In a world where the answer to any unticked educational box is an on-line module created by a third party, preferably on a contract, it sometimes seems as if the interpersonal nature of education and training has been lost.
A supervisor whom I have known for twenty years, and who has been a supervisor for thirty years, commented to me that he thought the most important activity of the supervisor is to be a role model. This is not always spelt out in textbooks, the literature and course curricula. The emphasis is often on “teaching skills.” Over the years I have heard many GPs spontaneously recall John Vaughan’s influence on their careers whether they encountered him as a student or a registrar. They have often commented that he takes the trouble to keep in touch with them well beyond their completion of training. Because I respect him enormously I threw it back to him and asked him to jot down half a dozen points about being a role model. I think these comments also include (conceptually) aspects of mentoring. Here they are (grouped in sections):
Ten points of mentoring and role-modelling:
- Be aware of being a role model (it happens whatever we do). By this I mean we need to be conscious of our actions at all times, particularly in the presence of registrars and not only in our dealings with them directly but in the way we interact with practice staff and nurses as well as colleagues and contacts beyond the practice environment. Registrars are absorbing much of this behaviour consciously and unconsciously and will model themselves on it or use it as a lesson in how not to behave.
- Be willing to accept and acknowledge your own limitations as a doctor and a supervisor
The supervisor’s approach to the registrar (mentor role)
3. Demonstrate interest and get to know the registrar as a person. Without being intrusive, it is so important to learn about and understand the registrar in the context of their world. It is particularly important, for instance, to try and learn where overseas trained doctors have come from and where they wish to take their careers in the future. The other group that comes to mind are those female practitioners who may lack confidence, despite often being outstanding practitioners and whom I have observed, over the last thirty years, to go on to achieve excellent Fellowship exam results.
4. Encourage registrars, demonstrate confidence in them and take time to support them. It is invaluable.
5. Be sensitive to the registrar’s needs. This moves into a more pastoral role. Be aware of their moods and state of mind, providing pastoral support when it is needed. Sometimes registrars can become a little lost in the morass of practice and picking up on this and enquiring about their needs and their concerns can be crucial. It is not all about education!
Specific attributes and attitudes that are worth consciously modelling
6. Enthusiasm for general practice – enthusiasm is contagious. By modelling our own enthusiasm for the role of a GP and the privileged entree into people’s personal lives, our registrars develop similar attitudes. The opposite is also true.
7. A positive response in challenging situations – especially when things go a little pear shaped clinically as they sometimes do.
8. A sense of lifelong learning can be promoted. It is not all about the Fellowship exam. Model your own learning for them and demonstrate the fact that you are constantly learning and open to this.
9. Collegiality – with the registrar
- Acknowledge your own limitations as doctor and supervisor
- Encourage questioning and accept criticism and constructive suggestions Encourage questioning – especially of you as a supervisor. We are all in this profession together and should not be afraid to accept criticism and constructive suggestions so that it becomes a two-way process.
10. Collegiality – with other doctors and health professionals. Too much of medicine is based on putting our colleagues down instead of understanding where they are coming from. Doing this with our senior colleagues can model behaviour for our registrars.
Mentoring can be described as “a personal process that combines role modelling, apprenticeship and nurturing”. The article, True Mentorship in Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038821/ describes some qualities of good mentors: “they exude genuine and infectious enthusiasm; they modify their teaching strategies according to learners’ needs; they consistently reflect on their roles; they have excellent interpersonal skills; and they are knowledgeable. These qualities act synergistically to create non-threatening learning environments……..Learning is not about obtaining good evaluations; it is part of the overarching goal of becoming a better physician. The atmosphere generated by a good mentor promotes self-esteem and the importance of lifelong learning…..Mentors, in addition to teaching through words and deeds, show us care and respect and empower us to confidently approach the myriad complications inherent to the human condition. In the end, we must repay our gratitude to our mentors by providing excellent patient care and evolving into effective role models ourselves.”
I think this echoes what John demonstrates and what he has so clearly described above.
Another lengthier and more academic look at the process is found (for those interested) at http://www.tandfonline.com/doi/pdf/10.3109/0142159X.2013.806982