How can we build mentorship in surgeons of the future?

Mapping the Mentorship Landscape in Otolaryngology-Head and Neck Surgery Training Programs: A Cross-Canadian Survey

OBJECTIVE

This study aims to explore the current landscape of mentorship within Canadian Otolaryngology-Head and Neck Surgery (OHNS) programs by investigating the experiences and perspectives of OHNS trainees and program directors (PDs).

STUDY DESIGN

A cross-sectional survey study.

METHODS

Anonymized online questionnaires were sent to all residents and PDs of the 13 accredited OHNS residency programs across Canada. The questionnaires collected qualitative and quantitative information about the type of mentorship (formal vs informal) programs implemented, as well as individuals' experiences and opinions on mentorship.

RESULTS

Of residents, 57.1% (92/161) completed the survey, whereas 84.6% (11/13) of PDs completed the survey. Of residents, 45.7% (42/92) participated in formal mentorship programs and 72.8% (67/92) participated in informal mentorship programs. The PDs perceived the importance of formal mentorship at 3.0/5. Residents reported greater satisfaction with informal mentorship relationships compared to formal mentorship (4.4/5 vs 3.7/5, P < .01) due to a more organic initiation of relationship and a better personality match. The main areas for improvement of current mentorship programs included the availability of mentors, networking opportunities, and protected time for encounters.

CONCLUSION

Surgical residents found informal mentorship to be more beneficial than formal mentorship. However, residency programs should provide more guidance and structure to optimize hybrid mentorship opportunities and mentor selection/availability. Mentorship training or development resources for attending physicians and feedback opportunities are essential for efficient relationships.

Mentorship in Otolaryngology Head and Neck Surgery: A Scoping Review

IMPORTANCE

Mentorship is increasingly recognized as a critical part of training across the spectrum of trainees. While explored more in-depth in the literature of other medical specialties, mentorship remains a nascent topic in the Otolaryngology Head and Neck Surgery (OHNS) literature.

OBJECTIVE

The objective of this study was to assess the current literature on mentorship in OHNS.

DESIGN

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines was used and the methodology was registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/X5FQ7). The Medline, EMBASE, and Web of Science databases were searched. Two authors independently selected studies, with the senior author resolving discrepancies. Study quality was assessed using the Oxford Centre for Evidence-Based Medicine levels of evidence.

SETTING AND PARTICIPANTS

English language studies employing any methodology that involved mentorship of medical trainees and staff in OHNS were included from the inception of the database up to September 20, 2023.

INTERVENTION OR EXPOSURES

Any form of mentorship.

MAIN OUTCOME MEASURE

The primary outcome was the benefits of mentorship afforded to the mentee.

RESULTS

From 415 unique articles identified, 45 studies were included. The median publication year was 2020 (IQR 6.5, range 1999-2023). The major themes of benefits from mentorship include improving residency uptake (n = 22), clinical competency and professionalism (n = 20), diversity and equity (n = 19), research productivity (n = 17), career planning and advancement (n = 17), and quality of life (n = 11). Other common themes included active mentorship (n = 29), near-peer mentorship (n = 13), and utilizing digital tools for mentorship (n = 6).

CONCLUSION AND RELEVANCE

Mentorship in OHNS has seen a sharp increase in publications in recent years. There are numerous benefits to mentorship including improving residency uptake, diversity initiatives, clinical competency and professionalism, research productivity, career planning and advancement, as well as quality of life.

Effective Mentoring Across Differences-Best Practices and Effective Models to Address the Needs of Underrepresented Trainees in Surgical Residency Programs

BACKGROUND

Mentorship plays a critical role in the career development of surgical trainees and faculty. As the surgical workforce continues to diversify, mentoring trainees who differ) race, ethnicity, country of origin, socioeconomic status, educational background, religion, gender, sexual orientation or ability) can pose challenges to the experience for both mentor and mentee.

OBJECTIVE

The aim of this manuscript is to introduce surgical educators to the systemic barriers faced by trainees and to models of effective mentorship.

METHODS

At the 2022 APDS Meeting, a panel convened to highlight the current challenges of mentoring across differences and effective models for surgical educators. This paper highlights and expands the summary of this panel.

RESULTS

Examples of novel mentoring models are described.

