Mentoring in Health Care

Mentoring best practices are built on a “foundation” of research. That is the source of the evidence of what works in mentoring, why it works, what happens when it works, and what does not work. But just presenting the research is not sufficient. We must evaluate the research for it’s quality and applicability to our program goals, AND then, tempered that with advice from expert mentoring practitioners. THEN, we’ll KNOW what the best practices are. Here we provide the research to get you started – no need to do it all yourself! Best practices and expert advice are elsewhere on this web site.

MENTORING IN NURSING

Greene, M.T. & Puetzer, M. (2002). The Value of Mentoring: A Strategic Approach to Recruitment and Retention. Journal of Nursing Care Quality, 17(1), 63-70.

The recruitment, training, and retention of experienced nursing staff remain the focus of business strategy planning for nursing services in many health care facilities.

  1. Implementation of structured mentoring programs is the most prevalent of those business strategies because mentoring develops and improves the performance and retention of new hire nurses.
  2. These positive results occur because mentoring develops and maintains supportive, growth-oriented relationships between the new and the experienced nurses.
  3. The use of still other staff as preceptors and resources is a useful, productive supplemental mechanism to enhanc diversity in skill and knowledge development.
  4. Clinical tracking forms, planning calendars, and feedback mechanisms are valuable as they ensure success in monitoring the program over the long-term.

Ramsey, P., Blowers, S., Merriman, C., Glenn, L. L., & Terry, L. (2000). The Nurse Center: A peer mentor-tutor project for disadvantaged nursing students in Appalachia. Nurse Educator, 25(6), 277-281.

The Program
This peer mentoring and tutoring program targeted at-risk students in typically lower SES areas of  Appalachia in the USA. The program consisted of:
• a formal “Nursing Center” to locate support activities and resources
• peer mentoring for general student support and personal and career support, and tutoring for academic support

The Results
Results were generally positive. Specifically, benefits included:
• improvement in students’ grades
• close mentor-mentee relationships which lasted longer than the one year of the program.

Although not measured in this study, the close relationships of mentoring partners extending past the formal program was expected to result in continued informal mentoring and support for mentees.


Higgins, B. (2004). Relationship between retention and peer tutoring for at-risk nursing students. Journal of Nursing Education, 43(7), 319-321.

The Program
The program provided structured peer tutoring for students who were at-risk of failing in a medical-surgical nursing course. The goals of the program were improvement of student retention in the university in general and academic performance in the medical-surgical nursing course in specific.

The Study
The study examined the effects of a peer tutoring program for at-risk students in a medical-surgical nursing course. No treatment of control groups were used as comparisons were to be made between the students in the peer tutoring program and students at the same level in the same program. Assessment consisted of tracking students in the program for
* Active participation in the peer tutoring program
• Continued enrollment in the subject course
• Enrollment (retention) in the university and program after the course was completed
• Final grades earned for the subject course
• Comparison of results between the participants in the peer tutoring program and equivalent students in the program in general.

Findings
The study found statistically significant effects of participation in the peer tutoring on retention and academic improvement.
• Peer tutored students received generally better grades than did the other students in the medical-surgical nursing course.
• Peer tutored at-risk students showed decreased course attrition from 12 percent to 3 percent in comparison with similar students who were not in the per tutoring program.


Sutherland, J.A., Hamilton, M.J., & Goodman, N. (2007). Affirming at-risk minorities for success (ARMS): Retention, graduation and success on the NCLEX-RN. Journal of Nursing Education. 46(8), 347-353.

The Problem
The rapidly increasing diversity in the U.S. population creates a need for a more diverse health care profession. Combine this need with the unfairness of the situation and the low minority representation in the nursing profession and we see a pressing need for more innovative strategies and programs to recruit, retain, and graduate nurses from diverse groups.

The Program
The Affirming at-Risk Minorities for Success (ARMS) Program which was the focus of this study was a combination approach including:
A. faculty mentoring of students
B. tutoring of students
C. faculty advisement of students
D.  educational seminar components.

The participants in this four part program were minority higher education nursing program students who were either at-risk of course failure in a very rigorous university program, or who were in some way disadvantaged because of their SES or other background, family, or academic reasons. The participants were enrolled in an undergraduate nursing program that has been predominantly White/ Anglo and is located in the south-central region of the United States.

This four-part program structure was used to address the different perceived needs of these target students:
>Advisement support was to help student successfully cope with registration, tuition, and other administrative issues of university student life;

>Tutoring was to specifically support the participant students with learning course content and skills, and student and study skills;

> Educational seminars were to provide direct instruction and interaction time for the peer group with each other and the faculty.

>Mentoring was done using a faculty mentor model, Mentoring was viewed as the larger ‘umbrella”, inclusive of all support. Therefore the mentoring was more than just the relational and career support plus socialization to the university community, but was also specifically designed to help the students make sense of all the pieces and integrate the varied kinds of support for greater synergy and impact.

