PROBLEM STATEMENT

Team science involves collaboration with more than one individual in an interdependent fashion, leveraging the expertise of professionals across disciplines.1–3 There are many long-term benefits from team science, including increases in research impact, novelty, productivity, and reach.1,4 In the near term, team science facilitates skill building and career satisfaction.5 Core competencies in team science include leadership, communication, and collaborative problem-solving.6 New opportunities for participating in team science help scholars in building networks across diverse teams; fostering these networks is a core element of effective mentoring,7–10 leading to the creation of support systems and lasting collaborations.11–15

Several principles shape our ability to maximize new collaborative opportunities for team-oriented scholarship in the health sciences. It is worth considering locus of control (ie, what control we have over our own behavior16) and how it affects academic job satisfaction. Work locus of control is a sense of control over events in the workplace.17 Employees with a higher internal locus of control—the belief that one's capacity influences events—report higher job satisfaction,18 and internal locus of control is relatively high among university professors.19 This ability to make choices in work priorities in the academic setting is juxtaposed with the curious mind of a scientist, clinician, and educator—we are often attracted by many opportunities (“bright shiny objects”) and end up with more interesting projects than time. There may also be a scarcity mindset at play—which can manifest as a “fear of missing out,” which is often leveraged to motivate consumers.20 Early career faculty may also worry that they will not be considered in the future if they turn down an opportunity. Consequently, these scholars typically say “yes” to nearly every opportunity.21 Early career choices help in shaping the trajectory of one's career, so weighing them carefully is crucial. Taking on too much can lead to “burnout, mental and physical health problems, and an ironic lack of bandwidth to say yes when more valuable opportunities arise.”21

It is also important to recognize power dynamics and inequities in academic settings, as in other work environments. Power involves the influence—formally via position or informally via respect or admiration—of one individual over another.22 Although power dynamics are inherent in every organization based on hierarchy,22 career stage,23 biases,24 leadership dynamics,25 and culture and climate of the organization,26 underrepresented scholars often face extra pressure to say yes. For example, women and racial/ethnic minority individuals retain an “unequal distribution of emotional labor related to supporting trainees and performing discipline-related service” (pg. 5).27 These training and service activities often do not garner adequate credit toward promotion and tenure for the time involved. On top of an unequal distribution of emotional labor, women also manage an unequal division of labor in the household, which adds an additional layer of complexity when balancing professional opportunities.28 Furthermore, faculty from underrepresented racial/ethnic subgroups experience an additional toll of the “minority tax”—being asked to participate and lead diversity initiatives while not being adequately compensated or given credit for their time and energy and time related to counseling and mentoring of students and trainees.29 Each of these uncompensated activities has the potential to reduce scholarly productivity related to research, teaching, clinical work, and service,30,31 yet underrepresented faculty may feel pressure to say yes given underlying power dynamics, and a sense of responsibility, particularly if they are the sole underrepresented faculty in their division or department. In addition, there is often a multiplier effect for all faculty who are talented, productive team members as they are asked to join more projects and teams.

Taking on any new activity comes with an opportunity cost, that is, choosing one activity lessens your ability to complete existing projects or take on a different activity.32 In assessing opportunity costs, it is helpful to consider the stakes or intensiveness of commitments, but it is important to recognize that even taking on many low-stakes commitments adds up. Examples of low-stakes opportunities include manuscript reviews, one-time, virtual consultations, covering colleagues' clinical shifts, and guest lectures. Medium-stakes opportunities include speaking or training with travel, periodic and ongoing consultation, professional society committee membership, and advisory groups that meet infrequently (eg, quarterly). High-stakes opportunities often involve multiyear research projects in an investigator role, teaching a new course, leadership roles (eg, in your institution, in your professional organizations), study section membership, and professional guideline panels. Particularly for medium- and high-stakes decisions, it is crucial to confer with mentors and peers when assessing opportunities.

We are not well-trained in how to choose among these multiple opportunities, and we often learn via trial and error. In addition, we are sometimes socialized to believe that saying no is impolite or inconsiderate.33 To provide guidance and a more systematic approach to weighing academic opportunities, we have assembled a set of questions to inform decision-making. These questions are designed primarily for individuals working in academic health sciences settings, who commonly balance clinical duties, research, teaching and mentoring, and service (within and outside their institution). Our team has primarily worked in academic settings and represents four career stages: a postdoctoral scholar and early-, middle-, and later-career faculty members.

