Leadership in anaesthesiology through mentoring

ANAESTHESIOLOGY – UNIQUENESS AND SALIENT ASPECTS

An anaesthesiologist is a unique specialist; a conglomeration of several specialists. He has the innate potential to know about every speciality largely, be it a simple surgery of the tonsil up to the challenging liver transplantation. An anaesthesiologist is groomed to anaesthetise a premature newborn to a centenarian; we can imagine the variation in the physiology of this very wide spectrum. Yet, he does a perfect job as he has been taught the basic physiology to the various complicated pathologies in detail. Anaesthesiology can truly be called the Mother of Modern Medicine, the only branch that encompasses in its curriculum a holistic mix of the entire umbrella of surgery and medicine.

Anaesthesiologists have taken huge responsibilities of late. They are playing several roles apart from providing anaesthesia to a surgical procedure. They serve as perioperative physicians, optimising the patient's internal physiology to give a safe anaesthetic followed by very focussed post-operative care that negates several changes, including pain, inflicted on the body during the surgery. They are also involved very effectively in several sub-specialisations including emergency care, trauma resuscitation, palliative care, chronic pain management and intensive care among others.

Yet, an anaesthesiologist is not widely known as other specialists. It could be because that first the speciality was a shadow of the surgeons for decades; second, the roles played were limited to the operation theatres; third, they never took part in patient care and patient education proactively; fourth, they were not proactive enough in giving the visibility to the branch by interacting with the common public. All these factors resulted in a vibrant branch not realising its full potential.

The last few decades have seen a resurgence in this field, a strong desire to grow progressively and effectively. However, to disseminate the goodness of the branch, it is truly vital the anaesthesiologists inculcate a strong sense of self-belief, restoration of self-esteem, pride and awareness of the above processes.

The need of the hour is that senior professionals serve as mentors to the young anaesthesiologists and enrich them with the enormous possibilities.

INTRODUCTION TO MENTORING

The concept of mentoring is as old as human race; Socrates mentored Plato, who, in turn, was a mentor to Aristotle; Aristotle was the mentor to Alexander the Great. In our Indian epic Mahabharata, Sri Krishna is regarded as Arjuna's mentor; he guided and advised Arjuna eliminating his fears and reservations. The term 'mentor' derives from a character in Homer's epic tale, The Odyssey. In Greek to mentor means to think, to counsel, to remember and to endure.

A further understanding of the role of the mentor can be found through Morris Zeldtich's useful summary.[1] Mentors are:

• Advisors, people with career experience willing to share their knowledge

• Supporters, people who give emotional and moral encouragement

• Tutors, people who give specific feedback on one's performance

• Sponsors, sources of information about and aid in obtaining opportunities

• Models, of identity, of the kind of person one should be to be in the chosen profession.

RELEVANCE OF ORGANISATIONAL MENTORING INITIATIVES

Mentoring is not new to the medical profession. Guidance is informally available through seniors, experienced doctors, interested colleagues, parents in the medical profession, friends, etc.

Research has consistently found that formally mentored individuals are more satisfied and committed to their professions than non-mentored individuals.[2] They often show faster career progression and more 'maturity' in dealing with difficult events.[3] One study by Hays group revealed that the differential between the best and average organisations was large and the single most important contributor (35% of the gain) was based on mentoring.[4]

RESEARCH AND STUDIES ABOUT MENTORING IN MEDICAL FIELD

A study to explore the potential contribution of mentors among medical general practitioners established that focussing on holistic development (continuing education, personal support and professional development) was the most effective approach.[3] Another study[5] with medical practitioners concluded that when participation in the mentoring programme is voluntary and mentors serve as role models, the programme was effective. In both cases, the programmes were successful and were extended in duration and coverage.

The four most important roles for anaesthesiologists derived from the CanMEDS[6] framework are as follows:

Medical expert, leader and manager, scholar and professional.

While academic expertise is fundamental to developing these roles, they need to be augmented with competencies such as communication, emotional intelligence, conflict management, mastery in 'human factors', general management, leadership values and the ability to discern what will work when.

HOW DOES MENTORING WORK?

Mentoring is fundamentally based on the relationship between mentor and mentee. Formal mentoring relationships develop within organisational initiatives that are specifically designed to facilitate the creation and maintenance of such relationships.

PHASES IN MENTORING

Mentoring generally has the following phases:[7]

• Initiation – understanding motivations for mentoring, clarity of expectation and role

• Cultivation – setting ground rules, boundaries, goals and criteria for success and schedule of meetings

• Engagement – focus on learning, thoughtful and timely feedback

• Separation – celebrating progress, evaluation of journey together.

CRITICAL BEHAVIOURS FOR MENTORS AND MENTEES

Successful mentoring programmes base themselves on the principles of human interaction and behavioural sciences. Carl Rogers, one of the acclaimed psychologists, argued that all that is required for successful helping relationships is 'unconditional positive regard', which translates to 'mutual respect' in mentoring.[8]

For real mentorship to succeed, there needs to be a baseline chemistry between a mentor and a mentee. Studies show that even the best-designed mentoring programmes are no substitute for a genuine, intercollegial relationship between mentor and mentee.

The most successful mentoring programmes go beyond competency, focussing on helping to shape other people's character, values, self-awareness, empathy and capacity for respect.

ABOUT ISA MENTORING ACADEMY

The ISA Mentoring Academy is the body that brings together learning needs, resources, process, tools and infrastructure around mentoring and leadership by building access to experts. The Academy has conceptualised and designed the mentoring process with an overall vision of enhancing the Anaesthesia fraternity. The academy will be creating a Digital Tech Infrastructure that enables learning. On an on-going basis, it will review the mentoring process, take periodic feedback to understand the effectiveness, build governance and reporting structures.

The components of the mentoring academy include as follows:

• Principles of mentoring workshops for mentors

• Mentor coaching sessions

• One-on-one mentoring sessions for mentees

• Monthly webinars on non-academic skills

• Discussion dashboards and forums

• Specially designed Mobile App

• Two-day leadership workshops for mentees.

CONCLUSION

Mentoring is a gratifying process for all – the institution, mentors and mentees. It grows the overall leadership quotient for both the mentors and mentees, equipping them to be more self-aware, grow various competencies, develop a reliable professional network and live a more fulfilling and wholesome life. The organisation benefits holistically by living its potential and hence its purpose of patient care more meaningfully.