Study Methods
The study used an experimental design with 64 program students in the treatment group and a control / comparison group made up of 265 non-program students derived from a comprehensive institutional database.

Research objectives were to investigate the extent of changes in:
> program retention
> graduation rates
> success on the National Council Licensure Examination for Registered Nurses, the NCLEX-RN[R]

The Results
• Sixty-fours students were mentored, and received advisement, seminars, and tutoring services.

The data indicated that together, the set of four interventions had the following effects:
1. Positively affected Program students’ graduation rates
2. Program student retention was increased to 98%;
3. Significantly positively affected Program students’ grades in the Leadership-Management capstone course
4. Eliminated the effects of ethnicity on NCLEX-RN exam success.

Conclusions
1. The program addressed and successfully met the socialization, academic, and administrative needs of the participating ARMS students.
2. By meeting student participants’ diverse needs, the combined impact of the four program components of advisement, tutoring, education seminars, and faculty mentoring countered the disadvantages experienced by the targeted at-risk / disadvantaged ARMS Program students.
3. The combined impact of the four program components of advisement, tutoring, education seminars, and faculty mentoring was significant for all targeted outcomes.


Myall, M., Levett-Jones, T., and Lathlean, J.  (2008). Mentorship in contemporary practice: the experiences of nursing students and practice mentors. Journal of Clinical Nursing. July, 2008. 17 (14):1834-42.

BACKGROUND: Within nursing, mentorship in some form is integral to students’ clinical placement experiences** and has attracted increased interest among researchers. Despite the existence of a considerable number of research studies focusing on mentoring and its nature and application within the practice setting, limited attention has been paid to the extent to which guidelines provided by regulatory bodies for nursing (Ed. mentoring standards**) inform and influence the practice of mentoring in contemporary healthcare settings.

STUDY DESIGN: The study was conducted in the Department of Primary Care & Population Sciences, University College – London, London, UK.  It was done to assess the impact on mentoring practice of the publication of standards for mentoring practice**, and thereby, to address the “problem”.

The study used a two-phased design with data on mentorship being primarily in the second phase.

One study investigated the impact of a local nursing education initiative on students, practice mentors and academic staff. Another study was conducted in the same setting, but at two Australian sites. That study examined the perceptions of nursing students and mentors.

METHOD: Data were collected using an online questionnaire of pre-qualified students and a mailed questionnaire for practice mentors. The responses were collated and organized to reveal meaningful data patterns. Data from the two studies were also compared.

FINDINGS:
Results from the first study indicate:
1. Mentoring provides important benefits for pre qualified students.
2. There is a considerable need to provide mentors with adequate preparation before they start mentoring and and ongoing support as mentoring continues.
3. These data confirm other previous research findings.
4. There are notable improvements in closing the gap between rhetoric and reality for mentorship. This improvement is important since, the larger the gap, the less application of professional development and mentoring theory and research there is in actual mentoring practice.

These results are further confirmed when compared with those of the second study.

CONCLUSIONS:
The findings provide new evidence of:
1. a narrowing of the gap between the theory and practice of mentoring;
2. the continuing implementation of national standards** to clarify the roles and responsibilities of the mentor.;
3. the benefits of developing such standards which could be achieved in other countries with similar systems of support for nursing students.
4. Mentorship is pivotal to nursing students’ clinical experiences and is shown to be instrumental in preparing them for their role as confident and competent practitioners.

** Editor’s Notes
The study was conducted in the United Kingdom where research-based definitions of effective mentor roles and responsibilities were defined and standards reflecting these were published. Since then, efforts have been underway to establish broad use of these standards for mentoring practice.

When the findings indicate a “closing of the gap between the theory and practice of mentoring”, they mean that the application of these research-based standards is achieving a more uniform level of actual mentoring support for targeted populations of protégés.


Marcum, E.H., and West, R.D. (2004). Structured orientation for new graduates: A retention strategy. Journal for Nurses in Staff Development. 2004 May-Jun; 20(3):118-24; quiz 125-6.

The Problem
1. The challenges of retaining nursing students, educating them, and then graduating them so they help us address the chronic nursing shortage, all have been well documented in the nursing literature.
2. It is also well known that, to varying extents, mentoring is an aid in addressing the nursing student retention issue.
3. Also documented are the broad use or a brief 1/2 to 2 day student orientation period to introduce nursing students to key people, expectations, the institution, and other information needed for a successful start in their program. This assumes that a brief initial orientation is sufficient support and that nursing students will succeed in adjusting to their new roles, the new requirements, and new culture. The poor retention evidence suggests this assumption is inaccurate and that more ongoing and extensive orientation and support are needed to increase nursing student retention.
4. What is not well known is the extent to which structured, extended nursing student orientation programs can provide benefits such as student retention.

