1. ASSOCIATION OF AMERICAN MEDICAL COLLEGES Maximizing our Impact as Mentors: Contemporary Approaches 6/27/07 Janet Bickel Career Development and Executive Coach Faculty Career & Diversity Consultant

2. Support/Challenge/Vision VISION high CHALLENGECHALLENGE low SUPPORThigh Anxiety Growth Stasis Confirmation Source: Bower, D., et al., Support-Challenge-Vision: A Model for Faculty Mentoring, Medical Teaching, 20:595-7, 1998.

3. Listening Reflecting Paraphrasing Summarizing Asking Questions that Raise Awareness Making Suggestions Giving Feedback Offering Guidance Giving Advice Instructing Spectrum of Advising/Coaching Methods DIRECTIVE NON-DIRECTIVE PUSH: Solving someone’s problem for them PULL: Helping someone to solve their problems

4. Mentoring –bringing ourselves fully into the moment. –giving full attention to other person –letting the other know that he or she is heard and respected –listening with curiosity ONE MOUTH TWO EARS

5. Skillful Inquiry involves….. a genuine wish to understand someone else’s thinking. inviting elaboration and clarification, asking non- leading questions that invite the other person to reflect and piece together the elements of their own thinking, eg “Tell me more about that,” “How did you come to hold this value?” temporarily putting aside our own ideas, letting the other person talk without interruption silencing the inner voice in us that is formulating a response

6. 9 Habits of Highly Effective Mentors Identify “Coachable Moments” and select best coaching method Create enough safety for learning Together set goals for the relationship Listen actively, avoiding assumptions Ask reflective Questions, eg “how do you think you did?” Give specific, constructive, timely feedback Support transition to independence Respect confidentiality Continuously develop mentoring skills

7. Gender and Ethnicity: When Heterogeneity meets Homogeneity

8. ASSOCIATION OF AMERICAN MEDICAL COLLEGES Disadvantages Minorities Sometimes Experience in Obtaining Mentoring relationships occur most naturally between “like” individuals different cultural norms can be confusing face higher hurdles to prove selves to potential mentors the accents of some ethnic minorities interfere with communication

9. Women’s Disadvantages in Obtaining Mentoring less likely to view mentor as a role model allowed a narrower band of “assertive behaviors” leadership potential underestimated work an invisible “2nd shift” at home miss out on hallway conversations and “golf” paucity of senior woman role models may be “dropped” if mentor threatened by her increasing expertise

10. Nine Circles of Mentee Hell underestimate of potential failure to respect protégé’s goals failure to promote independence taking credit for protégé’s work conflicts avoided inappropriate praise or criticism expecting protégé To defer ethical violations physical intimacy (or appearance of)

11. 4 Generations in workplace Veterans1922-1943 –55 million Baby Boomers1944-1960 –78 million Gen X 1961-1981 –47 million Millenials/Gen Y1982-2000 –75 million

12. Baby Boomers Unprecedented economic expansion in childhood THE Generation [define perfection as “like us”] Traditional family/upbringing Driven, go the extra mile Uncomfortable with conflict Overly sensitive to feedback Define professionalism in terms of hours and “complete dedication to the job”

13. ASSOCIATION OF AMERICAN MEDICAL COLLEGES Boomers Work hard out of loyalty Expect long-term job Pay dues Self-sacrifice is virtue Respect authority Generation X Find most efficient way Expect many job searches Entitled to flexibility Not gonna be “24/7” “You’re not the boss of me” Source: J. Bickel and A. Brown. “Generation X: Implications for Faculty Recruitment and Development in Academic Health Centers.” Acad Med. 2005; 80:205-10.

