Mentoring

Mentoring
  • 文章类型: Journal Article
    背景:有效的指导是医学教育的重要组成部分,对所有利益相关者都有好处。近年来,导师的概念化已经超越了传统的二元经验导师-新手导师关系,包括小组和同伴指导。现有的导师理论不承认导师的个性化,不断发展,目标驱动,和特定于环境的性质。论证了传统因果观念的局限性,这篇综述的目的是系统地搜索文献,以确定指导是否可以被视为一个复杂的适应系统(CAS)。
    方法:使用Krishna的系统循证方法进行了系统的范围审查,以研究医学生和居民在普通内科和相关亚专业中的指导和CAS的陈述2000年1月1日至12月31日在PubMed上发表的文章,Embase,PsycINFO,ERIC,谷歌学者,和Scopus数据库。纳入的文章进行了主题和内容分析,确定并组合主题以创建域,这是讨论的框架。
    结果:审查了5,704份摘要,对134篇全文进行了评估,共纳入216篇文章。这些领域描述了指导关系和指导方法如何体现CAS的特征,并且指导通常表现为实践社区(CoP)。指导的类似CAS的功能通过CoP显示,有明显的界限,螺旋指导轨迹,以及纵向指导支持和评估过程。
    结论:认识到作为CAS的指导需要重新思考设计,支持,评估,以及对导师的监督和导师的作用。需要进一步的研究,以更好地评估指导过程,并为导师提供最佳的培训和支持。
    BACKGROUND: Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring\'s personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS).
    METHODS: A systematic scoping review using Krishna\'s Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion.
    RESULTS: Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring\'s CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes.
    CONCLUSIONS: Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.
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  • 文章类型: Journal Article
    国家研究指导网络(NRMN)是美国国立卫生研究院资助的多元化科学计划,技术,工程,数学,和医学研究人员通过提供指导,网络,和专业发展资源。NRMN通过其在线平台MyNRMN为会员提供指导资源。
    MyNRMN帮助会员建立导师网络。我们的目标是扩大招生和指导联系,尤其是那些历来在生物医学培训和生物医学劳动力中代表性不足的人。
    为了提高注册的便利性,我们实现了平台注册用户界面迭代的分割测试。为了增加指导联系,我们开发了多种功能,便于通过不同的途径连接。
    我们改进的用户界面产生了更高的完成注册率(P<.001)。我们的分析表明,与使用传统表格的注册相比,使用版本1表格的注册人数有所改善(赔率比1.52,95%CI1.30-1.78)。版本2表格,随着它的简化,1步流程和较少的必填字段,优于传统形式(赔率比2.18,95%CI1.90-2.50)。通过改进招生表格,MyNRMN注册完成率从旧版表格的57.3%(784/1368)增加到版本2表格的74.5%(2016/2706).我们新开发的功能增加了成员之间的联系。
    我们的技术努力扩大了MyNRMN的会员基础,并增加了会员之间的联系。其他平台开发团队可以从这些努力中学习,以增加代表性不足的群体的入学率,并促进持续,成功参与。
    UNASSIGNED: The National Research Mentoring Network (NRMN) is a National Institutes of Health-funded program for diversifying the science, technology, engineering, math, and medicine research workforce through the provision of mentoring, networking, and professional development resources. The NRMN provides mentoring resources to members through its online platform-MyNRMN.
    UNASSIGNED: MyNRMN helps members build a network of mentors. Our goal was to expand enrollment and mentoring connections, especially among those who have been historically underrepresented in biomedical training and the biomedical workforce.
    UNASSIGNED: To improve the ease of enrollment, we implemented the split testing of iterations of our user interface for platform registration. To increase mentoring connections, we developed multiple features that facilitate connecting via different pathways.
    UNASSIGNED: Our improved user interface yielded significantly higher rates of completed registrations (P<.001). Our analysis showed improvement in completed enrollments that used the version 1 form when compared to those that used the legacy form (odds ratio 1.52, 95% CI 1.30-1.78). The version 2 form, with its simplified, 1-step process and fewer required fields, outperformed the legacy form (odds ratio 2.18, 95% CI 1.90-2.50). By improving the enrollment form, the rate of MyNRMN enrollment completion increased from 57.3% (784/1368) with the legacy form to 74.5% (2016/2706) with the version 2 form. Our newly developed features delivered an increase in connections between members.