SOLUTION Proposed Questions

Based on our experiences as mentors, mentees, and team members, along with lessons from the published literature, we provide 30 questions (including some with subquestions) across six domains. Within each domain, we have organized questions roughly in priority order knowing that every situation is distinct. Some domains or questions may be less important if you have previous experience with an individual or team (eg, the “person” questions may already be answered). These questions are intended primarily for medium- and high-stakes opportunities.

The Big Picture 1. What might you learn/what skills might you gain? 2. Is the opportunity a building block for your long-term career plan? 3. Does it align with your personal and professional values? 4. Could the activity have an impact within your organization or profession (eg, change in promotion/tenure guidelines, hiring a key new leader, developing practice guidelines, future scale-up potential of your work)? 5. What are the opportunity costs (ie, the relative value given the time spent)? The Context 1. How much do you already have on your plate? (a) How much will you have on your plate when the new opportunity becomes a significant time commitment? 2. Will a given collaboration extend your network in meaningful ways? 3. Are there power dynamics at play? (a) How might you learn about the power dynamics, knowing these are often more acute in your own institution? (b) How might you navigate the power dynamics (within your locus of control)? 4. If you work in an academic environment, what is your right mix of research, teaching, clinical responsibilities, and service, and does the opportunity help to blend these areas? 5. Are you and others in your environment keeping an eye on equity (eg, competent and productive people are asked to do more, the “minority tax” in academe29)? The Person 1. Who is asking? (a) If it is your supervisor, you often may feel pressure to say yes. (b) Is there a quid pro quo (a favor owed to a person or group)? (c) Are there risks to saying no (eg, closing off future opportunities)? 2. Is the person reliable, productive, and enjoyable to work with? 3. Is this a person from whom you could learn a new skill set? (a) Is this a collective effort of unlike minds that may lead to an important scientific discovery? 4. How will you learn about the person if you have not worked with them previously? 5. Do you have a list of people you are more likely to say yes to? (a) What are your reasons for saying yes to those people? The Team 1. What is the functional level of the team that you may join (eg, across the stages in Tuckman's model: forming, storming, norming, performing34)? (a) How long has the team worked together? 2. Is there evidence of the productivity of the team? (a) Has the team shown evidence of scientific innovation? (b) Have others benefitted from working with this team? 3. Will joining help you learn new skills and approaches to team work? 4. Is it clear what value you will add to the team? 5. Are the roles of team members clearly defined? (a) Is there a clear division of labor among the team? The Role 1. Will you lead or assist? 2. Do you have the requisite skills? 3. Can you get an accurate estimate of the time commitment? (a) When and how often will meetings occur? 4. What is the timeline for completing the project? 5. Is your role similar to other opportunities that you recently took on with little added benefit (eg, adding another presentation on the same topic)? The Outcomes 1. Might the opportunity lead to publications and/or grants, especially early in your career? (a) Are you confident that authorship order will be determined fairly? 2. Will it help with your promotion/advancement/tenure? 3. Returning to your career goals, may the opportunity lead to longer-term impacts outside of the academic metrics (eg, practice/policy changes, developing community partnerships, building capacity in practice settings)? 4. Will it build your network (internal or external) and lead to exposure and new opportunities? (a) Are there leadership opportunities? (b) Will it help you build social capital? (c) Will it help you leverage resources? 5. Is it paid—will your effort be covered? (a) How much do you need the salary coverage (ie, working in primarily a hard money or soft money environment)? (b) May you confer with colleagues on whether a paid opportunity from an external collaborator should be consulting (generally smaller obligations) or covered time via a subcontract (generally larger obligations)? Deciding

After receiving an invitation, our first piece of advice is to sleep on it—allow yourself at least 24 hours before deciding and often longer for high-stakes decisions. While in the deciding period, it is often helpful to confer with trusted mentors, peers, and others who know you well (eg, a loved one). Use the questions above to guide your conversation with your mentor. Remember that mentorship styles vary—some mentors nearly always advise colleagues to “go for it” and others take a more nuanced approach. It is also useful to talk with people who have worked with the team you are considering joining to determine whether the team provides a supportive environment.

