Where do medical students turn? The role of the assigned mentor in the fabric of support during medical school

Opening the black box of school-wide student wellbeing programmes: a critical narrative review informed by activity theory

PURPOSE

Medical schools have a duty of care to support student wellbeing but there is little guidance on how to translate this mandate into practice. Often schools focus on implementing and reporting individual-level interventions which typically only address one aspect of wellbeing. Conversely, less attention has been paid to holistic school-wide approaches towards student wellbeing that address multiple wellbeing dimensions. Thus, this review sought to improve our understanding of how support is mediated within such school-wide wellbeing programmes.

METHOD

This critical narrative review was conducted in two stages. First, the authors searched several key databases for papers published up to 25th May 2021, using a systematic search strategy and TREND checklist to guide our data extraction process. We later expanded our search to include literature published from the original date to 20th May 2023. Second, the identified articles were critically analysed using activity theory as a theoretical lens to aid explanation.

RESULTS

We found school-wide wellbeing programmes emphasize social connectivity and building a sense of community. Tutors take a key role in the activity of supporting students' wellbeing. We mapped out the activity system components to describe the complexity of this tutor role. This analysis illustrated: tensions and contradictions in the system which may open up opportunities for change; the importance of context for influencing how system components interact; and that students' trust underpins the whole activity system.

CONCLUSIONS

Our review shines a light into the black-box of holistic school-wide wellbeing programmes. We identified that tutors play a key role in wellbeing systems but confidentiality is a recurring tension which may jeopardise a wellbeing system. The time has come to investigate these systems in more detail, embracing and exploring the role of context at the same time as looking for common threads.

Combined novice, near-peer, e-mentoring palliative medicine program: A mixed method study in Singapore

INTRODUCTION

An acute shortage of senior mentors saw the Palliative Medicine Initiative (PMI) combine its novice mentoring program with electronic and peer mentoring to overcome insufficient mentoring support of medical students and junior doctors by senior clinicians. A three-phased evaluation was carried out to evaluate mentees' experiences within the new CNEP mentoring program.

METHODS

Phase 1 saw use of a Delphi process to create a content-valid questionnaire from data drawn from 9 systematic reviews of key aspects of novice mentoring. In Phase 2 Cognitive Interviews were used to evaluate the tool. The tool was then piloted amongst mentees in the CNEP program. Phase 3 compared mentee's experiences in the CNEP program with those from the PMI's novice mentoring program.

RESULTS

Thematic analysis of open-ended responses revealed three themes-the CNEP mentoring process, its benefits and challenges that expound on the descriptive statistical analysis of specific close-ended and Likert scale responses of the survey. The results show mentee experiences in the PMI's novice mentoring program and the CNEP program to be similar and that the addition of near peer and e-mentoring processes enhance communications and support of mentees.

CONCLUSION

CNEP mentoring is an evolved form of novice mentoring built on a consistent mentoring approach supported by an effective host organization. The host organization marshals assessment, support and oversight of the program and allows flexibility within the approach to meet the particular needs of mentees, mentors and senior mentors. Whilst near-peer mentors and e-mentoring can make up for the lack of senior mentor availability, their effectiveness hinges upon a common mentoring approach. To better support the CNEP program deeper understanding of the mentoring dynamics, policing and mentor and mentee training processes are required. The CNEP mentoring tool too needs to be validated.

Mentorship of US Medical Students: a Systematic Review

BACKGROUND

Mentoring of medical students remains a core pillar of medical education, yet the changing landscape of medicine has called for new and innovative mentoring models to guide students in professional development, career placement, and overall student well-being. The objective of this review is to identify and describe models of mentorship for US medical students.

METHODS

We searched PubMed, PsycINFO, Education Resources Information Center, and Cochrane Databases of Systematic Reviews following PRISMA guidelines. We included original, English-language studies of any research design including descriptive studies that described a mentorship program at a US medical school designed for medical students.

