Career-Focused Mentoring for Early-Career Clinician Educators in Academic General Internal Medicine

A Facilitated Peer Mentoring Program With a Dedicated Curriculum to Foster Career Advancement of Academic Hospitalists

Introduction

In the field of hospital medicine, there is both a limited pool of senior faculty to mentor the rapidly growing number of junior faculty and a lack of career development curricula focused on scholarly activities specific to the needs of the hospitalist. These deficits have resulted in a disproportionately low number of academic hospitalists being promoted to associate and full professor. We implemented a facilitated peer mentoring program with a dedicated curriculum to foster career advancement of academic hospitalists.

Methods

We recruited 29 academic hospitalists and divided them into five small groups, each guided by one senior faculty. Peer members participated in a 9-month curriculum consisting of alternating large- and small-group sessions that reviewed topics important for academic advancement. Quantitative analysis assessed feasibility of the program, as measured by participation and knowledge improvement on curriculum topics, with pre- and postprogram surveys.

Results

Results demonstrated feasibility of the large-group sessions as measured through participation. Small-group participation was more variable. Pre- and postsurvey results showed significant knowledge improvement (p < .05) in nearly all of the curriculum topics.

Discussion

Currently, there is a gap in both mentorship and scholarly skills of academic hospitalists. Our facilitated peer mentoring program with a dedicated curriculum can be used as a framework for other hospitalist programs to support career development.

Fostering Success and Promoting Professional Development of Clinician Educator Mentees: A Workshop for Mentors

Introduction

The goal of academic mentoring relationships is to enable the mentee to identify/achieve professional advancement. Although mentors of clinician educators (CEs) must understand the criteria for successful career advancement, few have received formal CE mentor training.

Methods

The National Research Mentoring Network convened an expert panel to develop a 90-minute module for training CE mentors. This module included individual development plans, case studies involving challenges for CE faculty, and examples of the broadened scope of scholarly activity. The workshop was delivered to 26 participants across four institutions and evaluated by a retrospective pre/post survey.

Results

Using a 7-point scale (1 = very low, 4 = average, 7 = very high), participants rated the overall quality of their CE mentoring as slightly below average preworkshop (M = 3.9) and as above average postworkshop (M = 5.2, p < .001). Areas of greatest self-perceived change in skills on a 7-point scale (1 = not at all skilled, 4 = moderately skilled, 7 = extremely skilled ) included setting clear expectations of the mentoring relationship (pre M = 3.6, post M = 5.1, p < .001), aligning mentor expectations with those of mentees (pre M = 3.6, post M = 5.0, p < .001), and helping mentees set career goals (pre M = 3.9, post M = 5.4, p < .001).

Discussion

This module trains CE mentors using an interactive and collective problem-solving approach. Workshop participants better defined demonstrable markers for CE progression with potential to impact tailored guidance for mentees.

A Scoping Review of Health Care Faculty Mentorship Programs in Academia: Implications for Program Design, Implementation, and Outcome Evaluation

INTRODUCTION

Formal mentoring programs have direct benefits for academic health care institutions, but it is unclear whether program designs use recommended components and whether outcomes are being captured and evaluated appropriately. The goal of this scoping review is to address these questions.

METHODS

We completed a literature review using a comprehensive search in SCOPUS and PubMed (1998-2019), a direct solicitation for unpublished programs, and hand-searched key references, while targeting mentor programs in the United States, Puerto Rico, and Canada. After three rounds of screening, team members independently reviewed and extracted assigned articles for 40 design data items into a comprehensive database.

RESULTS

Fifty-eight distinct mentoring programs were represented in the data set. The team members clarified specific mentor roles to assist the analysis. The analysis identified mentoring program characteristics that were properly implemented, including identifying program goals, specifying the target learners, and performing a needs assessment. The analysis also identified areas for improvement, including consistent use of models/frameworks for program design, implementation of mentor preparation, consistent reporting of objective outcomes and career satisfaction outcomes, engagement of program evaluation methods, increasing frequency of reports as programs as they mature, addressing the needs of specific faculty groups (eg, women and minority faculty), and providing analyses of program cost-effectiveness in relation to resource allocation (return on investment).

