Abstract
Purpose
To describe the experience and perceptions of physicians involved in group mentoring of undergraduate pre-clinical medical students.
Method
We conducted a cross-sectional questionnaire-based survey on perceptions of mentors regarding their motivation, personal development, reflective experience, and burnout. All the participants were mentors to undergraduate pre-clinical medical students in the course “Becoming a Physician.” This unique course focuses on various aspects of medical professionalism and aims to increase awareness and sensitivity to patients, especially of disadvantaged populations, and to promote sensitive effective communication skills. Mentors in the course are expected to serve as role models to their students.
Results
Of 36 mentors, 33 (91.7%) responded. The most frequent motivations to join the course were to contribute to students’ personal, social, and professional development and to contribute to educating more compassionate physicians. The topics discussed most in the groups were the meaning of being a physician and ethical dilemmas. Mentors expressed that they gained professional growth and opportunities to reflect on the complexity of physicians’ training and work. They perceived their highest success as being able to serve as role models for their students and provide them broad perspectives. Mentors stated that they failed in trying to facilitate content learning, and were disturbed by students’ lack of punctuality. Group mentors scored relatively low on the Maslach Burnout Inventory for Physicians.
Discussion
This study provides insights on the experience of mentorship of medical school students, and on mentors’ perceptions regarding their teaching experience and personal and professional development.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40670-020-01146-1.
Keywords: Mentor, Undergraduate medical students, Reflection, Burnout
Introduction
Enhancing empathy among medical students’ and imparting the practice of patient-centered medicine are goals of medical schools [1–4]. Curriculum planners and medical school teachers attempt to instill such values through diverse programs and teaching methods. At the Rappaport Faculty of Medicine of the Technion, we have developed a 3-year pre-clinical program called “Becoming a Physician.” The course is conducted in small groups and focuses on various aspects of medical professionalism. The objectives are to increase awareness and sensitivity to patients, especially of disadvantaged populations, and to foster sensitive effective communication skills [5]. A mentor escorts each group at weekly meetings. The mentors are physicians who represent a wide range of ages, specialties, and levels of training. They are carefully selected for their suitability to serve as professional role models [5]. Our data indicate very high satisfaction of the students with the program (based on annual anonymous students’ evaluations of the course and reference [5]). They have reported increased awareness to the particular needs of diverse populations, and the development of efficacy in conducting interviews tailored to patients’ needs. This may help students become more sensitive and thoughtful physicians [5]. In contrast to such outcomes, only sparse attention has been given in the literature to the experience of mentors of medical students. Preliminary data from our observations suggest that mentors report a sense of “personal growth” following their role as mentors [5]. The mentors receive special training before and during the course, which includes the following: the presentation of the course and its goals, acquaintance with the roles of a mentor in a group, practice in leading group discussions, and an introduction to reflection in medical education and working with reflective diaries.
Group mentoring is oriented to developing empathy and professionalism [6–8] in undergraduate medical students. This platform involves close interactions with students, guidance, and the development of students’ personal reflections [9–14] with close feedback from the mentors [15]. Such elements can undoubtedly foster the mentors’ personal experience and development through their deep and active involvement in the reflection cycle [9–14, 16]. Reward in mentorship can have positive repercussions in personal as well as professional development, such as improved teaching and improved relations to students [17, 18].
Burnout is a central problem in the medical profession [19–23], starting already from the years of medical studentship [24, 25]. Being involved in close relationships with the students, active involvement in medical education of junior students, and intensive reflexivity experience could increase motivation and decrease burnout in mentors [20].
Accumulating evidence shows positive effects of mentoring in medical undergraduate programs. However, studies focusing on the effects on mentors are relatively scarce. Thus, we explored the experience of mentors involved in group mentoring of undergraduate medical students in the 3 years’ course “Becoming a Physician.” Specifically, we aimed to describe the experience of being a mentor on mentors’ motivation, personal development, reflective experience, and burnout.
Methods
This was a cross-sectional survey-based study. Participants were the mentors of the 3 years’ course “Becoming a Physician” in the Rappaport Faculty of Medicine of the Technion. A web-based link to the questionnaire was mailed to all the 36 mentors in the course at the end of the academic year 2018–2019. Responses were anonymous. The study was approved by the institutional ethics committee of the Yezreel Valley College. At the introduction to the online questionnaire, participants gave their informed consent to have their responses included and analyzed for this study. The electronic completion of the questionnaire ensured anonymity.
