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Peer mentoring for core medical trainees: uptake and impact
  1. Jessica Webb1,
  2. Alexandra Brightwell2,
  3. Pamela Sarkar3,
  4. Roy Rabbie3,
  5. Indranil Chakravorty3
  1. 1Department of Cardiology, St George's Hospital, London, UK
  2. 2Department of Paediatrics, Norwich and Norfolk University Hospital, Norwich, UK
  3. 3Department of Acute Medicine, St George's Hospital, London, UK
  1. Correspondence to Dr Jessica Webb, Department of Cardiology, St George's Hospital, London SW17 0QT, UK; jess{at}jesswebb.net

Abstract

Objective To assess the uptake and impact of a peer mentoring scheme for core medical trainees on both mentors and mentees.

Method All second year core medical trainees in the Southwest London Training programme in September 2012 were invited to mentor a first year core medical trainee. In parallel, all first year core medical trainees were invited to be mentored. Both potential mentors and mentees were asked to submit personal statements, to attend a three-session mentoring training programme and to be matched into mentoring pairs. The impact of the mentoring scheme on trainees’ behaviour and outlook was assessed through questionnaires distributed at the start and at the end of the year.

Results 31 of 72 (43%) core medical trainees submitted personal statements and 40 of 72 (56%) attended training sessions. 42 trainees (58%) participated in the scheme (21 mentor/mentee pairs were established). Of the trainees who participated, 23 of 42 (55%) completed the end of year questionnaire. Participating trainees viewed the scheme positively. Reported benefits included changes in their behaviour and acquiring transferable skills that might help them in later career roles, such as an educational supervisor. The end of year questionnaire was sent to all trainees and 10 responded who had not participated. They were asked why they had not participated and their reasons included lack of time, lack of inclination and a desire for more senior mentors. Their suggestions for improvement included more structured sessions to allow the mentor/mentee pairs to meet.

Conclusions This simple peer mentoring scheme was popular despite busy workloads and benefited all concerned. It is a simple effective way of supporting doctors. More work is needed to improve training for mentors and to improve access to mentoring.

  • MEDICAL EDUCATION & TRAINING
  • QUALITATIVE RESEARCH
  • INTERNAL MEDICINE
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Introduction

Mentoring has been identified as a useful tool for both personal and professional development of doctors.1 It is defined as ‘a process by which an experienced, empathic person guides another individual in development and re-examination of their own ideas and learning, therefore helping in personal and professional development’.2 Mentoring is distinct from all formal assessment processes, including educational and clinical supervision, although there may be some overlap between these roles for individuals.

The recent Royal College of Physicians Core Medical Training curriculum in the UK has included ‘being willing to accept mentoring as a positive contribution to promote personal professional development’.3 Nevertheless, the evidence for the impact of mentoring is variable, and a lack of uniform definition and process for mentoring programmes makes designing and assessing their success challenging.4

When individuals are ‘equal in age, experience and rank’, the mentoring is described as ‘peer mentoring’. This model has potential benefits requiring fewer resources with the mentor and mentee usually being closer in personal and professional experiences, offering an opportunity for more understanding relationship.5 Peer mentoring has been established for medical students,6 ,7 in academic medicine8 and nursing.9 There are as yet no reports of peer mentoring for core medical trainees but in other programmes high-satisfaction rates, acquisition of new and transferable skills and changed behaviour for both peer mentors and mentees have been reported.8

We developed a pilot peer mentoring scheme for core medical trainees (see box 1). We wanted to assess the uptake and to determine the impact both on mentors and mentees.

Box 1

What is core medical training?

Core medical training is a 2-year programme designed for doctors who wish to follow a career in medical specialties having completed their first 2 years of training post qualification. Core medical training comprises different posts, typically 4 or 6 months in duration in medical specialties such as cardiology, gastroenterology and respiratory medicine.

Methods

Design

The mentoring scheme was designed by a senior trainee (JW) who had experience in mentoring, supported by someone with experience of delivering peer mentoring programmes (AB). During the year there were four planning meetings: two to design the scheme, one to assess progress and one to discuss the optimum method to evaluate the scheme. Both people were present at all three training sessions, and in addition the senior trainee met with the core medical trainees a further three times during the year. The scheme ran from September 2012 until August 2013.

