What makes mentors thrive? An exploratory study of their satisfaction in undergraduate medical education.

BACKGROUND: Mentoring medical students with varied backgrounds and individual needs can be challenging. Mentors' satisfaction is likely to be important for the quality and sustainability of mentorships, especially in programs where the mentor has responsibility for facilitating a group of mentees. However, little is known about what influences mentors' satisfaction. The aim of this study was to measure mentors' self-reported satisfaction with the mentoring experience and to explore associations between satisfaction and its putative factors. METHODS: An online survey was sent out to all physician mentors in each of the three mentorship programs (UiT The Arctic University of Norway, the University of Bergen, and McGill University, graduation years 2013-2020, n = 461). Data were analyzed by descriptive statistics, dimension reduction, and linear regression. RESULTS: On a scale from 1 to 5, mean mentor satisfaction score at two Norwegian and one Canadian medical school was 4.55 (95% CI 4.47, 4.64). In a multilevel multivariate regression analysis, two predictors were significantly associated with mentors' satisfaction: (1) the perception that students found the group meetings valuable (ß = 0.186, 95% CI 0.021, 0.351, p = 0.027) and (2) mentors' perceived rewards (ß = 0.330, 95% CI 0.224, 0.437, p < 0.001). Perceived rewards included experiencing gratifying relationships with students, and mentors' perception of self-development. CONCLUSIONS: In this study, mentors appeared to be highly satisfied with their mentoring functions. Our findings suggest that mentors' overall satisfaction is closely linked to their experiences of fulfilling mentor-student relationships and personal and professional development. Interestingly, and perhaps contrary to commonly held assumptions, we found no association between mentor satisfaction and financial compensation. Furthermore, satisfaction was not associated with the provision of pre-assigned topics for discussions for mentor group meetings. We propose that the mentors' experienced psycho-social rewards, and their competence in establishing well-functioning group dynamics, should be areas of focus for faculty development.

Traumatic dental injuries: Knowledge assessment of dentists in the Norwegian Public Dental Service of Vestland.

BACKGROUND/AIM: Most children and adolescents in Norway attend the Public Dental Service (PDS) where they are treated free-of-charge until the age of 19 years. Thus, general dentists employed in the PDS are the primary care providers for traumatic dental injuries (TDI) in young patients. This cross-sectional study assessed the knowledge of PDS general dentists on the acute management and follow-up of TDI and its socio-demographic and attitudinal covariates. MATERIALS AND METHODS: All general dentists employed in the Vestland County PDS, Western Norway, (N = 170) received an online questionnaire. Socio-demographic and professional profiles of respondents as well as attitudinal indicators were queried. Clinical case scenarios on emergency treatment and further follow-ups of TDI were used to calculate a dental trauma knowledge score (DTKS; range: 0-21). Mann-Whitney U tests and Kruskal-Wallis tests determined differences between the demographic subgroups. Logistic regressions determined the potential of single factors in explaining the variability in dental trauma knowledge. RESULTS: The response rate was 46%. Most participants (60.5%) had not participated in a TDI course after graduation but would like such a course (84.2%). Mean DTKS was 13.82 (±2.6). Knowledge scores differed significantly between age groups (p = .014) and years since graduation (p = .0018). Younger dentists and recently graduated dentists scored highest. Dentists under the age of 30 years scored higher than 30-39- and 40-49-year-old dentists in these areas: emergency treatment of crown fractures with pulp exposure, identification of complications after avulsion, and management of severe intrusive luxation injury. CONCLUSION: Younger dentists had a higher theoretical knowledge of TDI. Continuing professional development among dentists in the Norwegian PDS is needed for emergency treatment and complication management after TDI.

Transforming self-experienced vulnerability into professional strength: a dialogical narrative analysis of medical students' reflective writing.

