Development and initial results of a mandatory department of surgery faculty mentoring pilot program

Participant perspectives on a department of surgery faculty mentoring program

BACKGROUND

Mentorship in academic medicine serves to promote career advancement and job satisfaction. This study was to evaluate the initial results of a faculty mentorship program in an academic Department of Surgery.

METHODS

A faculty mentorship program was initiated in July 2015 with 63 participants. Junior faculty mentees (n = 35) were assigned senior faculty mentors (n = 28). After three years, an electronic survey was administered and the results analyzed.

RESULTS

Response rate was 67% (n = 42). 34 (81%) respondents had met with their mentor/mentee at least once. Topics discussed included: research (76%), leadership (52%), work-life balance (45%), and promotion (5%). Mentees endorsed achieving promotion (n = 2), increasing research productivity (n = 2), and obtaining national committee positions (n = 2). 61% of mentors and 53% of mentees felt they benefitted personally from the program. Actionable improvements to the mentorship program were identified including more thoughtful pairing of mentors and mentees with similar research interests.

CONCLUSIONS

Participants felt the mentorship program was beneficial. Further investigation regarding the optimization of the mentor-mentee pairing is warranted to maximize the benefits from structured mentorship in academic surgery.

The Impact of Establishing a Dedicated Liver Surgery Program at a University-affiliated Hospital on Workforce, Workload, Surgical Outcomes, and Trainee Surgical Autonomy and Academic Output

Objective

To detail the implementation of a dedicated liver surgery program at a university-affiliated hospital and to analyze its impact on the community, workforce, workload, complexity of cases, the short-term outcomes, and residents and young faculties progression toward technical autonomy and academic production.

Background

Due to the increased burden of liver tumors worldwide, there is an increased need for liver centers to better serve the community and facilitate the education of trainees in this field.

Methods

The implementation of the program is described. The 3 domains of workload, research, and teaching were compared between 2-year periods before and after the implementation of the new program. The severity of disease, complexity of procedures, and subsequent morbidity and mortality were compared.

Results

Compared with the 2-year period before the implementation of the new program, the number of liver resections increased by 36% within 2 years. The number of highly complex resections, the number of liver resections performed by residents and young faculties, and the number of publications increased 5.5-, 40-, and 6-fold, respectively. This was achieved by operating on more severe patients and performing more complex procedures, at the cost of a significant increase in morbidity but not mortality. Nevertheless, operations during the second period did not emerge as an independent predictor of severe morbidity.

Conclusions

A new liver surgery program can fill the gap between the demand for and supply of liver surgeries, benefiting the community and the development of the next generation of liver surgeons.

Mentoring as an intervention to promote gender equality in academic medicine: a systematic review

BACKGROUND

Mentoring is frequently suggested as an intervention to address gender inequalities in the workplace.

OBJECTIVES

To systematically review evidence published since a definitive review in 2006 on the effectiveness of mentoring interventions aimed at achieving gender equality in academic medicine.

DESIGN

Systematic Review, using the Template for Intervention Description and Replication as a template for data extraction and synthesis.

SAMPLE

Studies were included if they described a specific mentoring intervention in a medical school or analogous academic healthcare organisation and included results from an evaluation of the intervention.

ELIGIBILITY CRITERIA

Mentoring was defined as (1) a formally organised intervention entailing a supportive relationship between a mentor, defined as a more senior/experienced person and a mentee defined as a more junior/inexperienced person; (2) mentoring intervention involved academic career support (3) the mentoring relationship was outside line management or supervision of performance and was defined by contact over an extended period of time.

OUTCOMES

The impact of mentoring was usually reported at the level of individual participants, for example, satisfaction and well-being or self-reported career progression. We sought evidence of impact on gender equality via reports of organisation-level effectiveness, of promotion or retention, pay and academic performance of female staff.

RESULTS

We identified 32 publications: 8 review articles, 20 primary observational studies and 4 randomised controlled trials. A further 19 discussed mentoring in relation to gender but did not meet our eligibility criteria. The terminology used, and the structures and processes reported as constituting mentoring, varied greatly. We identified that mentoring is popular with many who receive it; however, we found no robust evidence of effectiveness in reducing gender inequalities. Primary research used weak evaluation designs.

