The Role of Mentoring in the Professional Identity Formation of Medical Students

Mentoring as a complex adaptive system - a systematic scoping review of prevailing mentoring theories in medical education

BACKGROUND

Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring's personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS).

METHODS

A systematic scoping review using Krishna's Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion.

RESULTS

Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring's CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes.

CONCLUSION

Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.

Mentoring: Shaping the professional identity of the academic internal medicine hospitalist

BACKGROUND

Burnout and lagging academic productivity are pressing challenges in hospital medicine, leading to stagnation and attrition. Mentoring shapes professional identity formation and enhances faculty vitality and retention, but has not been optimized among academic hospitalists.

OBJECTIVES

We sought to explore how mentoring impacts academic hospitalist professional identity and to elucidate barriers to mentoring in the field.

METHODS

We conducted focus groups at three academic medical centers. Informed by social-constructivist theory of identity development, we coded deidentified data and performed thematic analysis.

RESULTS

Thirty-one academic hospitalists participated with 1 to >20 years experience. Mentoring shaped professional identity formation in six core domains: choosing academic hospital medicine, identifying and focusing on an area of interest, progressing career, navigating work-life integration, staying in academic medicine, and becoming a mentor. Distinct models included dyadic mentoring, peer mentoring, organic mentoring, and mentoring teams, each with benefits and limitations. We identified nine key mentoring actions that influenced hospitalist professional identity formation and career development. Mentoring barriers included lack of time, awareness, and access to experienced mentors, as well as poor quality mentoring and mentor-mentee malalignment. Aspects of hospitalists' professional identity also posed barriers, including ambivalence around academic identity.

CONCLUSIONS

Mentoring fosters academic thriving and retention in academic hospitalists. Access to effective mentoring remains lacking due to few senior mentors in the relatively new field of hospital medicine and reticence in academic identity, among other factors. Mentoring training, impact on underrepresented minority hospitalists, and integration into institutional culture should be considered for enhancing the career development of academic hospitalists.

Assessing the role of mentors in mitigating burnout and enhancing professional development in medical education

Objectives

To assess the correlation between mentor behaviours and medical student burnout and their professional development within medical education.

Methods

A cross-sectional study using convenience sampling was conducted among third-, fifth-, and sixth-year medical students (N=307). Participants voluntarily completed anonymous online questionnaires measuring the Mentor Behavior Scale, the Maslach Burnout Inventory-Student Survey, and the Professional Self-Identity Questionnaire. Multivariate regression analysis was performed to analyse relationships between student burnout, mentor behaviours and their impact on professional development.

Results

Among participants, 26% (N=80) experienced burnout, which was significantly associated with lower competency support (OR = 2.0, 95% CI: 1.1-3.5, p = 0.016), medication use (OR = 2.1, 95% CI: 1.1-4.0, p = 0.029), and a lower Grade Point Average (OR = 3.3, 95% CI: 1.6-6.9, p = 0.001) compared to non-burnout students. In the development of professional identity, a high level of mentor relationship structure had statistically significant associations with higher scores in key domains of the Professional Self-Identity Questionnaire, including teamwork (OR = 3.9, 95% CI: 1.5-9.9, p < 0.01), communication (OR = 3.4, 95% CI: 1.5-7.7, p < 0.01), ethical awareness (OR = 3.3, 95% CI: 1.4-8.0, p < 0.01), and record use (OR = 2.8, 95% CI: 1.2-6.5, p < 0.05).

Conclusions

The impact of mentor behaviours on medical students is evident. Enhancing mentorship by addressing specific mentor behaviours can improve programme quality. Future research should explore the long-term effects and strategies for effectively implementing targeted enhancements in mentor behaviours.

Assessing the effects of a mentoring program on professional identity formation

BACKGROUND

Medical education has enjoyed mixed fortunes nurturing professional identity formation (PIF), or how medical students think, feel and act as physicians. New data suggests that structured mentoring programs like the Palliative Medicine Initiative (PMI) may offer a means of developing PIF in a consistent manner. To better understand how a well-established structured research mentoring program shapes PIF, a study of the experiences of PMI mentees is proposed.

METHODOLOGY

Acknowledging PIF as a sociocultural construct, a Constructivist approach and Relativist lens were adopted for this study. In the absence of an effective tool, the Ring Theory of Personhood (RToP) and Krishna-Pisupati Model (KPM) model were used to direct this dual Systematic Evidence-Based Approach (Dual-SEBA) study in designing, employing and analysing semi-structured interviews with PMI mentees and mentoring diaries. These served to capture changes in PIF over the course of the PMI's mentoring stages. Transcripts of the interviews and mentoring diaries were concurrently analysed using content and thematic analysis. Complementary themes and categories identified from the Split Approach were combined using the Jigsaw Approach and subsequently compared with mentoring diaries in the Funnelling Process. The domains created framed the discussion.

RESULTS

A total of 12 mentee interviews and 17 mentoring diaries were analysed, revealing two domains-PMI as a Community of Practice (CoP) and Identity Formation. The domains confirmed the centrality of a structured CoP capable of facilitating longitudinal mentoring support and supporting the Socialisation Process along the mentoring trajectory whilst cultivating personalised and enduring mentoring relationships.

CONCLUSION

The provision of a consistent mentoring approach and personalised, longitudinal mentoring support guided along the mentoring trajectory by structured mentoring assessments lay the foundations for more effective mentoring programs. The onus must now be on developing assessment tools, such as a KPM-based tool, to guide support and oversight of mentoring relationships.