CONCLUSION

The review found that several mentor program design, implementation, outcome, and evaluation components are poorly aligned with recommendations, and content for URM and women faculty members is underrepresented. The review should provide academic leadership information to improve these discrepancies.

A webinar series to educate applicants about the UK academic foundation programme: a longitudinal cross-sectional study

BACKGROUND

The UK academic foundation programme (AFP) is a competitive programme for medical graduates and forms the initial stage of the integrated clinical academic pathway. The application is complex and targeted education is beneficial. As online technologies improve, virtual medical education is becoming more common. Currently, webinar education, particularly that of webinar series, are poorly evidenced. An online course was created to investigate the acceptability and effectiveness of webinars for medical education.

METHODS

A six-part, one-hour sessional webinar course was developed following a focus group with academic foundation doctors. A pre- and post-course cross-sectional questionnaire study evaluated participant demographics, webinar opinion and self-rated understanding of the AFP via Google Form (Google, USA). Where applicable a five-point Likert scale (1-Strongly disagree to 5-strongly agree) was utilised and analysis using non-parametric paired statistical analysis.

RESULTS

Medical students (n=303) from 35 UK universities completed the pre-course questionnaire. Most students had not received targeted education on the AFP. They rated webinars useful for education (mean=4.2 s.d. 0.7). After the course, participants (n=66) expressed it was significantly convenient (mean=4.7), effective (mean=4.7) and suitably interactive (mean=4.4) (p<0.001 compared to neutral). Participants preferred short sessions over multiple days to the concept of a full-day event (mean=4.6 vs 3.1, p<0.001). Paired analysis of participants completing both forms (n=47) demonstrates a significant increase in self-rated understanding of AFP content, portfolio building, application process, acute clinical scenarios, interview technique and overall confidence in acquiring an AFP post (p<0.001). Follow-up identified 43 participants who completed the course were successful in their AFP application. This represents 7.8% of all successful AFP applicants in 2021.

CONCLUSIONS

This study evidences an accessible and effective webinar series for AFP education. Comprehensive webinar courses for similar topics and demographics may provide valuable utility in the provision of future medical education.

TRIAL REGISTRATION

Ethics requirements were waived for this study by Bristol University Ethics Committee. All participants in this study consented for anonymous use of their data. As such the trial is not registered.

Characteristics, satisfiers, development needs, and barriers to success for early-career academic hospitalists

BACKGROUND

Academic hospitalists engage in many non-clinical domains. Success in these domains requires support, mentorship, protected time, and networks. To address these non-clinical competencies, faculty development programs have been implemented. We aim to describe the demographics, job characteristics, satisfiers, and barriers to success of early-career academic hospitalists who attended the Academic Hospitalist Academic (AHA), a professional development conference from 2009 to 2019.

METHODS

Survey responses from attendees were evaluated; statistical analyses and linear regression were performed for numerical responses and qualitative coding was performed for textual responses.

RESULTS

A total of 965 hospitalists attended the AHA from 2009 to 2019. Of those, 812 (84%) completed the survey. The mean age of participants was 34 years and the mean time in hospitalist practice was 3.2 years. Most hospitalists were satisfied with their job, and teaching and clinical care were identified as the best parts of the job. The proportion of female hospitalists increased from 42.2% in 2009 to 60% in 2019 (p = 0.001). No other demographics or job characteristics significantly changed over the years. Lack of time and confidence in individual skills were the most common barriers identified in both bedside teaching and providing feedback, and providing constructive feedback was an additional challenge identified in giving feedback.

CONCLUSIONS

Though early-career hospitalists reported high levels of job satisfaction driven by teaching and clinical care, barriers to success include time constraints and confidence. Awareness of these factors of satisfaction and barriers to success can help shape faculty development curricula for early-career hospitalists.

How do internal medicine subspecialty societies support clinician-educator careers? A qualitative exploratory study

BACKGROUND

Internal Medicine (IM) subspecialty professional societies can provide valuable community, recognition, resources, and leadership opportunities that promote career success. Historically, this support focused on clinical and research dimensions of academic careers, but educational dimensions have gained more attention recently. This study explores how IM subspecialty professional societies support their clinician-educator members.