In any of these decisions, the communication channel matters. For example, there may be more immediate pressure in a face-to-face discussion of an opportunity and more urgency with a text than with an email. For decisions involving high stakes and negotiations, a conversation (in person or by phone) is often better than emailing or texting.

Once you have considered the questions we have provided and made a decision, there are multiple ways of communicating your decision. Remember that yes or no does not need to be binary. A simple yes is the easiest. In some cases—your answer may be a “soft no”—you want to take on the new opportunity, but want to clear up some details or negotiate for more time—or you may be able to join a team later (Table 1 for sample language). There may be a “rebound no”—after you say no, the person comes back with an alternative approach that may allow you more time to decide, a different role, or some other inducement. Importantly, saying no and balancing opportunities looks different for everyone, and we acknowledge that it may be more or less difficult based on power dynamics and the identities an individual holds.

TABLE 1. - Sample Text for Making a Request and Replying Category Sample Language Replying with a hard “sandwich no”  Positive side one “It is great to hear from you. I am very appreciative of your invitation. The research that you are leading is some of the most impactful work I know of.”  Negative middle “While I greatly appreciate this opportunity, I would not be able to give it the time and attention it needs, given my current workload. I do not like to take on new commitments unless I know I can do a good job and participate as a solid team member.”  Positive side two “If it is helpful, I would be glad to help you in finding another person to fill this role. I have several ideas of outstanding individuals who may be a fit.” Replying with an early-career hard no “I have been in conversation with my mentors and at this stage of my career, their best advice is to prioritize a few key parts of my research, so as much as I would love to help out on your project, it is best if I decline. I hope there will be opportunities in the future for us to work together.” Replying with a soft no “I am very grateful for this opportunity. I am not sure that I have the time to take this on right now, but I would be interested in talking with you to see whether there is any flexibility in your timeline. I would also like to learn more about the role you have in mind for me.”
“I will not be able to join the team, but I am glad to help in smaller ways in areas where I have expertise.” Delayed yes “I would love to join your team, but I cannot join until the next semester.” Reversing a yes “When I had agreed to join your project, I thought I would have the time to commit to fulfill my role. However, a few new commitments have dropped in my lap and I am afraid I will not be able to stay on your project.” Mentors and supervisors—making the ask “I realize you have a lot on your plate right now, but I want to tell you about this opportunity. You do not need to answer now, but take some time to think about this and get back to me with any questions.”

When replying with a firm no, the “sandwich method” is often helpful. The sandwich method involves beginning with something positive, declining the opportunity, then ending with something supportive or positive (Table 1).33 After saying no to an opportunity, it is best to not look back. When we make a decision that allows us to later change our minds, we are less satisfied with the decision.35 Therefore, it is useful to focus on the good that will come from saying no, not the guilt or regret.35

Reversing a Yes

Among the most challenging situations, there are times when it becomes clear that one has made the wrong choice and needs to drop a commitment after initially saying yes. This may involve situations where the ask is different than what you had been told (more labor intensive), there is conflict within a team leading to loss of productivity (even a “toxic” collaboration), the collaboration is unlikely to be fruitful, or you are simply overbooked.

In these situations, it is helpful to consider the trade-offs. For example, you may feel guilty about saying no after initially saying yes; however, if you cannot follow through on your commitment, the opportunity is unlikely to lead to high performance and effective networking. When shifting from a yes to a no, it is useful to be assertive and clear without overexplaining.36 If you provide a short explanation for your change in decision, it is likely to be more positively received.36

A Note for Mentors and Supervisors: Making the Ask

Our set of questions is important not only for the person being presented with an opportunity, but also for those doing the asking. The best supervisors, mentors, and colleagues—those making the ask—give their collaborators time to decide on projects (eg, they do not demand an immediate answer) and help them feel comfortable saying no. The issues we cover can be a starting point for mentoring discussions, and this topic (making choices about competing opportunities) can be formally incorporated into training programs. We have provided sample language for making the ask (Table 1). Our set of questions is extensive and in any given situation, some of the questions we have posed have unknowable answers. For mentors, a use of our list could involve discussions with mentees to identify a core set of 4 to 8 high-ranking issues for a particular collaboration decision (eg, gain in skills, networking, publication/grant opportunities). This could be the basis for reflection and discussions with mentors and peers to answer a smaller set of questions that are particularly relevant for a specific collaboration decision.