All 72 core medical trainees in a London regional training programme were invited to participate. There were 36 year one core medical trainees (invited to be mentees) and 36 trainees in year two core medical trainees (invited to be mentors). Participation was voluntary and opt out was possible at any stage. All the trainees rotated to different medical specialities during the year and were positioned either at the tertiary hospital or one of the three district general hospitals in the area. All the sessions were held at the tertiary hospital.

Mentor mentee matching

All trainees interested in the scheme were invited to submit a short personal statement. They were asked whether they had experience of mentoring, if and what they planned to do career wise and what their interests and experiences were outside work. They were asked whether they had any previous work experiences, such as voluntary work or work overseas. They was a free text box for the trainees to add any other details that they thought might be pertinent in the matching process, such as difficulties in the workplace, their experiences in the Annual Review of Competence Progression (ARCP) process (the assessment for core medical trainees) or other work experiences that had been memorable or relevant.

The senior trainee leading the scheme matched the mentors and mentees with help from the doctor with previous experience of peer mentoring schemes.

Training programme for mentors and mentees

A training programme, facilitated by the senior trainee and the doctor with experience in peer mentoring, was designed for both mentors and mentees. It was made up of three half-day sessions over a period of 10 weeks from September to November. The programme outlined:

  • the purpose of mentoring

  • the limitations of mentoring

  • how peer mentoring differed from other relationships in the workplace (educational supervisor, supervising consultant)

  • how peer mentoring could work and how the mentee should take the lead in organising meetings

  • how to be a successful mentor

  • how to be a successful mentee.

Each session included didactic teaching, group work for mentors and mentees separately and work in pairs for the established mentor and mentee pairs.

All 72 core medical trainees were invited to attend the sessions, even if they had not completed a personal statement or replied to the emails. After the first session all 72 trainees were sent a summary of the session, to try to encourage participation. Trainees who had attended the first session or submitted a personal statement were sent training summaries if they missed the second or the third training session. The pairs were given 15 min at the end of the training session to talk to each other and plan their next meetings.

Ground rules

Each pair of trainees signed a mentoring agreement covering expectations of frequency of meetings and agreed modes of contact and confidentiality. The mentoring pairs decided how often they planned to meet. Trainees were responsible for organising their meetings and each mentee was encouraged to take an active role in doing so. In case of any difficulties throughout the year, the senior trainee was available to provide confidential support for all trainees.

Evaluation

Evaluation of the scheme was through questionnaires distributed (1) after the training programme and (2) at the end of the year.

Questionnaires

The questionnaires were designed to assess the uptake of peer mentoring and the perceived impact of mentoring on their behaviour at work and acquisition of skills.

  1. The first questionnaire was handed out after the final training session and completed before leaving the sessions. Questions included how the trainees rated the training session, what they had found useful, whether they felt confident and able to contribute during the session and whether they had learnt anything from the session.

  2. At the end of the year a questionnaire was emailed to all 72 core medical trainees. This asked whether they had participated in the mentoring scheme and if not why not. All questions had free text boxes and all trainees were invited to add personal reflections.

For the trainees who had participated in the scheme, they were asked whether they had benefitted and there were free text boxes to include examples either in the work place or outside work. They were asked whether the new skills they had acquired had translated into clinical skills and asked for examples. These trainees were asked what they thought could be done to improve the scheme.

Trainees who had not participated were asked why they had not participated. They were asked whether they had attended any of the sessions or read any of the training summaries. These trainees were asked what could be done to improve the scheme and improve participation.

Ethical approval

The mentor training scheme was approved by the regional training programme board. The first email sent to all 72 trainees stated that this was a pilot scheme and the uptake and impact would be used to judge whether the scheme should be run again. They were all informed that the results would be published and they were asked to contact the organisers if they had any objections. At all three training sessions, the trainees were told that that the results would be published and were asked to let the organisers know if there were objections. Formal ethical approval was not thought to be required.

Results

Participants

Seventy-two core medical trainees were invited to participate and 31 (43%) replied with information for matching (figure 1). Two mentors and two mentees described experiences and interests in tropical medicine and overseas work, and they were matched into two pairs. Ten trainees described an interest in oncology or challenges with publishing papers, and they were matched into five pairs. Six mentees described challenges with the ARCP process and they were matched with mentors who had mentioned overcoming challenges in the ARCP processed. Eleven trainees were matched either on where they were working or the specialties they were rotating into during the year. The other trainees were matched during the training sessions.

Figure 1

Flow chart demonstrating participation in the mentoring programme.

