June 2020 - Mentorship

June 2020
EAST Monthly Literature Review


"Keeping You Up-to-Date with Current Literature"
Brought to you by the EAST Manuscript and Literature Review Committee

This issue was prepared by EAST Mentoring Committee Members Deepika Koganti, MD and Asanthi Ratnasekera, DO, FACS.

Thank you to Haemonetics for supporting the EAST Monthly Literature Review.


In This Issue: Mentoring 

Scroll down to see summaries of these articles

Article 1 reviewed by Deepika Koganti, MD
The Mentor Match: A New Approach to Implementing Formal Mentorship in General Surgery Residency. Ullrich LA, Jordan RM, Bannon K, Stella J, Oxenberg J. Am J Surg. 2020 Jan 22;S0002-9610(20)30012-X.

Article 2 reviewed by Deepika Koganti, MD
Paying It Forward: Four-year Analysis of the Eastern Association for the Surgery of Trauma Mentoring Program. Zakrison T, Polk T, Dixon R, Ekeh A, Gross KR, Davis KA, Kurek J, Stassen N, Patel M. J Trauma Acute Care Surg. 2017 Jul; 83(1):165-169. 

Article 3 reviewed by Asanthi Ratnasekera, DO, FACS
Development and Assessment of the Wisconsin Surgical Coaching Rubric. Vande Walle KA, Quamme SRP, Beasley HL, Leverson GE, Ghousseini HN, Dombrowski JC, Fry BT, Dimick JB, Wiegmann DA, Greenberg CC. JAMA Surg. 2020 Apr 22.

Article 1
The Mentor Match: A New Approach to Implementing Formal Mentorship in General Surgery Residency. Ullrich LA, Jordan RM, Bannon K, Stella J, Oxenberg J. Am J Surg. 2020 Jan 22;S0002-9610(20)30012-X.

Although mentorship in surgical training has been shown to positively impact a trainee’s academic and personal satisfaction and success, only half of general surgery residencies have dedicated mentoring programs.  Moreover, a majority of these programs do not follow a formal curriculum with residents often selecting their mentors based on personal preference instead of areas requiring improvement. 
 
In 1999, the Accreditation Council for Graduate Medical Education (ACGME) created six core competencies for training: practice based learning and improvement, patient care and procedural skills, systems-based practice, medical knowledge, interpersonal communication skills, and professionalism.  Based on these topics, surveys were administered to residents to identify which areas they needed to improve the most: operative skills, American Board of Surgery In-Training Exam (ABSITE) preparation, leadership and work/life balance, research and learning style, career guidance, and interpersonal relationships.  The same survey was given to faculty who volunteered to serve as mentors.  The faculty were asked to rank the areas in which they could provide the most guidance. Residents and faculty were then matched based on top three needs of the mentee and top three strengths of the mentor.
 
Mentoring pairs met every three months with 92% of residents saying they were satisfied with the program and 83% reporting improvement in the requested areas of need.  The “Mentor Match” appeared to be a successful, formalized tool to effectively mentor residents, leading to increased trainee fulfillment and faculty-resident support.  Limitations of this study include that is uses subjective data and was performed at a single institution.

Article 2
Paying It Forward: Four-year Analysis of the Eastern Association for the Surgery of Trauma Mentoring Program. Zakrison T, Polk T, Dixon R, Ekeh A, Gross KR, Davis KA, Kurek J, Stassen N, Patel M. J Trauma Acute Care Surg. 2017 Jul; 83(1):165-169. 

While the concept of mentoring has been present in surgical education dating back to apprenticeship models, structured programs have only recently been implemented.  The Eastern Association for the Surgery of Trauma (EAST) established a formal mentoring program in 2012, which is now the largest extramural surgical society mentoring program. The program pairs an experienced surgeon with “junior members” such as a resident, fellow, or junior faculty.  The pairs then communicate monthly to discuss academic, professional, and personal growth as well as any other mentee requests. 
 
Between 2012-2015, 65 mentoring pairs were created and 60 completed the program.  Review of the topics showed that research (26%), involvement in professional organizations (18%), and career development (16%) were the most popular to discuss.  During these four years, an online survey was distributed to mentors and mentees with a 57% response rate.  Interestingly, mentees felt like their goals were “always” or “usually” met compared to their mentors (89% vs. 77%, p=0.096).  91% of respondents said they would continue their mentoring relationship beyond the formal program and 85% of mentees recommended the experience.  Challenges of the program reported included busy schedules, difficulty in coordinating meetings, and lack of structure.
 
