Mentoring in Medical School

Gail L. Rose, Ph.D.

The University of Vermont

 

I.    Introduction [slide 1]

 

As medical students, one of the most important decisions youll make is who becomes your clinical and/or research mentor

 

      A. An important way to gain: [slide 2]

1.     A guide for career development. Can also be personal

2.     Explicit knowledge: facts, concepts

3.     Implicit professionalism, ethics, and values; art of medicine not learned from texts

4.     A role model

5.     Often: emotional support, encouragement

 

      B.  A mutually beneficial and multi-level relationship

 

      C.  No one will teach you how to:

1.     Select a mentor

2.     Make the most of your mentoring relationship

3.     Become a mentor

 

      D.  This lecture will cover: [slide 3]

1.     The definition of a mentoring relationship

2.     How to be a good mentor

3.     How to be a good mentee

4.     Alternate forms of mentoring

 

 

II.  The mentoring relationship

 

A.   Definition: A relationship between less experienced and older or more experienced persons intended to benefit development 2 4 [slide 4]18,25,26

 

1.   Explicit, bilateral, and often long-term 2,18,26,29

 

2.   Focus: professional expertise and political know-how 32

 

3.   Mentor is a role model and is more than a role model 2,4,18,33

 

      B.  Mentors vs. role models   [slide 5]

 

1.   Role model: observed and imitated

 

2.   Similarities: 4,29

a.   Knowledge and skill acquisition facilitated by another person

b.   Important aspects of medical education

 

3.   Differences: 4,18,29

a.   Role models may not know audience (e.g., Michael Jordan -- second click); mentors know their mentees (e.g., Tuesdays with Morrie -- third click)

b.     Passive vs. interactive learning

 

 

III. How to be a good mentor 20,26  [slide 6]

 

A.  Know yourself

 

1.     Your style and capabilities. Top 10 mentor characteristics from grad student prespective 33 [slide 7]

 

a.   Gives honest feedback

 

b.   Communicates openly, clearly, effectively

 

c.   Experienced

 

d.   Treats mentee like an adult; involves mentee in decisions

 

e.   Demonstrates specific techniques

 

f.    Available to discuss academic challenges

 

g.   Respectful of others

 

h.   Sees mentees potential

 

i.    Ethical

 

j.    Reliable; follows through on commitments

 

2.   Your limitations 1 [slide 8]

 

a.   How patient are you with the learning process of another?

 

b.   How willing are you to promote anothers career and introduce him/her to your colleagues?

 

c.   How much time do you have available for a mentee?

 

d.   How similar/different are the mentees interests, goals, values, background, &/or socio-demographic attributes to your own?

 

B.  Know your mentee. Good mentors know mentees unique attributes; challenges.

 

1.   Stage of educational development. Strategies change as students progress [slide 9]11,17,20,30

 

a.   Focus

i.    Beginner: specific, skills-based instruction; acquiring/mastering techniques, practical skills, concrete tasks [e.g., taking bp; Qs to ask in pt. interview]

ii.   Advanced: conceptual exchange; abstract ideas, theories [Example: CST vs. community rft]

 

b.     Time frame

i.    Beginner: short-term goals; tasks completeable in a prescribed period within a course, semester or clinical rotation

ii.   Advanced: long-term planning; focus on ultimate training &/or career direction

 

c.     Role of mentor

i.    Beginner: detailed feedback; Specific positive and negative feedback on entire task [Insert example: interviewing]

ii.   Advanced: mentor as consultant, sounding board; someone to whom the mentee brings ideas for discussion

 

d.     Source of Direction

i.    Beginner: directive, concrete; mentor assigns tasks and timelines

ii.     Advanced: student-directed; mentor guides and supports but does not direct

 

e.   Tailoring. Effective mentors tailor approach to trainees stage of development; weaning process helps mentees become independent, confident

 

2.   Demographic variables  [slide 10]

 

a.   Perceived similarity predicts initial attraction not long-term success 19

 

b.   Acknowledge differences 

 

c.   Accept education from mentees about their different perspectives 19,37 

 

a.     Specific demographic attributes

 

i.      Gender 30

 

a)   Women have different training experiences than men; may impact mentoring relationships 30

i)    Fewer same-sex options

ii)   More likely to experience harassment

iii)  Less often encouraged to assert power in training situations 27

 

b)   Most studies show no sex difference in incidence of mentoring or mentoring preferences. 15,33,38  Exceptions:

i)    Women show slight preference for:

(a)  Personal attributes: trustworthiness; integrity, humanism 16,33

(b) Lifestyle & values: work/family balance 16

ii)   Men show slight preference for power, status, & influence 13,16

 

ii.   Age.  Older/mature/returning students less likely to desire and participate in mentoring relationships 28,33,38

 

iii.  Race/ethnicity/culture

 

a)   Minorities historically have less access to mentors 9

 

b)   Fewer same-race options for minorities 5

 

c)   Minority students face social and institutional barriers not experienced by non-minorities 31

 

d)   Culture is a strong determinant of behaviors, values, & communication.  Examples:

i)       deference to authority

ii)      expressions of power

iii)     individualism/collectivism

iv)     conflict management

v)      assertiveness

vi)     frankness

vii)    self-promotion

viii)   importance of personal relationships 10

 

e)   Culturally sensitive mentors help minority students integrate racial heritage with professional identity 8,37

 

C.  Know the parameters of your relationship 20 [slide 11]

 

1.   Mentees goals.  Consider entire spectrum, e.g. [lecturer may customize list]:

 

a.   Become a successful MD

 

b.   Find a good residency

 

c.   Graduate medical school with honors

 

d.   Determine a suitable specialty

 

e.   Find relevant academic & extracurricular activities

 

f.    Improve time management

 

g.     Learn interviewing skills

 

2.   Structure of relationship

 

a.   Informal: Classic mentoring relationship 30 

 

i.    Develops organically from mutual interests, admiration, or goals among individuals already known to each other 

 

ii.   Typically includes discussion of personal values & interests [Nice place to insert an example] E.g. Tuesdays with Morrie

 

iii.  Assumed to be superior to arranged mentoring 7

 

iv.  Occurs infrequently (~30% of students have an informal mentor) 7

 

v.   Often excludes underrepresented or traditionally marginalized groups

 

b.   Formal: Relationship facilitated by an intentional mentoring program; designed to capitalize on anecdotal benefit of informal mentoring 28

 

i.    Members assigned or matched by mentoring program administrator, often with some consideration of each persons preferences, attributes, goals

 

ii.   Typically focused on a specific goal.  [lecturer may insert example] E.g., Womens Mentoring Project at U Vermont

 

a)   Designed by female medical students

 

b)   Focus: increase 1:1 contact btw students & female researchers and faculty to discuss and promote gender issues in field of medicine 14

 

iii.  Qualitatively different from informal relationships 21,24

 

      a) May be more task-oriented than informal relationships

     

      b) May take longer to build trust and productive working relationship

 

iv.  Provides access to mentors for students from underrepresented groups

 

3.   Evaluation of mentee by mentor. 

 

a.   Some relationships involve evaluation (e.g., course grade)

 

b.     Knowledge of evaluative component may inhibit trust.  Mentees resist showing weaknesses 7

 

4.   Meetings

 

a.   Frequency: Regular interactions critical to establishment of relationship, particularly formal ones. Frequency depends on focus of relationship 6,34 

 

b.     Length: Some recommend hour-long, uninterrupted sessions; 26 depends on goals & frequency.  Pair can decide

 

      D.  Mentor needs to maintain the relationship: Dos  [slide 12]

 

1.   Be available

 

2.   Convey respect and confidence in the mentee 11

 

3.   Maintain focus on mentee 35

 

4.   Ask questions vs. give advice; mentee verbalizes conceptions 22

 

5.   Track mentees progress 35

 

6.   Identify strengths

 

7.   Give feedback 20

 

8.   Periodically re-assess relationship

 

9.     Avoid problems that may inhibit mentee development. [slide 13] Dont:

 

a.   Promote the mentors agenda instead of the mentees 4 

 

b.   View mentee as free labor

 

c.   Take credit for mentees accomplishments

 

d.   Seek a clone who mimics mentors career path, philosophy, opinions39

 

E.   Review: How to be a good mentor [slide 14]

 

      1.   Know yourself (self-reflection)

 

      2.   Know your mentee

 

      3.   Know parameters of relationship

 

      4.   Maintain the relationship

 

      5.   Overall goal: Hold the focus for the mentees career growth potential

 

 

IV. How to be a good mentee [slide 15]

 

A.  Know yourself 4,19  [slide 16]

 

1.   Your professional goals: short- and long-term

 

2.   Your desires and preferences for the relationship. Ideal v. acceptable v. unacceptable. [slide 17]

 

a.   Demographics.  Ideal gender, age, cultural background of mentor

 

b.   Location; availability.  Ideal frequency & duration of meetings; physical proximity

 

c.   Personality.  E.g., Introvert vs. extrovert; sense of humor; detailed, methodical vs. big-picture visionary; even-keeled vs. intense, etc.

