Wolferth, Jr. Hahnemann University Dr. The number of additional successful surgeons who trained under Dr. On a personal note, Dr. Rhoads do?
All I could think about was heading straight home, skipping dinner and going immediately to bed! Then I hesitated, remembering there was one inpatient whom I had not seen earlier in the day. She was an elderly lady, several days postop, in a distant part of the hospital, whom the chief resident had previously told me was doing well and I could definitely see her the next morning.
Rhoads would see the patient. Suffused with fatigue I reluctantly trudged to her room where I was surprised to see four family members who had waited several hours to see me. A rapid chart review followed by a brief physical exam both unnecessary confirmed the prior feedback that the patient was doing well and was ready for discharge in the morning. Her family and she was effusive in their gratitude for my seeing 18 2 Why Surgical Mentoring is Important and Evidence their mother at such a late hour and mentioned it was definitely worth the wait. Once again Dr. Never underestimate the far-reaching guidance of a good mentor!
This hierarchical experience permeates all levels of surgeons from the medical student rotating on a surgical service to the accomplished professor. Mentoring benefits the surgical apprentice in many ways. Evidence-Based Benefits to the Mentee Mentoring in Academic Medicine Many investigators have tested the hypothesis that mentoring actually benefits the mentee. A recent review by Sambunjak and colleagues of the importance of mentoring in academic medicine Evidence-Based Benefits to the Mentee 19 examined the actual prevalence of mentorship and its relation to career development .
Although this study did not address surgical training per se, many of the findings encompass all medical specialties. Based upon predetermined criteria, 42 reports describing 39 studies were selected for analysis from 3, citations and full text articles. Questions arise as to the optimal methods to teach surgical skills and whether there is evidenced-based support to confirm these teaching methods.
Murphy and colleagues conducted a randomized trial to determine the benefits of mentoring surgical trainers on a specific cognitive method to insert an internal venous jugular catheter in mannequins at the John Radcliffe Hospital, Oxford, UK . Ten experienced surgeons were randomized to use either a 4-step cognitive instructional method or their own independent method to instruct medical students. When compared to independent techniques, students receiving the cognitive instruction had significantly better performance scores Fig.
http://ujapoduwas.ga The investigators concluded that instructing the trainer in a cognitive training method results in a significant improvement in training outcomes. While trainers are not always mentors, the acquisition of surgical skills is particularly relevant in these settings. Moreover, one can argue whether the statistically significant time saved in catheter insertion with the mentored approach is truly a clinically relevant difference.
Despite these concerns, simulation labs are important settings for mentoring. Performance score With permission from Elsevier Evidence-Based Benefits to the Mentee 21 Regardless of the setting, it is imperative for the mentor to continue to emphasize the importance of thinking about the whole patient and not just focusing on the technique being taught.
Investigators have questioned the relevance of having a faculty mentor present in a surgical skills laboratory. Forty-five junior residents were randomly assigned to learn basic surgical skills skin closure and bowel anastomosis in either a self-directed or faculty-directed setting. When compared to self-directed learning, Objective Structural Assessment of Technical Skill, time to completion, and skin aesthetic rating were not significantly improved in the faculty-directed group, although isolated improvement in anastomotic leak pressure was observed.
Although residents perceived facultydirected training to be superior, this perception was not supported by objective analyses of performance. The investigators concluded there was minimal objective evidence in the simulation lab that facultydirected training improved transfer of certain learned skills to more complex tasks. While these findings differ from the Murphy report, clinical tasks were not the same in each study. The teaching of many surgical skills can most likely be performed well by a senior level resident, whereas others are better taught by an experienced mentor.
Mentoring and Research Success in research is one of the most consistent examples of the benefits of mentoring. Steiner and colleagues examined the influence of mentors on the research development of Primary Care Fellows who were recipients of National Research Service Awards between and . The purpose of the study was to investigate the quality and quantity of their mentorship experience.
This study is particularly relevant because it is increasingly more difficult to obtain research funding. The major influence of mentoring on the research career of the junior investigator continues to be acknowledged as noted in this study. Additionally, increased student involvement may unnecessarily prolong the operation, which in turn, has both clinical and financial implications.
The role of the attending surgeon is vital in these situations. If the major segment of the operation has proceeded uneventfully and if the patient has no major co-morbidities, the student can be more engaged as discussed.
