MatricS-A novel tool for monitoring professional role development in surgical disciplines.

Introduction: Mentoring is an effective method for human resource development. Monitoring the process is important for individual mentee/mentor pairs as well as for program directors. Due to individual personality differences of both mentees and mentors and their respective interactions, it is challenging to monitor the individual development process of mentees in a structured manner. This study investigates to what extent a novel instrument, the mentee-based assessment tool for role development of interpersonal competencies in surgical professions (MatricS) can adequately monitor the professional role development process of residents during an established mentoring program. Material and methods: In a prospective longitudinal study, the competence development of 31 mentees in two subsequent cohorts was assessed by a modified role matrix based on Canadian Medical Education Directives for Specialists. The evaluation focused on three defined roles (D, developer; N, networker; M, multiplicator) at three levels (private, employer-related, national/international) with four stages of development. For validation of mentee self-assessments, the assessments of the respective mentors were recorded alongside. For correlation analyses, Pearson coefficients were calculated, pre-post-comparisons were done by paired t-tests; significance was assumed at p < 0.05, respectively. Results: Mentee self-assessments overall correlated well with the objective mentor assessments (Pearson's r 0.8, p < 0.001). Significant correlations of this magnitude were found for both individual cohorts as well as for all individual roles. The mentees acquired competencies in all roles indicated by significant increases of corresponding MatricS scores. The largest competency gains (mean ± SD) were found in the role D (start: 1.30 ± 0.77, end: 2.13 ± 0.83, p < 0.001). The majority of mentees achieved the prespecified target competency level in >75% of all roles and levels. Conclusion: The role development process during mentoring can be reliably monitored by using MatricS. MatricS scores highly correlate between mentees and mentors, indicating that mentee self-assessments are suitable and sufficient for monitoring. These findings help to lessen the work burden on senior surgeons and thus can help to increase the acceptance of mentoring programs in surgical disciplines.

[Mentoring in urological postgraduate training : Use of a competence matrix for the evaluation of results]. / Mentoring in der urologischen Weiterbildung : Einsatz einer Kompetenzmatrix zur Ergebnisevaluation.

OBJECTIVES: For the professional development of junior employees, sufficient competence is decisive for their career. The mentoring programme Urology Roadmap provides residents career planning in various roles (junior staff member, developer, networker, multiplier). To date, no data are available on the extent to which the role matrix instrument is suitable as a competence matrix for evaluating results. MATERIALS AND METHODS: In a prospective longitudinal study, the competence development of 21 mentees was recorded by their mentors in a validated questionnaire (The Munich Evaluation of Mentoring Questionnaire, MEMeQ). A modified role matrix based on CanMEDs (Canadian Medical Education Directives for Specialists) was used as an assessment tool. The focus of the evaluation was on four defined roles at three levels (private, employer-related, (inter)national) with four development stages. RESULTS: The highest level of satisfaction was found for the aspect "successful design of the career path" (93%) and the lowest was found for the aspect "facilitation of everyday working life" (67%). In all, 93% recommend participation. The mentees achieved significant increases in competence in all four roles. The highest level of competence was found in the role of junior employee (mstart 1.3 ± 0.7, mend 2.4 ± 0.7, p < 0.001), followed by developer (mstart 1.2 ± 0.8, mend 2.2 ± 0.7, p < 0.001) and networker (mstart 1.3 ± 0.7, mend 2.1 ± 0.6, p < 0.001). Of the mentees, 54% were able to achieve the target competence level 2 in more than 90% of all roles and levels. CONCLUSIONS: The instrument role matrix is suitable to objectively evaluate the results of the mentoring programme and reflects the state of personnel development.

Refractory lupus nephritis: a survey.

'Refractory lupus nephritis' is a frequently used term but poorly defined. We conducted a survey among nephrologists and rheumatologists to spot the diversity of perceptions of this term and to better understand the clinical practice related to 'refractory lupus nephritis'. A total of 145 questionnaires completed by lupus nephritis experts were available for analysis, of which 52% were nephrologists, 34% rheumatologists, and 13% internists. Response to induction treatment was mostly assessed after six months (58%), but assessment at three months was more common with the use of the EURO lupus protocol than with other treatment protocols. Rheumatologists used urinary sediment to assess response more frequently than nephrologists (66 vs. 48%, p < 0.05, Chi2), while nephrologists conversely relied significantly more on clinical symptoms (61 vs. 31%, p < 0.0001, Chi2). Non-nephrologists quantified proteinuria preferentially by 24 h urine sampling, while the majority of nephrologists relied on the urinary protein/creatinine ratio (UPCR) or the albumin/creatinine ratio of spot urine samples (59 vs. 38%, p < 0.05, Chi2). A total of 91% were concerned about persistent immunological systemic lupus erythematosus activity. There was less concern about drug adherence, renal scarring, genetic factors or other kidney diseases. Less than 20% check for drug adherence by regularly monitoring drug plasma levels. Nephrologists considered a re-biopsy more often than rheumatologists (58 vs. 38%, p < 0.05, Chi2). Together, among lupus nephritis experts there is considerable diversity in the perception of what the term 'refractory lupus nephritis' describes and how it is defined. A consensus definition of 'refractory lupus nephritis' is needed.