 

d.   Professional interests. Ideal mentors career focus.  How similar to your own?

 

e.   Professional skills. Ideal skill sets mentor should possess and transmit

 

f.    Stage of career.  Ideal extent of mentor advancement.  How far ahead of your own?

 

g.   Mentoring style. [slide 18] Mentee preferences fall into 3 categories: 33  [audience: consider your own]

 

i.    Integrity: Mentor respects self and others; empowers mentees to make deliberate, conscious choices. 

a)   Mentor values mentee as a person

b)   Mentor believes in mentee

c)   Mentor treats mentee as an adult; involves mentee in decisions

 

ii.   Guidance: Mentor helps mentee with explicit academic tasks and activities. 

a)   Mentor provides information to help mentee understand subject matter

b)   Mentor helps mentee investigate and solve specific problems

 

iii.  Relationship: Mentor is open to a personal relationship with the mentee, including extracurricular socialization and personal sharing.

a)   Mentor relates to mentee as an older sibling

b)   Mentor shares personal concerns

 

4.   Your strengths as a mentee.  [slide 19] Students who are successful at attracting mentors exhibit the following: 19

 

a.   Emotional stability: good sense of self-awareness, self-esteem, positive emotional affect

 

b.   Internal locus of control: belief that one can achieve a desired result through their own effort and initiative

 

c.   Coachability: willingness to learn, develop new skills, use constructive feedback

 

b.     Emotional intelligence: able to understand and successfully manage interpersonal relationships

 

c.     Achievement focus: dedication, commitment to the profession, tenacious work habits

 

5.   Your weaknesses as a mentee. [slide 20] Students who exhibit these workstyle and interpersonal dynamics are less likely to receive effective mentoring: 19

 

a.   Too independent: unwilling to be influenced by another or take a subordinate role; cant take direction or collaborate frustrate mentor; relationship will fizzle

 

b.   Hypersensitive: take feedback or criticism personally hampers communication

 

c.   Unmotivated: want to get by with as little effort as possible; performance consistently below ability level does not promote respect from others

 

d.     Poor work habits: disorganized, procrastinate, inefficient; overcommitted, fail to meet deadlines lack of respect for mentor

 

e.     Emotionally needy or negative: need constant reassurance; mood swings; complainer communicates immaturity; asks too much of mentor

 

B.  Be proactive 34 [slide 21]

 

1.     Identify candidates

 

a.     Senior students

 

b.     Residents

 

c.     Professors 11

 

i.    Junior faculty

a)     Closer identification with students and mentee role

b)    Awkward transition from peer to teacher

c)     May not feel confident in mentoring ability

d)    Instability in career identity / work-life balance. 

 

ii.   Mid-career

a)     More established, confident, experienced

b)    Stable personal & professional identity

c)     Career and family paths more focused

 

iii.  Late-career

a)     Wealth of experience and knowledge

b)    Power and influence in organization

c)     May not be on leading edge of field

 

d.   Keep an open mind re: mentors of different socio-demographic background

 

2.   Take initiative

 

a.   Im looking for a mentor

 

b.   Approach candidates; dont wait to be chosen.  You know more about them than they do about you

 

c.   Volunteer for projects.  Identify yourself as serious and hard-working 1

 

C.  Know the parameters of your relationship 20 [slide 22]

 

1.   Structure (Formal vs. informal: see section III.C.2)

 

2.   Evaluative vs. non-evaluative (see section III.C.3)

 

3.   Frequency and length of meetings (see section III.C.4)

 

D.  Maintain the relationship: Dos & Donts 19,34  [slide 23]

 

1.     Be on time.  Meet deadlines

 

2.     Convey respect for your mentor.  Accept a subordinate role

 

3.   Set goals and agenda for your meetings; keep mentor appraised of your progress 1

 

4.   Accept increasing responsibility and challenge

 

5.   Follow through on commitments

 

6.   Show appreciation for your mentors time and energy

 

7.   Accept constructive criticism from your mentor; admit mistakes; respond to suggestions 1

 

8.   Communicate directly and honestly

 

9.   Periodically re-assess relationship: goals, objectives, meeting arrangements

 

10. Avoid problems that may damage the relationship [Mentee over-dependence on mentor] Donts 19 [slide 24]

 

a.   Mentee does not make independent decisions

 

b.   Mentee relies on mentor exclusively for information, opportunities

 

c.   Mentee passivity, acquiescence: better to accept mentors perspective and not rock the boat

 

d.   Overidealization of the mentor: Inevitably leads to disappointment.  Dont expect your mentor to have all the answers.  Mentee is responsible for own learning.