Medical students' efforts to learn person-centered thinking and behavior can fall short due to the dissonance between person-centered clinical ideals and the prevailing epistemological stereotypes of medicine, where physicians' life events, relations, and emotions seem irrelevant to their professional competence. This paper explores how reflecting on personal life experiences and considering the relevance for one's future professional practice can inform first-year medical students' initial explorations of professional identities. In this narrative inquiry, we undertook a dialogical narrative analysis of 68 essays in which first-year medical students reflected on how personal experiences from before medical school may influence them as future doctors. Students wrote the texts at the end of a 6-month course involving 20 patient encounters, introduction to person-centered theory, peer group discussions, and reflective writing. The analysis targeted medical students' processes of interweaving and delineating personal and professional identities. The analysis yielded four categories. (1) How medical students told their stories of illness, suffering, and relational struggles in an interplay with context that provided them with new perspectives on their own experiences. Students formed identities with a person-centered orientation to medical work by: (2) recognizing and identifying with patients' vulnerability, (3) experiencing the healing function of sharing stories, and (4) transforming personal experiences into professional strength. Innovative approaches to medical education that encourage and support medical students to revisit, reflect on, and reinterpret their emotionally charged life experiences have the potential to shape professional identities in ways that support person-centered orientations to medical work.

Medisinsk pedagogikk som forskningsfelt i Norge ­ en bibliometrisk studie.

BACKGROUND: Medical education is a growing international field of research. However, no overview exists of Norwegian researchers' contribution to the field. This study aimed to identify and describe medical education research originating from Norwegian research institutions. MATERIAL AND METHOD: We performed targeted searches in Web of Science, PubMed, ProQuest Education and Cristin, and identified published research within the field from Norwegian institutions. Using bibliometric analyses, we mapped patterns in research output over time, research communities that have published their work, and which publication channels were used. We also categorized the research articles according to methodology, empirical origin, educational level and topic. RESULTS: We found 423 published research articles linked to Norwegian research institutions and an increase in the number of publications in the last decade. The studies were published in 141 different scientific journals. Of these, the Journal of the Norwegian Medical Association had 94 articles (22 %). A total of 122 (29 %) articles were published in key medical education journals. Altogether 249 (59 %) of the studies were quantitative and 262 (62 %) were based on empirical data from Norway. A little more than half, 237 (56 %), focused on undergraduate medical education. Researchers affiliated to the University of Oslo were involved in 173 (43 %) articles. The most frequently researched topics were curricula, teaching and learning technology, retention and career choices. INTERPRETATION: Research activity within the field of medical education is increasing in Norway, but few Norwegian researchers publish in the specialised medical education journals.

Educational supervisor's perceptions of their role in supporting residents' learning: a qualitative study.

Objectives: During the past decade, educational supervision (ES) has gained popularity as a key support mechanism in residents' training. However, few studies have mapped physicians' understanding of their roles as educational supervisors. This study aims to explore how supervisors experience this role and how they approach providing support to residents. Methods: We employed qualitative methodology and conducted semi-structured interviews with 13 senior hospital physicians regarding their experiences as educational supervisors. Participants were recruited via e-mail and snowball sampling. Interview transcripts were analysed using inductive systematic text condensation following a four-step procedure: (i) total impression (ii) identifying and sorting meaning units (iii) condensation from code to meaning (iv) synthesising condensation from description and concepts. Results: Our analysis yielded four main themes. We found that while ES was considered important in theory, its purpose appeared unclear in everyday practise. Second, ES was associated with filling multiple and sometimes contradictory expectations. Third, establishing a good relationship between residents and supervisors was considered critical for effective ES. Finally, being a supervisor was described as experiencing a personal cost in the absence of support and resources. Conclusions: The many roles embedded in attending physicians' understanding of ES indicate a wide definition of the supervisory role. Supervisors contribute to residents' training by ensuring educational quality while upholding quality in patient care. Educational supervisors considered themselves to be vital sources of support for residents, but found their role unclear in everyday practice. They strove to manage different expectations resulting from lack of supportive organisational structures.

Endeavouring interplay: a grounded theory study of how nurse educators' work with simulation-based learning.

