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      The importance of mentoring during educational supervision

      editorial
      Perspectives on Medical Education
      Bohn Stafleu van Loghum

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          Abstract

          Educational supervision is regular supervision taking place in the context of a recognized training programme in order to determine learning needs and review progress. Patel’s article [1] effectively evaluates postgraduate educational supervision in one UK trust. This was a mixed methods study in which educational supervisors and trainees working within a large UK trust were surveyed online about their experiences of educational supervision. In addition, observations of supervision sessions with a small group of supervisor and trainee pairs followed up by semi-structured interviews were conducted. The findings suggested methods to improve educational supervision and a framework was developed [1]. The framework illustrates the need to improve student support during educational supervision [1]. This commentary explores the importance of mentoring during educational supervision. A mentorship is a fortuitous relationship that fosters the development of the adult learner [2]. Educational supervision offers the unique opportunity to be an effective mentor to the student. The mentoring can be informal or more formal within the scheduled supervision meetings. Mentoring should be recognized as an important teaching activity [3]. During the initial educational supervision meetings, it is important to establish an effective relationship with the leaner and provide feedback on their current progress before offering specific guidance. Effective feedback is non-judgmental, timely and accompanied by reflection to help the learner improve [4]. The educational supervisor can then provide specific guidance to enhance academic, professional and personal development. Firstly, with regard to academic development, the educational supervisor can discuss learning styles, progress with training and time management. It is valuable to discuss the learner’s personal development plan to check that this is specific, relevant and realistic. The personal development plan should include any relevant courses to attend and preparation for postgraduate exams. Educational supervision also offers the opportunity for reflection on career plans as students may be considering specific speciality choices. Career choices in medicine can be challenging for the trainee and supervisors can offer expertise regarding the different specialities, preparing the curriculum vitae, application processes and requirements. Secondly, with regard to professional development, it is important that the supervisor ensures the learner demonstrates high standards of medical professionalism. There are numerous definitions of medical professionalism provided by major medical organizations. In the UK, the Royal College of Physicians of London’s Working Party on Medical Professionalism has defined medical professionalism succinctly as ‘a set of values, behaviours and relationships that underpin the trust the public has in doctors’ with doctors being committed to integrity, compassion, altruism, continuous improvement, excellence and teamwork’ [5]. The educational supervisor has the unique opportunity to read the workplace-based assessments of the trainee and can review the multisource feedback report and patient satisfaction reports, both of which offer information regarding the professional attributes of the trainee. Thirdly, with regard to a trainee’s personal development, the educational supervisor can offer pastoral support. This is particularly important for students who may be experiencing some difficulties during their training and in these circumstances the supervisor should demonstrate compassion, empathy and a non-judgemental, confidential approach. In addition, a new emerging theme in medical education is the importance of developing resilience [6]. Resilience has been described as an emotional competence and can be considered as behaviour to be acquired during training [7]. Educational supervisors can offer suggestions to develop resilience, avoid burnout and maintain a healthy work-life balance during training. In summary, the educational supervision offers an important opportunity for effective mentoring. Educational supervisors should ensure high standards of mentoring and student support throughout the curriculum. The trainees should make best use of this support to ask questions, to discuss any concerns, to seek professional and career advice. Observe, record, tabulate, and communicate. Use your five senses. Learn to see, learn to hear, learn to feel, learn to smell and know that by practice alone you can become an expert. (William Osler 1849–1919).

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          Towards an understanding of resilience and its relevance to medical training.

          This article explores the concept of resilience and its potential relevance to medicine. It also looks at the dimensions of resilience and its ethical importance for effective professional practice, and considers whether a focus on resilience might be useful in medical training. An applied literature search was conducted across the domains of education, ethics, psychology and sociology to answer the research question: 'What is resilience and what might it mean for professional development in medical education?' This article predominantly considers the findings in relation to training in undergraduate and postgraduate settings, although the literature is wide-ranging and findings may be applicable elsewhere.   Resilience is a dynamic capability which can allow people to thrive on challenges given appropriate social and personal contexts. The dimensions of resilience (which include self-efficacy, self-control, ability to engage support and help, learning from difficulties, and persistence despite blocks to progress) are all recognised as qualities that are important in clinical leaders. Much of what is deemed good practice in modern pedagogical approaches to medical training may support the development of resilience in adulthood, but this concept has rarely been used as a goal of professional development. More research is needed on the ways in which resilience can be recognised, developed and supported during and after clinical training.   Resilience is a useful and interesting construct which should be further explored in medical education practice and research. © Blackwell Publishing Ltd 2012.
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            Teaching and learning resilience: a new agenda in medical education.