    UNASSIGNED: Our technical efforts expanded MyNRMN\'s membership base and increased connections between members. Other platform development teams can learn from these efforts to increase enrollment among underrepresented groups and foster continuing, successful engagement.
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  • 文章类型: Journal Article
    目的:健康的癌症生存涉及患者积极参与预防性健康行为和后续护理。虽然临床医生和患者通常对激活这些行为负有双重责任,将一些临床医生的努力转变为技术和健康教练可能会增强指南的实施。本文报告了幸存者共享医疗行动和反思电子系统(SHARE-S)计划的可接受性,完全虚拟的多成分干预,包括电子推荐,远程提供的健康指导,和自动短信,以增强患者的自我管理并促进健康的生存。
    方法:SHARE-S在单组混合实施-有效性试验研究中进行了评估。将患者从临床团队电子转介给健康教练,进行三个健康自我管理教练电话,并收到短信以加强教练。对21名患者参与者进行了半结构化定性访谈,2名临床医生,和2名健康教练,以确定干预的可接受性(态度,适当性,适用性,便利性,和感知的有效性),并确定计划的重要要素和潜在的行动机制,以指导未来的实施。
    结果:SHARE-S被描述为具有影响力和便利性。非指令,以患者为中心的健康指导和正念练习被认为是最可接受的;短信不太可接受.利益相关者建议增加格式的灵活性,频率,定时,和参与的时间长短,和其他量身定制的教育材料。患者报告了有形的健康行为变化,改善情绪,并提高责任感和自我效能感。
    结论:SHARE-S总体上是一种可接受且潜在有效的干预措施,可以增强幸存者的自我管理和幸福感。对定制内容的更改,定时,和剂量应进行测试,以确定对可接受性和结果的影响。
    OBJECTIVE: Healthy cancer survivorship involves patients\' active engagement with preventative health behaviors and follow-up care. While clinicians and patients have typically held dual responsibility for activating these behaviors, transitioning some clinician effort to technology and health coaches may enhance guideline implementation. This paper reports on the acceptability of the Shared Healthcare Actions & Reflections Electronic systems in survivorship (SHARE-S) program, an entirely virtual multicomponent intervention incorporating e-referrals, remotely-delivered health coaching, and automated text messages to enhance patient self-management and promote healthy survivorship.
    METHODS: SHARE-S was evaluated in single group hybrid implementation-effectiveness pilot study. Patients were e-referred from the clinical team to health coaches for three health self-management coaching calls and received text messages to enhance coaching. Semi-structured qualitative interviews were conducted with 21 patient participants, 2 referring clinicians, and 2 health coaches to determine intervention acceptability (attitudes, appropriateness, suitability, convenience, and perceived effectiveness) and to identify important elements of the program and potential mechanisms of action to guide future implementation.
    RESULTS: SHARE-S was described as impactful and convenient. The nondirective, patient-centered health coaching and mindfulness exercises were deemed most acceptable; text messages were less acceptable. Stakeholders suggested increased flexibility in format, frequency, timing, and length of participation, and additional tailored educational materials. Patients reported tangible health behavior changes, improved mood, and increased accountability and self-efficacy.
    CONCLUSIONS: SHARE-S is overall an acceptable and potentially effective intervention that may enhance survivors\' self-management and well-being. Alterations to tailored content, timing, and dose should be tested to determine impact on acceptability and outcomes.
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  • 文章类型: Journal Article
    背景:在年轻成年期发展癌症是一种非规范性生活事件,与不良身体相关,社会和心理后果。高心理困扰在AYA癌症患者中很常见,包括焦虑,抑郁或害怕复发。同时,众所周知,AYA经常报告未满足的支持需求,特别是在信息交流和同龄人的情感支持方面,以便从分享的经验中受益并提高自我效能感。尤其是在AYA组,与其他同龄癌症患者的互动可能是应对疾病的重要资源,因为家人和朋友经常不知所措,在无助中挣扎。目前,缺乏使用同伴支持的专业支持服务(例如,心理肿瘤支持,善后咨询,社会法律咨询)或评估德国的同伴支持干预措施。我们的目标是评估Peer2Me干预对AYAs的有效性,其中急性患者(受训者)由AYA幸存者(导师)陪伴三个月。
    方法:将使用具有重复措施的前瞻性综合队列设计来评估Peer2Me对AYA的有效性。将纳入180名年龄在18至39岁的积极癌症治疗患者的样本,并将其随机分配到干预或控制条件(单个AYA特异性咨询)。在导师培训之后,学员和导师通过诊断相匹配,年龄,和性别。主要结果是自我效能感;次要结果包括焦虑,抑郁症,健康素养,生活满意度和社会支持生活。结果将在干预前的基线测量(t1),在完成3个月干预后立即(t2)和完成干预后3个月(t3)。对于最终分析,我们将使用意向治疗方法(ITT),并比较指定治疗组中的患者.