CONCLUSIONS

Acknowledgment of barriers, Implementation of deliberate mentoring strategies, and collaboration with national surgical organizations and surgery departments and faculty may help to reduce physician attrition.

How can pediatric surgeons address racism and become actively anti-racist?

BACKGROUND/PURPOSE

This is an article submitted on behalf of the Canadian Association of Pediatric Surgeons. We assert that Pediatric Surgeons must work to dismantle systemic racism. Pediatric Surgeons have expertise in both common and rare surgical diseases affecting patients ranging from premature neonates to adolescents. Thus, our professional obligation is to transform our health and social systems to prevent the harms of racism to our patients.

METHODS

Specific to the Canadian context, we describe a brief history, the ongoing impact on individuals and communities, and the harmful effect on the surgical community and trainees. Finally, we developed a series of practical recommendations to help surgeons become actively anti-racist.

RESULTS

Four primary recommendations are made: (1) Increasing and supporting anti-racism education; (2) Changing individual behaviours to combat racism; (3) Developing strategies for organizational change; and (4) Committing to diversity in leadership.

CONCLUSION

As surgeons, we are actors of change, and we can take meaningful steps to combat racism in our health systems.

LEVEL OF EVIDENCE

V.

Exploring variation in surgical practice: does surgeon personality influence anastomotic decision-making?

BACKGROUND

Decision-making under uncertainty may be influenced by an individual's personality. The primary aim was to explore associations between surgeon personality traits and colorectal anastomotic decision-making.

METHODS

Colorectal surgeons worldwide participated in a two-part online survey. Part 1 evaluated surgeon characteristics using the Big Five Inventory to measure personality (five domains: agreeableness; conscientiousness; extraversion; emotional stability; openness) in response to scenarios presented in Part 2 involving anastomotic decisions (i.e. rejoining the bowel with/without temporary stomas, or permanent diversion with end colostomy). Anastomotic decisions were compared using repeated-measure ANOVA. Mean scores of traits domains were compared with normative data using two-tailed t tests.

RESULTS

In total, 186 surgeons participated, with 127 surgeons completing both parts of the survey (68.3 per cent). One hundred and thirty-one surgeons were male (70.4 per cent) and 144 were based in Europe (77.4 per cent). Forty-one per cent (77 surgeons) had begun independent practice within the last 5 years. Surgeon personality differed from the general population, with statistically significantly higher levels of emotional stability (3.25 versus 2.97 respectively), lower levels of agreeableness (3.03 versus 3.74), extraversion (2.81 versus 3.38) and openness (3.19 versus 3.67), and similar levels of conscientiousness (3.42 versus 3.40 (all P <0.001)). Female surgeons had significantly lower levels of openness (P <0.001) than males (3.06 versus 3.25). Personality was associated with anastomotic decision-making in specific scenarios.

CONCLUSION

Colorectal surgeons have different personality traits from the general population. Certain traits seem to be associated with anastomotic decision-making but only in specific scenarios. Further exploration of the association of personality, risk-taking, and decision-making in surgery is necessary.

Participant expectations in a national otolaryngology mentorship programme

OBJECTIVE

Mentoring within surgery is increasingly recognised as a powerful development tool, but participant expectations have not previously been explored. This study aimed to explore and analyse participant expectations from the UK's first national otolaryngology mentorship programme.

METHOD

Participants completed open-ended questionnaires. Responses were qualitatively analysed using a grounded theory approach. Iterative cycles were used to develop codes using a constant comparison technique. Emerging categories were refined to identify core themes.

RESULTS

Key mentee expectations were career, and clinical and academic guidance. Enhancing networking opportunities was highlighted by medical students and junior trainees. Psychosocial and lifestyle support were predominant themes for all trainees. Receiving impartial advice and guidance from outside their training region was expressed only by senior trainees. Mentor expectations aligned with those of mentees.

CONCLUSION

This study identified key areas of the 'hidden curriculum' for students and trainees in otolaryngology, showing the evolving expectations and priorities as they progress through training.

"It's good for the soul:" Perceptions of a formal junior faculty mentorship program at a large academic cancer centre

BACKGROUND

Mentorship fosters professional and personal growth; however, the components essential to program success remain unclear. Our objective was to evaluate and explore the impact of a junior faculty mentorship program within an academic radiation oncology department.

