Mentoring for the New Millennium
William O. Walker, M.D.*, Patrick C. Kelly, COL MC USA†, Roderick F. Hume, Jr., M.D‡
In his national best seller Hope Is Not A Method, former Army Chief of Staff General Gordon Sullivan identified leadership development, “preparing tomorrow’s leaders today”, as a core function of learning organizations and of critical importance to their future success.1,2 The Accreditation Council for Graduate Medical Education (ACGME) has similarly called for the professional development of future academic leaders through mentoring.3 The American Board of Obstetrics and Gynecology (ABOG) implemented major training curriculum changes to create future academic leaders in subspecialty fellowship programs, renewing an emphasis on scholarly activity and faculty development.
Medical education research, including investigations of the mentoring process, is expanding. The Army’s Office of Graduate Medical Education (GME) cites mentoring as an important faculty and trainee developmental tool throughout its New Program Directors Course. Madigan Army Medical Center (MAMC) established an institutional award, The Mentor’s Cube, recognizing this special relationship and its importance to continued institutional success.4,5
This paper seeks to define the mentoring process and identify its challenges and benefits within this graduate medical education system. Is there sufficient evidence of success to support establishing formal mentoring programs within academic institutions? Is there a single definition or model that will be effective in diverse situations? We have undertaken a review of the literature with the goal of redefining the mentoring relationship to include the institution or organization. In effect, we are proposing that the traditional dyad model is, in fact and by necessity, a triad model.
It is apparent that much is made of this rather elusive term, mentoring. What is a mentor? Is it a person, a process, a noun or a verb? In Homer’s Odyssey, Athena, goddess of wisdom, takes the shape of Mentor and advises Odysseus’ son, Telemachus, while his father is away. Why has that mythical advisor and relationship had such a continuing impact on professional growth and development?6 But just what is a mentor, and how can we improve mentoring for the new millennium?
Interest in mentoring as a method for personnel development substantially increased following the appearance of two articles in the Harvard Business Review in the late 1970’s: "Everyone who makes it has a mentor" and "Much ado about mentors".7,8 This interest continues today with the publication of more recent articles such as "Take my mentor, Please."9 The focus of mentoring programs necessarily differs between business and academic settings. In an academic setting, mentoring focuses on development of the person rather the organizational outcome focus of business-based programs: the conflict between “learning” and “earning.” Mentoring and the benefits derived from these relationships create high expectations by all parties within organizations. Some view mentoring as an entitlement.10 Should the measure of success be personal or organizational goals, both in the short and long-term? There may not even be agreement on what is the best measure of a successful mentoring relationship; mentors value the career related behaviors exhibited by their protégés while protégés value the social support behaviors exhibited by their mentors.
In 1994, Darling defined the mentor's role using 14 specific parameters (Table 1).11 The numerous descriptive systems of mentoring share six common attributes: teaching/learning process; reciprocal role; career development relationship; knowledge differential between the participants; duration of several years; reciprocity.12 Although there are many definitions of mentoring in the literature, this one may capture all of the essential elements of this transactional relationship.
"Mentors are resource persons and counselors with whom protégés clear their thinking or sound out the validity of an important decision. A mentor is an individual whom the protégé can trust to have his or her best interest at heart, someone who would risk telling them what they need to know even though it might be painful to them. A mentor is someone whose perspective and judgment a protégé values and trusts implicitly."13
The Three Essential Core Requirements
Three essential core requirements must exist for a significant mentoring relationship: Attraction, Action, and Affect.14 These core requirements, in varying proportions, are integrated throughout the four traditional phases of the mentoring relationship.15 In the initiation phase, the relationship between the mentor and protégé is established. The career and psychosocial functions provided by that relationship expand to their maximum benefit, both for the mentor and the protégé, during the cultivation phase. During the separation phase, the established nature of this relationship is substantially changed, either by organizational contact or psychological factors. Finally, the relationship between the mentor and protégé may evolve into a new form or end entirely during the re-defining phase. There is clear interplay between these mentoring stages and the career stages described by Dalton: apprentice, colleague, mentor, and sponsor.16 Mismatches in any or all of these variables can certainly doom or limit the value of the mentoring relationship.