    结论:Peer2Me可能是年轻癌症患者现有专业社会心理支持服务的重要补充。在研究结束时,应该对接受急性治疗的年轻癌症患者进行心理肿瘤干预,导师和受训者都可以从中受益。应通过与不同合作伙伴的合作确保Peer2Me的长期连续性。
    背景:该研究于2022年2月4日在clinicaltrials.gov(NCT05336318)进行了回顾性注册。
    BACKGROUND: Developing cancer in young adulthood is a non-normative life event and associated with adverse physical, social and psychological consequences. High psychological distress is common in AYA cancer patients including anxiety, depression or fear of recurrence. At the same time, it is well known that AYA often report unmet needs for support, particularly in terms of informational exchange and emotional support from peers in order to benefit from shared experiences and enhance self-efficacy. Especially in the AYA group, interactions with other same-aged cancer patients may represent an essential resource in terms of coping with the disease, as family members and friends are often overwhelmed and struggling with helplessness. Currently, there is a lack of professional support services using peer support (e.g. psycho-oncological support, aftercare consultations, social legal counselling) or evaluated peer support interventions in Germany. Our aim is to assess the effectiveness of the Peer2Me intervention for AYAs, in which acute patients (mentees) are accompanied by an AYA survivor (mentor) over a period of three months.
    METHODS: A prospective Comprehensive Cohort Design with repeated measures will be used to evaluate the effectiveness of Peer2Me for AYA. A sample of 180 patients in active cancer treatment aged 18 to 39 years will be enrolled and randomized to the intervention or control condition (a single AYA-specific consultation). Following mentor training, mentees and mentors are matched by diagnosis, age, and gender. The primary outcome is self-efficacy; secondary outcomes include measures of anxiety, depression, health literacy, life satisfaction and social support life. Outcomes will be measured at baseline before the intervention (t1), immediately after completion of the three-month intervention (t2) and three months after completion the intervention (t3). For the final analyses, we will use an intention-to-treat approach (ITT) and compare patients in the assigned treatment groups.
    CONCLUSIONS: Peer2Me might be an important addition to existing professional psychosocial support services for young cancer patients. At the end of the study, a psycho-oncological intervention for young cancer patients undergoing acute treatment should be available, from which both mentors and mentees could benefit. The long-term continuity of Peer2Me should be ensured through collaboration with different partners.
    BACKGROUND: The study was retrospectively registered on February 4, 2022 at clinicaltrials.gov (NCT05336318).
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  • 文章类型: Journal Article
    背景:在医疗机构中整合复杂的干预措施可能具有挑战性。指导可以嵌入随机对照试验(RCT)中,以提高技能并支持提供干预的人员。本研究旨在了解,从现实主义的角度来看,指导如何在RCT背景下为职业治疗师(OTs)提供职业康复(VR)干预的实施保真度。
    方法:使用次要数据的现实主义评估(电子邮件,指导记录表格,访谈)作为RCT的一部分收集。三名研究人员在内容分析后对数据进行编码,通过探索上下文之间的相互作用,专注于完善或驳斥初始程序理论,机制,和结果。研究小组开会进一步完善了计划理论。
    结果:来自584封电子邮件的数据,184指导记录表,并按照现实主义的方法分析了25次采访。我们开发了一种由两个上下文组成的程序理论(试验设置,持续的指导),九种机制(集体理解,监测,及时支持,正强化,反思性实践,支持数据完整性,促进战略,分享学习经验,研究和临床职责的管理),和三个结果(信心提高,改进的保真度,减少污染)。
    结论:为提供VR干预作为RCT的一部分的OTs提供指导支持可提高干预的保真度并降低污染风险。它提高了OTS对其临床和研究角色之间差异的理解,并提高了他们对完成试验文书工作和识别潜在污染问题的信心和能力。
    BACKGROUND: Integrating complex interventions within healthcare settings can be challenging. Mentoring can be embedded within a randomised controlled trial (RCT) to upskill and support those delivering the intervention. This study aimed to understand, from a realist perspective, how mentoring worked to support implementation fidelity for occupational therapists (OTs) delivering a vocational rehabilitation (VR) intervention within the context of an RCT.
