The Values and beliefs of mentoring

Mentoring is a dynamic complex developmental relationship between two. They share experience, values and beliefs (Palmer 1987).Through this partnership the mentee, with assistance from the mentor sets goals for purpose of the development of the mentee. Enhancing skills, gaining new knowledge and implementing new behaviours are the intended targets of the mentoring journey. To achieve these goals in personal development, professional development and learning, the relationship requires time, patience, dedication and to some degree selflessness .In medicine , mentoring is changing the culture of sink or swim attitude.(20)

The concept of developmental mentoring therefore, with its emphasis on peer support, self managed learning, development contracts and reflective practice has the potential to challenge the individual mentors and mentees. While it is a close relationship, it is not a friendship .Problems can arise and lead to dysfunctional relationship .Some measures are recommended to avoid such outcome.

Mentoring is a relationship between two people in which trust and respect enables problems and difficulties to be discussed in an open and supportive environment (Whittaker and Cartwright 2000). It is psychological bond between two people .Connor (2006) suggests that mentors provide a safe place for reflection; they listen and support, explore strengths and blind spots, enable self challenge, generate insight and focus on goals. .The focus in mentoring is emotional and behavioural aspect of knowledge transfers rather the processes or techniques as compared to tutoring. (Fig 1)

It has benefits and satisfies needs of both. Once grasped, this is often seen as one of the most liberating aspects of being a mentor/mentee (3)

Fig (1): Tutoring v Coaching v Mentoring

What the mentor do (activities)? (6x5x5)

I can summarize these as: 6 attitudes and 5 skills in 5 phases

Attitudes: Fig (2) (mentor= MENTOR)

In the mentee centred model which I prefer, the mentor helps the mentee set goals in personal and career development and learning objectives. We know that self discovery and self experience are important facets of learning (Rogers1983) and as (kobbs1984) & (Knowles 1984) observed in adult learning theories. Mentee are expert in their own right. The mentor just motivates, empower, nurture self confidence, and teach by example, and sometime, offer counsel and advice and raise the performance bar (Scouba 1999). He helps the mentee to grow and achieve his goals. These goals should be specific, measurable, achievable, and realistic and time bound (SMART). He recommends and creates learning opportunities, transfer knowledge in such areas like critical thinking, problem solving, and points strength and areas for development

Motivate

Empower

Nurture self-confidence

Teach by

Example

Offer counsel&advice

Raise performance bar

Fig (2): mentor = MENTOR= 6 attitudes

He wears these different hats according the situation and mentoring moments

In simple words he involves the mentee in mentoring conversation (the five mentoring phases) (fig3)

2-Undersatnding

The mentee

5 Implementation

& Review

1-Contraction and Building rapport

3 Analysis

Mentee needs/Mentor perspective

4 Action planning

Options/choice

Fig (3): Mentoring: The 5 phases

During this special conversation the mentor applies the 5 mentoring (communication) skills: Fig (5)

Mentoring skills:

1-Rapport: is the ability to relate to others in a way that creates a climate of trust and understanding. Rapport is also the ability to see each other point of view (not necessary agree with), to be in the same wavelength and to appreciate each other feelings.(24) To build rapport different techniques can be used starting with small talks to explore common interest, day to day chat and progress to opinions, beliefs, feeling and emotions. With time as the relation becomes stronger and people become comfortable, unspoken rapport can be reached. Fig (3)

Unspoken Rapport

Feeling and emotions

Judgement, values and belief

Ideas and opinions

Facts, opinions and small talk

Ritual and cliché’

FIG (3): Building Rapport steps

2-Effective listening:

This is an art and skill to learn. Active and then deep listening requires the listener to understand, interpret, and evaluate what they hear. This involves tuning in to what the mentee is saying, giving them complete concentration, and waiting patiently for them to finish, without diving in or making assumptions about what they are likely to say. The provision of maximum attention is displayed both verbally and non-verbally through body language and eye contact. Words and actions should be used to convey encouragement to the mentee and benefit from active listening to get people to open up. (8)The ability to listen actively can improve personal relationships through reducing conflicts, strengthening cooperation, fostering understanding and building trust . Mentor should avoid cosmetic listening only. Fig (4)