BACKGROUND: Simulation-based learning is frequently used as a teaching and learning strategy in nursing and other health professions educations, and educators have a key role as facilitators. This facilitator role provides them with a particularly relevant perspective to help us understand and theorize around the essence of simulation-based learning, and how it is approached. This study aims to explore nurse educators' experiences and strategies in simulation-based learning. METHOD: Data were collected in 2018-2021 using in-depth interviews with eight nurse educators. Transcripts were analysed through constant comparison using Classical Grounded Theory approach. RESULT: The participants' main concern was how to Maximize students' learning-space in simulation. To resolve this, four strategies were identified: legitimizing simulation, self-development, preparing students, and tailoring simulation. Legitimisation, and self-development were found to be important prerequisites for developing the learning space and were therefore defined as the background or context of the theory. Nurse students were the focus of the two remaining categories, preparing students and tailoring simulation, and are thus defined as being in the foreground of the theory. The dynamics of these four strategies were captured in the Grounded theory of Endeavouring interplay. CONCLUSION: The theory of Endeavouring interplay illustrates the complexity educators are encountering when aiming to optimize simulation as a learning space for nurse students. The strategies used are adapted to the organisational climate, available resources and context, and include striving to legitimize simulation, pursue self-development in the role as facilitator, help students prepare for simulation-based learning, and tailor the simulation to both contextual factors and individual student needs.

Educational supervision in internal medicine residency training - a scoping review.

BACKGROUND: Although supervision is an important part of residency training, its scope and how it relates to other types of support, such as mentoring, precepting and feedback, remain unclear. While clinical supervision consists of ongoing instructions and feedback in the workplace setting, educational supervision is a formalized component of postgraduate medical educational and supports the process that facilitates a trainee's progression throughout their training. Since medical specialties have different supervisory traditions, this study focuses on educational supervision in internal medicine. Our aim was to investigate what is known about educational supervision practices in internal medicine and the role of educational supervision in supporting residents' learning. METHODS: We conducted a scoping review of the literature on educational supervision in residency training in internal medicine based on Levac et al.'s modification of Arksey and O'Malley's six-step framework. The literature search was performed in the following databases: Medline, Embase, Web of Science and the Educational Resources Information Center. In addition, we conducted a handsearch in Medical Teacher and Google Scholar. We followed the PRISMA guidelines for systematic research. RESULTS: Eighteen of the 3,284 identified articles were included in the analysis. We found few empirical studies describing how educational supervision is conducted and what effect routine educational supervision has on residents' learning. Our findings suggest that the terminology can be confusing and that educational supervision practices in internal medicine has a weak theoretical foundation. CONCLUSION: The distinction between educational supervision and other support structures, such as mentoring and feedback, has not been clearly defined in the research literature. We argue that shared terminology is needed to better understand current educational practices and to facilitate clear communication about how to help residents learn.

Peer Teaching in Undergraduate Medical Education: What are the Learning Outputs for the Student-Teachers? A Systematic Review.

Introduction: To achieve quality in medical education, peer teaching, understood as students taking on roles as educators for peers, is frequently used as a teaching intervention. While the benefits of peer teaching for learners and faculty are described in detail in the literature, less attention is given to the learning outputs for the student-teachers. This systematic review focuses on the learning outputs for medical undergraduates acting as student-teachers in the last decade (2012-2022). Aim: Our aim is to describe what learning outputs student-teachers have from peer teaching, and map what research methods are used to assess the outputs. We defined learning outputs in a broad sense, including all types of learning experiences, intended and non-intended, associated with being a peer teacher. Methods: A literature search was conducted in four electronic databases. Title, abstract and full text were screened by 8 independent reviewers and selection was based on predefined eligibility criteria. We excluded papers not describing structured peer teaching interventions with student-teachers in a formalized role. From the included articles we extracted information about the learning outputs of being a student-teacher as medical undergraduate. Results: From 668 potential titles, 100 were obtained as full-texts, and 45 selected after close examination, group deliberation, updated search and quality assessment using MERSQI score (average score 10/18). Most articles reported learning outputs using mixed methods (67%). Student-teachers reported an increase in subject-specific learning (62%), pedagogical knowledge and skills (49%), personal outputs (31%) and generic skills (38%). Most articles reported outputs using self-reported data (91%). Conclusion: Although there are few studies that systematically investigate student-teachers learning outputs, evidence suggests that peer teaching offers learning outputs for the student-teachers and helps them become better physicians. Further research is needed to enhance learning outputs for student-teachers and systematically investigate student-teachers' learning outputs and its impact on student-teachers.