MATERIALS AND METHODS

In 2016, our institution implemented a junior faculty mentorship program consisting of: (1) an orientation handbook; (2) faculty development sessions; and (3) direct, one-to-one selection of a mentor. Confidentiality agreements are signed, a goals template is provided, and meeting dates are tracked. Mentors/mentees were invited to participate in a program evaluation using mixed-methodology: a questionnaire followed by a one-on-one semi-structured interview to explore perceptions of the program. Interviews were audiotaped and transcribed verbatim. Descriptive statistics summarized questionnaire results and thematic analysis summarized interview results.

RESULTS

Eleven junior faculty have selected 10 mentors. Of these, 17 completed the evaluation questionnaire (81%) (7 mentors, 10 mentees; 5 women, 12 men) and 13 were interviewed (62%) (5 mentors, 8 mentees; 3 women, 10 men). The majority (80%) have participated in the program for >2 years. Although most mentees report additional mentors, 30% report this as their sole mentorship relationship. Four themes emerged: (i) Components of an Ideal Mentoring Relationship, (ii) The Value of Mentorship, (iii) Sponsorship, in addition to Mentorship and (iv) Cultivating Departmental Bonds and Boundaries.

CONCLUSION

Implementation of a junior faculty mentorship program within an academic radiation oncology department is feasible. Participants expressed satisfaction with most formal program components. Many junior faculty have additional mentors; however, some do not, highlighting the importance of formal programs for professional development.

The Mentor-Mentee Relationship, Addressing Challenges in Veterinary Medicine Together

This article provides a summary of the current veterinary and medical literature concerning mentor-mentee relationships. In particular, the authors discuss how mentorship may be expanded and improved to address current challenges faced by the veterinary profession. They consider both the positive effects of mentorship on retention and recruitment, mental well-being, and competency, as well as the potential negatives or downsides of mentorship. Although rigorous, controlled studies are rare, the available evidence indicates that mentorship may be a key method to restore career satisfaction in veterinary medicine. Further studies are needed as well as monitoring programs.

Influence of undergraduate medical education exposure to cadaveric dissection on choice of surgical specialty: a national survey of Canadian surgical residents

Background

The number of Canadian Residency Matching Service (CaRMS) applicants ranking surgical specialties as their first choice has declined over the past 20 years; concurrently, there has been a reduction in the number of hours spent teaching undergraduate medical education (UGME) anatomy, particularly with cadaveric dissection. The aim of this study was to determine the factors that most influence selection of a surgical specialty, with specific focus on the impact of UGME anatomy training.

Methods

A 36-item cross-sectional survey was designed by experts in medical education and distributed to all current surgical residents in Canada in October 2018. Responses were recorded on a 5-point Likert scale or by means of list ranking. We analyzed univariable outcomes with a t test for continuous outcomes and the χ² test for dichotomous outcomes.

Results

Of 1493 surgical residents, 228 responded to the survey (response rate 15.3%). Respondents reported experiences on core rotations and elective rotations, and access to a mentor as the most important factors in deciding to pursue a surgical residency. Anatomy training with or without cadaveric dissection was moderately influential in respondents’ first-choice CaRMS discipline (mean Likert scale score 2.97 [standard deviation (SD) 1.34] and 2.87 [SD 1.26], respectively). General surgery residents’ CaRMS applications were more likely to have been influenced by UGME anatomy training than the applications by residents in other surgical specialties (p < 0.001). The impact of UGME anatomy training did not vary between postgraduate years or between male and female residents.

Conclusion

Canadian surgical residents’ decision to apply to a surgical specialty did not seem to be strongly influenced by their UGME anatomy training, with or without cadaveric dissection, but, rather, by factors such as clinical experience and surgical mentorship. Further evaluation of groups that were more positively affected by their UGME anatomy training is warranted.

Retired Surgeons as Mentors for Surgical Training Graduates Entering Practice: An Underutilized Resource

OBJECTIVE

Our study evaluated the willingness of retired surgeons to mentor newly trained surgeons.

SUMMARY BACKGROUND DATA

Although mentoring is very important during the transition in practice, many novice surgeons are faced with inadequacy or lack of mentoring.