We followed the guidelines for conducting and reporting survey-based research [26, 27]. To describe the experience of being a mentor, we chose a single cross-sectional survey that was given to all mentors in the 3-year course at the end of the academic year. We based our survey on previous studies [17, 18, 21, 28–31]. Most of the items in the survey questionnaire were adapted from items of established validated questionnaires used in previous studies: For the items that addressed motivation, gains and problems experienced by the mentors (questions 1–3), we followed the study of de Fátima Aveiro Colares et al. [18]. To describe areas in which tutors felt successes or failures (questions 4–5), we followed the study of Stenfors-Hayes et al. [17] and “the important questions a mentor should consider” published by the American Psychological Association [28]. Question 6, regarding the topics discussed with the students, was based on the study of Stenfors-Hayes [17]. To describe mentors’ feelings regarding the teaching experience, and personal and professional development (questions 7–18), we used the questionnaire described in the study of Stenfors-Hayes et al. [17], with the same items and four Likert-based scores to indicate level of agreement. The only items that we drafted specifically for this questionnaire dealt with the mentors’ responses to the reflective diaries written by the students. These items on communication with students and mentors’ reflective abilities (questions 19–22) used the same Likert-based scores as in the previous questions (7–18). Questions 23–40 were taken from the Maslach Burnout Inventory (MBI) for Physicians, which has been validated. This included the items on emotional exhaustion, depersonalization, and personal accomplishment [29–32]. The participants were asked to evaluate the feelings they had regarding each of these MBI items before and after joining the course as mentors. We used the Hebrew version of the MBI, as translated by the Shalem Fund, and from it, we took the item included in the abbreviated version of MBI adapted for physicians. The English version of the full questionnaire appears in the Appendix. The questionnaire was based on closed-ended, multiple-choice, Likert scale graded questions.
The first author drafted the questionnaire and translated it to Hebrew. To verify that the items were clearly written and relevant to the construct of interest, the other authors independently reviewed the items for clarity, relevance to the construct, and cognitive difficulty—expert validation. These authors had been mentors and academic counselors of the course in the past. We verified that when applicable, items would be presented in the form of questions and with Likert-based graded responses (both in words and in numbers). For the questions that dealt with gains and successes, or problems and failures, we provided a number of response options and allowed for more than one response. The same was true for the questions regarding motivation and topics discussed with the students. These multiple responses were our closest approximation to an open interview. We provided statements regarding both positive and negative aspects of the mentors’ experiences.
Results were analyzed quantitatively using descriptive statistics. Statistical analyses were conducted using SigmaPlot, version 11.0 (Systat Software Inc., San Jose, CA). For calculations of internal validity, we used Wessa P. (2017), Cronbach alpha (v1.0.5) in Free Statistics Software (v1.2.1), Office for Research Development and Education, URL https://www.wessa.net/rwasp_cronbach.wasp/
Results
The Mentors
Of the 36 mentors approached, 33 responded to the questionnaire, resulting in a response rate of 91.7%. The mean age of the participating mentors was 44.3 ± 8.5 years (median: 45, range: 31–69). Nineteen were females (58%) and fourteen were males (42%). The mean tenure of the mentors as physicians was 14.5 ± 9.1 years (median: 13, range: 2–40). The majority of the mentors were either married or living in parity (94%), and their mean number of children was 2.3 ± 1.0 (median: 2, range: 0–5). Thirty (91%) were Jews and three (9%) were of Arab ethnicity. The mentors’ specialties were grouped into three major disciplines: medicine 24%, surgery 46%, and pediatrics 30%. The majority of the mentors studied medicine in Israel (79%), almost half graduated from our faculty of medicine (48%). Thus, most of the mentors experienced the course as students. Twenty-six (79%) of the respondents completed their first experience as mentors in the course. Yet for six (18%), it was their second round in this 3-year course, and for one (3%), it was the third time as a mentor in the course.
The Motivation for Enrollment in the Mentoring Program (Table 1)
Table 1.