The Orientation Program
The subject institutional nursing program sought to increase nursing student retention rates by better understanding and addressing  nursing student needs. These needs were addressed through the use of a structured, progressive orientation program.

The Study
Twenty new graduate level nurses participated in the 13-week orientation program during the study period.

Multiple forms of data collection were used to create a rich data set that could allow comparisons of diverse factors and results.
1. One of the tools was a quiz which was developed to assess the extent of participants’ learning during the course of the orientation sessions.
2. Other tools used to evaluate success were:
A. Performance Based Development System;
B. American Society for Training and Development Evaluation Tool,;
C. The Professional Judgment Rating Form – Novice/Internship Level;
D. Student retention rates.

The Findings
Results of the study suggest that:
1. an ongoing, extensive 3 month long orientation program was what was needed to positively effect nursing student retention.
2. The ongoing orientation provided or assisted in the development of skills in:
A. critical thinking;
B. problem solving;
C. patient care and management;
D. enhancement of student nurse success
E. enhancement of student nurses’ self-esteem.
3. It was found that effectiveness in these factors directly and positively influenced student nurse retention.

Conclusions
1. Provision of a structured, progressive orientation program in the range of 12-13 weeks long is needed to support the learning, development, and success of graduate level student nurses.

2. Although our study was not designed to assess this, we strongly suggest that it was the total effect of an initial orientation, long-term mentoring, and extended orientation along with other possible factors such as faculty advisement and institutional student services, which together are necessary to produce the significant gains in student nurse retention which we found.

While it is logical and even circumstantial, we can only suggest this total effect because our study was not designed to isolate the effects of the extended orientation program from other coexisting supports these students experienced, or to which they had access.


    MENTORING OF DOCTORS

Buddeberg-Fischer B, and Herta KD. (2006). Formal mentoring programs for medical students and doctors–a review of the Medline literature. Medical Teacher. 2006 May;28(3):248-57.

The Problem
Mentoring programs have been implemented as a specific career-advancement tool in the training and further education of various groups in the medical profession.  However, little of the literature addresses:
A. the needs of or mentoring programs for doctors
B. the goals these projects pursue
C. evidence of program effects.

The Program
The study’s intention was not to review a specific program, but rather to summarize the literature relevant to the problem.

The Study
The goal of the investigation was to examine the types of structured mentoring programs that exist for doctors, what short- and long-term goals these projects target, and whether conclusions can be reached about the effectiveness and efficiency of these programs.

A literature-search strategy was the research method. The search focused on Medline research reports for 1966-2002 using the keyword combinations:
a. mentor* [AND] program* [AND] medical students
b. mentor* [AND] program* [AND] physicians.

Although a total of 162 publications were identified, only 16 papers (nine for medical students and seven for doctors) met the selected methodological criteria.
(Ed. These criteria would be helpful but were not in the report we reviewed.)

The Findings
1. Most of the studied programs do not have a formal structure.
2. Most of the studied programs have done no short- or long-term rigorous program evaluation. What has been typical is descriptive of participants’ great interest and high level of satisfaction.
3. The typical program goals are to:
A. increase professional competence:
a.  in research
b. in further specialization
B. help the mentees build a professional network.
4. No discussion was found on benefits of mentoring for mentors.
5. No publication contains statements on the effectiveness or the efficiency of the programme.

Conclusions
Although the results of mentoring reported by participants are promising, more rigorous evaluations of formal programs with clear goals and a short- and long-term evaluation of the individual successes of the participants as well as the cost-benefit analysis are needed.


Connor, M.P., Bynoe, A.G., Redfern, N,. Pokora, J., & Clarke, J. (2000). Developing senior doctors as mentors: a form of continuing professional development. Medical Education. 2000 Sep; 34(9):747-53.

PROGRAM:

The Northern and Yorkshire Region Doctors’ Development and Mentoring Network was set up in 1994. Since then there have been six programs with 116 senior doctors participating. In 1997 an evaluation was done of the first four programs.

STUDY METHOD:   Focus groups and a mailed questionnaire.

RESULTS:
1. Responses were received from 71 senior doctors, a response rate of 86%.
2. Responses were received from 78 professional stockholders in 49 NHS organizations, for a response rate of 54%.
3. The programs were highly valued by the participants, especially concerning:
A. being part of a network of senior doctors;
B. developing mentoring skills;
C. engaging in personal and professional development.
4. The most difficult part of the program was setting up mentoring networks for junior doctors. The reasons included:
A. personal factors, such as:
1. level of confidence in providing mentoring;
2. cultural factors, such as juniors afraid to appear needy;
B. organizational factors, such as:
1. lack of time allocated for mentoring.
5. Senior doctor mentors reported that mentoring skills are transferable to patient relationships in everyday medical practice and to the management of junior doctors.

