ASSOCIATION OF AMERICAN MEDICAL COLLEGES

Maximizing our Impact as Mentors: Contemporary Approaches

6/27/07

Janet Bickel Career Development and Executive Coach Faculty Career & Diversity Consultant

Support/Challenge/VisionVISIONhigh

CHALLENGE

low SUPPORT high

Anxiety Growth

Stasis Confirmation

Source: Bower, D., et al., Support-Challenge-Vision: A Model forFaculty Mentoring, Medical Teaching, 20:595-7, 1998.

Listening

Reflecting

Paraphrasing

Summarizing

Asking Questions that Raise Awareness

Making Suggestions

Giving Feedback

Offering Guidance

Giving Advice

Instructing

Spectrum of Advising/Coaching Methods

DIRECTIVE

NON-DIRECTIVE

PUSH: Solving someone’s problem for them

PULL: Helping someone to solve their

problems

Mentoring – bringing ourselves

fully into the moment.

– giving full attention to other person

– letting the other know that he or she is heard and respected

– listening with curiosity ONE MOUTH

TWO EARS

Skillful Inquiry involves…..• a genuine wish to understand someone else’s

thinking.

• inviting elaboration and clarification, asking non-leading questions that invite the other person to reflect and piece together the elements of their own thinking, eg “Tell me more about that,” “How did you come to hold this value?”

• temporarily putting aside our own ideas, letting the other person talk without interruption

• silencing the inner voice in us that is formulating a response

9 Habits of Highly Effective Mentors• Identify “Coachable Moments” and select

best coaching method• Create enough safety for learning• Together set goals for the relationship• Listen actively, avoiding assumptions• Ask reflective Questions, eg “how do you

think you did?”• Give specific, constructive, timely

feedback• Support transition to independence• Respect confidentiality• Continuously develop mentoring skills

Gender and Ethnicity:

When Heterogeneity

meets Homogeneity

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Disadvantages Minorities Sometimes Experience in Obtaining Mentoring

• relationships occur most naturally between “like” individuals

• different cultural norms can be confusing

• face higher hurdles to prove selves to potential mentors

• the accents of some ethnic minorities interfere with communication

Women’s Disadvantages in Obtaining Mentoring

•less likely to view mentor as a role model

•allowed a narrower band of “assertive behaviors”

•leadership potential underestimated

•work an invisible “2nd shift” at home

•miss out on hallway conversations and “golf”

•paucity of senior woman role models

•may be “dropped” if mentor threatened by her increasing expertise

Nine Circles of Mentee Hell

underestimate of potential

failure to respectprotégé’s goals

failure to promoteindependence

taking credit for protégé’s work

conflicts avoidedinappropriate

praise orcriticism

expecting protégé To defer

ethicalviolations

physical intimacy(or appearance of)

4 Generations in workplace

• Veterans 1922-1943– 55 million

• Baby Boomers 1944-1960– 78 million

• Gen X 1961-1981– 47 million

• Millenials/Gen Y 1982-2000– 75 million

Baby Boomers Unprecedented economic expansion in

childhood THE Generation [define perfection as

“like us”] Traditional family/upbringing Driven, go the extra mile Uncomfortable with conflict Overly sensitive to feedback Define professionalism in terms of hours

and “complete dedication to the job”

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Boomers

•Work hard out of loyalty

•Expect long-term job

•Pay dues

•Self-sacrifice is virtue

•Respect authority

Generation X

•Find most efficient way

•Expect many job searches

•Entitled to flexibility

•Not gonna be “24/7”

•“You’re not the boss of me”Source: J. Bickel and A. Brown. “Generation X: Implications for Faculty

Recruitment and Development in Academic Health Centers.” Acad Med. 2005; 80:205-10.

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Generation X

•Weak USA/economic downturns

•Absent parents

•Reject rules

•Multitask

•Mistrust organizations

•Pragmatic

•Cynical

Millenials

•9/11

•Protective parents/Pressured

•Rewrite rules

•Multitask faster

•Organizations relevant?

•Seek personalized career/inventive

•Optimistic

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Millennials/Gen Y [why?]