METHODS

A survey regarding mentorship of new surgeons was sent in April 2018 to retired general, colorectal, vascular, and cardiothoracic surgeons that are members of the American College of Surgeons. The analysis of the data was performed in September 2018 and October 2018.

RESULTS

A total of 2295 of 5282 surveys were completed (43.4% response rate). Mean age was 79.0 ± 0.8 years, mean retirement age was 63.9 ± 0.1 years, and mean interval since retirement was 15.2 ± 0.9 years. Most retired surgeons were in private practice (66.4%), with other practice environments, including academic teaching hospital (12%), academic/private combination (11.3%), employment by community hospital or health system (6.4%), veteran affairs institution (2.7%), military hospital (1%), and Indian Health Service (0.09%). Approximately a third (31.1%) of respondents were not mentored when they first entered practice. The vast majority (98.3%) of participants considered mentoring beneficial during transition in practice. More than half (51.2%) of retired surgeons are interested in mentoring recently trained surgeons, with most of them (81.8%) willing to mentor even for free.

CONCLUSION

Our findings suggest that a significant number of retired surgeons are enthusiastic about mentoring young surgeons during their transition in practice. Specific programs are necessary to meet the needs of newly hired surgeons and better utilize the expertise of retired surgeons.

Mentorship and Sponsorship in a Diverse Population

Mentorship and sponsorship are critically important for otolaryngologists at all levels of their career. Mentorship is typically found within a long-term professional relationship and provides career advice and support. Sponsorship is a more transactional relationship that promotes the mentee for specific career advancement opportunities. Both help mentees achieve more in their careers and have higher career satisfaction. This article defines mentorship and sponsorship and the current state of these within otolaryngology. Strategies for being an effective mentor and mentee are listed. Mentorship needs among women and underrepresented minorities within otolaryngology are discussed.

Mentoring experience of new surgeons during their transition to independent practice: A nationwide survey

BACKGROUND

New surgeons are faced with inadequate mentoring when first entering practice. Our study examined challenges faced by young surgeons during their transition in practice and their mentoring experience when entering practice.

METHODS

An article-based survey was mailed in August 2019 to general, colorectal, vascular, and cardiothoracic surgeons that became members of the American College of Surgeons within the past 5 years.

RESULTS

A total of 853 of 2,915 surveys were completed (29.3% response rate). Both female (38%) and male (62%) surgeons participated. The 3 most common challenges during the transition to practice were confidence building (26.0%), adjusting to a new institutional culture (16.9%), and business and administrative aspects of practice (16.3%). First job attrition rate 44.2%, with the mean duration of the first job being 3.28 ± 0.17 years. Nearly one-third (28.3%) of respondents were not mentored when they first entered practice. The proportion of nonmentored young surgeons leaving their first job (64.3%) was almost twice as that of surgeons who received mentoring (36.3%). Furthermore, the mean duration of the first job was significantly shorter in nonmentored versus mentored surgeons (3.16 ± 0.26 vs 3.76 ± 0.25 years; P < .05). A significant number (43.3%) of respondents reported a desire to be mentored by retired surgeons.

CONCLUSION

Our survey highlights the importance of mentoring for young surgeons during their transition into practice. With many young surgeons being enthusiastic about mentoring by retired surgeons, specific programs are necessary to better use their expertise.

Video Coaching Improving Contemporary Technical and Nontechnical Ability in Laparoscopic Education

OBJECTIVE

A video coaching (VC) system has been developed in surgical education. This study compares the educational effect on technical and nontechnical skills of the VC method for teaching laparoscopic surgery.

DESIGN

We conducted a prospectively randomized study of an education program to teach laparoscopic procedures.

SETTING

The study was performed at the Chang Gung Memorial Hospital, a university hospital in Taiwan.

PARTICIPANTS

We enrolled sixteen first- or second-year surgical residents.The participants were randomized into VC and conventional teaching (CT) groups, and their surgical skills were judged by the Global Operation Assessment of Laparoscopic Skills (GOALS) and the Objective Structured Assessment of Technical Skills (OSATS). Nontechnical skills were evaluated by the Non-Technical Skills for Surgeons (NOTSS) assessment and self-efficacy questionnaires (SEQs). After the program, posttraining scores were compared to assess improvements.