 

E.   Review: How to be a good Mentee [slide 25]

 

1.   Know yourself. Requires self-examination

 

2.   Be proactive

 

3.   Know parameters of your relationship

 

4.   Maintain your relationship

 

 

V.  Alternate forms of mentoring. Optimal development = primary mentor + personal mentoring network. 19,34  Especially if no primary mentor  [slide 26]

 

A.   Peer mentoring (1:1 or group): fellow students or colleagues provide career-enhancing and psychosocial functions to each other 12 [slide 27]

 

1.   Non-hierarchical

 

a.   Parallel goal(s) and stage of educational development [E.g., mastering psychopathology course content; writing group]

 

b.   Complimentary skills, knowledge

 

c.   Share strategies to accomplish goals

 

d.   Mutual emotional support, trust

 

2.   More options for same-sex or same-race mentoring

 

3.   May not be able to provide

 

a.   Depth and breadth of experience; wisdom

 

b.   Professional contacts

 

c.   Political power

 

4.   [Lecturer may insert personal example] E.g., study group or writing group

 

B.    Multiple mentoring: Relationships with more than one mentor, each of whom may provide some important function(s) [slide 28]

 

1.   Primary mentorships may be preferred, but comprehensive mentors are rare. 3  No one may match your ideal in all ways

 

2.   Different skill sets, attributes, perspectives

 

a.   Primary mentor may meet most important criteria, but not other important criteria

 

b.   Two or more mentors may collectively meet mentees needs; fill in the gaps

 

c.   Example: Primary mentor is famous, powerful, excellent role model.  But, not available for emotional support, not same-race or same-gender.  OR: one mentor for scholarly activities; one mentor for clinical training

 

[d.  Personal example]      

 

C.    External mentors.  Guides or supporters located in a different department or institution [slide 29]

 

1.   Ones department or school may not include an appropriate mentor (especially for minorities 36)

 

2.   Professional organizations may offer access to mentors with specific interests, attributes, skills, or expertise in your research area

 

3.   May offer more objective perspective; confidentiality; usually no evaluative component or conflict of interest

 

3.   [Lecturer may offer a personal example]

 

 

VI. Summary [slide 30]

 

A.  Mentoring offers important educational benefits

 

B.  Mentoring is more than role-modeling

 

C.  Mentors and mentees can have more satisfying and productive relationships through self-awareness, focus, mutual respect, and explicit communication about the relationship

 

D.  Mentoring relationships take a variety of forms

 

 

-------

Optional Material.  This section may be presented in addition to or instead of III.B.1 [Mentees stage of development - slide 9], or may be reserved for the end of the lecture to cover if time or in response to questions.

 

Predictable stages of a mentoring relationship: 23,24 [slide 32]

 

1.   Initiation.  Relationship begins; becomes important to both parties

 

a.   6 months - 1 year

b.   Opportunities for interaction around work tasks

c.   Mutual attraction/admiration leads to positive expectations for other

d.   Mentor provides coaching, challenging work, visibility

e.   Mentee provides technical assistance, respect, desire to be coached

 

2.     Cultivation: Active phase of mentee development, when maximum range of career and psychosocial functions are provided

 

a.   Lasts 2-5 years

b.   Opportunities for meaningful and more frequent interaction increase

c.   Both individuals continue to benefit from the relationship

d.   Emotional bond deepens and intimacy increases

 

3.   Separation: end/loss of active phase initiated by significant change in structure or emotional meaning of relationship

 

a.   Lasts 6 months - 2 years

b.   Mentee no longer wants guidance; wants more autonomy, and/or

c.   Mentor is less emotionally or intellectually available to provide mentoring functions, and/or

d.   Graduation/job change limits opportunity for continued interactions; career and psychosocial functions can no longer be provided, and/or

e.   Blocked opportunity creates resentment and hostility that disrupt positive interaction

 

4.   Redefinition: end of relationship or evolution towards peer-like friendship

 

a.   Occurs after a period of separation (several years?).  Lasts for indefinite time period

b.   Mentor relationship no longer needed in its previous form

c.   Stresses of earlier separation diminish; Resentment & anger diminish

d.   Gratitude and appreciation increase

e.   New peer relationship forms

 


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E:\MyDocuments\A.M.S.P\RoseOutlineForWeb.doc          4/9/03