COSMETIC LISTENING

CONVERSATIONAL LISTENING

ACTIVE LISTENING

DEEP LISTENING

Fig (4) Listening types: mentoring level social level

3-Asking powerful Questions

Questional skills are fundamental to effective mentoring. The role of questioning here is how to draw out learning and ideas from mentee– In mentoring one need to ask open question rather than close ones, probing and challenging than leading. Even sometimes smiles, pauses, nods or gestures are as effective as spoken questions— (14)

Contracting

Giving constructive

Feedback

Asking

Powerful

Questions

Effective

Listening

REFLECTION

Building

Rapport

MENTORING SKILLS (Applied in mentoring 5phases) Fig (3)

Fig (5) Mentoring: The 5 skills

4-Giving constructive feedback

A mentor can apply the principles of johari window (fig 6) during the mentoring process of giving feedback and encouraging self disclosure and to move information from blind spot and facade into the ARENA therefore increasing the size of the arena. (8)The blind spot will decrease as individual accept and own new information about themselves .The façade get smaller as they disclose more information about their feeling, perception and opinions. Fig (6)

Fig (6) : Principles of

Feedback is the mechanism to enable people to develop, improve and change. One myth is that feedback is always negative, and it always a description of someone’s inadequacies and failures in developmental mentoring it is important to feedback successes as well as failures. What is important is that feedback is designed to help the person learn (constructive) while destructive feedback simply undermine and devalue them. What make the feedback effective when it is specific, nonjudgmental and given with purpose e.g. to improve performance (4)

5–Contraction – this more or less about mentoring agreements and helps (as I shall explain later) to resolve conflicts and problems that may arise

6- Reflection

Both mentor and mentee must reflect at all the times to see that is learned and redefine more goals. A mentor can support the mentee by recognizing that each mentee is different. Some mentees may come with the solution himself/herself— the mentor here is just acting as sound board. In other occasions the mentor must be prepared to respond in a number of ways called influencing styles as per need of mentee(6) These range from listening and interpretation, challenging, probing and diagnosing, gathering and adding new data, identifying options or last resort even planning for the mentee( defeat the issue, generally not recommended ). At end, the degree of intervention chosen by the mentor is : what mentoring is all about.

Problems& challenges

Like any relationship things may not run smoothly. Problems usually stem from poor implementation of mentoring process. Nevertheless, this may exist at outset such as conflict between the mentoring and supervisory roles of the mentor; Mentors should not be the mentee’s educational supervisor or line manager or otherwise be involved in their appraisal to avoid blurring of these distinct roles… Shaw (1983) has also referred to these inherent tensions in the role of the mentor if he or she also contributes, at whatever distance, to any assessment or performance at work (14)

Another potential downside of mentoring is that over a period of time mentors tend to develop a considerable personal and private knowledge about their mentees and this knowledge base Safeguards of confidentiality are of vital importance in maintaining the integrity of the mentoring process.

A dysfunctional mentoring relationship could also result from possession of certain personality traits that are not compatible with the process. Hence the importance of the mentor and the mentee having some common interests to give the relationship a good start..There should be matching and some choice given to mentee in mentoring programme.

It is very important to have the right chemistry, to really, be able to mentor anyone in addition there must be a sense of win-win in both the mentor and the mentee. Both should want to participate, then the relationship can stretch over months or even years.

Good mentoring is a facilitative, and during the mentoring process sometimes it is easy for the mentor to develop a patronizing attitude towards the mentee and it is important for the mentor to be aware of this tendency and resist it. Hence, mentoring should not always be about the mentor advising the mentee what to do in a particular situation, but rather should be about the mentor facilitating exploration of the issues by the mentee, at his or her own pace.(8) Thus by encouraging critical reflection on the issues the mentee should be able to find solutions to his or her own problems. Other difficulties include frustration due to lack of progress. Mentoring relationships that can be unproductive, unfulfilling, or (at an uncommon extreme) dysfunctional. i.e. primarily characterized by conflict. It occurs when a mentoring relationship is not working for one or all people involved because needs are not being met or individuals experience distress as a result of the relationship (Eby and Allen1997)

Problems and challenges in mentoring

@ The Outset (avoidable)

