MERIT: a mentor reflection instrument for identifying the personal interpretative framework

Combining Support and Assessment in Health Professions Education: Mentors' and Mentees' Experiences in a Programmatic Assessment Context

Introduction

Mentors in programmatic assessment support mentees with low-stakes feedback, which often also serves as input for high-stakes decision making. That process potentially causes tensions in the mentor-mentee relationship. This study explored how undergraduate mentors and mentees in health professions education experience combining developmental support and assessment, and what this means for their relationship.

Methods

The authors chose a pragmatic qualitative research approach and conducted semi-structured vignette-based interviews with 24 mentors and 11 mentees that included learners from medicine and the biomedical sciences. Data were analyzed thematically.

Results

How participants combined developmental support and assessment varied. In some mentor-mentee relationships it worked well, in others it caused tensions. Tensions were also created by unintended consequences of design decisions at the program level. Dimensions impacted by experienced tensions were: relationship quality, dependence, trust, and nature and focus of mentoring conversations. Mentors and mentees mentioned applying various strategies to alleviate tensions: transparency and expectation management, distinguishing between developmental support and assessment, and justifying assessment responsibility.

Discussion

Combining the responsibility for developmental support and assessment within an individual worked well in some mentor-mentee relationships, but caused tensions in others. On the program level, clear decisions should be made regarding the design of programmatic assessment: what is the program of assessment and how are responsibilities divided between all involved? If tensions arise, mentors and mentees can try to alleviate these, but continuous mutual calibration of expectations between mentors and mentees remains of key importance.

How do peer group reflection meetings support medical students' learning and personal development during clinical rotations?

BACKGROUND

Medical schools look to support students in coping with challenges and stressors related to clinical rotations. One potential approach is implementing Intervision Meetings (IM): a peer group reflection method during which students address challenging situations and personal development issues with peers, guided by a coach. Its implementation and perceived effectiveness in undergraduate medical education has however not yet been widely studied and described. This study evaluates how students perceive the effect of a three-year IM-programme during their clinical rotations, and explores which processes and specific factors support students' personal development and learning during clinical rotations.

METHODS

Using an explanatory Mixed Methodology, medical students participating in IM were asked to evaluate their experiences through a questionnaire at three time points. Questionnaire results were further explored through three focus groups. Data were analysed using descriptive statistics and thematic analysis.

RESULTS

Three hundred fifty seven questionnaires were filled out by students across the three time points. Students perceived IM to contribute to their ability to cope with challenging situations during clinical rotations. Participants in the focus groups described how IM created an increase in self-awareness by active self-reflection supported by peers and the coach. Sharing and recognizing each other's' situations, stories or problems; as well as hearing alternative ways of coping, helped students to put things into perspective and try out alternative ways of thinking or behaving.

CONCLUSIONS

IM can help students to better deal with stressors during clinical rotations and approach challenges as learning opportunities under the right circumstances. It is a potential method medical schools can use to aid their students on their journey of personal and professional development.

Mentoring future mentors in undergraduate medical education

Background

Efforts to support flagging mentoring programs facing shortages of experienced clinical mentors have had an unexpected and welcome effect. Supplementing traditional mentoring programs with peer-mentoring have not only addressed gaps in practice, structure, support and mentee oversight but have offered mentees charged with peer-mentoring duties the opportunity to take on mentoring roles under senior supervision. This study evaluates the experiences of peer-mentors within a local research mentoring program to better understand and advance this endeavor.

Methods

Semi-structured interviews and post-interview surveys based on recent reviews on mentoring were employed. Adapting the Systematic Evidence Based Approach, data was analysed using thematic and content analysis. Results were combined using the Jigsaw Perspective to ensure that key elements of the different mentoring stages were identified.

Results

The interviews and surveys revealed the following domains: Motivation, Initiation, Practicing, and Mentoring Environment.

Conclusion

These findings provide novel insight into a structured framework that may help guide the experiences, training, assessment, and oversight of peer-mentors beyond the auspices of our local program. These general observations will equip host organizations with the direction they need to take in designing and executing peer-mentoring training and assessment programs of their own. Whilst the stages of peer-mentoring need further evaluation and an effective means of assessment and support pivotal, we believe our findings suggest that peer-mentoring may not only help to address the shortfall in mentors but is an invaluable learning experience that prepares and instils key values, beliefs and principles in young would-be mentors.

Mentoring is in the 'I' of the beholder: supporting mentors in reflecting on their actual and preferred way of mentoring

BACKGROUND

An important strategy to support the professional development of mentors in health professions education is to encourage critical reflection on what they do, why they do it, and how they do it. Not only the 'how' of mentoring should be covered, but also the implicit knowledge and beliefs fundamental to the mentoring practice (a mentor's personal interpretative framework). This study analyzed the extent to which mentors perceive a difference between how they actually mentor and how they prefer to mentor.

METHODS

The MERIT (MEntor Reflection InstrumenT) survey (distributed in 2020, N = 228), was used to ask mentors about the how, what, and why of their mentoring in two response modes: (1) regarding their actual mentoring practice and (2) regarding their preferred mentoring practice. With an analysis of covariance, it was explored whether potential discrepancies between these responses were influenced by experience, profession of the mentor, and curriculum-bound assessment requirements.

RESULTS

The averaged total MERIT score and averaged scores for the subscales 'Supporting Personal Development' and 'Monitoring Performance' were significantly higher for preferred than for actual mentoring. In addition, mentors' experience interacted significantly with these scores, such that the difference between actual and preferred scores became smaller with more years of experience.

CONCLUSIONS

Mentors can reflect on their actual and preferred approach to mentoring. This analysis and the potential discrepancy between actual and preferred mentoring can serve as input for individual professional development trajectories.