CONCLUSION

We present a framework to assist trainees and faculty in decisions surrounding professional opportunities in the health sciences. We urge consideration of these questions to improve mentoring, mentored training programs, and approaches for fostering team science. Although often an emphasis on professional development, mentoring competencies, and mentor training programs do not typically place an explicit focus on the ability to weigh and negotiate competing professional opportunities.9,37–40 Importantly, mentors and mentees should consider power dynamics when delegating and accepting opportunities. For example, a mentee may find it difficult to say no when there is a large power differential. To conduct effective teamwork, several useful models and competency frameworks are available.6,41,42 Although every situation is different and there is no single formula for decision-making, we have outlined some fundamental issues and questions to consider when one is presented with a new opportunity, especially an activity involving a significant time commitment.Lessons for Practice ■ Faculty and trainees in the health sciences are often presented with a wide range of opportunities and are sometimes chasing the “bright shiny object.” ■ To make the best use of time and enhance impact in one's career, answering a set of questions across six overlapping domains (the big picture, the context, the person, the team, the role, the outcomes) can inform decision-making. ■ Mentors who are making the ask should provide an environment where it is comfortable for mentees to say no.

ACKNOWLEDGMENTS

The authors would like to thank the following individuals for initial ideas and input on the manuscript: Ana Baumann, Carol Brownson, David Dowdy, Cyrus Mugo, Patience Muwanguzi, Sarah Rutstein, Rajesh Vedanthan, and Jennifer Velloza.