Motivation for enrollment in the mentoring program (n = 33 respondents)
| Motivation | |
|---|---|
| Make a contribution to students’ personal, social, and professional development | 20.2% |
| Make a contribution to preparing more compassionate human physicians | 20.2% |
| Help students adapt to a new environment and offer support for those experiencing difficulties | 12.9% |
| Make a personal contribution to a program that deserves to be successful | 12.9% |
| Enjoy working with students in an academic environment | 9.7% |
| Help students cope with day-to-day difficulties, including those related to future participation in the medical profession | 8.1% |
| Become a better and more well-rounded teacher, instructor or mentor | 7.3% |
| Improve students’ perception of the contribution of pre-clinical basic sciences studies to clinical skills in the future | 2.4% |
| Gain insight on how undergraduate students perceive teaching and medical studies, in general, and in our faculty in particular | 2.4% |
| Improve faculty-student relations | 1.6% |
| Have the possibility of working objectively on students’ problems related to the undergraduate program | 1.6% |
| Explore other teaching roles | 0.8% |
The two most frequent motivations that mentors mentioned (20% each) were “To make a contribution to students’ personal, social and professional development” and “To make a contribution to preparing more compassionate physicians.” Next were motivations “To help students adapt to a new environment and offer support for those experiencing difficulties” and “To make a personal contribution to a program that deserves to be successful” (13% each). For the frequencies of the other motivations suggested in the questionnaire, refer to Table 1.
Perceived Gains from Participating in the Mentoring Program and Experienced Successes as Mentors (Table 2)
Table 2.
Perceived gains from participating in the mentoring program and successes experienced as mentors (n = 33 respondents)
| Perceived gains | Experienced successes | ||
|---|---|---|---|
| Professional growth in the medical educational field | 21.5% | Serving as a role model to the students | 15.6% |
| Relating and providing wide perspectives on different subjects in wide contexts | 15.6% | ||
| The opportunity to reflect on the complexity of the physician training process | 20.6% | Providing guidance, constructive feedback, and balance that challenges and encourages the mentees | 10.1% |
| Facilitating my students’ personal and professional development | 10.1% | ||
| Introduction to otherwise unavailable knowledge, reading and subject matter, work and achievements, and interesting issues | 15.9% | Being accepting, encouraging, and supportive to the students | 9.2% |
| Encouraging reflection on the part of my mentees (students) | 7.3% | ||
| Giving information and demonstrating coping methods | 7.3% | ||
| Opportunity to reflect on the diversity of the teacher’s and mentor’s roles in medicine | 13.1% | Being accepting of the mentees as they are and valuing their individual unique differences | 4.6% |
| Setting realistic expectations for the mentees | 4.6% | ||
| Meeting and exchanging ideas with other peers, faculty members and physicians (from a variety of specialties, hospitals and clinics) in the mentoring program | 12.1% | Ensuring access to appropriate resources to facilitate the mentee’s goals | 3.7% |
| Assessing and giving feedback | 2.7% | ||
| Helping the mentees problem solve such as to address challenges that impact their ability to achieve goals | 2.7% | ||
| Being receptive to feedback from my students about how I can improve as an instructor and mentor | 2.7% | ||
| Closer contact with undergraduate students | 11.2% | Making a commitment to the success of my mentees | 0.9% |
| Balancing support with appropriate professional boundaries | 0.9% | ||
| Increased knowledge on junior students’ needs and expectations | 5.6% | Being collaborative in the mentoring process | 0.9% |
| Being receptive to my mentees needing/wanting to find a new mentor if their goals change | 0.9% | ||
| Facilitating content learning | 0 |
The perceived gains most mentioned from participating in the mentoring program were “Professional growth in the educational field” (21%) and “The opportunity to reflect on the complexity of the physician training process” (21%). The two items for which the perceived success as mentors was the highest (16% each) were “To serve as a role model” and “To relate and provide broad perspectives on multiple subjects and contexts.” For the frequencies of the other perceived gains and successes from being a mentor, refer to Table 2.
Perceived Problems Related to Mentoring Program Activities and Experiences of a Sense of Failure as Mentors (Table 3)
Table 3.