RESULTS

The 16 enrolled participants finished the entire course and completed all the videos during the study period. Comparing the VC and CT groups, we found that the pretraining GOALS, OSATS, NOTSS and SEQ scores were similar between both groups. However, after training, the OSATS score gain was higher in the VC groupthan in the CT group (9.25 ± 2.05 vs. 6.50 ± 1.51, p=0.009). Regarding nontechnical skills, the NOTSS score improved more in the VC group than in the CT group (5.50 ± 0.93 vs. 4.25 ± 0.89, p=0.015). The SEQ score was also higher in the VC group (32.13 ± 2.10) than in the CT group (29.50 ± 1.77), with a significant difference (p=0.018).

CONCLUSION

VC can help surgeons build their expertise using a more accessible method. Additionally, VC can shorten the learning curve and improve self-efficacy, thereby contributing to surgeons' education.

Modern Plastic Surgical Practice: Technical Competence Alone Is Not Enough

Annually, an estimated 234 million major surgical operations occur worldwide, with concomitant seven million complications and one million deaths. It is now well established that technical competence is necessary, but not sufficient for modern surgical practice and outcomes. Breakdown in non-technical skills has been attributed as a key root cause for near misses and patient harm in the operating room. This article discusses the multi-faceted skills-set that is necessary for the modern surgeon to succeed and for optimal patient outcomes. This includes technical skills, non-technical skills, with a focus on key CanMEDS framework domains, including leadership, communication, evidence-based surgery and mentorship.

Structuring Mentoring in Medicine and Surgery. A Systematic Scoping Review of Mentoring Programs Between 2000 and 2019

INTRODUCTION

Evidence of novice mentoring's successes in having senior clinicians support junior doctors and/or medical students in their clinical, academic, and research goals has spurred efforts to include mentoring in the core medical curriculum. However, lack of effective structuring threatens the viability of mentoring programs, precipitating ethical concerns about mentoring. This review aims to answer the question "what is known about mentoring structures in novice mentoring among medical students and junior doctors in medicine and surgery postings?," which will guide the design of a consistent structure to novice mentoring.

METHODS

Levac (2010)'s framework was used to guide this systematic scoping review of mentoring programs in medicine and surgery published between 1 January 2000 and 31 December 2019 in PubMed, ScienceDirect, ERIC, Embase, Scopus, Mednar, and OpenGrey. A "split approach" involving concurrent independent use of a directed content analysis and thematic approach was used to analyze included articles.

RESULTS

Three thousand three hundred ninety-five abstracts were identified. There was concordance between the 3 themes and categories identified in analyzing the 71 included articles. These were the host organization, mentoring stages, and evaluations.

CONCLUSION

The data reveal the need for balance between ensuring consistency and flexibility to meet the individual needs of stakeholders throughout the stages of the mentoring process. The Generic Mentoring Framework provides a structured approach to "balancing" flexibility and consistency in mentoring processes. The Generic Mentoring Framework is reliant upon appropriate, holistic, and longitudinal assessments of the mentoring process to guide adaptations to mentoring processes and ensure effective support and oversight of the program.

Clinical Improvement Interventions for Residents and Practicing Physicians: A Scoping Review of Coaching and Mentoring for Practice Improvement

BACKGROUND

Graduate medical education (GME) bodies are beginning to mandate coaching as an integral part of the learning process, in addition to current requirements for mentorship. Once an emergency medicine physician transitions beyond graduate training, there is no requirement and little focus on coaching as a method of improving or maintaining clinical practice. Our objective was to understand and describe the current state of the published literature with regard to the use of coaching and mentorship for both GME and practicing physicians.

METHODS

We conducted a structured review of the literature through PubMed and Google Scholar and included all articles applying coaching or mentorship modalities to GME trainees or practicing physicians. A Google Form was used for standardized data abstraction. Data were collected pertaining to the settings of intervention, the nature of the intervention, its effect, and its resource requirements.

RESULTS

A total of 3,546 papers were isolated during the literature review. After exclusion, 186 underwent full-text review by the authors of which 126 articles were included in the final data analysis. Eighty-two articles (65%) pertained to mentorship and 14 (11%) to coaching; the remainder of the articles discussed a combination or variation of these two concepts. Fifty-three (42%) articles were descriptive studies and 35 (28%) were narrative reviews or commentaries. Forty-seven (37%) articles originated from within surgical specialties and coaching was most commonly applied to procedural or manual skills with 22 (17%) instances among all studies.