What do Mentors do?
The best response to the question “What do mentors do?” may be "It depends." Mentors may be thought of as teachers. They may develop their protégé’s intellectual and career skills. They model, inform, confirm or disconfirm, prescribe, or question. Mentors may also act as sponsors, assisting protégés in developing and sharing their own network of personal contacts. They protect, promote and support. Mentors may act as counselors, providing advice, guidance, moral support and nurturing. They listen, probe, clarify and advise.17 The mentor may act simply as a host or guide, sharing an informal social network with the protégé. Mentors may serve as exemplars to their protégé. The mentor may provide a standard of excellence that the protégé will aspire to surpass.
Mentoring is a long-term adult developmental process. It is not an "all or nothing" phenomenon. It is a "new and whole way of seeing things." Mentoring differs by its context and its role definition. It may be either task centered, social support centered or career guidance centered. It may be affected by organizational, occupational, positional, and interpersonal variables. One can describe mentoring either in terms of the person, the mentor, or the process, mentoring.18 Interestingly, neither the Oxford or Webster’s dictionaries define mentoring as a verb.19
is centered more on the relationship than any specific structure. It is
a strategy to share intellectual and emotional resources. Kram described
the various dimensions of mentoring in the late 1980s.20 Recognizing
the multiple components of mentoring, he defined two broad categories:
Career Mentoring and Psychosocial Mentoring. Career mentoring depends
on the mentor's degree of power while psychosocial mentoring is based
on the mentor's network and ability to establish beneficial relationships
for the protégé. The goal of career mentoring is advancement
while psychosocial mentoring’s goal is to provide a sense of competence
and clarify the identity of the protégé.
Mentoring should not be confused with other learning activities such as precepting, role modeling, or networking.12,19 Precepting is most often an orientation technique, formally assigning qualified established employees to assist in the transition of new staff into a setting over a very limited period of time. It is characterized by its brief duration and its lack of emotional content. In role modeling, one individual internalizes another's appearance, mannerisms, behaviors, values, or standards. There does not have to be an actual personal relationship between the one who incorporates these characteristics and the one who is the model. There is reciprocal learning between the individuals involved in networking. Each seeks to identify how resources can be mutually shared. Other learning activities that have been confused with mentoring include collaboration and peer strategizing. Collaboration is more often a partnership between peers having a short-term goal of increasing productivity, increasing resources or refining specific skills. Peer strategizing is a relationship between peers of similar age and experience seeking reciprocal benefit. It is characterized by an equality of experience and does not include the different levels of expertise seen most often between mentor and protégé.
A “learning organization” establishes a culture where individual development is a priority. This culture may be more of an aspiration than an objective state to be measured. No organization can choose and control all of the variables that impact mentoring relationships within it. If such control were possible, these relationships would appear significantly different.21 Ideally, mentors would find protégés who exhibit intelligence, ambition, the desire and ability to accept power and risk, loyalty, and the ability to eventually perform the mentor's job. Proteges would have perceptions of work in the organization similar to those of the mentor and a commitment to the organization or discipline. They would be organizationally savvy, have a strong ability to establish alliances within the organization and, finally, have the capacity to be positively perceived by the organization. Likewise, protégés would seek out mentors who perform their job well, who have the power or influence in the company or discipline to move the protégé forward, to be a good teacher and motivator, to be secure in their own position and to be judged well by the organization.