Perceived problems related to mentoring program activities and an experienced sense of failure as mentors (n = 33 respondents)
| Perceived problems | Experienced sense of failure | ||
|---|---|---|---|
| Students’ lack of punctuality (e.g. failure to arrive on time) | 27.9% | Facilitating content learning | 22.7% |
| Difficulties related to the extremely open thematic agenda of the course | 20.6% | Assessing and giving feedback | 10.7% |
| Difficulties related to the extremely open (under defined) mentors’ roles | 16.2% | Helping the mentees solve problems in ways that address challenges impacting their ability to achieve goals | 8.0% |
| Setting realistic expectations for the mentees | 8.0% | ||
| Anxiety associated with the perceived responsibility concerning student education | 8.8% | Encouraging reflection on the part of my mentees (students) | 6.7% |
| Ensuring access to appropriate resources to facilitate the mentees’ goals | 6.7% | ||
| Making a commitment to the success of my mentees | 6.7% | ||
| Difficulties related to group dynamics | 8.8% | Being collaborative in the mentoring process | 6.7% |
| Giving information and demonstrating coping methods | 5.3% | ||
| Difficulties in motivating students to attend course activities | 5.9% | Balancing support with appropriate professional boundaries | 4.0% |
| Facilitating my students’ personal and professional development | 4.0% | ||
| Difficulties in increasing student adherence to group work (e.g. in group discussions) | 5.9% | Providing guidance, constructive feedback, and balance challenging and encouraging the mentees | 2.7% |
| Being accepting of the mentees as they are and valuing their individual unique differences | 2.7% | ||
| Discouragement due to perceived ineffectiveness of the mentoring program | 5.9% | Relating and providing wide perspectives on various subjects in broad contexts | 2.7% |
| Being receptive to feedback from my students regarding how I can improve as an instructor and mentor | 2.7% | ||
| Discouragement due to reduced student participation (or poor motivation on behalf of the students to participate in the course activities) | 0 | Serving as a role model to the students | 0 |
| Being accepting, encouraging, and supportive to the students | 0 | ||
| Being receptive to my mentees needing/wanting to find a new mentor if their goals change | 0 |
The problem reported most was “Students’ lack of punctuality” (28%), followed by “Difficulties related to the extremely open thematic agenda” (21%). A sense of failure as mentors was mostly experienced in relation to trying “To facilitate content learning” (23%). For the frequencies of the other perceived problems and failures regarding the mentor role, refer to Table 3.
The Topics That Mentors Discussed with Their Mentees
“Being a doctor” was the most discussed subject (27%) followed by “Ethical issues” (22%). For the other subjects discussed by mentors and mentees, refer to Fig. 1.
Fig. 1.
The subjects that mentors discussed with their mentees
The Impact of the Mentor Role on the Respondents’ Teaching Experience, and on Personal and Professional Development (Table 4)
Table 4.
The effects of mentorship on issues related to the respondents’ teaching experience, and personal and professional development (scores range from 1 “not at all” to 4 “to a very high extent”) (n = 33 respondents)
| The effect of mentorship on issues related to the respondents’ teaching (questions 7–14) | Mean score | Standard deviation |
| Has being a mentor increased your interest in teaching and supervising students? | 3.2 | 0.7 |
| Has being a mentor led to development of your teaching instruction and supervision skills? | 3.1 | 0.7 |
| Do you discuss pedagogical issues (including the mentorship) more now than before you were a mentor? | 2.7 | 0.8 |
| Has being a mentor developed your view on what it means to be a good teacher? | 2.9 | 0.8 |
| Has being a mentor developed your view on what is important to you as a teacher? | 2.8 | 0.7 |
| Has being a mentor led to increased reflections regarding your teaching? | 2.8 | 0.7 |
| Has being a mentor increased your understanding of the students’ situation? | 2.8 | 0.7 |
| Has being a mentor improved your relations with the students? | 3.1 | 0.8 |
| Overall effect of mentorship on issues related to the respondents’ teaching | 2.9 | 0.5 |
| Cronbach’s alpha for questions 7–14 | 0.86 | |
| The effect of mentorship on issues related to the respondents’ personal and professional development (questions 15–18) | Mean score | Standard deviation |
| Has being a mentor led to personal development for you? | 3.1 | 0.9 |
| Has being a mentor led professional development for you? | 2.4 | 0.9 |
| Has being a mentor led to increased reflections regarding your own values? | 2.7 | 0.8 |
| Has being a mentor led to increased reflections regarding your own work practices as an MD? | 2.5 | 0.9 |
| Overall effect of mentorship on issues related to the respondents’ personal and professional development | 2.6 | 0.7 |
| Cronbach’s alpha for questions 15–18 | 0.89 | |
Scores to items regarding the impact of mentorship on the respondents’ teaching experience and on their personal and professional development are presented in Table 4. Most scores ranged between 2.4 and 3.2, suggesting some effects but not very remarkable ones. The Cronbach alpha for these items (items 7–18) was in the range of 0.82–0.90, suggesting good internal consistency reliability. All the responses to the items were normally distributed. The Cronbach alpha for the items that addressed the impact of mentorship on issues related to the respondents’ teaching (items 7–14) was 0.86, indicating high correlation. The Cronbach alpha for the items that addressed the impact of mentorship on respondents’ personal and professional development (items 15–18) was 0.89, indicating high correlation.
The Impact of the Reflective Diaries Written by the Students and Responded by the Mentors on Mentor-Student Communication and on Mentors’ Reflective Abilities (Table 5)
Table 5.