Mix of roles— matching

Lack of progress

Patronizing attitude, confidential breach

Boundaries /Emotions

Too close or dysfunctional

Dysfunctional

Fig (8): Mentoring: the challenges

There are a number of things that mentors can do to avoid or cope with conflict that may arise in a mentoring relationship like avoid self defeating behaviour: slow down, engage in critical self reflection( appendix1 appraisal check list ), consider ethical and professional obligations as a Mentor, be proactive and seek consultation. Also being too close to mentee can be a problem. I see it as one of the biggest challenges. Mentor should remind himself and his mentee that although the relation is a psychological bond but still not a blind friendship. There are boundaries and limitation to be observed. People can refer to their mentoring agreement ( see appendix ) to resolve these issues. There is always the option to end the relation with mutual respect. ( life cycle of mentoring by Hay(1995) appendix 2

What makes a good mentor?

Mentors should enjoy helping others, has genuine interest in the mentee not only professionally but as human being. A good mentor accept their mentees, is empathetic, and free of judgment or rejection , maintains a positive outlook, yet is able to be realistic and have a strong interest in their own growth and self-development. A good mentor is committed to the role of mentoring and believes in the value of mentoring. He shows a desire and a willingness to give up time to help others with an open mind and a willingness to support the relationship. This good intention should by be supported with knowledge about mentoring techniques (8)

Successful mentorship requires mentors with a balance of skills, attributes, and qualities. Some of these attributes can be learned or developed while others are inherent individual qualities that are part of who the mentor is. The attributes of a ‘good’ mentor are widely discussed in the mentorship literature. Drawing from

years of experience designing formal mentoring programs, Bowley offers these essential qualities of a ‘good’ mentor: commitment, acceptance for mentee, teaching, learning and optimism.(8) Mentor should possess certain virtues, abilities and competences.(Johson2003)

MENTOR

Competent, committed, &

Confident

Virtues

Integrity, caring

Prudence

pru

Abilities

Cognitive, emotional

Relational

Competencies

Teaching, mentoring

Communication

Fig (9) : Mentor Attributes

1—Virtues

Integrity, Caring, Prudence

Mentor virtues of integrity, caring and prudence are described as

The foundation to mentoring. Integrity reflects the ability to

establish and maintain trust in a mentoring relationship, drawing

from the presence of honesty and mutuality. Caring as a virtue

means that the mentor shows respect and empathy to

others-both within and outside of the mentoring relationship.

Prudence indicates the intentionality and appropriateness of the

mentor as shown through decision making (8)

2- Abilities

Cognitive, Emotional, Relational

Cognitive abilities include a sense of curiosity and dedication to experiential and theoretical learning. Emotional abilities reflect the individual’s emotional self-awareness and receptivity, the person’s engagement in self-reflection finally, relational abilities include the capacity to communicate empathy, respect and compassion.

3-Competencies

Teaching, Mentoring, communication : These are specific skills, knowledge or techniques that mentors can develop through training and education.

Teaching competencies include an understanding of adult learning processes and of the developmental needs and transitions commonly experienced by mentees. A facilitator to enable the mentee to open up new possibilities and set/achieve goals and models continuous learning, actively engaging mentees in their own learning and reflective processes, stimulates the student’s thinking and reflection and net worker who helps to develop useful connections for the mentee.(14)

Mentoring competencies

This compasses all technical aspects of mentoring: knowledge and

Skills (fig 6) in the structure and process of the mentoring relationship,

Skills to cope with challenges arising within a mentoring

relationship (fig8)and understanding of the roles and responsibilities

Of a mentor, recognition of dysfunction in a mentoring relationship. Communicating competencies address the interpersonal communication capacity and the self-awareness of the mentor.

Conclusion

What mentor do ( in mentee perspective) is to put in place achievable development plan, act as sounding board or devil advocate ,open doors and support in seeking opportunities .(9)The effective mentor gently probes to understand the relevant issues, asks open-ended and fact-seeking questions and understands that silence is useful when information is being digested or breathing space is needed.  Questions should be used to obtain information and/or steer the discussion in a particular direction. “Appreciative” listening is also important – (7)

It is important for mentors to convey understanding through feedback, reflecting back the mentee’s feelings and accurately summarizing or paraphrasing their thought processes. Overall good mentorship is about empowering the mentee to become self aware, self directing, develop a sense of their own purpose and understand their personal needs.(2) They also enjoy the reward from feedback about accomplishments in which they have shared. At the end a happy mentee is an evidence of a good mentor.