METHODS

Using a qualitative study with two phases, the authors collected information from each IM subspecialty society's website about support for medical education. Using information from the first phase, we developed an interview guide for subspecialty society leaders. We used inductive thematic analysis to analyze interview transcripts.

RESULTS

Website analysis identified various mechanisms used by several IM subspecialty societies to promote medical education. These included websites focused on medical education, dedicated medical education poster/abstract sessions at annual meetings, and strategies to promote networking among clinician-educators. Interviews with eight subspecialty society leaders about the professional societies' roles with respect to medical education yielded four main themes: [1] varying conceptions of "medical education" in relation to the society [2] strategies to advance medical education at the society level [3] barriers to recognizing medical education [4] benefits of clinician-educators to the societies. Integrating these themes, we describe recommended strategies for professional societies to better serve clinician-educators.

CONCLUSIONS

We explore how IM subspecialty societies attend to a growing constituency of clinician-educators, with increasing recognition and support of the career path but persistent barriers to its formalization. These conversations shed light on opportunities for professional subspecialty societies to better serve the needs of their clinician-educator members while also enabling these members to make positive contributions in return.

Influences on and Characteristics of the Professional Identity Formation of Clinician Educators: A Qualitative Analysis

PURPOSE

Professional identity formation is the process of internalizing the ideals, values, and beliefs of a profession. In recent years, research on clinician-educator (CE) identity formation has expanded, yet gaps exist in understanding initial influences on an educator identity, sustainment throughout a career, and development of successful pathways for early CEs. This study explored the initial influences on and characteristics of the professional identity formation of CEs in an age-diverse, multispecialty population in the United States.

METHOD

This was a cross-sectional qualitative study of a purposive sample of medical educators at 6 institutions across the United States between 2018 and 2019. Focus groups were conducted to obtain participants' perspectives on their career choice and subsequent formation of their professional identity as CEs. The authors used a thematic analysis of focus group data to identify themes and domains through an iterative process.

RESULTS

Twelve focus groups were conducted with a total of 93 participants. Responses were categorized into 5 domains: community supportive of medical education, culture of institution and training, personal characteristics, facilitators, and professionalization of medical education. Themes highlighted the importance of role models and mentors, an affinity and aptitude for teaching and education, specific facilitators for entry into a career in medical education, the evolution from a layperson, importance of formalized training programs, and a supportive academic community.

CONCLUSIONS

Clinicians experienced a variety of factors that influenced their initial career choice in medical education and subsequent professional identity formation as a CE. This study confirms and expands the current understanding of this process in an age-diverse, multispecialty population of CEs. Educators and administrators designing career development programs across the continuum of medical education should consider these aspects as they mentor and support their learners and faculty.

A systematic scoping review of ethical issues in mentoring in medical schools

BACKGROUND

Mentoring provides mentees and mentors with holistic support and research opportunities. Yet, the quality of this support has been called into question amidst suggestions that mentoring is prone to bullying and professional lapses. These concerns jeopardise mentoring's role in medical schools and demand closer scrutiny.

METHODS

To better understand prevailing concerns, a novel approach to systematic scoping reviews (SSR) s is proposed to map prevailing ethical issues in mentoring in an accountable and reproducible manner. Ten members of the research team carried out systematic and independent searches of PubMed, Embase, ERIC, ScienceDirect, Scopus, OpenGrey and Mednar databases. The individual researchers employed 'negotiated consensual validation' to determine the final list of articles to be analysed. The reviewers worked in three independent teams. One team summarised the included articles. The other teams employed independent thematic and content analysis respectively. The findings of the three approaches were compared. The themes from non-evidence based and grey literature were also compared with themes from research driven data.

RESULTS

Four thousand six titles were reviewed and 51 full text articles were included. Findings from thematic and content analyses were similar and reflected the tabulated summaries. The themes/categories identified were ethical concerns, predisposing factors and possible solutions at the mentor and mentee, mentoring relationship and/or host organisation level. Ethical concerns were found to stem from issues such as power differentials and lack of motivation whilst predisposing factors comprised of the mentor's lack of experience and personality conflicts. Possible solutions include better program oversight and the fostering of an effective mentoring environment.

