Inclusive Mentorship: an Important Tool to Promote Equity and Belonging

5-6 Minutes

Author: Gretchen Keys, EdD, MS

Purpose

Provide clinical educators with guidelines for effective and inclusive mentoring in the clinic.

Learning Objective

1. Describe the importance of inclusive mentoring in medical education;

2. Identify barriers to inclusive mentoring; and

3. Illustrate ways to promote and provide inclusive mentorship in the clinic.

Embarking on the journey of medical school is inherently challenging, and the experience becomes even more formidable for students who feel isolated or marginalized. All medical schools are required to have effective policies to achieve diversity outcomes and robust academic advising for medical students.(1) Inclusive mentoring is a valuable tool for supporting diversity outcomes and incorporating clinical faculty into comprehensive academic advising systems. This article delves into the vital role of mentorship in promoting these essential values within medical education, spanning both classroom and clinical settings.

The Importance of Equity and Inclusion in Medical Education

Equity, inclusion, and a sense of belonging in medical schools are imperative for several reasons. Future physicians must be prepared to serve diverse patient populations effectively, necessitating an understanding of various cultures, backgrounds, and perspectives. Inclusive medical education is also instrumental in addressing health disparities by producing culturally humble healthcare professionals sensitive to the needs of underrepresented communities. When mentors affirm the cultural identity of their students (and vice versa), it is easier to affirm one’s patients. Lastly, students who feel a sense of belonging and inclusion are more likely to maintain better mental health, a crucial factor for academic success.

The Role of Mentorship

Mentorship programs within medical schools are increasingly recognized as powerful tools for fostering equity, inclusion, and a sense of belonging among students.(2) Inclusive mentoring involves providing guidance that recognizes and affirms a student's social identity as an important influence on learning processes and working to create an environment in which students can learn from the course, their peers, and the mentor while still being their authentic selves.(3) Mentors play a pivotal role in guiding and supporting mentees through the challenges of medical school. For underrepresented students, this support is particularly crucial. Mentors from diverse backgrounds can serve as inspirational role models, providing encouragement to students who may otherwise feel isolated. Through mentorship, students gain access to valuable networks and resources that may otherwise be inaccessible, as demonstrated in studies involving African American and Latino medical students.(4)

Barriers to Inclusive Mentorship in Medicine

Despite the recognized importance of inclusive mentorship, barriers persist including biased views of success, invalidation, inappropriate motivation, and the hero complex. Biased views often lead mentors to overlook potential mentees who do not fit preconceived standards. Invalidation of a mentee’s experience, a phenomenon particularly encountered by women and minorities, comes in the form of statements such as “that’s just the way they are” or “perhaps you are too sensitive.” Statements invalidating a mentee’s experiences negatively impact mentee confidence. Inappropriate motivation, driven by selfish reasons, and the hero complex, imposing undue stress on students, further hinders inclusive mentorship. When mentorship roles are pursued for academic advancement or to enhance one's professional and social media standing rather than a genuine investment in the individual, it can be detrimental to mentees. This lack of authentic interest and commitment can distort the mentor/mentee relationship when it becomes apparent and ultimately negatively impacts the profession.(5) While the mentor/mentee relationship can offer reciprocal benefits, authenticity may be compromised without genuine substance in the exchange. Finally, a mentor’s hero complex, which assumes minority or underrepresented students need to be saved or be bigger and better for their community, can negatively impact mentees by adding additional stress to excel.(5)

Keys to Inclusive Mentorship

To ensure diverse students experience inclusive mentorship, several steps should be taken by both potential as well as current mentors. While many of these guidelines apply to the potential/current mentor, they also apply to the institution in relation to providing resources for both mentors and mentees.

• Be Available: The first and most important step in mentoring is to be available for the process. When a student expresses the need for a mentor, don’t hesitate to accept the challenge. Also, keep in mind that some students may hesitate to seek help from a mentor to avoid the appearance of incompetence. So, don’t hesitate to take the initiative.

• Embrace Differences: In 1985, the Heckler Report unveiled the disparities in healthcare amid black and other minorities.(6) This knowledge brought about a call for increased diversity and inclusivity in medical education to address these disparities. It is imperative that we embrace our differences and become comfortable working with people from various backgrounds. Identify biases and remain open and curious about your mentee’s cultural heritage and personal and professional values.

• Develop Relationships: Mentor/mentee relationships are based on trust, respect, open communication, and a commitment to career advancement. Having a relationship with a mentee will make it easier to have difficult conversations, both personal and professional, should the need arise.(7) It is imperative that mentors and mentees communicate openly and often. It is uncommon for two relative strangers to discuss sensitive topics early in a relationship, so it may be helpful to begin with safe conversations such as professional goals, professional associations to join, and basic institutional structure.(8) Make sure to actively engage the mentee in these conversations.

• Student Choice: Allow students to choose mentors who they believe will best meet their needs and preferences.(9)

• Employ Empowerment: Allow the mentee to take control of situations, encouraging them to trust their instincts and tap into their confidence, rather than emphasizing the role of the mentor as a hero. Keep in mind that we are all learners, and everyone has knowledge to contribute. Wise mentors will extinguish any fears of mentees, assuring them that mentoring provides a beneficial learning experience for both partners. (8)

• Regular Feedback: It is vital to work with the mentee to set realistic goals that are important and reflective of their needs and wants. Establish mechanisms for mentees to provide feedback on their mentorship experiences, allowing for continuous improvement. Regularly assess the effectiveness of mentorship programs in promoting equity and inclusion, and make necessary adjustments.

"Mentoring is not about making people like you, but about helping them become the best version of themselves." - David Stoddard■

References

(1) Liaison Committee on Medical Education. Standards 3 & 11 in Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the MD Degree. Liaison Committee on Medical Education; November 2023.

(2) Afghani B, Santos R, Angulo M, Muratori W. A novel enrichment program using cascading mentorship to increase diversity in the health care professions. Acad Med. 2013;88(9):1232-1238.

(3) Addy, TM, Dube D, Mitchell KA, SoRelle M. What Inclusive Instructors Do: Priciples and Practices for Excellence in College Teaching. Routledge; 2021.

(4) Ulloa JG, Viramontes O, Ryan G, Wells K, Maggard-Gibbons M, Moreno G. Perceptual and structural facilitators and barriers to becoming a surgeon: a qualitative study of African American and Latino surgeons. Acad Med. 2018;93(9):1326-1334. doi:10.1097/ACM.0000000000002282

(5) Thompson K, Taylor E. Inclusive Mentorship and Sponsorship. Hand Clin. 2023;39(1):43-52. doi:10.1016/j.hcl.2022.08.012

(6) Heckler MM. Report of the Secretary’s Task Force on Black and Minority Health. US Department of Health and Human Services; August 1985.

(7) Quiroga E, Gonzalez A, Newhall K, Shalhub S. Understanding and finding opportunities for inclusive mentorship and sponsorships in vascular surgery. J Vasc Surg. 2021;74(2S):56S-63S. doi:10.1016/j.jvs.2021.03.048

(8) Bland C, Taylor A, Shollenberger S. Mentoring systems: benefits and challenges of diverse mentoring partnerships. Association of American Medical Colleges, Group on Faculty Affairs; 2010.

(9) Miller B, Lauffer A, Risher M, Semeret M, Waloford M. Mentorship journeys: navigating challenges and embracing growth. Presented at Marshall University Roadmap to Mentoring Virtual Symposium; October 2023.