The liminal landscape of mentoring-Stories of physicians becoming mentors.

INTRODUCTION: This study explores narratives of physicians negotiating liminality while becoming and being mentors for medical students. Liminality is the unstable phase of a learning trajectory in which one leaves behind one understanding but has yet to reach a new insight or position. METHODS: In this study, we analysed semi-structural interviews of 22 physician mentors from group-based mentoring programmes at two Norwegian and one Canadian medical school. In a dialogical narrative analysis, we applied liminality as a sensitising lens, focusing on informants' stories of becoming a mentor. RESULTS: Liminality is an unavoidable aspect of developing as a mentor. Which strategies mentors resort to when facing liminality are influenced by their narrative coherence. Some mentors thrive in liminality, enjoying the possibility of learning and developing as mentors. Others deem mentoring and the medical humanities peripheral to medicine and thus struggle with integrating mentor and physician identities. They may contradict themselves as they shift between their multiple identities, resulting in rejection of the learning potentials that liminality affords. CONCLUSION: Mentors with integrated physician and mentor identities can embrace liminality and develop as mentors. Those mentors with contradicting dialogues between their identities may avoid liminality if it challenges their understanding of who they are and make them experience discomfort, confusion and insufficiency while becoming a mentor. Support of the mentoring role from the clinical culture may help these physicians develop internal dialogues that reconcile their clinician and mentor identities.

Types of exams used in medical education in Norway. / Eksamensformer i de norske medisinstudiene.

BACKGROUND: No overview exists of the types of exams used in medical education in Norway. In this study, we have identified these and analysed the reasons why directors of studies choose a particular type of exam. The aim has been to form an overview and to frame the reasoning behind assessment practices in Norwegian undergraduate medical education in an international and research-based perspective. MATERIAL AND METHOD: We gathered information about the types of exams used in the four undergraduate medical education programmes in Norway. We also conducted semi-structured interviews with a director of studies at each university. The strengths and weaknesses of the types of exams used were discussed in the interviews. RESULTS: The number of exams, the types of exams and their position in the study programme varied considerably across the four study programmes. Multiple-choice exams were the most common, supplemented with various oral exams and practical assessments. Arguments for choosing the various types of exam were largely related to the need for standardisation, objectivity and resource availability. INTERPRETATION: Assessment seems to be largely intended to measure and control, while the opportunities to foster learning that examination affords are not well exploited. Systems thinking in relation to the different intentions of the types of assessment, which is touched on in international guidelines, seems to be a low priority.

The affective component of learning in simulation-based education - facilitators' strategies to establish psychological safety and accommodate nursing students' emotions.

BACKGROUND: Active learning situations such as simulation-based education (SBE) are found to trigger a wide range of emotions among students. Facilitators have an important educational role in SBE which include being attentive and adaptive to students'cognitive and affective responses. Although the importance of emotions in SBE is recognized in facilitator guidelines, little is known about how facilitators accommodate student affect. Hence, this study explores facilitators' strategies for addressing students' emotions in SBE. METHOD: Individual interviews with nine facilitators were performed and transcripts were subjected to qualitative analyses in accordance with interpretive description approach. RESULTS: Findings show that facilitators are attentive to and continuously assess students' emotional responses in SBE. Both positive emotions, such as interest and surprise, and negative emotions such as anxiety are cultivated, yet adapted to the perceived needs of the individual student. Psychological safety was seen as a prerequisite for optimal learning, regardless of the students' previous level of knowledge. Furthermore, significant learning was seen as something that might also arise from uncomfortable experiences, such as students realizing their own mistakes or uncertainty. Hence facilitators were found to balance levels of difficulty, emotional arousal and psychological safety during the various phases of SBE. CONCLUSION: Facilitators recognize the emotional dimension of learning in SBE and have numerous strategies for accommodating students' emotions. This study highlights the complexity of the facilitator's role in adapting training to individual cognitive and emotional needs. These findings have implications for facilitator training which should include awareness of the role of emotions in learning and strategies for observing and accommodating training to meet emotional needs.