RECOMMENDATIONS
1. The positive benefits from the mentoring network for junior doctors led senior doctors mentors to seek the development of mentor training for themselves.
2. Suggested Mentor Training Topics included:
A. ways that mentoring provides professional development for mentors;
B. clarification about who needs mentoring;
C. the relationship between mentoring and the organization;
D. transferability of mentoring skills to everyday patient relationships;
E. increasing the number of participants in the network so more senior and junior doctors may benefit .


Steven, A., Oxley, J., and Fleming, W.G. (2008). Mentoring for NHS doctors: Perceived benefits across the personal-professional interface. Journal of the Royal Society of Medicine. 2008 Nov; 101(11):552-7.

THE STUDY
The goal of this study was to investigate National Health System (NHS) doctors’ perceptions of benefits of being involved in mentoring and the overlaps and relationships among the benefits.

The research took place in six NHS mentoring programs in England. A standard protocol was developed to structure all the interviews which were done of doctors at each site to collect the data.

Study participants were senior doctor mentors and junior doctor protégés who were participants in these mentoring programs.

The preliminary analysis resulted in lists of perceived benefits. Extended qualitative analysis of these data was done to interpret meaningful patterns found in these data.

RESULTS
1. The extended analysis revealed three pervasive “benefits” themes:
A. professional practice;
B. personal well-being.
C. Professional and career development.

2. The key processes of problem solving and change management were common “threads” that wove across the personal and professional benefits reported. For example, development of problem solving skills became the focus of mentoring interactions but were found to be a useful benefit in one or more other areas.
A. Junior doctor inquiries or seeking of guidance from a mentor, led to –
B. The senior doctor mentor reflecting on his or her own practice and knowledge to formulate a response, which led to –
C. The mentor’s increased conscious awareness of their own thinking processes and practices, which led to –
D. The mentor’s questioning the effectiveness of their own practice, which led to –
E. The mentor’s greater openness to new practices and efforts to create improvement in their work, which led to –
F. Realizations that such improvements could be useful in other professional and non professional relationships as well.

3. Analysis suggests that mentoring benefits initially are developed and felt in one area, but then are viewed as spilling over to be expressed and create further value in other areas. As an example, senior doctor mentors reported that mentoring skills and strategies developed to help them in their mentoring relationships with protégé doctors were later found to carry over and provide benefits in their patient, family, and other relationships.

4. The senior doctor mentors report accelerated professional growth and a sense of renewal as a result of being mentors.

5. The junior protégé doctors report being more satisfied and confident in their professional roles as a result of being mentored.

Conclusions
1. There are clear, multiple benefits from mentoring for mentors, protégés, and their organizations.

2. There are complex interrelationships among the development and expression of benefits in the three areas of professional practice, personal well being, and personal and professional development.

3. These connections first develop in one area, typically the mentoring relationship, but the benefits multiply for the participant as their learning from that context is applied and then felt in the other areas.

4. The consistency of these findings across the six site studies suggests that organizations are strengthened by doctors who feel more satisfied and confident in their professional roles as a result of participation in mentoring.

5. Other research into mentoring which the authors examined has mainly taken place in a single health care location. This multisite study suggests that the perceived benefits from mentoring may be derived despite organizational differences.


MENTORING OF MEDICAL EDUCATORS

McArthur-Rouse, F.J. (2008). From expert to novice: An exploration of the experiences of new academic staff to a department of adult nursing studies. Nurse Education Today. 2008 May; 28(4):401-8.

Editor’s Note

We find the title section, “From Expert to Novice” confusing and wonder if it should not be the reverse, “Novice to Expert”?

The Study
The study was conducted by a faculty member in the Department of Academic Planning and Quality, Faculty of Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, in the United Kingdom.

This goals of the study were to explore:
A. the experiences of new academic staff to assess their difficulties while adapting to their new roles;
B. the effectiveness of the existing informal mentorship approach in addressing these difficulties.

There were two concurrent parts of the study.
1. Semi-structured interviews were used to collect the same data from each interviewee, yet allow additional concerns to be expressed. These interviews primarily assessed perceptions of the new hires concerning:
A. their prior experiences;
B. their reasons for applying for their new post;
C. their main concerns as they began their new role.
D. their reactions to their experiences as participating mentees in the formal induction and mentorship system.

2. The perceptions of the mentors.

The Findings
1. All academic staff employed in the department for less than two years were invited to participate in the study.
2. With the exception of the researcher’s own mentee; six out of seven agreed to participate in the study.
3. The interviews were audio-taped and subjected to thematic analysis.
4. Key themes in mentees’ reactions to the program included:
A. a lack of understanding regarding the functioning of the organization;
B. a lack of clarity about their new role;
C. concerns their effectiveness in undertaking their new role.
D. a need for more practical guidance regarding the functional aspects of teaching.
E. Although, the mentees reported positive mentoring experiences the nature and quality of these experiences varied.