References

1)D. a. l. Macafee: Is there a role for mentoring in surgical specialty training?

medical teacher jan 2008, vol. 30, no. 2, pages e55-e59: e55-e59

2)S.Rramani, L Gruppen, E. Kachur :Twelve tips for developing effective mentors ,medical teacher Jan 2006, Vol. 28, No. 5, Pages 404-408: 404-408

3) T.Stenfors-Hayes, S Kalén, & et al : Being a mentor for undergraduate medical students enhances personal and professional development

Medical Teacher Jan 2010, Vol. 32, No. 2, Pages 148-153: 148-153.

4) K Taherian, M.Shekarchian: Mentoring for doctors. Do its benefits outweigh its disadvantages? medical teacher Jan 2008, Vol. 30, No. 4, Pages e95-e99: e95-e99

5)Exploring mentoring: Board of medical education,BMA August 2004

6)Mentoring for doctors, guidance from doctors forum , DH 2004

7)B Buddeberg-Fischer, K-D. Herta :Formal mentoring programmes for medical students and doctors – a review of the Medline literature

medical teacher, Jan 2006, Vol. 28, No. 3, Pages 248-257: 248-257.

8) Module Two:: Competency in Mentoring,:Canadian coalition for global health research,2007

9) Oxley et al, 2003: Mentoring for doctors: enhancing the benefit (behalf of the Doctor’ Forum)

10) Megginsion, Clutterbuck, Garvey :Mentoring in Action – A Practical Guide., Stokes, Garrett-Harris, 2006

11) Klasen and Clutterbuck, : Implementing Mentoring Schemes – A practical guide to successful programmes. 2007

12) Megginson and Clutterbuck: Techniques for Coaching and Mentoring -2007

13) http://www.rcplondon.ac.uk/mentoring:RCP Pilot Mentoring Scheme in Wales

14)N.Cooper, k Forrest, Educational supervision in postgraduate medical education, wiley-blackwell,2009

15) SCOPME 1998 report in mentoring : Standing Committee On Postgraduate Medical Education

16) L H. Toledo-pereyra : Mentoring Surgeon ,Journal of Investigative Surgery Jan 2009, Vol. 22, No. 2, Pages 77-81

17) M. F. Longhurst: The mentoring experience ,medical teacher Jan 1994, Vol. 16, No. 1, Pages 53-59: 53-59

18)M.G.Moller,J.Karaichalis &et al : Mentoring the modern surgeon, bulletin of the American college of surgeon, july2008

19)M.PConner, ,J.Pokora,N,Redfern : Developing senior doctors as mentor,medical education,34:747-75

20) C.Doherty: Introducing mentoring to doctors( challenging the of sink or swim culture), development&learning organization journal ,18:1, 6-8,2004

21)R. Alliot: Facilitatory mentoring in general practice,BMJ supplement,sep1996

WEB SITE

22) www.academicmedicine.ac.uk › Mentoring and Outreach

23) www.academicmedicine.ac.uk/mentoring

24) www.nwmentoring.nhs.uk : northwest mentoring programme

25) www.rcseng.ac.uk/support/mentoring

26)www.emccouncil.org/uk

Appendix 1

Mentoring agreement

Some questions for mutual agreement

1what is aim of relationship?

2- What each contributions will be?

3- When, where to meet?

4-how to contact each other?

5-will meeting be structured and how?

6- How to deal with difficulties?

7- What confidentiality mean in this relationship?

8-how to review progress?

9- How (and under what circumstances) we end the relationship?

Other issues can be added

Mentor appraisal checklist for

mentoring sessions (Hay 1999)

• Was there rapport between us?

• Did we feel able to challenge each other if appropriate?

• Was the content of our discussions relevant to our contract?

• Was I genuinely pleased when the mentee made his own decisions?

• How well was I using the skills of listening, questioning, reflecting,

feedback and review etc?

• Was I avoiding the mentee becoming dependant?

• Did the mentee have ownership of his/her decisions? Was he/she the

decision maker?

• Have we identified alternative options?

• Is she/he accepting responsibility?

• Have we celebrated achievements?

• Do we need to plan for an ending yet?