The EAST Mentoring Program has grown into the largest and most successful structured mentorship program dedicated to the personal and professional development of surgeons.  Mentees were highly satisfied with the program, and the majority would recommend it to their peers.  As the program evolves, improved techniques to better match mentors and mentees and a more structured curriculum will continue to improve this highly beneficial program.
 

References

1. Davis KA. EAST 2015 Presidential Address: Look both ways. J Trauma Acute Care Surg 2015;79(1):1–9.
 
2. Straus SE, Johnson MO, Marquez C, Feldman MD. Characteristics of successful and failed mentoring relationships: a qualitative study across two academic health centers. Acad Med 2013;88(1):82–89.
 
3. Jackson VA, Palepu A, Szalacha L, Caswell C, Carr PL, Inui T. “Having the right chemistry”: a qualitative study of mentoring in academic medicine. Acad Med 2003;78(3):328–34.
 
4. Feldman MD, Arean PA, Marshall SJ, Lovett M, O’Sullivan P. Does mentoring matter: results from a survey of faculty mentees at a large health sciences university. Med Educ Online 2010:15.
 
5. Kibbe MR, Pellegrini CA, Townsend CM, Helenowski IB, Patti MG. Characterization of mentorship programs in departments of surgery in the United States. JAMA Surg 2016;151(10):900-906.
 
Article 3
Development and Assessment of the Wisconsin Surgical Coaching Rubric. Vande Walle KA, Quamme SRP, Beasley HL, Leverson GE, Ghousseini HN, Dombrowski JC, Fry BT, Dimick JB, Wiegmann DA, Greenberg CC. JAMA Surg. 2020 Apr 22.

Surgical coaching has been gaining attention and is of major significance for professional development in a surgeon’s career. Surgical coaching consists of a practicing surgeon being “coached” by a trained surgeon. During surgical coaching sessions constructive feedback is given to improve technical, cognitive and interpersonal skills. There is currently no method to evaluate a surgical coach’s performance. The Wisconsin Surgical coaching Rubric (WiSCoR) is a novel tool developed to assess coach competencies. The WiSCoR was developed off the Wisconsin Surgical Coaching Program (WSCP).

The tool was created based on the fundamentals used to develop the WSCP. Key categories of coaching were identified by experts in surgery, education, cognitive psychology and executive coaching. WiSCoR consists of 4 domains. These are: “(1) shares responsibility and contributes to equal exchange; (2) uses questions/prompts to guide coachee self- reflection/analysis; (3) provides constructive feedback and encouragement; and (4) guides goal setting and action planning.” Each domain was rated from low to high with a 5 being the highest and expected from a professional coach. The coaching sessions are audio recorded and reviewed by the coach and coachee. These sessions were then independently reviewed by a group of twelve raters (an executive coach, expert in human performance, an education researcher, and surgeons). WiSCoR was also used by the Michigan Bariatric Surgery Collaborative (MBSC) coaching program.

106 sessions were included (13.2% from WSCP and 86.8% from MBSC) with 282 WiSCoR ratings. There were 23 coaches and 28 coachees who participated. The domain with the highest mean rating was domain 1: shares responsibility and contributes to equal exchange.  The domain with the lowest mean rating was domain 4: goal setting and action planning. The Gwet weighted agreement coefficient was used to measure the interrater reliability (AC2) for the overall WiSCoR rating (0.87) with the 95% CI and ranged from 0.84 to 0.93 for the individual domains. Of the 106 coaching sessions, 89 (84%) had a WiSCoR and coachee rating of the coach. The mean rating of coaches by coachees was significantly higher than the mean (SD). The coachee ratings had a weak positive correlation with the WiSCoR scores. The authors contributed this to coachees enjoying the experiences and valuing the feedback regardless of the quality of the coaching. The aspect of professional respect for the coaches were also taken into consideration. However, the WiSCoR was demonstrated to be a suitable coaching score and used fundamental coaching principles. The authors believe the WiSCoR allow for actionable feedback and help refine surgical coaching. The goal setting domain was identified as the lowest score. The authors hope to improve this domain in future surgical coaching sessions.

The limitations of this study are related to its reliability which will need to be evaluated further since it is a novel program. Most constituents in the program were men therefore, further investigation is needed with more gender diversity. Further validation will be needed with correlation in improvement of coachee’s surgical skills and outcomes. In conclusion, the authors examined the utility of WiSCoR as a novel tool to evaluate surgical coaching and has found it to be efficacious.

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 This Literature Review is being brought to you by the EAST Manuscript and Literature Review Committee. Have a suggestion for a review or an additional comment on articles reviewed? Please email litreview@east.orgPrevious issues available on the EAST website.