Conclusions
1. Despite an existing mentoring program, the variations in the nature of the mentoring roles, extent and quality of support, and the lack of more formal structures to address these variations, the transition from novice lecturer/teacher to expert practitioner can be problematic.

2. The persistence of these problems suggest there will be a continuing retention problem for new hires.

Recommendations
Solutions the participants and researchers offer include:
1. a formal group orientation process;
2. better facilitation of the new hire transition process;
3. development of a more robust and effective mentoring system, based on research-based best practices and evaluated at routine intervals;
4. provision of mentor training for the mentors;
5. development of a positive departmental learning culture to include, by job description changes, a role of informal mentoring for all faculty.


Dunham-Taylor, J., Lynn, C.W., Moore, P., McDaniel, S. & Walker, JK. (2008). What goes around comes around: Improving faculty retention through more effective mentoring. Journal of Professional Nursing. 2008 Nov-Dec; 24(6):337-46.

The Problem
The United States is in the midst of a critical nursing shortage. A key element in addressing this shortage must be first addressing the critical shortage of nursing faculty in university student nursing programs. Therefore, the recruitment and retention of new faculty becomes of utmost importance if the country is to educate and graduate a sufficient number of nurses to fill the demands for quality health care.

The pressure of horizontal hostility combined with lack of support, guidance, and knowledge about the educational system makes the novice nurse faculty members vulnerable to burnout and early resignations.

The Study
The authors conducted research into the literature on effective mentoring and mentoring programs. Although we discovered a great deal has been studied and reported, there is a significant lack of quantitative, controlled studies which could provide best practice guidelines for newer or improving programs to follow.

The Findings
Clearly, there is sufficient evidence for the following:
1. Mentorship is the single most influential and feasible way to successfully develop new nursing faculty.

2. Even mentoring which is not research-based can deliver moderate positive effects on recruitment, retention, and long-term maturation of future nurse mentors.

3. There is some evidence from settings other than higher education that mentoring programs which use best practices that are shown by the research to be effective, can deliver greater retention and job satisfaction benefits for junior and senior faculty, as well as improved performance and other desirable benefits which can impact the success of entire programs and institutions.

4. Currently these best practices must generally be derived from the literature on effective mentoring in settings other than higher education. This is a lacking which the research capacities of higher education are well suited to address, but which these have not done so far.

Conclusions
1. When it is negative, the new faculty experience is at-risk for a downward spiral with far-reaching implications. That downward spiral starts with lack of support and guidance for new faculty, and continues with increasing frustration, which leads to feelings of inadequacy, poor performance, and poor student learning. The students we serve and the progress toward attaining the mission of the institutions in which we work then suffer.

2. The mentoring process can change the downward spiral of poor support, poor learning, and poor retention and graduation rates into an upward spiral of success. That success starts with better support for the transition to the new positions, better nursing educators, and leads to improved nursing education, better faculty retention, better nurse graduates, better nursing practices, higher quality patient care, and more successful health care organizations.

3. When “even mentoring which is not research-based can deliver moderate positive effects”, we are left wishing for the research-based mentoring best practices which now exist in some other contexts, which can guide mentoring program planning and evaluation, which inform mentoring practice, and which are shown to deliver increased performance and results.

4. Although outside the data produced by this study, the authors conclude that the lack of research for best mentoring practices in higher education derives from the fact that the most effective research is extensive and so the most effective researchers seek external funding to sustain these extensive studies. External funding carries with it it’s own priorities and dictates the focus of the research.

5. We further conclude that the higher education institutions which would benefit most from mentoring of new faculty must provide internal funding for the extensive, more rigorous research studies needed to determine best practices for mentoring in higher education settings.

6. Our literature review leads us to conclude that the essential elements of an effective nursing educator mentorship program might include the following:

  1. socialization – orientation to the mew setting, job, and expectations;
  2. collaboration – support and guidance from a mentor and informal network of peer support;
  3. operation – effective implementation and monitoring/supervising;
  4. validation/evaluation – capturing participant learning from experience and using that knowledge base to guide improvements;
  5. expectations – clarity of who does what, for mentors, mentees, the program, the supervisors, and the organization;
  6. transformation – gradual but continual improvement in program and participant practices which lead to gradual, but relentless increases in performance and results;
  7. reputation – gradual increases in the collegial and professional esteem of the faculty, department, and institution due to improved performance and results;
  8. documentation – a relentless pursuit of quality, rich data to inform the learning, decisions, planning, conduct, and evaluation of the professional development system and it’s participants;
  9. generation – the “pay it forward” attitude and mentoring culture which is developed in a learning organization, and which is repeated as those who receive the benefits take their turn at offering those benefits to others;
  10. perfection – the desired state in which support, learning, growth, and improvement are constants and the daily norm.