CONCLUSIONS

Mentoring is a complex intervention. Future evaluations should adopt standardised approaches used in applied health research to the design and evaluation of effectiveness and cost-effectiveness.

How to Get Ahead: Early-Career Colorectal Surgeons Reflect on Their First Few Years in Practice

OBJECTIVE

To identify strategies and barriers to career progression in early-career colorectal surgeons.

DESIGN

Qualitative research study performed via semi-structured interviews with early-career, board-certified colon, and rectal surgeons. Responses were analyzed, coded, and categorized to understand strategies towards career progression, perceived barriers to career progression, beliefs about case mix, and referral patterns.

SETTING

Interviews conducted in person and via telephone across the United States and Canada.

PARTICIPANTS

Early-career board-certified colorectal surgeons RESULTS: Twenty-two board-certified colorectal surgeons currently employed in 14 states and 1 foreign country were interviewed. Fourty-five percent were female. Their current practice environment was described as academic (77%), private practice (18%), or military (5%). Seventy-seven percent of surgeons were satisfied with their career progression. Seventy-two percent were satisfied with the case volume. Seventy-two percent were satisfied with their case mix. When asked about strategies for career progression, surgeons made 77 comments focused on three main themes: optimization of their job search, optimization of relationships while on the job, and efforts to augment individual achievement. When asked about barriers to career advancement, surgeons most frequently commented on a lack of time and a lack of mentors. When asked about case mix, 63% of surgeons felt that they had no control over it. They were evenly divided between believing that a broad case mix or a niche specialized case mix was more instrumental for career progression.

CONCLUSIONS

Early-career colorectal surgeons were mostly satisfied with their career progression, volume, and case mix. In discussing their careers, many have developed a number of strategies focused on growth as an individual as well as relationship building. They also identified a number of barriers including lack of time and lack of mentorship. Early-career surgeons may be able to utilize these strategies and anticipate barriers prior to starting their first job, leading to greater likelihood of career satisfaction.

Implementation of a Weekly Administrative Hour and the Impact on Case Logging and Duty Hour Reporting in Surgical Residents

OBJECTIVE

To investigate the impact of a dedicated weekly administrative hour on case logging, duty hour reporting, and duty hour violations.

DESIGN

Retrospective analyses of 2 timeframes pre-implementation and post-implementation of a dedicated weekly administrative hour in a surgical residency were assessed for changes in duty hour reporting, case logging, and duty hour violations. The preimplementation period spanned from July 2011 to June 2014 and the postimplementation period from July 2014 to June 2017.

SETTING

Community-based, university-affiliated hospital.

PARTICIPANTS

A total of 79 surgical residents were included over a 6-year period. The subjects worked before and after the implementation of a weekly dedicated administrative time.

RESULTS

Seven and 30-day procedure logging rates improved from 28.7% to 37.2% and 52.7% to 69.9%, respectively (p < 0.001). PGY 1 residents showed a significant increase in procedures logged within 7 days during the postimplementation period. PGY 1, PGY 2 and PGY 3 all showed a significant increase in procedures logged within 30 days during the postimplementation period. Seven and 30-day duty hour completion rates increased postimplementation from 7.8% to 9.2% (p < 0.001) and 64.7% to 67.3% (p < 0.001), respectively. Duty hour violations decreased in the postimplementation time frame (40.6% vs 29.2%, p < 0.001). Duty hour violations were more common in earlier years of training. PGY 1 were 15.6 times more likely to have an 80 hours. per week violation than a PGY5 (OR: 15.1; 95% CI: 2.1-118.0).

CONCLUSIONS

Procedural logging and duty hour compliance improved after implementation of a dedicated weekly time for administrative duties. The year of a resident in training is related to compliance with logging and may impact the incidence of duty hour violations. Residents reported significantly fewer duty hour violations, however this may be multifactorial.

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.

High enthusiasm about long lasting mentoring relationships and older mentors

BACKGROUND

Mentoring plays a pivotal role in workplace-based learning, especially in the medical realm. Organising a formal mentoring programme can be labor and time intensive and generally impractical in resource constrained medical schools with limited numbers of mentors. Hence, informal mentoring offers a valuable alternative, but will be more likely to be effective when mentors and protégés share similar views. It is therefore important to gain more insight into factors influencing perceptions of informal mentoring. This study aims to explore mentors and protégés' perceptions of informal mentoring and how these vary (or not) with gender, age and the duration of the relationship.