CONCLUSIONS

Most literature on coaching and mentorship is descriptive or narrative, and few papers are in the specialty of emergency medicine. Most interventions are limited to single instances of coaching or mentorship without longitudinal application of the intervention. There is an important need to study and publish further evidence on coaching interventions.

Mentorship in Medicine and Other Health Professions

Mentoring skills are valuable assets for academic medicine and allied health faculty, who influence and help shape the careers of the next generation of healthcare providers. Mentors are role models who also act as guides for students' personal and professional development over time. Mentors can be instrumental in conveying explicit academic knowledge required to master curriculum content. Importantly, they can enhance implicit knowledge about the "hidden curriculum" of professionalism, ethics, values, and the art of medicine not learned from texts. In many cases, mentors also provide emotional support and encouragement. It must be noted that to be an effective mentor, one must engage in ongoing learning in order to strengthen and further mentoring skills. Thus, learning communities can provide support, education, and personal development for the mentor. The relationship benefits mentors as well through greater productivity, career satisfaction, and personal gratification. Maximizing the satisfaction and productivity of such relationships entails self-awareness, focus, mutual respect, and explicit communication about the relationship. In this article, the authors describe the development of optimal mentoring relationships, emphasizing the importance of different approaches to mentorship, roles of the mentors and mentees, mentor and mentee benefits, interprofessional mentorships for teams, gender and mentorship, and culture and mentorship.

Screening for Harassment, Abuse, and Discrimination among Surgery Residents: An EAST Multicenter Trial

Estimating the prevalence of harassment, verbal abuse, and discrimination among residents is difficult as events are often under-reported. The purpose of this study was to determine the prevalence of discrimination and abuse among surgical residents using the HITS (Hurt, Insulted, Threatened with harm or Screamed at) screening tool. A multicenter, cross-sectional, survey-based study was conducted at five academic teaching hospitals. Of 310 residents, 76 (24.5%) completed the survey. The HITS screening tool was positive in 3.9 per cent. The most common forms of abuse included sexual harassment (28.9%), discrimination based on gender (15.7%), and discrimination based on ethnicity (7.9%). There was a positive correlation between individuals who reported gender discrimination and racial discrimination (r = 0.778, n = 13, P = 0.002). Individuals who experienced insults were more likely to experience physical threats (r = 0.437, n = 79, P < 0.001) or verbal abuse (r = 0.690, n = 79, P < 0.001). Discrimination and harassment among surgical residents in academic teaching hospitals across the United States is not uncommon. Further research is needed to determine the impact of these findings on resident attrition.

A Systematic Scoping Review of Ethical Issues in Mentoring in Surgery

BACKGROUND

Mentoring is crucial to the growth and development of mentors, mentees, and host organisations. Yet, the process of mentoring in surgery is poorly understood and increasingly mired in ethical concerns that compromise the quality of mentorship and prevent mentors, mentees, and host organisations from maximising its full potential. A systematic scoping review was undertaken to map the ethical issues in surgical mentoring to enhance understanding, assessment, and guidance on ethical conduct.

METHODS

Arksey and O'Malley's methodological framework was used to guide a systematic scoping review involving articles published between January 1, 2000 and December 31, 2018 in PubMed, Embase, Scopus, ERIC, ScienceDirect, Mednar, and OpenGrey databases. Braun and Clarke's thematic analysis approach was adopted to compare ethical issues in surgical mentoring across different settings, mentee and mentor populations, and host organisations.

RESULTS

A total of 3849 abstracts were identified, 464 full-text articles were retrieved, and 50 articles were included. The 3 themes concerned ethical lapses at the levels of mentor or mentee, mentoring relationships, and host organisation.

CONCLUSIONS

Mentoring abuse in surgery involves lapses in conduct, understanding of roles and responsibilities, poor alignment of expectations, and a lack of clear standards of practice. It is only with better structuring of mentoring processes and effective support of host organisation tasked with providing timely, longitudinal, and holistic assessment and oversight will surgical mentoring overcome prevailing ethical concerns surrounding it.