MENTORING OF UNIVERSITY MEDICAL STUDENTS

Black, K. A., & Voelker, J. C. (2008). The role of preceptors in first-year student engagement in introductory courses. Journal of The First-Year Experience and Students in Transition.20 (2), 25-44.

The Program

The Peer Preceptor Program is a peer student mentoring program sponsored by
the University of Hartford, Connecticut, USA.

  • The purpose of the preceptor program is…
    • to increase the opportunity for first-year students to:
      • Make a successful transition from high school to college life and student expectations for course work.
      • Succeed academically in their first year courses
  • The goals of the preceptor program are to:
    • Increase engagement of first-year students with university life and their coursework
    • To provide role-modeling and teaching opportunities through peer mentoring by upper-class students.

Incentives / Recognition – Student preceptors are paid for their service and participating faculty are rewarded a “small” professional development stipend. (See “Results” regarding thefaculty professional development experienced.)

Preceptor Selection and Employment – Faculty who employ a preceptor:

  1. Iinform the director of the Preceptor Program and their college dean of
    their intention to employ a preceptor in a course that typically enrolls first-year students.
  2. Faculty invite the student they have chosen to serve as a preceptor and
    send that student’s name and e-mail address to the program director.

Training for Faculty and Preceptor Teams – The Preceptor Program holds
several
sessions to allow faculty – preceptor teams to find a convenient time. The training has two topics:

  1. Faculty/preceptor teams consider how bets to address issues raised by two case studies of challenging situations.
  2. Faculty/preceptor teams use a course syllabus to plan for their work together and the kinds of tasks both consider appropriate for the preceptor.

Is a Preceptor a Mentor? – (Judge for yourself.) A preceptor is an advanced student of superior experience, talents and character, who has been hand picked by a professor to assist the professor and facilitate student learning in a course that enrolls all or almost all freshmen.

Preceptors Play a Variety of Roles – They are study coaches, role models, advisors, guides, writing and homework tutors, and most importantly, preceptors bridge communication between the faculty and students, and ensure that students are engaged in and understanding the course material. The preceptor can communicate to the professor when the course content is not getting through, or communicate the faculty member’s expectations to the student.

The Study

A. Instruments Developed – To determine the effects of the Preceptor Program, a faculty member designed a survey. The survey assessed perceptions of student engagement in course work and other success factors, university community life, and the extent of student success in the courses.

B. Data Sources

Students Surveyed – One survey was given to first-year students in preceptor courses and first-year students in non-preceptor courses Students were probably randomly enrolled in these courses, especially the first year of the program, but no data were collected to allow determining the extent to which the groups were equivalent. While this was not a treatment and control design strictly speaking, it did allow the program to make comparisons similar to such an experimental approach.

Faculty and Preceptors Surveyed – very similar versions of the survey were also developed for faculty and preceptors, and these were used to assess their perceptions for the same items.

C. Triangularization – This method created three data sources which allowed a three-way comparison to be made for each of the following foci.

D.. Data were compared in four ways:

  • After the first program year:
    • First program year data from the preceptor course group were compared to the data from the non precptor course group.
  • After the second program year:
    • Second program year data from the preceptor course group was compared to the second program year data from the non preceptor course group.
    • First program year and second program year data from the preceptor course groups were compared.
    • First program year and second program year data from the non preceptor course group were compared.

Results

  1. In the first year, there were 611 undergraduate students in 40 introductory-level courses who participated in the study.
  2. Of these, 26 courses (65%) had preceptors and 14 were without a preceptor.
  3. During the program’s second year, there were 664 undergraduate students who were in 52 introductory-level courses (12 added courses, or exactly an increase of about 25%.
  4. Of these, there were 35 courses with preceptors (an increase of 9) and 17
    courses without a preceptor.
  5. First-year students in preceptor courses reported significantly greater
    feelings of engagement than first-year students in non-preceptor courses.
  6. There was some evidence that the positive preceptor effect was greater in professional courses than in liberal arts courses.
  7. Both preceptors and faculty reported that the preceptors were effective
    role models for good student habits.

Conclusions

  1. The data for student success factors, such as academic engagement, are increasing among irst-year students who took classes that had preceptors, so the program purpose is being served. This strongly indicates that the foundation for increased student retention and success are in place and getting stronger.
  2. Since faculty members have increasing chosen to use preceptors and the
    number of courses doing so have doubled, it is evident that the first program goal is being positively effected.
  3. The study found that, in addition to benefiting freshmen, the program provides a valuable leadership opportunity for preceptors.so the second program goal is also being attained.
  4. An Unintended, But Positive Result – Faculty who have used preceptors reported that they have been professionally challenged by the experience to
    rethink what they are doing as teachers, why they are doing it, and if there is a more effective way to do it. For example, one faculty member stated,
    “You have to have courage as a professor to take on a preceptor – you are opening the door to having your practices examined.But it’s not a negative factor. It’s a chance to be reflective and more self-aware about your teaching, to take a hard look at it and say, ‘Could I have done something differently and more effective?’.”

