Dr. PulciniEffective mentoring of trainees in pediatrics is an important step in improving children’s health. Forming and sustaining mentee-mentor relationships, however, can be challenging.
Following is an overview of the benefits of mentorship in pediatrics and some ideas to stimulate discussion on how to lay the groundwork for effective mentoring relationships.
Mentoring in medicine
In general, mentoring describes a personal relationship that persists and evolves over time according to the needs of the mentor and mentee. Mentorship requires a longitudinal investment on the part of both mentee and mentor. Effective mentoring relationships can be based on a variety of factors, including shared career and research interests, other professional interests and interests outside of medicine.
Mentorship differs from advising, which can be described as guidance rendered at single or multiple points in time from an individual who does not necessarily have a personal relationship with the advisee. While advising is valuable at times for trainees, mentorship is a more challenging, rewarding and important process for career development of pediatric trainees.
Mentoring in medicine was first mentioned in an article published in 1967. Most articles since then have focused primarily on medical students and junior faculty, with a paucity of literature focused on residents, fellows and senior faculty (Buddeberg-Fischer B, Herta KD. Med Teach. 2006;28:248-257). A majority of these studies, regardless of their goal and level of training, report the positive impact of mentorship on mentees (Sambunjak D, et al. JAMA. 2006;296:1103-1115).
Challenges to forging relationships
Several barriers exist for mentorship of trainees in medicine.
Barriers for medical students include the short duration of medical school courses and clerkships and geographical distribution. Residents and fellows often prioritize clinical and personal responsibilities over forming and developing mentoring relationships.
The largest barriers to establishing a formal mentoring program are at the systems level and include lack of compensation and the need for focused time for mentoring (Morrison LJ, et al. Med Teacher. 2014;36:608-614).
Overcoming barriers
Sustaining mentoring relationships is as important as identifying suitable mentors. Mentees should be aware that although faculty members may be interested in mentoring, time limits are a significant barrier to effective mentorship. Mentees should be prepared for mentoring meetings with a clear agenda and an awareness of their short-term and long-term goals. They also should work to stay connected with mentors. In addition, multiple mentors may be needed, and trainees can be encouraged to seek out mentors for different domains of interest.
As mentee-mentor priorities and goals change, so can their relationship. It is important that mentees not become discouraged if a once-flowering relationship appears to wilt over time and to be able to conclude an unproductive mentorship situation in a professional manner.
Faculty should reach out, as individuals or groups, to serve as mentors or connect trainees with someone who could serve well in these roles if they lack the time or training to do so.
It would be worthwhile to develop infrastructure within a department of pediatrics to train mentors, match mentors and mentees, develop guidelines and expectations for mentoring, and guide mentees in ways to initiate and sustain the relationship. Departments need to consider ways to communicate that mentoring is valued and provide creative incentives for mentors.
A few dedicated faculty leaders might be able to change the dynamic of mentorship at their institution. Publication of mentorship program successes will be foundational in guiding other faculty seeking to do the same. Continuing efforts at the national level, including professional development programs for mentors, guidance for trainees on how to manage mentor relationships and establishing mentoring networks across organizations, would support this work.
Noteworthy examples
Two programs exemplify the development of an institutional infrastructure for mentoring trainees. The AAP Section on Medical Students, Residents, and Fellowship Trainees recently spearheaded an effort to provide an online forum for mentorship (http://www2.aap.org/sections/ypn/r/mentorship.html). The program is open to all pediatricians. The accessibility of the program, willingness of mentors across the career spectrum to participate and enthusiasm of trainees likely will make this model successful for participants.
At Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, the Bridges personalized mentoring program for pediatric residents, fellows and faculty also is in the early stages of implementation. The Bridges program has established and maintained mentoring relationships for a year with evaluation of the program to follow. Perhaps the most promising aspect of the program is that it is slowly changing institutional culture by providing mentee/mentor training and participation as an expectation for individuals at all levels.
Conclusion
While barriers exist, effective mentoring of trainees in pediatrics can be successful.
Evidence-based mentorship models to guide best practices and changes in institutional culture(s) at offices, clinics and teaching institutions are needed. In addition, national organizations must prioritize mentorship of trainees.
Perhaps most importantly, both faculty and trainees must have the desire and will to address the need for mentorship as they strive to improve children’s health.
Drs. Pulcini and Umaretiya are members of the AAP Section on Medical Students, Residents, and Fellowship Trainees. Mentors Dena Hofkosh, M.D., FAAP, and Sherilyn Smith, M.D., FAAP, contributed to this article.