An Abrupt Transition to Digital Teaching-Norwegian Medical Students and Their Experiences of Learning Output during the Initial Phase of the COVID-19 Lockdown.

Norwegian universities closed almost all on-campus activities on the 12 March 2020 following a lockdown decision of the Norwegian government in response to the COVID-19 pandemic. Online and digital teaching became the primary method of teaching. The goal of this study was to investigate how the transition to digital education impacted on medical students enrolled at the University of Bergen (UiB). Key points were motivation, experience of learning outcomes, and fear of missing out on important learning. Using an online questionnaire, students were asked to evaluate the quality of both lectures and taught clinical skills and to elaborate on their experience of learning output, examination, and digital teaching. Answers from 230 students were included in the study. Opinions on the quality and quantity of lectures offered and their experience of learning output varied based on gender, seniority and the amount of time spent on part time jobs. Students at UiB were generally unhappy with the quality of teaching, especially lessons on clinical skills, although both positive and negative experiences were reported. Securing a satisfying offer of clinical teaching will be important to ensure and increase the student experience of learning output in the time ahead.

Threshold concepts in group-based mentoring and implications for faculty development: A qualitative analysis.

INTRODUCTION: The literature on faculty development programs for mentors is scarce. This study examines mentors' experiences and challenges, with the aim of identifying threshold concepts in mentoring. It also discusses the implications for the faculty development of mentors. METHODS: Semi-structured interviews solicited personal narratives and reflections on mentors' lived experiences. Data analysis was guided by the threshold concepts framework allowing for the identification of significant and transformative shifts in perspectives. RESULTS: We interviewed 22 mentors from two Norwegian and one Canadian medical school with group-based mentoring programs. The mentoring experience involved four significant threshold concepts: focusing on students' needs; the importance of creating a trusting learning space; seeing oneself through the eyes of students; and aligning mentor and physician identities. CONCLUSION: Taking on a mentor role can provoke personal and professional dilemmas while also sparking growth. The trajectories of developing as a mentor and as a professional physician may be seen to mutually validate, mirror and reinforce each other. Faculty development programs designed specifically for mentors should aim to stimulate reflection on previous learning experiences and strive for a successful alignment of the distinct pedagogical and clinical content knowledge required to fulfill various professional roles.

Group mentorship for undergraduate medical students-a systematic review.

INTRODUCTION: Mentoring has become a prevalent educational strategy in medical education, with various aims. Published reviews of mentoring report very little on group-based mentorship programs. The aim of this systematic review was to identify group-based mentorship programs for undergraduate medical students and describe their aims, structures, contents and program evaluations. Based on the findings of this review, the authors provide recommendations for the organization and assessment of such programs. METHODS: A systematic review was conducted, according to PRISMA guidelines, and using the databases Ovid MEDLINE, EMBASE, PsycINFO and ERIC up to July 2019. Eight hundred abstracts were retrieved and 20 studies included. Quality assessment of the quantitative studies was done using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS: The 20 included studies describe 17 different group mentorship programs for undergraduate medical students in seven countries. The programs were differently structured and used a variety of methods to achieve aims related to professional development and evaluation approaches. Most of the studies used a single-group cross-sectional design conducted at a single institution. Despite the modest quality, the evaluation data are remarkably supportive of mentoring medical students in groups. DISCUSSION: Group mentoring holds great potential for undergraduate medical education. However, the scientific literature on this genre is sparse. The findings indicate that group mentorship programs benefit from being longitudinal and mandatory. Ideally, they should provide opportunities throughout undergraduate medical education for regular meetings where discussions and personal reflection occur in a supportive environment.