Evidence Base for Mentoring Women in Academic Medicine

Abstract

I n this issue of the Journal of Graduate Medical Education, Welch et al 1 describe a mentoring program for female residents and faculty in an academic emergency medicine department. The mentoring interven-tion included role modeling and mentoring by local area alumni of the residency program as well as faculty. Vertical and peer group mentoring occurred in the form of sessions focused on topics specific to women in medicine, which supplemented formal academic mentoring at the depart-ment. The program ran from 2004 to 2010 as structured 2-hour sessions in noninstitutional settings every other month. Regular sessions were supplemented by other meetings, including wellness workshops and an annual statewide breakfast with a national female leader in emergency medicine. Residents, faculty, and alumni who participated in the mentoring program perceived it to be valuable and to provide an emotionally supportive and encouraging environment for professional and personal development. The analysis of qualitative responses of program participants identified social networking, inclu-siveness, and the supportive nature and solidarity of the group as the most appreciated features of the program. Other themes identified were the benefits of networking with mentors who served as role models and addressing barriers specific to a woman's career in academic medicine. Work-life balance was the most valued session topic. The study is an important contribution to the growing body of evidence for successful interventions in mentoring women in residency and academic medicine and comple-ments recent efforts in designing effective programs in other disciplines. A pilot study of mentoring female academics in psychiatry by senior academic colleagues for 1 year improved the aspects of job-related well-being, self-esteem, and self-efficiency. 2 Another study of peer mentoring in academic skills of female faculty at the Department of Medicine at Mayo Clinic 3 in Rochester, Minnesota, showed a positive effect on the number of research articles submitted and/or published in peer-reviewed journals, as well as the increased satisfaction with academic achieve-ment, improved skills in literature search and critical appraisal, and increased confidence in the ability to write a comprehensive review article. Each of these studies addressed one of the 3 research themes we identified in our 2006 systematic review of academic mentorship: (1) effects of mentorship on education-based careers of physicians, (2) effects of mentorship strategies for women in medicine, and (3) comparison of formal versus informal mentoring and of multifaceted versus single-component strategies. 4 These studies also used an uncontrolled prospective study design at a single location. The critical next step in mentorship research is collaborative research across multiple sites, with a fair comparison group. Although difficult, collaboration among institutions and professional organizations in academic medicine will be essential to move the field forward. Survey research in mentorship interventions would also benefit from more uniformity in assessment instruments. An example of a potentially useful survey tool is the Mentor Role Instrument for assessing perceptions of mentoring relationships, 5 which has validity evidence for academic medical settings. 6 The need for more robust study designs in testing mentorship interventions 4 is based on the premise that faculty development and education are major responsibilities of medical schools and residency programs and, thus, require serious and rigorous evaluation. Future studies in mentoring should also clearly define the mentorship intervention. There is significant confusion, both in everyday language and in scientific discourse, about the meaning of mentoring versus other forms of academic personal relationships: peer support (peer mentoring), tutoring, teaching, coaching, supervising, advising, coun-seling, sponsoring, role modeling, and precepting. 7 When mentoring or mentoring-like interventions are not defined clearly, feedback from participants, such as provided in a survey, will not be reliable. Similarly, other studied outcomes cannot be reliably attributed to a particular mentoring strategy. Without an operationalized definition of the mentoring intervention, we cannot be sure which process or relationship is under evaluation nor whether it can be generalized to other settings and situations. This is a crucial conceptual problem in many studies; our systematic review showed that only 4 out of 34 survey studies of mentorship (12%) used a clear definition of mentors and mentorship. 4