Attracting more medical students into careers in surgery is a major goal of residency program directors and surgical chairs. This study provides strong support for meaningful engagement of students in the operating room. These studies underscore the importance of acknowledging the medical students as part of the surgical team and allowing them to actively participate in general surgery operations. In some instances this influence occurs merely by serving as an example, whereas in other situations, the mentor has a more proactive role in career decisions of the mentee.
Mentoring by example often includes subliminal communication by the mentor through behavior, attitudes and an expression of job satisfaction and personal fulfillment.
Every experienced surgeon has learned there is no utopian job. As a result of age and experience, the surgical mentor is generally well qualified to elucidate both the favorable and unfavorable aspects of various job and fellowship opportunities and to help guide the younger surgeon to an independent decision. The reasons for choosing a surgical specialty for a resident in training were investigated by Ko and colleagues .
Three hundred and fifty-two surveys from senior surgeons of regional and national societies were reviewed. Stages of training at which the respondents became most interested in a specialty or an area of surgical expertise were at the junior resident level. This study confirms the significant influence of attending surgeons on career choices of surgical trainees during early periods of residency training.
These results have implications for the types i. The investigators concluded that mentor guidance was an important criterion in selecting career specialties. More recently, the impact of mentoring on career choices by surgical residents was investigated. McCord and colleagues sent a 32 item web survey to 99 graduates of the University of Wisconsin surgical residency who matriculated between and . An important focus of this study was to determine the effect of mentoring on career decision-making in graduates who acknowledged an influential mentor when compared to their colleagues who did not identify such a mentor.
With permission from Elsevier in support of their decisions to become a surgeon. More often than not, the decision was strongly influenced by an enthusiastic and knowledgeable individual e. Importance of Mentoring to the Mentor Most individuals who have assumed the title of senior surgeon readily acknowledge the importance and continued impact of mentors in their own careers and personal lives.
Consequently, it behooves interested and experienced surgeons, whenever possible, to mentor their younger colleagues. The enriching experience of mentoring leads to enormous rewards for the mentor, the most significant of which are subjective. There is indeed a purposeful feeling which arises from sharing information and experience. Surgeons with major teaching responsibilities often live 26 2 Why Surgical Mentoring is Important and Evidence vicariously through the achievements of their trainees and find their accomplishments provide enormous personal joy and gratification.
The mentor also receives objective benefits from the two-way process of mentoring.
Additionally, mentors with increasing clinical or administrative responsibilities and major research commitments realize the importance of a junior research mentee. These younger individuals are frequently the key determinants in the overall success of a laboratory or a specific research project. Importance of Mentoring to the Patient and Surgical Care in General The most significant benefit of surgical mentoring is to the patient, thus collectively improving surgical care in our society. This long learning process emphasizes the importance of mentoring early in the training of the mentee especially since more surgeons are retiring in their mids.
From the surgery clerkship, through residency, fellowship and clinical practice, surgeons learn from each other both formally and informally. Each generation follows in the footsteps of the last, while also blazing new trails in the hopes of. Surgical Mentoring: Building Tomorrow's Leaders provides practical guidance for all surgeons, in training and in practice, about the pedagogical, clinical, and.
It stands to reason that if senior surgeons become involved in mentoring and convinced of its value, their careers will be extended, References 27 increased mentoring of younger trainees will ensue and more patients will be the ultimate beneficiaries. As most senior surgeons have learned, the process of transferring knowledge and perpetuating wisdom primarily accrues through clinical experience. Hence, it is intuitive that if the professional longevity of the surgeon is prolonged, general improvements in healthcare will accrue.
As surgeons age and become clinically less active, increased time may be available for mentoring. Furthermore, this setting is a perfect opportunity for experienced surgeons to continue to make a difference even though they may not be directly caring for patients. Additional opportunities to mentor result from somewhat lessened pressures to generate departmental revenue, and decreased stresses engendered by competing for patients in a fixed clinical population.
Summary and Conclusions Most successful surgeons have been mentored by accomplished surgeons. Mentoring provides numerous objective and subjective benefits to enhance the professional career and personal successes of the mentee. These benefits are confirmed in evidence-based studies and include guiding selection of surgical careers, enhancing research productivity, facilitating acquisition of fellowships, and obtaining jobs in private practice or academic institutions. The results of surgical mentoring collectively improve patient care and enhance healthcare throughout our society.
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