CONCLUSIONS

This structured SSR found that ethical issues in mentoring occur as a result of inconducive mentoring environments. As such, further studies and systematic reviews of mentoring structures, cultures and remediation must follow so as to guide host organisations in their endeavour to improve mentoring in medical schools.

Psychologists' Contributions to Medical Education and Interprofessional Education in Medical Schools

Recognition of the importance of behavioral and psychological phenomena has grown. Patients and physicians are receptive to psychological insights and processes in health and healthcare. Psychologists serve in diverse roles in medical schools, spanning activities such as didactics, rounds, precepting, supervising, mentoring, participating in educational projects, directing courses, and serving on educational committees. They address multiple content areas fundamental to medicine. Their participation in medical education and professional development activities for faculty are well-regarded. As healthcare becomes more interprofessional, with services delivered via interprofessional teams, opportunities for psychologists to contribute to, and play leadership roles in, interprofessional education (IPE) are expanding. It is critical that psychologists seize them. This article reviews psychologists' historic roles in medical education and provides a snapshot of their educational, faculty development, and IPE activities based on the 2017 survey of members of the Association of Psychologists in Academic Health Centers and their colleagues.

A systematic scoping review of ethical issues in mentoring in internal medicine, family medicine and academic medicine

Mentoring's role in medical education is threatened by the potential abuse of mentoring relationships. Particularly affected are mentoring relationships between senior clinicians and junior doctors which lie at the heart of mentoring. To better understand and address these concerns, a systematic scoping review into prevailing accounts of ethical issues and professional lapses in mentoring is undertaken. Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005. https://doi.org/10.1080/1364557032000119616) methodological framework for conducting scoping reviews was employed to explore the scope of ethical concerns in mentoring in general medicine. Databases searcheed included PubMed, ScienceDirect, ERIC, Embase, Scopus, Mednar and OpenGrey. 3391 abstracts were identified from the initialy search after removal of duplicates, 412 full-text articles were reviewed, 98 articles were included and thematically analysed. Unsatisfactory matching, misaligned expectations, inadequate mentor training, cursory codes of conduct, sketchy standards of practice, meagre oversight and unstructured processes have been identified as potential causes for ethical and professional breaches in mentoring practice. Changes in how professionalism is viewed suggest further studies of educational culture should also be carried out. The host organization plays a major role in establishing codes of conduct, expectations, and holistically, longitudinally oversight of the mentoring process and mentoring relationships.

A scoping review of mentor training programs in medicine between 1990 and 2017

Effective mentoring enhances the personal and professional development of mentees and mentors, boosts the reputation of host organizations and improves patient outcomes. Much of this success hinges upon the mentor's ability to nurture personalized mentoring relationships and mentoring environments, provide effective feedback and render timely, responsive, appropriate, and personalized support. However, mentors are often untrained raising concerns about the quality and oversight of mentoring support.To promote effective and consistent use of mentor training in medical education, this scoping review asks what mentor training programs are available in undergraduate and postgraduate medicine and how they may inform the creation of an evidenced-based framework for mentor training.Six reviewers adopted Arksey and O'Malley's approach to scoping reviews to study prevailing mentor-training programs and guidelines in postgraduate education programs and in medical schools. The focus was on novice mentoring approaches. Six reviewers carried out independent searches with similar inclusion/exclusion criteria using PubMed, ERIC, EMBASE, SCOPUS, Google Scholar, and grey literature databases. Included were theses and book chapters published in English or had English translations published between 1 January 1990 and 31 December 2017. Braun and Clarke's approach to thematic analysis was adopted to circumnavigate mentoring's and mentor training's evolving, context-specific, goal-sensitive, learner-, tutor- and relationally dependent nature that prevents simple comparisons of mentor training across different settings and mentee and mentor populations.In total, 3585 abstracts were retrieved, 232 full-text articles were reviewed, 68 articles were included and four themes were identified including the structure, content, outcomes and evaluation of mentor training program.The themes identified provide the basis for an evidence-based, practice-guided framework for a longitudinal mentor training program in medicine and identifies the essential topics to be covered in mentor training programs.