    METHODS: A realist evaluation using secondary data (emails, mentoring record forms, interviews) collected as part of an RCT. Three researchers coded the data following content analysis, focused on refining or refuting an initial programme theory by exploring the interactions between context, mechanisms, and outcomes. The research team met to further refine the programme theories.
    RESULTS: Data from 584 emails, 184 mentoring record forms, and 25 interviews were analysed following a realist approach. We developed a programme theory consisting of two contexts (trial set-up, ongoing mentoring), nine mechanisms (collective understanding, monitoring, timely support, positive reinforcement, reflective practice, support data completeness, facilitation strategy, shared learning experience, management of research and clinical duties), and three outcomes (improved confidence, improved fidelity, reduced contamination).
    CONCLUSIONS: Offering mentoring support to OTs delivering a VR intervention as part of an RCT improves intervention fidelity and reduces the risk of contamination. It improves OTs\' understanding of the differences between their clinical and research roles and increases their confidence and competence in trial paperwork completion and identification of potential contamination issues.
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  • 文章类型: Journal Article
    背景:印度有一些针对健康研究人员的领导力培训计划。然而,有必要制定符合背景的领导和指导方法。
    目的:本研究的目的是批判性地分析印度卫生研究人员和服务提供商可用的领导力培训计划,对于领导力领域的整合和整体培训方法。
    方法:我们使用探索性描述性设计来确定和审查印度机构在2013年至2018年期间为卫生研究人员和服务提供商/经理提供的领导力培训计划。我们的分析方法基于“变革型领导”和“领导者-成员交换”的领导理论,全球流行的领导力培训课程,和国际临床流行病学网络模型在全国范围内的初步研究基础上,领导在印度的健康研究。
    结果:我们确定并审查了20个领导力培训项目。这些目标是异质的,范围(基础广泛/主题),课程内容,设计,目标参与者和班级简介,交付方式和培训方法,持续时间,频率,和资金安排。这些程序很少包含有关软技能的主题,指导,风险缓解,合作研究,资金动态,体制转型,自我观点和同伴感知,和个人福祉。该计划没有充分解决职业探索和风险缓解的背景挑战,项目管理,战略规划,和决策,道德和诚信,谈判,网络和协作,了解资金动态,和指导。只有三个计划与培训参与者的生态系统相关联。
    结论:需要制定定制的课程内容和培训策略,以满足本地环境对全球互联研究生态系统的要求。
    BACKGROUND: There are several leadership training programs for health researchers in India. However, there is a need to develop context-tailored leadership and mentoring approaches.
    OBJECTIVE: The objective of the study is to critically analyze the available leadership training programs in India for health researchers and service providers, for the leadership domains incorporated and overall training approaches.
    METHODS: We used an exploratory-descriptive design to identify and review leadership training programs for health researchers and service providers/managers that had been offered by Indian institutions between 2013 and 2018. Our analytic approach was based on \"transformational leadership\" and \"leader-member exchange\" theories of leadership, curricula of popular leadership training programs worldwide, and the International Clinical Epidemiology Network model for leadership in health research in India based on a nationwide primary study.
    RESULTS: We identified and reviewed 20 leadership training programs. These were heterogeneous in aim, scope (broad-based/thematic), course content, design, target participants and class profile, mode of delivery and training method, duration, frequency, and fund arrangements. The programs infrequently included topics on soft skills, mentoring, risk mitigation, collaboration for research, funding dynamics, institutional transformation, self-view and peer perception, and personal well-being. The programs insufficiently addressed contextual challenges of career exploration and risk mitigation, project management, strategic planning, and decision-making, ethics and integrity, negotiations, networking and collaboration, understanding funding dynamics, and mentoring. Only three programs linked to the training to the participants\' ecosystem.
    CONCLUSIONS: There is a need to develop customized course contents and training strategies that address the requirements of the local context vis-à-vis globally connected research ecosystems.