RESULTS

Our search yielded 3743 unique citations. Thirty articles met our inclusion criteria. There was significant diversity of the identified programs with regard to program objectives and size. The traditional dyad model of mentorship was the most frequently cited model, with a combination of models (dyad and group mentorship) cited as the second most common. Outcome measures of the programs were largely survey based, with satisfaction being the most measured outcome. Overall, satisfaction was highly rated throughout all the measured mentoring programs. Seven programs provided objective outcomes measures, including improved residency match data and increased scholarly productivity. The programs with objective outcomes measures were smaller, and 6/7 of them focused on a specific clinical area. Five of these programs relied on the traditional dyad model of mentorship. Cost and faculty time were the most frequently cited barriers to these programs.

DISCUSSION

Our review demonstrates that mentoring programs for medical students can positively improve medical school satisfaction and career development. These results underscore the need for continued innovative mentoring programs to foster optimal student development in the setting of the increasingly competitive residency match process, growing expectations about student research productivity, and the national focus for overall student wellness.

Mentoring stages: A study of undergraduate mentoring in palliative medicine in Singapore

BACKGROUND

Mentoring nurtures a mentee's personal and professional development. Yet conflation of mentoring approaches and a failure to contend with mentoring's nature makes it difficult to study mentoring processes and relationships. This study aims to understand of mentee experiences in the Palliative Medicine Initiative (PMI). The PMI uses a consistent mentoring approach amongst a homogeneous mentee population offers a unique opportunity to circumnavigate conflation of practices and the limitations posed by mentoring's nature. The data will advance understanding of mentoring processes.

METHODS

Sixteen mentees discussed their PMI experiences in individual face-to-face audio-recorded interviews. The two themes identified from thematic analysis of interview transcripts were the stages of mentoring and communication.

RESULTS

The 6 stages of mentoring are the 'pre-mentoring stage', 'initial research meetings', 'data gathering', 'review of initial findings, 'manuscript preparation" and 'reflections'. These subthemes sketch the progression of mentees from being dependent on the mentor for support and guidance, to an independent learner with capacity and willingness to mentor others. Each subtheme is described as stages in the mentoring process (mentoring stages) given their association with a specific phase of the research process. Mentoring processes also pivot on effective communication which are influenced by the mentor's characteristics and the nature of mentoring interactions.

CONCLUSION

Mentoring relationships evolve in stages to ensure particular competencies are met before mentees progress to the next part of their mentoring process. Progress is dependent upon effective communication and support from the mentor and appropriate and timely adaptations to the mentoring approach to meet the mentee's needs and goals. Adaptations to the mentoring structure are informed by effective and holistic evaluation of the mentoring process and the mentor's and mentee's abilities, goals and situations. These findings underline the need to review and redesign the way assessments of the mentoring process are constructed and how mentoring programs are structured.

A framework for mentoring of medical students: thematic analysis of mentoring programmes between 2000 and 2015

A consistent mentoring approach is key to unlocking the full benefits of mentoring, ensuring effective oversight of mentoring relationships and preventing abuse of mentoring. Yet consistency in mentoring between senior clinicians and medical students (novice mentoring) which dominate mentoring processes in medical schools is difficult to achieve particularly when mentors practice in both undergraduate and postgraduate medical schools. To facilitate a consistent approach to mentoring this review scrutinizes common aspects of mentoring in undergraduate and postgraduate medical schools to forward a framework for novice mentoring in medical schools. Four authors preformed independent literature searches of novice mentoring guidelines and programmes in undergraduate and postgraduate medical schools using ERIC, PubMed, CINAHL, OVID and Science Direct databases. 25,605 abstracts were retrieved, 162 full-text articles were reviewed and 34 articles were included. The 4 themes were identified-preparation, initiating and supporting the mentoring process and the obstacles to effective mentoring. These themes highlight 2 key elements of an effective mentoring framework-flexibility and structure. Flexibility refers to meeting the individual and changing needs of mentees. Structure concerns ensuring consistency to the mentoring process and compliance with prevailing codes of conduct and standards of practice.

Mentoring Clinical-Year Medical Students: Factors Contributing to Effective Mentoring

THEORY

Academic mentoring is an effective method of enhancing undergraduate medical student academic performance, research productivity, career planning, and overall satisfaction.