METHOD

We administered an Informal Mentor Role Instrument (IMRI) to medical practitioners and academics from Egypt, Pakistan and Saudi Arabia. The questionnaire was developed for the study from other validated instruments. It contained 39 items grouped into 7 domains: acceptance, counselling, friendship, parenting, psychological support, role modelling and sociability.

RESULTS

A total of 103 mentors and 91 protégés completed the IMRI. Mentors had a better appreciation for the interpersonal aspects of informal mentoring than protégés, especially regarding acceptance, counselling and friendship. Moreover, being older and engaged in a longer mentoring relationship contributed to more positive perceptions of interpersonal aspects of mentoring, regardless of one's role (mentor or protégé).

CONCLUSION

It can be concluded that the expectations of mentors and protégés differed regarding the content and aim of the interpersonal characteristics of their mentoring relationship. We recommend mentors and protégés to more explicitly exchange their expectations of the informal mentoring relationship, as typically practiced in formal mentoring. Additionally, in our study, seniority and lasting relationships seem crucial for good informal mentoring. It appears beneficial to foster lasting informal mentoring relationships and to give more guidance to younger mentors.

Perceptions Regarding Mentorship Among General Surgery Trainees With Academic Career Intentions

OBJECTIVE

Effective mentorship may be an opportunity to mitigate career de-prioritization, improve stress management, and bolster professional growth. Relatively few studies address specific challenges that occur for general surgery trainees. We conducted a focus group-based investigation to determine facilitators/barriers to effective mentorship among general surgery residents, who are intending to pursue an academic career.

DESIGN

A semistructured focus group study was conducted to explore residents' attitudes and experiences regarding (1) needs for mentorship, (2) barriers to identifying mentors, and (3) characteristics of successful mentor-mentee interactions. Subjects self-identified and were characterized as either "Mentored" or "Nonmentored." Transcriptions were independently reviewed by 3 coders. Inter-rater reliability between the coders was evaluated by calculating Cohen's kappa for each coded item.

SETTING

General surgery residents from 2 academic tertiary hospitals, University of Pittsburgh Medical Center, and University of Washington, participated.

PARTICIPANTS

Thirty-four general surgery trainees were divided into 8 focus groups.

RESULTS

There were no gender-based differences in mentoring needs among residents. Barriers to establishing a relationship with a mentor, such as lack of exposure to faculty, and time and determination on the part of both mentor and mentee, were exacerbated by aspects of surgical culture including gender dynamics, criticism, and hierarchy. Successful relationships between mentee and mentor were perceived to require personal/professional compatibility and a feeling that the mentor is invested in the mentee, while conflicts of interest and neglect detracted from a successful relationship.

CONCLUSIONS

Our investigations demonstrate the importance of surgical hierarchy and culture in facilitating interpersonal interactions with potential mentors. Further studies will be necessary to determine how best to address these barriers.

Identifying Components of Success Within Health Sciences-Focused Mentoring Programs Through a Review of the Literature

Objective. To identify programmatic components and structural features associated with success of mentoring programs within the health sciences. Findings. Thirty-eight manuscripts representing 34 individual programs were reviewed. Of the institutions represented, 68% were public. Sixty-eight percent of programs included single disciplines only, with four focused in pharmacy, 13 in medicine, and six in nursing. Of the 34 individual programs, all programs reporting participant confidence and self-efficacy reported success in that domain. Eighteen programs reported outcomes related to scholarly activity that included publications or funding/grantsmanship; 16 reported success. Eleven of 16 programs reporting promotion/tenure and/or faculty retention rates reported success. Program components associated with successful programs included frequent meetings (at least monthly) and delivering content within formal curricula. Content categories common within programs reporting success were content related to research, funding/grantsmanship and networking/collaboration. In addition, specific for the promotion/retention domain, content related to curriculum/teaching was commonly found within successful programs. Summary. Although somewhat dependent on the program's specific goals, curriculum most commonly associated with success contained content on research, grantsmanship/funding, curriculum/teaching, and networking/collaboration. Among many programs, the reporting lacked objective, standardized metrics and often included only generalized descriptions/categorization of course content. The incomplete and inconsistent reporting limited our ability to draw conclusions regarding individual topics important for each program component. Proper planning, execution, and assessment of faculty mentoring programs is critical to the identification of additional program characteristics for optimal faculty success.