The effects of the reflective diaries written by the students and the mentors responses to them on communication with the students and mentors’ reflective abilities (scores range from 1 “not at all” to 4 “to a very high extent”) (n = 33 respondents)
| How important were the students’ reflective diaries, written after each meeting, to the process of their education and your communication with them? | 2.7 | 0.8 |
| How long and detailed were your comments in response to the students’ reflective diaries, and to what extent did they include detailed address and discussion of the issues the students raised? | 2.8 | 0.8 |
| To what extent do you think the students’ reflective diaries contribute to improving and strengthening the interactions and communication between you and your mentees? | 2.5 | 0.8 |
| To what extent do you think the students’ reflective diaries and your commitment to respond to them contribute to your own reflective abilities? | 2.3 | 0.8 |
| Overall evaluation of the reflective diaries and their contribution to communication with the students and mentor’s reflection (questions 19–22). | 2.6 | 0.7 |
| Cronbach’s alpha for questions 19–22 | 0.85 | |
Scores relating to the reflective diaries of the students, their effects on the interactions and communication of the mentors with the students, and mentors’ reflective capabilities are presented in Table 5. These scores were relatively low. Most of the responses suggested a limited impact. The Cronbach alpha for these items (19–22) was in the range of 0.78–0.83, suggesting relatively reliable internal consistency. All the responses to the items were normally distributed.
The Impact of Mentors’ Mentoring on Their Professional Burnout
The abbreviated version of the MBI adapted for physicians showed that the mentors experienced generally low scores of burnout, which decreased significantly after joining the course; the mean MBI was 1.0 ± 0.6 before and 0.9 ± 0.6 after (p = 0.029 using the Wilcoxon signed-rank test on medians).
Discussion
This study provides insights on the experience of mentorship and on mentors’ perceptions regarding their teaching experience and personal and professional development. The main findings were that the most frequent motivations to mentor the course “Becoming a physician” were to contribute to students’ personal, social, and professional development, and to contribute to educating more compassionate physicians. Accordingly, the topics discussed most in the groups were the meaning of being a physician and ethical dilemmas. Mentors perceived their highest success as being able to serve as role models for their students and providing them broad perspectives. Mentors stated that they failed in trying to facilitate content learning, and were disturbed by students’ lack of punctuality. Group mentors scored relatively low on the abbreviated version of MBI for Physicians.
We surveyed 33 mentors in the course using a structured questionnaire that applied a quantitative methodology of analysis. The response rate was very good. Most of the mentors were young senior attending physicians in their mid-40s, married, and with children. The higher proportion of female mentors reflects the current trend in medicine, which is also represented in the composition of our students (~ 60% females). Only 9% of our mentors were of Arab origin, which is less than their proportion (~ 20%) in the student population, though representative of their proportion of the faculty. It was encouraging to find that 45% of our group mentors were from surgical disciplines; in the past, faculty of such disciplines were less involved in issues relating to communication. Almost half our mentors were graduates of our faculty; most of them experienced the course as students, and this motivated them to join the course as mentors. This was reflected in the high proportion of respondents who stated as one of their motivations to becoming a mentor: to make a personal contribution to a program that deserves to be successful.
As expected, the most frequent motivations to join the course were to make a contribution to students’ personal, social, and professional development, and to make a contribution to educating more compassionate physicians. Many mentors also wished to help the students adapt to the new medical environment and to offer support for those experiencing difficulties. Accordingly, the subjects most addressed in group discussions were understanding the meaning of being a physician and ethical dilemmas that students encounter during their exposure to the world of clinical medicine.
Several of the group mentors felt that participation in the mentoring program afforded them the opportunity for professional growth and reflection on the complexity of physicians’ training and work. Their greatest success was to serve as role models for their student mentees, and to succeed in providing them with broad perspectives on multiple subjects and aspects of medical practice.
Our mentors were disturbed by the students’ lack of punctuality and were frustrated because they felt that they failed in trying to facilitate content learning in their students. We raise the possibility that this could be related to students nowadays belonging to Generation Y (Millennials). This evidently affects their attitudes towards work-life balance and priorities in life, as well as their access to readily available quick online knowledge from a very young age [33, 34]. Some of the mentors also mentioned difficulties related to the extremely open thematic agenda of the course. Such approach is typical of an informal education course that deals with gradual exposure to the world of clinical medicine, communication with patients, and ethical dilemmas.
The respondents did not think that mentorship would have remarkable effects on their teaching experience, or on their personal and professional development. While we expected such a perception, we believe that some effects could be evident over time, possibly even years later. However, we have no evidence to support such claim beyond our observations on past graduate mentors of the course.