• Digital natives, expect innovations• More service-oriented and respectful• Prefer structured, highly interactive,

supportive educational methods• Expect frequent candid feedback

MESSAGES• Challenge me• Respect me• Be flexible• Team up with me

Senior Faculty say:• “I don’t think kids these days want to

work as hard.”

• “They act like they’re entitled to privileges I had to earn.”

• “They just don’t make ‘em like they used to.”

• “There is a tremendous gap between what the younger generation wants and what the older generation expects.”

• “Junior faculty seem to want a lot of handholding.”

Gen X and Y say:• “I just don’t buy the values of many senior

faculty ‘success stories’.”

• “When I’ve made different choices than my mentors would, they treat me as if I were failing them.”

• “I thought my chair was looking out for me. Turned out I was just gullible.”

• “My mentor wants me to remain ‘monogamous’—but I’m ready to date!”

• “Every time someone said they would mentor me, they simply gave me more work. But no one’s helping me seeing how my work fits into the larger picture.”

• “How do I get help in creating a plan for my future, including milestones and choice-points?”

A

B

I take Actions

I adopt Beliefs

I draw Conclusions

I make Assumptions

I add Meanings (Cultural and Personal)

I select “Data” from what I observe

(The reflexive loop: Our beliefs affect what data we select)

Ladder of Inference

Mentoring Across Differences

• Use an exploratory survey

• Discuss important influences and acknowledge differences, eg “this approach worked for me but it may not for you”

• Break the ice: Recognize effects of differences in power, gender

• Set goals for the relationship

• Ask for feedback

Exploratory Survey for Advisees• Looking at last year: What are you

proudest of? And what would have done differently?

• What do you want to accomplish in the next 1-2 yrs? 5-10 yrs? What measures of success will you use?

• What relationships outside our discipline and institution do you want to build?

• What if anything is holding you back from reaching your potential?

• What areas of personal and professional growth do you most want to work on now?

Mentoring Gen X and YExamples of productive questions:• What qualities does excellent clinical

judgment encompass?• How will you develop the necessary

expertise?• What are your goals and timelines?• What is your plan for assuring that ..?• How will you evaluate your progress? • Let’s agree about the desired

outcome, then discuss methods.

Contemporary Mentoring is:*a continuum: not “all or nothing”

*differs by context and role—task-centered guidance and support.

*collective approach in service of life-long co-learning

*a scaffold for sharing expertise that could otherwise only be attained from experience

See: Pololi, L.H., Knight S. Mentoring faculty in academic medicine. JGIM. 2005; 20:866-70

Activities To Support Mentoring• Offer resources and tools, eg programs,

guides

• Work with new faculty in selecting one (or a small “team”)

• Address in faculty orientation

• Create Peer and Group mentoring opportunities

• Establish Mentoring Awards

• Add mentoring to promotion criteria; return dossiers when inadequate

• Evaluate mentoring skills

• Acting as if Mentoring Were a Core Mission, eg CREAM

Three-headed Approach Approach to Mentoring at Johns Hopkinsto Mentoring at Johns Hopkins• Team of 1 faculty and 2 GIM fellows

mentored 1 intern and 1 resident on research projects over 18 months

• Fellows gained experience in mentoring, picking up tips from the seasoned faculty member

• All 3 able to observe “mentoring-in-action” • Multiple mentor approach modeled teamwork

and communication skills

[Source: The three-headed mentor: rethinking the classical construct by Rachel Levine, et al, Med. Educ. 2003; 37:473-89]

Mentoring Agreements

Accountability encourages:

•deliberate planning

•structure and follow-through

•honest assessment of actions and attitudes

•evaluation

Mentoring is critical…• To attract, retain and engage high performers• To maximize “return on investment” in faculty• To nurture the academic aspirations of

residents and junior faculty• To swiftly acculturate new members• To foster a collaborative environment• To increase stability and productivity• To promote diversity• To develop leadership talent• Being a mentor is the most effective way of

extending one’s professional contributions• Everyone can become a better mentor.

If Mentoring were a Core Mission, what would we do differently?