REFERENCES 1. National Research Council. Enhancing the Effectiveness of Team Science. Washington DC: The National Academies Press; 2015. 2. Little MM, St Hill CA, Ware KB, et al. Team science as interprofessional collaborative research practice: a systematic review of the science of team science literature. J Investig Med. 2017;65:15–22. 3. Steer CJ, Jackson PR, Hornbeak H, et al. Team science and the physician-scientist in the age of grand health challenges. Ann N Y Acad Sci. 2017;1404:3–16. 4. Hall KL, Vogel AL, Huang GC, et al. The science of team science: A review of the empirical evidence and research gaps on collaboration in science. Am Psychol. 2018;73:532–548. 5. Stokols D, Harvey R, Gress J, et al. In vivo studies of transdisciplinary scientific collaboration Lessons learned and implications for active living research. Am J Prev Med. 2005;28:202–13. 6. Lotrecchiano GR, DiazGranados D, Sprecher J, et al. Individual and team competencies in translational teams. J Clin Transl Sci. 2020;5:e72. 7. National Academies of Sciences Engineering Medicine. The Science of Effective Mentorship in STEMM; 2019. 8. Kashiwagi DT, Varkey P, Cook DA. Mentoring programs for physicians in academic medicine: a systematic review. Acad Med. 2013;88(7):1029–37. 9. Hamer DH, Hansoti B, Prabhakaran D, et al. Global Health Research Mentoring Competencies for Individuals and Institutions in Low- and Middle-Income Countries. Am J Trop Med Hyg. 2019;100:15–19. 10. Sood A, Qualls C, Tigges B, et al. Effectiveness of a Faculty Mentor Development Program for Scholarship at an Academic Health Center. J Contin Educ Health Prof. 2020;40:58–65. 11. Guise JM, Geller S, Regensteiner JG, et al. team mentoring for interdisciplinary team science: lessons from K12 scholars and directors. Acad Med. 2017;92:214–221. 12. Luke DA, Baumann AA, Carothers BJ, et al. Forging a link between mentoring and collaboration: a new training model for implementation science. Implement Sci. 2016;11:137. 13. Sood A, Tigges B, Helitzer D. mentoring early-career faculty researchers is important-but first “train the trainer”. Acad Med. 2016;91:1598–1600. 14. Wingard DL, Garman KA, Reznik V. Facilitating faculty success: outcomes and cost benefit of the UCSD National Center of Leadership in Academic Medicine. Acad Med. 2004;79:S9–11. 15. Brownson RC, Jacob RR, Carothers BJ, et al. Building the next generation of researchers: mentored training in dissemination and implementation science. Acad Med. 1 2021;96:86–92. 16. Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr. 1966;80:1–28. 17. Spector P Development of the work locus of control scale. J Occup Psychol. 1988;61:335–340. 18. Padmanabhan S. The impact of locus of control on workplace stress and job satisfaction: A pilot study on private-sector employees. Curr Res Behav Sci. 2021;2:100026. 19. Ahluwalia A, Preet K. Locus of Control among University teachers: an Empirical Study. Int J Eng Technol Sci Res. 2016;3:75–80. 20. Hodkinson C. ‘Fear of Missing Out’ (FOMO) marketing appeals: A conceptual model. J Mark Commun. 2019;25:65–88. 22. Kovach M. Leader influence: a research leader influence: a research review of French & Raven's (1959) power dynamics. J Values-Based Leadership. 2020;13. 23. Looman N, van Woezik T, van Asselt D, et al. Exploring power dynamics and their impact on intraprofessional learning. Med Educ. 2022;56:444–455. 24. Keating JA, Jasper A, Musuuza J, et al. supporting midcareer women faculty in academic medicine through mentorship and sponsorship. J Contin Educ Health Prof. 2022;42:197–203. 25. Lindberg C, Schneider M. Combating infections at Maine Medical Center: insights into complexity-informed leadership from positive deviance. Leadership. 2013;9:229–253. 26. In: Ashkanasy N, Wilderom C, Peterson M, eds. The Handbook of Organizational Culture and Climate. 2nd ed. SAGE Publications, Inc; 2010. 27. Spencer S, Burrows C, Lacher SE, et al. Framework for advancing equity in academic medicine and science: Perspectives from early career female faculty during the COVID-19 pandemic. Prev Med Rep. 2021;24:101576. 28. Woitowich NC, Jain S, Arora VM, et al. COVID-19 threatens progress toward gender equity within academic medicine. Acad Med. 2021;96:813–816. 29. Williamson T, Goodwin CR, Ubel PA. minority tax reform—avoiding overtaxing minorities when we need them most. N Engl J Med. 2021;384:1877–1879. 30. Rodriguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: what of the minority tax? BMC Med Educ. 2015;15:6. 31. Rodriguez JE, Wusu MH, Anim T, et al. Abolish the Minority Woman Tax. J Womens Health (Larchmt). 2021;30:914–915. 32. Shepherd D, Williams T, Patzelt H. Thinking about entrepreneurial decision making: review and research agenda. J Manag. 2015;41:11–46. 33. The Menninger Clinic. The power of “no” and tips for learning how to say it. Available at: https://www.menningerclinic.org/news-resources/the-power-of-no-and-tips-for-learning-how-to-say-it#. Accessed November 13, 2022. 34. Tuckman B. Developmental sequence in small groups. Psychol Bull. 1965;63:384–399. 35. Carter C. 21 Ways to “Give Good No”. Greater Good Magazine. Berkeley: The Greater Good Science Center at the University of California; 2014. Available at: https://greatergood.berkeley.edu/article/item/21_ways_to_give_good_no. Accessed November 13, 2014. 36. Wilding M. How to Say “No” After Saying “Yes”. Vol 20. Harv Bus Rev. Harvard Business Publishing; 2021:2021. Available at: https://hbr.org/2021/09/how-to-say-no-after-saying-yes. Accessed September. 37. Berk RA, Berg J, Mortimer R, et al. Measuring the effectiveness of faculty mentoring relationships. Acad Med. 2005;80:66–71. 38. Fleming M, House S, Hanson VS, et al. The Mentoring Competency Assessment: validation of a new instrument to evaluate skills of research mentors. Acad Med. 2013;88:1002–1008. 39. Hyun SH, Rogers JG, House SC, et al. Revalidation of the Mentoring Competency Assessment to evaluate skills of research mentors: The MCA-21. J Clin Transl Sci. 2022;6:e46. 40. Yukawa M, Gansky SA, O'Sullivan P, et al. A new Mentor Evaluation Tool: Evidence of validity. PLoS One. 2020;15:e0234345. 41. Bisbey TM, Wooten KC, Salazar Campo M, et al. Implementing an evidence-based competency model for science team training and evaluation: TeamMAPPS. J Clin Transl Sci. 2021;5:e142. 42. Nurius P, Kemp S. Individual-level competencies for team collaboration with cross-disciplinary researchers and stakeholders. In: Hall K, Vogel A, Croyle R, eds. Strategies for Team Science Success Handbook of Evidence-Based Principles for Cross-Disciplinary Science and Practical Lessons Learned from Health Researchers. Springer; 2019:171–187.