Conceptual Framework of Mentoring in Low- and Middle-Income Countries to Advance Global Health

Although mentoring is not a common practice in low- and middle-income countries (LMICs), there is a strong need for it. Conceptual frameworks provide the structure to design, study, and problem-solve complex phenomena. Following four workshops in South America, Asia, and Africa, and borrowing on theoretical models from higher education, this article proposes two conceptual frameworks of mentoring in LMICs. In the first model, we propose to focus the mentor-mentee relationship and interactions, and in the second, we look at mentoring activities from a mentees' perspective. Our models emphasize the importance of an ongoing dynamic between the mentor and mentee that is mutually beneficial. It also emphasizes the need for institutions to create enabling environments that encourage mentorship. We expect that these frameworks will help LMIC institutions to design new mentoring programs, clarify expectations, and analyze problems with existing mentoring programs. Our models, while being framed in the context of global health, have the potential for wider application geographically and across disciplines.

National survey of mentorship in Canadian general surgery residency programs: Where are we and what do we need?

BACKGROUND

The benefits of mentorship on residents are well established. The current state of mentorship in General Surgery (GS) residency programs in Canada is unknown. The objectives of this study were to obtain GS residents' and program directors' (PD) perspectives on resident mentorship.

STUDY DESIGN

An electronic survey was developed and distributed to all 601 GS residents in Canada. All 17 PDs were invited for telephone interviews.

RESULTS

A total of 179 of the 601 residents responded. Ninety-seven percent (n=173) felt mentorship was important. Only 67% (n=116) identified a mentor and only 53% (n=62) reported a mentorship program. Most who identified a mentor (n=87/110, 79%) were satisfied with the mentorship received. Significant variations in mentorship existed between demographic subgroups and mentorship program types. Overall, residents (n=121, 74%) favoured having a required mentorship program.A total of 11 out of 17 PDs participated in the telephone interviews. The majority of PDs (n=9, 82%) were satisfied with current resident mentorship but most acknowledged that barriers exist (n=8, 73%).

CONCLUSION

GS programs in Canada should ensure they are providing equal opportunities for mentorship across demographic subgroups. Programs are encouraged to examine both their program's and their residents' needs as well as local barriers to improve mentorship.

Formal mentorship in a surgical residency training program: a prospective interventional study

Background

Otolaryngology-Head and Neck surgery resident physicians (OHNSR) have a high prevalence of burnout, job dissatisfaction and stress as shown within the literature. Formal mentorship programs (FMP) have a proven track record of enhancing professional development and academic success. More importantly FMP have an overall positive impact on residents and assist in improving job satisfaction. The purpose of the study is to determine the effects of a FMP on the well-being of OHNSR.

Methods

A FMP was established and all OHNSR participation was voluntary. Eight OHNSR participated in the program. Perceived Stress Survey (PSS) and the Maslach Burnout Inventory (MBI) were administered at baseline and then at 3, 6, 9, and 12 month intervals. World Health Quality of Life-Bref Questionnaire (WH-QOL) was administered at baseline and at 12 months.

Results

Baseline statistics found a significant burden of stress and burnout with an average PSS of 18.5 with a high MBI of 47.6, 50.6, and 16.5 for the emotional, depersonalization, and personal achievement domains respectively. Quality of life was also found to be low with a WH-QOL score of 71.9. After implementation of the FMP, PSS was reduced to 14.5 at 3 months (p = 0.174) and a statistically significant lower value of 7.9 at 12 months (p = 0.001). Participants were also found to have lower emotional scores (14.9, p < 0.0001), levels of depersonalization (20.1, p < 0.0001), and higher personal achievement (42.5, p < 0.0001) on MBI testing at 12 months. Overall quality values using the WH-QOL was also found to be significantly improved (37.5, P = 0.003) with statistically significant lower scores for the physical health (33.9, p = 0.003), psychological (41.1, p = 0.001), social relationship (46.9, p = 0.019), and environment (53.5, p = 0.012) domains.

Conclusion

This is the first study to show that FMP can potentially alleviate high levels of stress and burnout within a surgical residency program and achieve higher levels of personal satisfaction as well as overall quality of life.

The effect of mentoring on clinical perioperative competence in operating room nursing students

AIMS AND OBJECTIVES

The aim of this study was to investigate the effects of mentoring on the clinical perioperative competence of nursing operating room students in Iran.