Forty (56%) trainees attended the training sessions. Two trainees did not attend any of the sessions but were still matched in pairs. These trainees were both mentors and were sent the training session summaries. In total, 42 of 72 (58%) participated and 21 pairs were established. Equal numbers of first year trainees (mentees) and second year trainees (mentors) took part in the scheme. Only one trainee had previous experience of mentoring and none had experience of peer mentoring.

Difficulties

Three mentors and three mentees identified reported difficulties with their allocated pairings either because of time or because the pairs did not establish mutually supportive relationships. All six trainees contacted the senior trainee (four in person on the wards and two via email). These six trainees all identified alternative pairings themselves (two pairs swapped and the others identified core medical trainees who had not attended the training sessions to partner with). These trainees were sent the training session summaries.

Meeting frequency

The mentors and mentees were asked in their end of year evaluation how often they had met. This ranged from two to five times in the year. The average was three times during the year. The sessions usually lasted 30–40 min. All the mentors and mentees described email contact at least once a month, as well as face to face contact.

Evaluation of the training

The training sessions were described as useful or very useful by 37 of 40 (93%) of the trainees (equal number of mentors and mentees).Three trainees felt the sessions were neither useful or not useful. A total of 34 of 40 (85%) felt the scheme should be run again, six trainees did not comment, no trainees felt the scheme should not be run again.

Evaluation of the programme

The end of year questionnaire was emailed to all 72 trainees. Only 14 mentees and nine mentors (23/42, 55%) replied. In addition, 10 trainees who had not attended any of the training sessions or participated in the scheme replied.

A total of 23 of 23 trainees in the scheme reported improved listening skills and understanding of the issues facing their respective partner.

Eight of nine of the mentors described improved organisation skills and learning from challenging their mentees to improve their experience and performance as a mentor. Mentors felt these were skills that would be transferrable to other future roles especially as educational supervisors.

A total of 12 of 14 mentees described an improved ability to present the issues they were experiencing during their ARCP or in managing their workload, to their mentor. They all felt that this had helped them to become more concise. Some mentees reported that this perspective had contributed to an improved work life balance and improvements in time management. All of the mentees felt the experience of being mentored would encourage them to become mentors.

Both mentees and mentors reported changes in behaviour, such as an improvement in managing stressful situations at work and managing work relationships with other doctors. Six of nine mentors and eight of 14 mentees indicated that they would seek out mentoring in future placements, such as seeking more training via e-learning modules, actively mentoring medical students, seeking mentors in their own specialty, applying to other established mentoring programmes and even facilitating similar programmes in their own higher specialty training. Interestingly, some of the mentees reported seeking their own mentors in their own medical specialty. We have included one pair's perspective from the mentor and mentee as an example of the free text (see boxes 2 and 3).

Box 2

A personal perspective from a mentee

▸ I was very keen to participate in the peer mentoring programme despite having no specific experience of mentoring. The programme was introduced with an interactive introductory session when I immediately appreciated the role of the ‘mentor’ as distinct from the ‘supervisor’. We were encouraged to develop our own personal goals and objectives as part of the unique mentee-driven approach. As fellow medical trainees we shared almost identical academic and professional experiences and a common desire to develop as clinicians. We met every 2 months outside working hours and away from the pressures of the job.

▸ Peer mentoring has offered me invaluable first-hand guidance on addressing the components of the core medical training curriculum, including work-based assessments, clinical presentations and acquiring all the necessary procedural skills. It has been a major factor in my ability to complete all parts of the Membership of the Royal Colleges of Physicians (MRCP) during CT1. In addition, it has given me significant support and encouragement in my chosen career plans. By exchanging ideas on career development and discussing first-hand experience of the ST3 application process, I have been able to take huge steps towards my ultimate career goals. Importantly, it has provided a supportive environment to reflect on clinical experiences and exchange in honest feedback. This has helped me gain confidence in my skills and provide fresh inspiration to continue and progress down this path.

▸ At each meeting we discussed different aspects of clinical training and personal development, setting out specific tangible goals for the next. The emphasis on the mentee constructing their own objective and receiving their encouragement and support to progress through these proved particularly satisfying.