14. ASSOCIATION OF AMERICAN MEDICAL COLLEGES Generation X Weak USA/economic downturns Absent parents Reject rules Multitask Mistrust organizations Pragmatic Cynical Millenials 9/11 Protective parents/Pressured Rewrite rules Multitask faster Organizations relevant? Seek personalized career/inventive Optimistic

15. ASSOCIATION OF AMERICAN MEDICAL COLLEGES Millennials/Gen Y [why?] Digital natives, expect innovations More service-oriented and respectful Prefer structured, highly interactive, supportive educational methods Expect frequent candid feedback MESSAGES Challenge me Respect me Be flexible Team up with me

16. Senior Faculty say: “I don’t think kids these days want to work as hard.” “They act like they’re entitled to privileges I had to earn.” “They just don’t make ‘em like they used to.” “There is a tremendous gap between what the younger generation wants and what the older generation expects.” “Junior faculty seem to want a lot of handholding.”

17. Gen X and Y say: “I just don’t buy the values of many senior faculty ‘success stories’.” “When I’ve made different choices than my mentors would, they treat me as if I were failing them.” “I thought my chair was looking out for me. Turned out I was just gullible.” “My mentor wants me to remain ‘monogamous’—but I’m ready to date!” “Every time someone said they would mentor me, they simply gave me more work. But no one’s helping me seeing how my work fits into the larger picture.” “How do I get help in creating a plan for my future, including milestones and choice-points?”

19. I take Actions I adopt Beliefs I draw Conclusions I make Assumptions I add Meanings (Cultural and Personal) I select “Data” from what I observe (The reflexive loop: Our beliefs affect what data we select) Ladder of Inference

20. Mentoring Across Differences Use an exploratory survey Discuss important influences and acknowledge differences, eg “this approach worked for me but it may not for you” Break the ice: Recognize effects of differences in power, gender Set goals for the relationship Ask for feedback

21. Exploratory Survey for Advisees Looking at last year: What are you proudest of? And what would have done differently? What do you want to accomplish in the next 1-2 yrs? 5-10 yrs? What measures of success will you use? What relationships outside our discipline and institution do you want to build? What if anything is holding you back from reaching your potential? What areas of personal and professional growth do you most want to work on now?

22. Mentoring Gen X and Y Examples of productive questions: What qualities does excellent clinical judgment encompass? How will you develop the necessary expertise? What are your goals and timelines? What is your plan for assuring that..? How will you evaluate your progress? Let’s agree about the desired outcome, then discuss methods.

23. Contemporary Mentoring is: *a continuum: not “all or nothing” *differs by context and role—task-centered guidance and support. *collective approach in service of life-long co- learning *a scaffold for sharing expertise that could otherwise only be attained from experience See: Pololi, L.H., Knight S. Mentoring faculty in academic medicine. JGIM. 2005; 20:866-70

24. Activities To Support Mentoring Offer resources and tools, eg programs, guides Work with new faculty in selecting one (or a small “team”) Address in faculty orientation Create Peer and Group mentoring opportunities Establish Mentoring Awards Add mentoring to promotion criteria; return dossiers when inadequate Evaluate mentoring skills Acting as if Mentoring Were a Core Mission, eg CREAM

25. Approach to Mentoring at Johns Hopkins Three-headed Approach to Mentoring at Johns Hopkins Team of 1 faculty and 2 GIM fellows mentored 1 intern and 1 resident on research projects over 18 months Fellows gained experience in mentoring, picking up tips from the seasoned faculty member All 3 able to observe “mentoring-in-action” Multiple mentor approach modeled teamwork and communication skills [Source: The three-headed mentor: rethinking the classical construct by Rachel Levine, et al, Med. Educ. 2003; 37:473-89]

26. Mentoring Agreements Accountability encourages: deliberate planning structure and follow-through honest assessment of actions and attitudes evaluation

27. Mentoring is critical… To attract, retain and engage high performers To maximize “return on investment” in faculty To nurture the academic aspirations of residents and junior faculty To swiftly acculturate new members To foster a collaborative environment To increase stability and productivity To promote diversity To develop leadership talent Being a mentor is the most effective way of extending one’s professional contributions Everyone can become a better mentor.

28. If Mentoring were a Core Mission, what would we do differently?