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  • 文章类型: Journal Article
    研究人员实施了一个短期级联教练模型,重点是对三个参与者的自然发展行为干预。三合会由一名研究生临床医生组成,患有自闭症谱系障碍的最低限度语言儿童,和孩子的父母。在跨专业的夏季诊所中进行辅导和干预,其中包括来自特殊教育,言语和听力科学部门的研究生临床医生。短期教学的功效,为学生临床医生提供研究人员指导,和学生临床医生对父母的指导使用跨参与者设计的多个基线进行评估。因变量是学生临床医生和家长对启发技术的使用(创造交流诱惑,等待,和提示)和响应技术(自然地加强儿童的交流并提供口语模型)。在指导之后,所有三合会的家长和学生临床医生都增加了对启发和反应技术的使用,在所有变量中具有非常大的效果大小。视觉分析结果表明,三合会之间存在个性化差异和变异性。讨论了对研究生教育和家长辅导计划的影响。
    Researchers implemented a short-term cascading coaching model focusing on naturalistic developmental behavioral intervention with three participant triads. Triads consisted of a graduate student clinician, a minimally verbal child with autism spectrum disorder, and the child\'s parent. Coaching and intervention occurred during an interprofessional summer clinic that included graduate student clinicians from special education and speech and hearing sciences departments. The efficacy of short-term instruction, researcher coaching for student clinicians, and student clinician coaching of parents was evaluated using a multiple baseline across participants\' design. The dependent variables were student clinician\'s and parent\'s use of elicitation techniques (creating communication temptations, waiting, and prompting) and response techniques (naturally reinforcing children\'s communication and providing spoken language models). Following coaching, parents and student clinicians from all triads increased their use of elicitation and response techniques, with very large effect sizes across all variables. Visual analysis findings suggest individualized differences and variability across triads. Implications for graduate education and parent coaching programs are discussed.
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  • 文章类型: Journal Article
    背景:同行指导可以成为减少高收入国家与低收入和中等收入国家之间卫生研究能力差异的潜在工具。本案例研究描述了同行指导解决两个关键问题的潜力:弥合来自低收入和中等收入国家(LMICs)的医生的健康研究能力,以及将人力资源转化为健康人才流失为“人才增长”。
    方法:2021年,贝宁大学医学院的16名校友成立了虚拟同伴指导小组,居住在三大洲。该计划旨在促进具有不同研究经验水平的同事之间的研究合作和技能发展,为研究中的职业发展营造有利的环境。由于小组成员的地理位置不同,该小组严重依赖数字技术来开展活动。由经验丰富的同行领导,该小组营造了一个协作学习环境,成员可以利用彼此的专业知识。18个月内,我们在高影响力同行评审的全球健康期刊上发表了两篇研究论文,开展了一项混合方法研究,并举办了研究设计和实施培训课程。在会议和研讨会上介绍了我们工作的结果。然而,后勤障碍,相互竞争的优先事项,结构限制,不均衡的参与带来了挑战。
    结论:到目前为止,同行指导合作已经取得了一些成功,这个模型可以被LMIC的其他医疗专业人员群体模仿。尽管该小组在微观或个人层面取得了成功,在中等收入国家的研究能力建设方面仍然存在重大的结构性障碍,只能由机构和政府在中观和宏观层面加以解决,分别。需要一种系统级方法来发展和支持研究能力建设,促进全球研究合作,并有效地将人才流失转化为人才增长。
    BACKGROUND: Peer mentorship can be a potential tool to reduce the disparities in health research capacity between high- and low- and middle-income countries. This case study describes the potential of peer mentorship to tackle two critical issues: bridging health research capacity of doctors from low- and middle-income countries (LMICs) and the transformation of human resource for health brain drain into \"brain gain\".
    METHODS: In 2021, a virtual peer mentorship group was established by 16 alumni of the University of Benin College of Medical Sciences\' 2008 graduating class, residing across three continents. This program aimed to facilitate research collaboration and skill development among colleagues with diverse research experience levels, fostering a supportive environment for career development in research. The group relied heavily on digital technology to carry out its activities due to the different geographical locations of the group members. Led by experienced peer leaders, the group fostered a collaborative learning environment where members leveraged each other\'s expertise. Within 18 months, we published two research papers in high-impact peer-reviewed global health journals, launched a mixed-methods research study, and conducted training sessions on research design and implementation. Findings from our work were presented at conferences and workshops. However, logistical hurdles, competing priorities, structural constraints, and uneven participation presented challenges.
    CONCLUSIONS: The peer mentorship collaboration has achieved some successes so far, and this model can be emulated by other cohorts of medical professionals across LMICs. Despite the group\'s success at a micro- or individual level, there remain significant structural barriers to research capacity building in LMICs that can only be addressed at the meso- and macro-levels by institutions and government, respectively. A systems-level approach is required to develop and support research capacity building and foster global research collaboration and effectively turn brain drain into brain gain.
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