Box 3

A personal perspective from a mentor

▸ Mentoring junior medical trainees is an alien concept. I had no experience of mentoring and was inquisitive how peer mentoring would work out. As I was just about to apply for my ST3 job I was keen to develop the ‘mentor’ role. Our pairing worked well because we both got on well with each other. I tried to keep the meetings slightly formal ensuring we had set targets to achieve for the next meeting, such as focusing on elements of the ePortfolio or setting goal posts for MRCP revision. We both found it useful to revisit the targets and to assess whether they had been achieved, and if not, trying to explore why this was the case. There was an open platform so the mentee could ask anything—about aspects of training, career progression and coping with their work/life balance. The sessions were productive which cemented the mentor–mentee relationship and together we ‘problem-solved’ many issues.

▸ At the end of the year my mentee gave me positive feedback on our sessions and I found that I enjoyed knowing that I had made a difference. I learnt more about myself that I thought—that I need to continue to work on giving effective feedback and not to be too regimented in keeping to targets. The programme has changed how I behave at work and given me the confidence to seek out mentorship for myself in my new job. Overall it was a very positive experience—I wish I had experienced being mentored as a junior trainee.

Trainees who did not participate

Ten of 72 trainees who did not participate in the scheme replied to the end of year questionnaire and used the free text to explain their reasoning for not getting involved. Nine were second year core medical trainees and so would have been mentors. These nine trainees felt that the scheme should be run with more senior doctors as mentors (such as their registrars or consultants) and felt that they were not senior enough to take the role of mentor. They described not thinking they had anything to offer other trainees, not having time to mentor other trainees or being too busy applying for specialty training jobs. The one mentee who replied but did not participate felt that she would not benefit from peer mentoring as she did not feel she needed it.

Discussion

Despite demands of busy jobs, over half the eligible trainees joined this pilot peer mentoring scheme for core medical trainees. From the evaluations both mentors and mentees viewed the experience positively and reported benefits that included improvement at managing stressful situations at work, improved work life balance and acquisition of transferable skills.

We did not explore in depth the reasons why other trainees did not join the scheme. Mentoring is less likely to be successful if participants are not fully engaged in the process.9 So, we did not mandate participation and ensured trainees were responsible for driving their mentor:mentee relationships. More trainees might have been encouraged to join the scheme if we had increased the organisational support, with more reminder emails or organising more of the training sessions within the compulsory core medical training teaching programme. Or perhaps, the demands of their workload might have made some consider that there simply was not enough time for this. Of course the scheme simply might not have appealed to them. Other schemes have achieved higher participation, for example, 90% joined a peer mentoring programme for first year trainees in the same UK city in 2014.10 But the ‘peer’ mentors in this study were 4–5 years more senior and that may have improved perceived credibility and so participation.

The limitations to this scheme include small size, only one training programme in a single specialty and limited uptake of the end of year evaluation process. It is difficult to draw too many conclusions from our data due to the small response rate, and more research is needed to establish whether these results are representative. In addition, the lack of standardised validated approach to collecting feedback makes comparisons with other schemes challenging. The brief training programme did not help those trainees invited to be mentors, who did not feel ‘senior enough’ to take on the role. However, we have demonstrated that with just a little organisation it is possible to provide helpful peer:peer support even in the context of busy jobs.

Mentoring can have benefits for the individuals and for the organisation in which they work. A substantial number of core medical trainees were willing to take part in a small pilot programme. With more resources and organisational support, such as access to more formal training for mentors and facilitation of regular meetings, mentorship could become a core part of postgraduate medical training.

Main messages

  • 58% core medical trainees participated in this pilot programme of peer mentoring.

  • Mentors and mentees reported benefits including changes in behaviour and development of transferrable skills.

  • Some trainees have actively sought out other mentoring experiences since being involved in this peer mentoring scheme.

Current research questions

  • What are the long-term benefits of peer mentoring?

  • What does the organisation gain from mentoring schemes?

  • Does peer mentoring help trainees make career choices?

Key references

  • Colon-Emeric CS, Bowlby L, Svetkey L. Establishing faculty needs and priorities for peer-mentoring groups using a nominal group technique. Med Teach 2012;34:631–4.

  • Rotheray S, Watts D. Peer mentorship for medical students and junior doctors. Med Teach 2012;34:673–4.

  • Eisen S, Sukhani S, Brightwell A, et al. Peer mentoring: evaluation of a novel programme in paediatrics. Arch Dis Child 2014;99:142–6.

References

View Abstract

Footnotes

  • Contributors All authors have contributed equally to the manuscript.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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