Mentoring should be considered within the broad spectrum of social learning and adult learning theory, as learning occurs across an entire continuum of educational activities. Adults are goal oriented. They are less flexible and more impatient in their pursuit of specific objectives. Social learning theory argues that both direct and observational learning is used to acquire behavioral patterns and to strengthen specific expectations. Experiential teaching methods provide activities, guidance, feedback and application of principles to practice. Their primary goal is to avoid trial and error learning that is unproductive. Mentoring, based in adult learning principles, can be viewed as guided learning. The mentor provides structure or “scaffolding” to the learning process, shares knowledge that could otherwise only be attained through experience and supports the protégés efforts without “rescuing” them from their failures. The challenge in effective, successful mentoring is to decipher and integrate the unique learning history of both the mentor and protégé to their mutual benefit. The best mentoring will always occur within this framework of adult learning.
It has also been suggested that the process of mentoring can be described using the concepts of behavior management or behavior analysis.12,19,22 Behavior management and analysis takes an “A, B, C” approach: antecedents, behaviors, and consequences. Antecedents are those events or incidents that occur prior to the development of some concept or action. The behavior is that concept or action and the consequences are the outcomes. With this as a starting point, we may be able to see the value of these “A, B, C’s” in developing effective mentoring.
The two critical antecedents in any mentoring relationship are the mentor and the protégé. Other antecedents that must be considered include altruism, belief in the other's potential, the capacity to work hard, integrity, mastery of concepts and ideas, unselfish gifts of time, energy, trust and a willingness for self-disclosure. The mentoring process is the desired behavior. The consequences of mentoring should be examined in general terms and for their specific benefit to the protégé and the mentor. Mentoring may result in career progression, in the development of new investigators, in empowerment, in expanding professional knowledge, in a feeling of generativity, that is the “passing of the torch”, in institutional stability and continuity and, finally, in professional socialization.10 As a result of mentoring, the protégé may become more self-confident and optimistic about his future. The mentor’s reward may be a feeling of empowerment and personal satisfaction. They can observe the extent to which they have influenced the organization and its structure through mentoring and organizational citizenship.
Mentoring is wonderful, right?
There are negative consequences to mentoring. The literature presents the consequences of mentoring through “rose colored glasses.”19 There is a fine line between “mentor” and “tormentor.”10 There are certainly areas of concern and potential pitfalls. Either party may enter the relationship with unrealistic expectations of time commitment or objective benefits. To answer the question, "Is mentoring always a good thing with a happy ending?” the reality is “No.” A better question may be "When does a mentoring relationship become truly dysfunctional?"
There are toxic mentors, toxic protégés, and toxic environments.23 Any one of these three elements can adversely affect the balance within the mentoring relationship." It should be considered dysfunctional if it frustrates the major needs of either the protégé or the mentor. It should be considered dysfunctional when one or both members perceive the long-term cost of that relationship to outweigh its long-term benefit. Finally, a relationship should be considered dysfunctional if one or both partners engage in specific concrete behaviors to sabotage the work projects, or the career success of the other.
Formal Mentoring Programs
Many organizations have established formal mentoring programs; the number of business with mentoring programs doubled between 1995 and 1996.24 Formal mentoring programs are seen as the most expeditious and immediately beneficial approach to a clear need: to provide valuable career enhancement to more than just a select few. Such programs have been shown to have benefits comparable to those promoted by informal mentoring programs.21 In some organizations, time and personnel turnover requires this formal mentoring program. While many organizations have implemented a variety of formal mentoring programs, few have aligned their mentoring programs either with their long-term objectives or the strategic positioning of their organization.25
Several key points should be considered when instituting a formal mentoring system: determine who will be mentored; decide on a matching method; insure the voluntary participation of the mentors; minimize the rules; maximize the mentor's personal freedom within the relationship.26 The temptation to “mechanize” this process should be avoided. To prevent a corporate mentoring program from being a “fad,” a business analysis to allocate appropriate organizational resources may be needed.
The organization can contribute to the success of formal mentoring by creating networking possibilities for the identified protégés. This provides not only a system of mutual support for the protégés but may encourage the emergence of a “constellation model” of support – support from a number and variety of sources. Organizations must insure that the managers of the specific protégé are included in the process. Organizations can reward mentors by increasing their visibility within the organization and recognizing mentoring as a valuable component of organizational citizenship. The organization can further assist the process by sharing and negotiating expectations between the mentors and protégés, before and during the relationship.