MENTORING OF MEDICAL ADMINISTRATORS

Lloyd, S.S., Fenton, S.H. (2008). Mentoring health information professionals in the Department of Veterans Affairs. Perspectives in Health Information Management. 2008 Apr.: 7;5:4.

The Problem
As a major employer of health information professionals, the Veterans Administration (VA) faces significant recruitment and retention challenges.

The Program
The VA has a health information management mentoring program.

The Study
The authors evaluated mentoring as a retention tool by using two methods:
1. a review of existing mentoring literature to assess the existing knowledge base of good practices in mentoring;
2. a retrospective review of the mentoring experiences and retention data in the VA health information management mentoring program.

The Findings
1. The literature review showed the following:

A. There is a link between employers providing mentoring and employee retention.
B. The effect of mentoring on retention is felt regardless of the nature or the structure of the mentoring relationship.
C. Most organizations support employees who are willing to serve as mentors through increased compensation, recognition, and other types of support.

D. No literature was found that studied retention rates for more than three years after a mentoring experience.

2. The review of the VA mentoring program showed:

A. increased retention in the three years following participation in the mentoring program;
B. the increase in retention was not statistically significant.

C. The review did not demonstrate improvement in retention over a seven-year period.

Conclusions
1. The combined evaluation gives mixed findings for mentorship as a retention tool.
2. The findings and the lack of program description or clarity about the content of the mentoring demonstrates the need for more research on these topics to discover best practices in mentoring programs and practices.
3. When implemented in mentoring programs these best practices  could substantially improve those programs and the mentoring practices in them, and the benefit of employee retention could be increased.


Weiss, L.M., Williams, C.A., Wetzel, D.E., Drake, A.C., Cumberlander, L.B. and Gordon, CL. (2008). Veterans Health Administration mentoring model for new nurse executives. Nursing Administration Quarterly. 2008 Jul-Sep; 32(3):226-9.

The Problem
As a major employer of health care professionals, the Veterans Administration (VA) faces major recruitment and retention challenges. The age of the executives who administer the programs created a concern about the impact their retirement could have on the effectiveness of the VA.

The Study
The study included several steps.
1. An ad hoc group was assembled to conduct the needed research study and propose solutions to the problems identified.
2. Research was done in cooperation with VA Human Resources/ Personnel Offices to assess the number of nurse executives who were eligible to retire.
3. Research included a review of the mentoring literature to determine best practices for mentoring and mentoring programs.
4. The research findings were assembled and were reported to the full ad hoc group.
5. A mentoring program model for nurse executives was proposed and the needed components of that program were recommended.

The Findings
1. At the time of this study the Veterans Health Administration system had 154 nurse executives throughout the United States.
2. 74% ( 114) of these nurse executives were eligible for retirement.
3. These potential retirements in the very short-term created several challenges.

A. An incentive was needed to encourage senior nurse executives to postpone retirement and so to “spread” the impact of retirement across several more years and minimize the impact of retirements in any one year.
B. A means was needed that could help capture and transfer to new hired executives the knowledge and wisdom that senior nurse executives had developed during their many years of service.
C. A means of orienting, training, and professionally developing newly hired nurse executives was needed to ensure accelerated growth and faster adjustment of the new hires to allow them to become fully effective sooner than the normal extended process allows.
D. Without immediate solutions to these three problems the VA nursing departments, and by extension the VA health care system, would suffer significant damage that would compromise the VA’s ability to meet the needs of armed forces veterans who depend on the VA system.

E. Senior nurse and other executives uniformly suggested the  immediate development and implementation of a mentoring program to address all four of the identified needs.

The Resulting Mentoring Program
A nurse executive mentoring program was implemented through the Veterans Health Administration Office of Nursing Service.

1. The goals of the mentoring program were to:

A. standardize the content and process of orientation of new executives;

B. use mentoring appointments as an incentive to increase retention rates at the vital executive level to minimize the impact of retirement by existing executives in any specific year.

C. appoint the senior executives mentors so they could transfer their accumulated knowledge and wisdom to the newly hired executives.

D. increase new hire retention and success by providing them with the mentoring of senior nurse executives.This mentoring program is intended to address all aspects of the challenges facing the VA for this position, and to support the quick integration of new appointees into the nurse executive role and the accelerated development of the skills and knowledge necessary for them to function effectively.

