing this field is legendary.”

“Cross-institutional mentoring is more challenging,” says Dr. Inouye. “You cannot just bump into someone in the hallway. It requires forethought, planning, and getting on someone’s schedule regularly. Yet it can be done quite effectively. And I love bringing people together who bring different perspectives, experiences, and insights to address clinical questions. There is so much richness and creativity.”

The value of cross-institutional and cross-disciplinary mentoring for aging research is increasingly recognized. To foster such relationships, the Clin-STAR Coordinating Center offers initiatives for clinician-scientists across disciplines and specialties. In addition, the Clin-STAR pilot grants are meant to pair mentors and grantees from different disciplines and institutions.

For early career investigators seeking mentors, Dr. Daiello and Dr. Inouye share this advice:

• “Early stage is a very difficult place to be in research, because if you haven’t identified your primary interest, it’s going to be hard to find an effective mentor. So come prepared.” says Dr. Daiello. As an example, says Dr. Inouye, “For every meeting, Lori comes with an agenda and supporting materials. She comes with specific “asks” and thoughtful questions. We problem-solve together to actionable solutions. She is so respectful of my time, and we get through everything quickly and efficiently.”
• “Come to the relationship with a humble and curious mind, and listen to what your mentors say about what you need to do to succeed,” says Dr. Daiello. “If you are going to be NIH funded, you’d better listen to the people who have gone there before you!”
• “Schedule time to have a frank conversation with the person that you hope will be your mentor, and talk about what strengths and weaknesses they see in others coming to the field. Ask for advice on how to address them.”
• “Another way to learn is to assist your mentor with some type of program or experience that they’re participating in,” says Dr. Daiello, who became one of the faculty for the CEDARTREE Delirium boot camp. “I would echo that the relationship is most successful when it is reciprocal,” says Dr. Inouye. “Mentors really like and appreciate being included on papers and grants—they need “rewards and funding” too—and having help with teaching activities.

On the value of cross-disciplinary collaboration, Dr. Inouye adds, “When you are dealing with older adults, in all their complexity—ranging from comorbidity, functional and cognitive impairments, multi-sensory impairment, social and environmental challenges, and polypharmacy—you need to embrace the fact that you will need the expertise of multiple disciplines to effectively address any issue in the field,” she says.

“I have been able to succeed in my work—both clinically and in research—because of what I have learned from my colleagues across clinical disciplines, and also epidemiology, biostatistics, research methods, economics, and policy. As Dr. Daiello says so beautifully, having a humble and curious mind and being willing to learn from others will take you a long way.”