It was disappointing to learn of the low evaluations attributed by the mentors to the impact of the reflective diaries on their interactions and communication with the students. Guided reflective writing during practical experience has been found to be an effective tool for comprehending meanings and values of experiences while forming a professional identity [35]. Supporting reflections enhances empathy and understanding towards patients, develops critical thinking, and increases professionalism. Being able to write a reflection is also an integral part of self-regulation and continuous learning [15]. Moreover, reflective writing supports the development of medical morality and enhances evaluation and thinking capabilities. We believe that the mentors’ evaluations should not discourage us or lead us to abandon such an important reflective educational tool. We need to better acquaint our mentors with this learning tool, and demonstrate its necessity as an important means for developing students’ professional identity.
Physicians are known to experience high levels of stress at work, which can lead to physical, psychological, and emotional harm, and eventually burnout [19]. Coping with burnout and its devastating effects on physicians is challenging. Coping with stress and burnout is recognized as a challenge even for pre-clinical undergraduate students [24]. Thus, the finding that engagement as mentors in informal educational programs with medical students could suggest another coping mechanism is of utmost importance. Whether such educational activity may foster a coping mechanism against burnout for the students as well should be further studied. Nonetheless, the encouraging findings that our mentors scored low on the MBI and that group mentorship decreased burnout among the physician mentors should be addressed with caution. First, the physicians who served as mentors in our program are probably not representative of the general physician populations, as their MBI scores were low at the start. This suggests that they experienced unprecedented low burnout levels. Second, using a cross-sectional survey at one time point with retrospective assessment of burnout (before and after) does not suggest causal link. Indeed, this method could be biased by memory distortions—memory recall bias. Thus, at the most, our findings could suggest that physicians who join such programs as mentors represent a relatively resilient group of physicians, and that engagement in mentorship programs to students might generally decrease burnout.
Our study has some limitations. The main one is related to its design as a quantitative cross-sectional survey based on a very structured questionnaire. Although the items were mostly taken from other studies [17, 18, 21, 28–31], and a number of possible responses were offered for each question, the content was limited to the text of the questionnaire. We enabled some flexibility by allowing the respondents to add a few more items if they felt it necessary to fully express their opinions. Nonetheless, this is obviously not identical to open-ended questions in an interview of a qualitative study. On the other hand, analysis and interpretation of a quantitative study are much easier and may lead to more decisive findings than those of qualitative studies, which are more amenable to interpreter’s bias. Another limitation of our study is the relatively small sample size.
Future studies could employ mixed qualitative and quantitative methodology on a much larger group of mentors to enhance the understanding of perceptions and thoughts regarding the role of group mentoring. Most of the mentors who were offered to participate agreed. Nevertheless, as a cross-sectional survey conducted at a certain point in time, this study can only describe motivations, feelings, and experiences of mentors in relation to their active participation in students’ mentoring. Such study cannot truly examine the causal effects of being a mentor on motivation, personal development, reflective experience, or burnout. For this, the optimal study should be based on a longitudinal design following a number of mentors over time.
We believe that the results of this study could help medical educators in constructing programs based on group mentoring of medical students. In our practice, the results helped us make changes in the organization of our course based on the mentors’ perspectives. We put much more effort to continuously escort our mentors and support them in gaining professional growth from their roles as mentors. We try to meet our mentors’ needs and provide expanded times for them to reflect on their mentorship experience and on the complexity of physicians’ training and work. We celebrate their successes with them and appreciate their ability to serve as role models for their students.
Conclusions
The findings of this study on group mentoring of pre-clinical medical students provide insights regarding the motivation and feelings of mentors, and areas of strengths and weaknesses. Group mentorship appears to have a positive influence on the mentors’ teaching experience, and on personal and professional development.
Electronic Supplementary Material
(PDF 382 kb)
Authors’ Contributions
All authors meet all of the ICMJE criteria for authorship:
AR made substantial contributions to the conception and design of the work and the acquisition, analysis, and interpretation of data for the work; drafted the work and revised it critically for important intellectual content; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved.
GY made substantial contributions to the conception and design of the work and the acquisition, and interpretation of data for the work; revised the work critically for important intellectual content; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved.
AF made substantial contributions to the conception and design of the work and the acquisition, and interpretation of data for the work; revised the work critically for important intellectual content; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved.
All those listed as authors are qualified for authorship and all who are qualified to be authors are listed as authors on the byline
Compliance with Ethical Standards
Conflict of Interest
The authors declare that there is no conflict of interest.
Ethical Approval
The study was approved by the institutional ethics committee of the Yezreel Valley College.
