Module Mentor Registration

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Personal Information
Name

First NameLast Name
Preferred Email
example@example.com

CANTRAIN envisions several different mentor roles. Which of the following mentor roles would you be most interested in fulfilling? Please identify your preferred type of participation and rank them in order of preference.

	first choice	second choice	third choice	not interested
One-on-one mentorship of a junior professional in my field
Teach/train a small group in my area(s) of expertise in clinical trials
Share my professional experience and career path with a small group
One-on-one career mentorship as part of a student placement/internship at my institution/organization
Mentor a research trainee (MSc, PhD, PDF) interested in working in clinical trials as part of their degree program

CANTRAIN education and training is based on a core competency framework for clinical research. This framework contains 9 core competency domains, including inclusion, diversity, equity, and accessibility. Please identify your area(s) of expertise within this framework:
DOMAIN 1: Scientific Concepts and Research Design. Encompasses knowledge of scientific concepts related to the design and analysis of clinical trials.

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Expert in some elements of this domain
Please provide more detail about your expertise in this domain:
DOMAIN 2: Ethical and Participant Safety Considerations. Encompasses care of patients, aspects of human participant protection and safety in the conduct of a clinical trial.

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DOMAIN 3: Investigational Products Development and Regulation. Encompasses knowledge of how investigational products are developed and regulated.

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DOMAIN 4: Clinical Study Operations (Good Clinical Practice). Encompasses study management (adverse event identification and reporting, post-market surveillance, and pharmacovigilance), and handling of investigational product.

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DOMAIN 5: Study and Site Management. Encompasses content required at the site level to run a trial (financial and personnel aspects). Includes site and study operations (not including regulatory/GCP).

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DOMAIN 6: Data Management and Informatics. Encompasses how data are acquired and managed during a clinical trial, including source data, data entry, queries, quality control, and correction and the concept of a locked database.

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DOMAIN 7: Leadership and Professionalism. Encompasses the principles and practice of leadership and professionalism in clinical research.

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DOMAIN 8: Communications and Teamwork. Encompasses all elements of communication within the site and between the site and sponsor, CRO, and regulators. Understanding of teamwork skills necessary for conducting a clinical trial.

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DOMAIN 9: Equity, Diversity, Inclusion and Accessibility. A diversity of perspectives and lived experiences (all ways of knowing and learning) is essential to achieving research excellence. A strong commitment to inclusion, diversity, equity, and accessibility (IDEA) promotes and diversifies talents in research groups. To attract and retain a diversity of researchers, everyone needs to feel welcomed, valued, supported, and included.

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Module Mentor Public Profile