Shift for Success
Mentoring has been traditionally thought of as a dyad between mentor and protégé, between assistance and assessment, between formal and informal approaches and finally, between the conditions that can and cannot be controlled.10 It is hard to untangle the effects of mentoring from the effects of supervision, to distinguish assistance from assessment, when mentors are supervisors. Informal mentoring implies a mutual selection process and may take significantly more time to develop. In contrast, formal mentors are usually assigned. At the organizational level, there must be a balance between the optimal conditions and the optimal match between mentor and protégé. An organization should try to create these optimal conditions but may not always be able to guarantee them. Organizations often set themselves up for failure, trying to control the uncontrollable personal chemistry that is so vital to effective mentor/protégé relationships. Their efforts are better focused on other more controllable aspects. Organizational characteristics believed to positively influence protégé mentoring include hierarchical structures, specific task designs, reward structures, performance appraisal systems and organizational ranks.20 This has many of the characteristics that are deeply ingrained in the military system.
We are encouraging a paradigm shift from this traditional dyad model of mentoring to a triad model: organization, mentor, and protégé.22,27 The traditional dyad model limits the protégés exposure to a single perspective and information source. There may also be a significant shortage of senior mentors in an organization, limiting the number of dyads that can be developed. Issues of unmet expectations, personality conflicts, and inconsistency may be much more critical and disruptive these dyads.28
The conflicting research regarding mentoring and its benefits may be due, in part, to not considering the effect of an organization on the mentoring that is occurring there. Clearly, mentoring and mentoring relationships affect organizations. The exchange of knowledge and experience in such relationships contributes to the “organizational memory.” The culture of mentoring is based on the individuals’ ability to trust each other and can exist only in an atmosphere where trust and openness are valued. Organizations, cannot, by fiat, dictate trust and liking among colleagues. Mentoring is not subject to mandate, but must be nurtured within the organizational culture.10
The goal of future mentoring initiatives should be toward a concept of mentoring as a triad rather than the incomplete dyad, recognizing the essential components: mentor, protégé, organization. Mentoring must be an active process involving higher professional development and life long “co-learning” among the participants. While the demands of managed care models affect all aspects of the health care profession, the fostering of mentoring relationships cannot be abandoned. This active learning must be paired with reflection (praxis). The question can then be asked, "Where do we go from here?” Defining the optimal metrics of the mentor-protege relationship within an organization will be critical to continued success. What qualities exist in the optimal exchange between mentor and protégé? Multimodal educational intervention outcome studies to evaluate the impact of mentorship programs should identify the best methods and benefits attributed to mentoring. The measure of success within these relationships should be the participants’ perception of adequate, rather than more, support.
There have been virtually no empirical assessments of mentor/protégé relationship over time. The tendency is to look at mentor/protégé relationships as single points, rather than longitudinally.10 Qualitative data of a longitudinal nature looking at specific outcome and performance measures for all aspects of mentoring must be collected. Survey results based only upon recall or opinions are inadequate to assess the consequences of any systematic effort to improve the quality of medical education through mentoring or mandating.
Can the two initial questions be answered? Can mentoring be defined? Is there a single systematic formal approach to mentoring? The definition and approach are intimately entwined. If the triad model is accepted, the mentoring process, both as a noun and a verb, as a definition and as an approach, is outcome based. That outcome is built on the goals and the investments, short and long term, of the involved partners: protégé, mentor, organization. That outcome is the acculturation of an individual to an organization and their attainment of expected professional skills and attitudes. For that outcome to be the one desired, mentoring must be thoughtfully planned and implemented. It cannot be left to chance or good fortune.
Walker WO, Kelly PC, Hume RF. Mentoring for the new millennium. Med Educ Online [serial online] 2002;7:15. Available from. http://www.med-ed-online.org .
William O. Walker, Jr. MD
Phone: (206) 987-2204