Ethics
Ethical approval was sought and received for the research described. The study was approved by the institutional ethics committee of the Yezreel Valley College.
Informed Consent
At the introduction to the online questionnaire, participants gave their informed consent to have their responses included and analyzed for this study. Anonymity was ensured.
Footnotes
The manuscript has not been previously published and is not under consideration in the same or substantially similar form in any other journal.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Stepien KA, Baernstein A. Educating for empathy - a review. J Gen Intern Med. 2006;21(5):524–530. doi: 10.1111/j.1525-1497.2006.00443.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Batt-Rawden SA, Chisolm MS, Anton B, Flickinger TE. Teaching empathy to medical students: an updated, systematic review. Acad Med. 2013;88(8):1171–1177. doi: 10.1097/ACM.0b013e318299f3e3. [DOI] [PubMed] [Google Scholar]
- 3.Branch WT, Kern D, Haidet P, Weissmann P, Gracey CF, Mitchell G, et al. Teaching the human dimensions of care in clinical settings. JAMA-J Am Med Assoc. 2001;286(9):1067–1074. doi: 10.1001/jama.286.9.1067. [DOI] [PubMed] [Google Scholar]
- 4.Meirovich A, Ber R, Moore M, Rotschild A. Student-centered tutoring as a model for patient-centeredness and empathy. Adv Med Educ Pract. 2016;7:423–428. doi: 10.2147/Amep.S107115. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Riskin A, Kerem NC, Van-Raalte R, Kaffman M, Yakov G, Aizenbud D, et al. ‘Becoming a Physician’-medical students get acquainted with disadvantaged populations, and practise sensitive and effective communication. Perspect Med Educ. 2015;4(6):339–343. doi: 10.1007/s40037-015-0222-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Holden M, Buck E, Clark M, Szauter K, Trumble J. Professional identity formation in medical education: the convergence of multiple domains. HEC Forum. 2012;24:245–255. doi: 10.1007/s10730-012-9197-6. [DOI] [PubMed] [Google Scholar]
- 7.Holden MD, Buck E, Luk J, Ambriz F, Boisaubin EV, Clark MA, Mihalic AP, Sadler JZ, Sapire KJ, Spike JP, Vince A, Dalrymple JL. Professional identity formation: creating a longitudinal framework through TIME (Transformation in Medical Education) Acad Med. 2015;90(6):761–767. doi: 10.1097/Acm.0000000000000719. [DOI] [PubMed] [Google Scholar]
- 8.Moss JM, Gibson DM, Dollarhide CT. Professional identity development: a grounded theory of transformational tasks of counselors. J Couns Dev. 2014;92(1):3–12. doi: 10.1002/j.1556-6676.2014.00124.x. [DOI] [Google Scholar]
- 9.Hargreaves K. Reflection in medical education. J Univ Teach Learn P. 2016;13(2). Available at: https://ro.uow.edu.au/jutlp/vol13/iss2/6.
- 10.Jorwekar GJ. Reflective practice as a method of learning in medical education: history and review of literature. Int J Res Med Sci. 2017;5(4):1188–1192. doi: 10.18203/2320-6012.ijrms20171223. [DOI] [Google Scholar]
- 11.Stark P, Roberts C, Newble D, Bax N. Discovering professionalism through guided reflection. Med Teach. 2006;28(1):e25–e31. doi: 10.1080/01421590600568520. [DOI] [PubMed] [Google Scholar]
- 12.Wald HS. Professional identity (trans)formation in medical education: reflection, relationship, resilience. Acad Med. 2015;90(6):701–706. doi: 10.1097/Acm.0000000000000731. [DOI] [PubMed] [Google Scholar]
- 13.Wong A, Trollope-Kumar K. Reflections:an inquiry into medical students’ professional identity formation. Med Educ. 2014;48(5):489–501. doi: 10.1111/medu.12382. [DOI] [PubMed] [Google Scholar]
- 14.Wald HS, Anthony D, Hutchinson TA, Liben S, Smilovitch M, Donato AA. Professional identity formation in medical education for humanistic, resilient physicians: pedagogic strategies for bridging theory to practice. Acad Med. 2015;90(6):753–760. doi: 10.1097/Acm.0000000000000725. [DOI] [PubMed] [Google Scholar]