BACKGROUND

Mentoring is an essential part of clinical education, which has been studied in different populations of students. However, there is a need to assess its effectiveness in operating room students' competence.

DESIGN

A randomised controlled trial was performed.

METHODS

Sixty nursing operating room students were randomly assigned to experimental and control groups. Both the control and experimental groups had routine training in the form of faculty supervision. The experimental group had an additional mentoring program. Using the Persian Perceived Perioperative Competence Scale-Revised, clinical competence was compared between the two groups, before and after the intervention. Using SPSS 19, descriptive and inferential statistics, including chi-square and t-tests, were conducted.

RESULTS

In the experimental group, the difference between the mean scores of clinical competence before (19·43 ± 2·80) and after (27·86 ± 1·87) the intervention was significant (p ≤ 0·001). After intervention, the difference between the mean scores of the control (3·9 ± 0·15) and experimental (8·61 ± 0·68) groups was significant (p ≤ 0·003).

CONCLUSION

Findings affirmed the positive effect of mentorship programmes on clinical competence in nursing operating room students.

RELEVANCE TO CLINICAL PRACTICE

Mentoring is an effective method for preparing nursing students in practice. Health care systems may improve as a result of staff-student relationships that ultimately increase the quality care for patients.

Providing mentorship support to general surgery residents: a model for structured group facilitation

SUMMARY

Mentorship is foundational to surgical training, with recognized benefits for both mentees and mentors. The University of Ottawa General Surgery Mentorship Program was developed as a module-based group facilitation program to support inclusive personal and professional development of junior general surgery residents. The group format provided an opportunity for both vertical and horizontal mentorship relationships between staff mentors and resident mentees. Perceived benefits of program participants were evaluated at the conclusion of the first year of the program. The program was well-received by staff and resident participants and may provide a time-efficient and inclusive mentorship structure with the additional benefit of peer support. We review the development and implementation of the program to date and share our mentorship experience to encourage the growth of formal mentorship opportunities within general surgery training programs.

Individualized feedback during simulated laparoscopic training:a mixed methods study

OBJECTIVE

This study aimed to explore the value of individualized feedback on performance, flow and self-efficacy during simulated laparoscopy. Furthermore, we wished to explore attitudes towards feedback and simulator training among medical students.

METHODS

Sixteen medical students were included in the study and randomized to laparoscopic simulator training with or without feedback. A teacher provided individualized feedback continuously throughout the procedures to the target group. Validated questionnaires and scales were used to evaluate self-efficacy and flow. The Mann-Whitney U test was used to evaluate differences between groups regarding laparoscopic performance (instrument path length), self-efficacy and flow. Qualitative data was collected by group interviews and interpreted using inductive thematic analyses.

RESULTS

Sixteen students completed the simulator training and questionnaires. Instrument path length was shorter in the feedback group (median 3.9 m; IQR: 3.3-4.9) as compared to the control group (median 5.9 m; IQR: 5.0-8.1), p<0.05. Self-efficacy improved in both groups. Eleven students participated in the focus interviews. Participants in the control group expressed that they had fun, whereas participants in the feedback group were more concentrated on the task and also more anxious. Both groups had high ambitions to succeed and also expressed the importance of getting feedback. The authenticity of the training scenario was important for the learning process.

CONCLUSIONS

This study highlights the importance of individualized feedback during simulated laparoscopy training. The next step is to further optimize feedback and to transfer standardized and individualized feedback from the simulated setting to the operating room.

A framework to establish a mentoring programme in surgery

INTRODUCTION

Mentoring programmes help to facilitate the process of continuous professional development in surgery, providing an organizational structure around a mentor-mentee relationship which helps to develop the mentee. The lack of guidelines outlining how to set up such mentoring programmes, the fragmented inter-relationships of existing schemes and the lack of a unified strategy for their implementation are obstacles to the creation of such initiatives within many surgical departments.

METHODS

We draw upon previous research, the experiences of certain authors and our own reflections to identify the key features of a surgical mentoring programme.

RESULTS

We propose a ten step process which aims to encourage the development of formalised mentoring programmes in surgery.

CONCLUSION

This outline may improve the delivery and effectiveness of mentoring programmes, which may ultimately enhance surgical training and hence quality of patient care.