The program has tapped key nurse executives to help in the production of a written resource to capture their knowledge and  standardize the knowledge base for the nurse executive role. The mentoring program includes a leadership skills self-assessment to guide new hires in evaluating their leadership style and structure a professional growth goals setting process to be facilitated by their mentors.


MENTORING OF MEDICAL RESEARCHERS

Editor’s Note – the following is known as a descriptive study – it describes what was done and what participants felt. While the participants’ support for mentoring were strong, this type of study did not use a treatment and control group approach, so we are unable to directly attribute cause and effect. In other words, there may have been other unexamined factors which also contributed to the positive findings. Without controlling for these other possible variables, the possibilities exist that duplicating this program elsewhere may or may not yield similar results. These results MAY be replicable in your program, but this study does not allow such predictions.

Kahn, J., Des Jarlais, C.D. Dobkin, L., Barrs, S.F. and Greenblatt, R.M (2008). Mentoring the Next Generation of HIV Prevention Researchers:   A Model Mentoring Program at the University of California San Francisco and Gladstone   Institute of Immunology and Virology Center for AIDS Research. Journal of Acquired Immune Deficiency Syndromes. March 2008, Vol. 47. Pages 55-59.

The Program Being Studied
The Center for AIDS Research (CFAR) at the University of California San Francisco and the Gladstone Institute of Virology and Immunology piloted a multidiscipline mentoring program which targeting support for postdoctoral scholars and early career faculty concentrating on HIV/AIDS research..

Selection and Matching

  1. Mentees were self-referred postdoctoral scholars and early career faculty.
  2. Mentors were drawn from the senior faculty.
  3. Early career mentees were matched with senior investigators.

The program had three elements:

  1. It starts with a 0ne day mentoring seminar;
  2. Mentees have individual meetings with assigned mentors;
  3. Mentees attend a monthly workshop on topics selected by the mentees.

The Study

The study collected data in several ways:

  1. Participant Demographic Data – career stage, contact information, etc.
  2. Program Participation Data – role in program (mentor or mentee), program entry and exit dates, etc.)
  3. Participant Perception Data – collected by survey regarding each program component;
  4. Mentoring Pair Data – Frequency of meetings, perception of effectiveness, etc.
  5. Suggestions for improvement

These data were analyzed, especially by comparisons such as changes from one program year to the next, comparison of mentee versus mentor perceptions, etc.

Patterns in these data were interpreted by the authors to produce the findings of the study.

Results:

  1. More than 30 mentees and 20 mentors participated.
  2. All mentees were at beginning stages of their career:
    1. usually at the postdoctoral scholar level (45% and 35% in years 1 and 2, respectively) or,
    2. assistant professor level (45% and 55% in years 1 and 2, respectively).
  3. Five mentees left the program after the first year. Two left for reasons not associated with the program:
    1. One because she recognized that she was not interested in a career focused on HIV research.
    2. The other left because she successfully competed for a career development award overseas. Both of these cases may represent mentoring program successes in that it helped a mentee to identify a career path with higher level of personal satisfaction and it helped another mentee to obtain a career award in HIV research at another center.
    3. The 3 mentees who chose not to continue in the program because of insufficient time probably failed to obtain value from the pilot program.
  4. The program added 15 new mentees in its second year.
  5. Most mentees reported that the 1-on-1 mentoring was a satisfying experience.
  6. The most highly valued activities were those that:
    1. facilitated networking among mentees;
    2. promoted networking between mentors and mentees;
    3. the workshops that focused on very practical challenges, especially completing grant applications and information on first academic appointments and promotions. One mentee commented typically, “Provided career-related skill-building tips.”
  7. The mentoring program had a stated expectation that each mentee would meet with his or her mentor at least once every 2 months. Because there were 2 mentors for each mentee, it was expected that each mentee would have a monthly meeting with at least one mentor. However, only 4 pairs met monthly; the other pairings met less frequently, and 6 pairs met only every 6 months during the two years of the program to date. Interestingly, the most common explanation for infrequent meetings was mentee preference.
  8. That evaluation results demonstrated the program was rated valuable to the mentees, led to the decision to continue the program with some modifications.
  9. Program changes between the first and second years included:
    1. reducing perceived burdens among the mentees and mentors. An example is that the total number of meetings was described as “excessive”, so the number of meetings was reduced.
    2. mentees were encouraged to rank their choice of mentors to influence the assignment of mentor-mentee pairings.

Key Finding: Mentoring is critical in the development and nurture of early career investigators, and it helps them to succeed in building networks of colleagues. Mentoring is especially important support and guidance for investigators focused on HIV research where the complexities of the subject syndromes require effective collaborative sharing of information, team work, and planning of research activity.

Conclusions: A multidisciplinary mentoring program for postdoctoral scholars and early career faculty which is focused on HIV/AIDS research is valuable. Umbrella organizations, such as the CFAR are well suited to create and provide similar highly valued mentoring experiences.