Identifying Priorities for Faculty Development in General Surgery Using the Delphi Consensus Method

OBJECTIVE

Faculty teaching skills are critical for effective surgical education, however, which skills are most important to be taught in a faculty development program have not been well defined. The objective of this study was to identify priorities for faculty development as perceived by surgical educators.

DESIGN

We used a modified Delphi methodology to assess faculty perceptions of the value of faculty development activities, best learning modalities, as well as barriers and priorities for faculty development. An expert panel developed the initial survey and distributed it to the membership of the Association of Program Directors in Surgery. Responses were reviewed by the expert panel and condensed to 3 key questions that were redistributed to the survey participants for final ranking.

PARTICIPANTS

Seven experts reviewed responses to 8 questions by 110 participants. 35 participants determined the final ranking responses to 3 key questions.

RESULTS

The top three priorities for faculty development were: 1) Resident assessment/evaluation and feedback 2) Coaching for faculty teaching, and 3) Improving intraoperative teaching skills. The top 3 learning modalities were: 1) Coaching 2) Interactive small group sessions, and 3) Video-based education. Barriers to implementing faculty development included time limitations, clinical workload, faculty interest, and financial support.

CONCLUSIONS

Faculty development programs should focus on resident assessment methods, intraoperative and general faculty teaching skills using a combination of coaching, small group didactic and video-based education. Concerted efforts to recognize and financially reward the value of teaching and faculty development is required to support these endeavors and improve the learning environment for both residents and faculty.

Factors Affecting Women's Success in Academic and Private Practice Plastic Surgery

Because plastic surgery trainees generally spend the majority of their training in academic centers and may have minimal exposure to other practice models, it can be difficult to decide which is the best route to achieve satisfaction and success. Surgeons need to be aware of benefits and challenges associated with different practice models and with workplace factors in general that contribute to happiness at work. This article reviews common practice models and provide specific and practical advice for the female surgeon.

The Role of Mentoring in the Development of Successful Orthopaedic Surgeons

Mentoring plays an integral role in orthopaedic surgeons' career development and personal growth. Effective mentors are committed to their roles, provide skilled instructional support, model continuous learning, and communicate optimism. Numerous obstacles impede productive mentoring relationships in medicine, including reluctance to ask for help, time constraints due to extensive work obligations, lack of institutional support, relational difficulties, and lack of mentoring skills. Effective partnerships require a concerted effort to establish behaviors conducive to mentoring, such as sharing knowledge and providing constructive feedback. Given that women represent only 13% of orthopaedic surgery residents and racial/ethnic minorities account for 3% to 10% of US orthopaedic surgeons, mentoring may help diversify the workforce by providing early exposure and professional support to physicians from underrepresented demographic groups. Orthopaedic leaders must embrace their professional obligation to cultivate and inspire the next generation of orthopaedic surgeons.

Social capital and career advancement of female academic staff in Nigerian universities

Purpose

The purpose of this paper is to examine the social capital factors of career advancement of female academic staff in Nigerian universities.

Design/methodology/approach

A measurement and structural analysis were conducted for the three independent variables and a dependent variable on 20 public universities. Data were collected using a structured self-administered questionnaire. The dependent variable was female academic staff career advancement and the independent variables were mentoring, networking and government machinery. Using stratified random sampling, 532 academic staff were selected as the study respondents. They represented sampling criteria such as federal and state universities.

Findings

Structural modeling analysis showed that social capital variables, specifically mentoring, networking and government machinery variables, were significant contributors to the career advancement of the female academic staff in Nigerian universities.

Practical implications

This study creates an insight into the knowledge of career advancement among female academic staff in public universities. These institutions dominate the university system in Nigeria and serve as the main avenue for university education in the country. At the level of higher institution, HRD is significant, particularly in creating awareness among academic staff about their career planning and aspirations, the role that the perceived environmental factors play in their advancement to higher positions in the university and how they should further utilize those factors.

Originality/value

The paper examines social capital factors (limited to mentoring, networking and government machinery) that are of concern to managing the career advancement of female academic staff in public universities.