HYPOTHESES

This study investigates the relationship between mentor characteristics and mentee academic performance, with an emphasis on identifying students who need special support.

METHODS

A cross-sectional study was conducted among fourth-year medical students at King Abdulaziz University Faculty of Medicine undertaking the clinical skills module (CSM) rotation. Mentors included senior and junior faculty members from the Department of Internal Medicine and the Department of Family Medicine. King Abdulaziz University Faculty of Medicine assigned 1 mentor for every 10 medical students. We organized our mentoring program in the following format: (1) an initial group meeting (mentor with all 10 medical students) and (2) subsequent one-on-one meetings (mentor with each mentee alone). We assessed mentor characteristics, student academic performance and satisfaction, and the rate of mentees referred for special support.

RESULTS

A total of 184 students completed the CSM rotation. Among these, 90 students responded to the preprogram survey, with 83% reporting that mentoring was important to them. Group meetings and one-on-one meetings were attended by 60% and 49% of all students, respectively. The most frequent type of support required by the participating students was psychological support (12% of mentees). Participation in the mentoring program had no significant effect on student academic performance. Mentor seniority (P = .024) and motivation (P = .002) were significantly associated with the rate of student referral for special support.

CONCLUSIONS

This study demonstrated that academic mentoring can be effective in enhancing student outcomes and promoting special support for students. Moreover, mentor and mentee motivation were found to be essential elements of a successful mentoring program.

Reassessing the educational environment among undergraduate students in a chiropractic training institution: A study over time

OBJECTIVE

The aim of the study was twofold: (1) to compare the perceived educational environment at 2 points in time and (2) to longitudinally examine potential changes in perceptions of the educational environment over time.

METHODS

The validated Dundee Ready Educational Environment Measure (DREEM), a 50-item, self-administered Likert-type inventory, was used in this prospective study. Employing convenience sampling, undergraduate chiropractic students were investigated at 2 points in time: 2009 (n = 124) and 2012 (n = 127). An analysis of 2 matching samples was performed on 27% (n = 34) of the respondents in 2009.

RESULTS

A total of 251 students (79%) completed the inventory, 83% (n = 124) in 2009 and 75% (n = 127) in 2012. The overall DREEM scores in both years were excellent: 156 (78%) and 153 (77%), respectively. The students' perceptions of teachers differed significantly between the 2 cohort years, decreasing from 77% to 73%. Three items received deprived scores: limited support for stressed students, authoritarian teachers, and an overemphasis on factual learning; the latter significantly decreased in 2012. In the longitudinal sample these items also displayed scores below the expected mean.

CONCLUSION

Students viewed the educational environment as excellent both in 2009 and 2012. The perceptions of teachers declined with time; however, this could be attributed to teachers' new roles. Certain aspects of the educational environment factored prominently during the comparative points in time, as well as longitudinally, and these ought to be further investigated and addressed to provide an enhanced educational environment.

A tiered mentorship program improves number of students with an identified mentor

BACKGROUND

Mentorship is critical to professional development and academic success. Unfortunately, only about 40% of medical students can identify a mentor. While group mentorship has been evaluated - the concept of a specialty specific, tiered group mentorship program (TGMP) has not. In the latter, each member of the group represents a unique education or professional level.

PURPOSE

The purpose of this study was to investigate the ability of a specialty-specific, tiered group mentorship program to improve mentorship for students interested in emergency medicine.

METHODS

Groups consisted of faculty members, residents, 4th-year students pursuing a career in Emergency Medicine, and junior (MS1, MS2, and MS3) medical students (13 total groups). Students completed confidential electronic surveys before and after completion of the program.

RESULTS

Of 126 students, 85 completed the Course Evaluation Survey. At program onset, 11.4% of 1st-year students, 41.7% of 2nd-year students, 50% of 3rd-year students, and 28% of the total students could identify a mentor. After completion, 68.6% of 1st years, 83.3% of 2nd years, 90% of 3rd years, and 77.6% of the total reported they could identify a mentor. Faculty were rated most important members followed by the 4th-year student.

CONCLUSION

A tiered group mentorship program improved the ability of students to identify a mentor. Students identified mentoring relationships from individuals at various professional levels.