- 15.Wald HS, Reis SP. Beyond the margins: reflective writing and development of reflective capacity in medical education. J Gen Intern Med. 2010;25(7):746–749. doi: 10.1007/s11606-010-1347-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Lutz G, Pankoke N, Goldblatt H, Hofmann M, Zupanic M. Enhancing medical students’ reflectivity in mentoring groups for professional development - a qualitative analysis. BMC Med Educ. 2017;17:122. doi: 10.1186/S12909-017-0951-Y. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Stenfors-Hayes T, Kalen S, Hult H, Dahlgren LO, Hindbeck H, Ponzer S. Being a mentor for undergraduate medical students enhances personal and professional development. Med Teach. 2010;32(2):148–153. doi: 10.3109/01421590903196995. [DOI] [PubMed] [Google Scholar]
- 18.de Fátima Aveiro Colares M, de Castro M, Martins Peres C, Costa Passos AD, de Castro Figueiredo JF, de Lourdes Veronese Rodrigues M, et al. Group mentoring for junior medical students: perceptions of mentees and mentors. Rev Bras Educ Med. 2009;33(4):670–675. doi: 10.1590/S0100-55022009000400019. [DOI] [Google Scholar]
- 19.Bruce SM, Conaglen HM, Conaglen JV. Burnout in physicians: a case for peer-support. Intern Med J. 2005;35(5):272–278. doi: 10.1111/j.1445-5994.2005.00782.x. [DOI] [PubMed] [Google Scholar]
- 20.McManus IC, Keeling A, Paice E. Stress, burnout and doctors’ attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates. BMC Med. 2004;2:29. doi: 10.1186/1741-7015-2-29. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Maslach C, Leiter MP. Early predictors of job burnout and engagement. J Appl Psychol. 2008;93(3):498–512. doi: 10.1037/0021-9010.93.3.498. [DOI] [PubMed] [Google Scholar]
- 22.McManus IC, Smithers E, Partridge P, Keeling A, Fleming PR. A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study. Br Med J. 2003;327(7407):139–142. doi: 10.1136/bmj.327.7407.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Nedrow A, Steckler NA, Hardman J. Physician resilience and burnout: can you make the switch? Fam Pract Manag. 2013;20(1):25–30. Available at www.aafp.org/fpm. [PubMed]
- 24.Fares J, Al Tabosh H, Saadeddin Z, El Mouhayyar C, Aridi H. Stress, burnout and coping strategies in preclinical medical students. N Am J Med Sci. 2016;8:75–81. doi: 10.4103/1947-2714.177299. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.IsHak W, Nikravesh R, Lederer S, Perry R, Ogunyemi D, Bernstein C. Burnout in medical students: a systematic review. Clin Teach. 2013;10:242–245. doi: 10.1111/tct.12014. [DOI] [PubMed] [Google Scholar]
- 26.Artino AR, Durning SJ, Sklar DP. Guidelines for reporting survey-based research submitted to academic medicine. Acad Med. 2018;93(3):337–340. doi: 10.1097/Acm.0000000000002094. [DOI] [PubMed] [Google Scholar]
- 27.Magee C, Rickards G, Byars LA, Artino AR. Tracing the steps of survey design: a graduate medical education research example. J Grad Med Educ. 2013;5(1):1–5. doi: 10.4300/JGME-D-12-00364.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.American Psychological Association. Important questions to consider before selecting a mentor or becoming one. American Psychological Association; 2016. Available at www.apa.org.
- 29.Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory (MBI) - Hebrew translation. Israel: The Shalem Fund; 1996. [Google Scholar]
- 30.McClafferty H. Abbreviated Maslach Burnout Inventory. Physician health and well-being: the art and science of self-care in medicine: McClafferty, H. 2014.
- 31.McClafferty H, Brown OW. Physician health and wellness. Pediatrics. 2014;134(4):830–835. doi: 10.1542/peds.2014-2278. [DOI] [PubMed] [Google Scholar]
- 32.Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory manual. 3. Palo Alto: Consulting Psychological Press (CPP), Inc; 1996. [Google Scholar]
- 33.Almog T, Almog O. As if there is no tomorrow : how Generation Y is changing the face of Israel. Ben-Shemen, Israel: Modan; 2015. [Google Scholar]
- 34.Waljee JF, Chopra V, Saint S. Mentoring Millennials. JAMA-J Am Med Assoc. 2018;319(15):1547–1548. doi: 10.1001/jama.2018.3804. [DOI] [PubMed] [Google Scholar]
- 35.Wald HS, White J, Reis SP, Esquibel AY, Anthony D. Grappling with complexity: medical students’ reflective writings about challenging patient encounters as a window into professional identity formation. Med Teach. 2018;41:152–160. doi: 10.1080/0142159X.2018.1475727. [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
(PDF 382 kb)

