CEBM deputy director Kamal R. Mahtani writes on the value of mentoring.
There are times in our careers when we are not sure what to do next, whoever we are. We may lack experience or the confidence to decide what to do; or we may have made a decision and need a word of advice from someone more experienced, reassuring us that the idea was sensible. At such times, having a mentor to advise, guide, or simply assuage our uncertainties, can be the key to taking the next steps successfully and enhancing our professional development.What is mentoring?
What is mentoring?
Mentoring is distinct from the process of coaching, although both are considered important in the development of healthcare leaders. The NHS Leadership Academy describes coaching as “a method of developing an individual’s capabilities in order to facilitate the achievement of organisational success.” In contrast, mentoring is much more focused around personal development and the success of the individual; it tends to be more informal, usually involves a mentor who is more experienced and (often) in the same field, and usually takes place over a reasonable length of time, months, or even years.
The late David Sackett, regarded by many as “the father of evidence-based medicine,” or at least one of them, saw effective mentoring as an essential component in the development of future leaders of clinical research. In his final interview, he highlighted several times during his own career when he had been mentored and the effect this had had on him. What was particularly telling was that, despite his many accolades, he described the mentoring of over 300 “aspiring academics” as the most fulfilling element of his career.
But what is the evidence for mentoring? A 2006 systematic review, of mostly cross-sectional surveys, of variable quality, explored the effect of mentorship on career development in academic clinical medicine. Mentorship was found to be of value to personal development, career guidance, and career choice, as well as publication and grant success.
Another systematic review explored the meaning and characteristics of mentoring. The findings suggested that the characteristics of a good mentor spanned three dimensions and included:
• Personal—being altruistic, understanding, patient, honest, responsive, trustworthy, nonjudgmental, reliable, motivational, and an active listener.
• Relational—being accessible, sincerely dedicated to developing an important relationship with the mentee, sincerely wanting to offer help in the mentee’s best interests, able to identify potential strengths in the mentee, able to assist mentees in defining and reaching goals, promoting a high standard for the mentee’s achievements, and being compatible (“a good match”) in terms of practice style, vision, and personality.
• Professional—senior and well-respected in their field, knowledgeable and experienced.
Beyond the characteristics, the review also explored the expected roles of a good mentor, which encompassed two themes: those at a personal level and those at an institutional level. For the former, the evidence suggested that a mentor’s role included helping create a safe environment for mentees to express emotions and share thoughts honestly, providing moral support, promoting vision building and goal setting, and signposting to skills development. Mentors also promoted mentees in their institutional and wider academic network, through opportunities for collaboration and access to higher academic circles.
And what of the characteristics of receptive mentees? A qualitative study showed that mentees should be open to feedback and active listeners, respectful of their mentor’s time and input, and prepared to take responsibility for the focus of the advice they are seeking.
The evidence thus presented points to several benefits of mentoring. But this needs to be good mentoring. Ineffective or failed mentoring relationships have been described as leading to feelings of disillusionment with the possibility of future mentoring opportunities or, in some cases, a change of career.
David Sackett and his mentoring legacy
Given the value that David Sackett put on good mentoring, it is not surprising that he wrote several articles and a book on the subject. But what of his own style of mentoring? Two of his mentees, both well-established professors, mentors, and proponents of evidence-based medicine themselves, recently reflected on their experiences as mentees of Sackett. They summarised (and I have interpreted) what they learned about being a mentor in six points:
1. Infect the young—Create opportunities for early career healthcare practitioners to become enthusiastic about what they practise and learn, whether individually or in groups.
2. Provide opportunities—Be altruistic. Ensure the provision of fair opportunities and support for mentees to develop career-enhancing skills and their own research profile. Whether through co-authoring, collaborating, conference speaking, or co-teaching. If a mentee takes any opportunities and succeeds, be the first to congratulate them.
3. Celebrate knowledge gaps—Create a safe environment where the mentee can honestly say “I don’t know” to a question, then turn this into a structured and supportive learning opportunity so that they can answer the question in the future. Don’t also be afraid to admit your own ignorance.
4. Manage your time to match your priorities—Being a successful clinical academic is not easy, but there are steps that can help. A good mentor should provide guidance and advice to their mentees to ensure that a mentee’s personal development goals are kept in sight, even if that means saying “no” to certain, less prioritised, activities. In providing advice do not tell the mentee what to do, but instead, provide signposts and suggestions.
5. Inject fun into everything—Remind mentees that being able to design and conduct research that can benefit patient care is a privilege and one that should be enjoyed, because of the successes, and despite the inevitable disappointments, that come with a research career.
6. Strive for work-life balance—Although good mentors should instil in their mentees a sense of enjoyment in their research journey, loving what we do in our professional lives does not give us an excuse to neglect other aspects of our lives. Despite technological advances that allow us to be continuously “connected” we should never forget the importance of others in our personal lives.
All in all, it seems like very good advice to me.
Kamal R Mahtani is GP, NIHR clinical lecturer and deputy director of the Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford. He is also deputy director of the Oxford International Primary Care Leadership Programme and a member of the Evidence Live 2016 steering committee which this year includes a Future Leaders theme.
You can follow him on Twitter at @krmahtani