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              Doctors in society. Medical professionalism in a changing world.

              (2006)
              Medicine bridges the gap between science and society. Indeed, the application of scientific knowledge to human health is a crucial aspect of clinical practice. Doctors are one important agent through which that scientific understanding is expressed. But medicine is more than the sum of our knowledge about disease. Medicine concerns the experiences, feelings, and interpretations of human beings in often extraordinary moments of fear, anxiety, and doubt. In this extremely vulnerable position, it is medical professionalism that underpins the trust the public has in doctors. This Working Party was established to define the nature and role of medical professionalism in modern society. Britain's health system is undergoing enormous change. The entry of multiple health providers, the wish for more equal engagement between patients and professionals, and the ever-greater contribution of science to advances in clinical practice all demand a clear statement of medicine's unifying purpose and doctors' common values. What is medical professionalism and does it matter to patients? Although evidence is lacking that more robust professionalism will inevitably lead to better health outcomes, patients certainly understand the meaning of poor professionalism and associate it with poor medical care. The public is well aware that an absence of professionalism is harmful to their interests. The Working Party's view, based on the evidence it has received, is that medical professionalism lies at the heart of being a good doctor. The values that doctors embrace set a standard for what patients expect from their medical practitioners. The practice of medicine is distinguished by the need for judgement in the face of uncertainty. Doctors take responsibility for these judgements and their consequences. A doctor's up-to-date knowledge and skill provide the explicit scientific and often tacit experiential basis for such judgements. But because so much of medicine's unpredictability calls for wisdom as well as technical ability, doctors are vulnerable to the charge that their decisions are neither transparent nor accountable. In an age where deference is dead and league tables are the norm, doctors must be clearer about what they do, and how and why they do it. We define medical professionalism as a set of values, behaviours, and relationships that underpin the trust the public has in doctors. We go on to describe what those values, behaviours, and relationships are, how they are changing, and why they matter. This is the core of our work. We have also identified six themes where our definition has further implications: leadership, teams, education, appraisal, careers, and research. The Working Party's definition and description of medical professionalism, and the recommendations arising from them, can be found in Section 5 of this report. If our recommendations are acted upon, we believe that professionalism could flourish and prosper to the benefit of patients and doctors alike. However, the exercise of medical professionalism is hampered by the political and cultural environment of health, which many doctors consider disabling. The conditions of medical practice are critical determinants for the future of professionalism. We argue that doctors have a responsibility to act according to the values we set out in this report. Equally, other members of the healthcare team--notably managers--have a reciprocal duty to help create an organisational infrastructure to support doctors in the exercise of their professional responsibilities. Just as the patient-doctor partnership is a pivotal therapeutic relationship in medicine, so the interaction between doctor and manager is central to the delivery of professional care. High-quality care depends on both effective health teams and efficient health organisations. Professionalism therefore implies multiple commitments--to the patient, to fellow professionals, and to the institution or system within which healthcare is provided, to the extent that the system supports patients collectively. A doctor's corporate responsibility, shared as it is with managers and others, is a frequently neglected aspect of modern practice. The audience for this report is, first and foremost, doctors. But we believe it should be of equal interest to patients, policy-makers, members of other health professions, and the media. All these groups have a vital part to play in discussing and advancing medical professionalism. This report is only the beginning of an effort by the Royal College of Physicians, together with others, to initiate a public dialogue about the role of the doctor in creating a healthier and fairer society. Medical professionalism has roots in almost every aspect of modern healthcare. This Working Party could not hope to solve all the issues and conflicts surrounding professionalism in practice today. But our collective and abiding wish is to put medical professionalism back onto the political map of health in the UK.
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                Author and article information

                Contributors
                vimmi.passi@nhs.net
                Journal
                Perspect Med Educ
                Perspect Med Educ
                Perspectives on Medical Education
                Bohn Stafleu van Loghum (Houten )
                2212-2761
                2212-277X
                4 August 2016
                4 August 2016
                August 2016
                : 5
                : 4
                : 195-196
                Affiliations
                Buckinghamshire, United Kingdom
                Article
                291
                10.1007/s40037-016-0291-3
                4978643
                27492322
                2da57a54-0921-48a0-9ad8-23ea0cb01d5f
                © The Author(s) 2016

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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