MENTORING OF EMERGENCY RESIDENTS A DESIRED NECESSARY OR IMPOSITION

Dr. Raja Ghosh, Dr. Indraneel Dasgupta, Dr. Sambit Maiti and Dr. Sudip Chakroborty Institute of Emergency Medicine Peerless Hospital and B.K. Roy Research Centre kolkata. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 07 December 2019 Final Accepted: 10 January 2020 Published: February 2020

There is much published literature regarding the importance of mentoring in faculty development.Mentoring for medical students and residents has always been strongly encouraged. It makes sense that the presence of mentors at probably one of the most important transition points in a physician's career would be highly desirable. Although mentoring is a well-recognized topic in academic medicine, relatively little has been written about mentoring in emergency medicine. Although the reasons for this are numerous, I would argue that in the Emergency department mentors needed most where a resident skills and knowledge gets tested every minute and have to maintain a very less margins of errors at emergency. Perhaps as residents enter practice we need to be more explicit that there will be Yorkshire accident and emergency mentoring scheme Mentoring was introduced to the accident and emergency medicine trainees of this region in 1997. The regional coordinator sends out names of volunteer mentors (15 of them) to the prospective mentees who then choose a mentor that they are comfortable with and feel will respect their confidentiality. They remain together for the duration of the mentee's training. As capacity is always a problem, mentees are advised to nominate a second choice, as their first choice may not be accommodated. Mentors are encouraged to attend the regular semiformal trainee meetings giving them an opportunity to assess one another. A survey was carried out in May 1999 to assess the impact, if any, that the mentoring had on their training and determine if there was any enthusiasm for the mentoring scheme. All 28 specialist registrar trainees in emergency medicine were sent a questionnaire of nine questions (see appendix) either by post or in person. All were guaranteed anonymity. Twenty five replied (89%), of which 19 were male and six were female; four were from an ethnic minority. This good response was matched by very good completion of the questionnaires. All 25 respondents had mentors and were familiar with the concept of mentoring. Seventeen selected their mentors while eight were allocated mentors. Reasons were not given in the reply sheets. All of the respondents met at least two to three times a year with their mentors. Seventeen of these met more than four times a year with their mentors. When asked if they found appraisals and assessments intimidating, five said yes and 18 said no. Four of the five who replied yes were from an ethnic minority and one was a white female. The most common reason advanced was, -Assessments were confrontational like examinations and too formal‖. When asked if mentoring helped their preparation for appraisals and assessment, 18 said yes, five said no.
Two did not answer as they were in year 1 and had not yet had an assessment. Those who replied no to the question were in years 4 and 5. They felt that the mentoring scheme had no impact on their training. Ethnic minority and female trainees were most enthusiastic and felt that mentoring was very helpful in preparing them for appraisals and assessments. These findings mirror the reported conclusions of the investigations into the outcomes of the doctors development and mentoring network in the Northern and Yorkshire region of the NHS, carried out by Dr Mary Connor. It showed that mentoring could be of particular value to marginalised groups such as ethnic minorities and women in medicine.  found that a mentor is a person who takes a special interest in the professional development of a junior colleague and provides guidance and support. Mentoring can be beneficial for students, residents, junior colleagues and researchers and can be very rewarding for the physician who provides this guidance. Although mentoring is a well-recognized topic in academic medicine, relatively little has been written about mentoring in emergency medicine (EM). Consequently, we conducted a literature review on mentoring in EM and present our findings in this paper. We discuss different models of mentoring, factors that foster the development of strong mentorship programs,the responsibilities of mentors and mentees, and issues specificto mentorship of female, minority and research physicians. We also present several case scenarios as a basis for recommendations for teachers and learners in EM. Welch JL et al (2016) found that Mentoring in academia is considered a fundamental element of career choice, satisfaction, and productivity. While there is an expectation that trainees and junior faculty will have a mentor, there is no standard practice for training or establishing mentoring relationships. This mentoring workshop is designed to help leaders in academic medicine train mentees. This workshop is built around the fundamental belief that training the mentee to be proactive, take ownership, and drive the relationship will not only jump-start the mentoring process but also cultivate a more sustainable mentoring relationship. The materials for this workshop include instructor and participant resources to facilitate self-reflection and group discussion. Tools include a mentee needs self-assessment and a mentoring network map. Implementation of the workshop was successfully carried out in a residency program with 21 interns in their first year of training. Participants believed the workshop was appropriate for their needs and provided useful knowledge and tools to enhance their mentoring relationships. This workshop is the first session in a mentoring training series designed to provide ongoing mentoring training, resources, and tools to encourage both the mentor and the mentee to cultivate a productive relationship.  found that Mentoring is an important aspect of career development for medical students, residents, and junior faculty. It is vital to the professional growth and maturation of individuals early in each phase of their careers. Additionally, mentoring has a critical role throughout all career stages, because the mentor-mentee relationship provides mutual benefit to both participants. This article will describe the role of the mentor; suggest ways to increase the likelihood of successful.
Welch J et al (2017) Mentoring is considered a fundamental component of career success and satisfaction in academic medicine. However, there is no national standard for faculty mentoring in academic emergency medicine (EM) and a paucity of literature on the subject. The objective was to conduct a descriptive study of faculty mentoring programs and practices in academic departments of EM. An electronic survey instrument was sent to 135 department chairs of EM in the United States. The survey queried faculty demographics, mentoring practices, structure, training, expectations, and outcome measures. Chi-square and Wilcoxon rank-sum tests were used to compare metrics of mentoring effectiveness (i.e., number of publications and National Institutes of Health [NIH] funding) across mentoring variables of interest. Thirty-nine of 135 departments completed the survey, with a heterogeneous mix of faculty classifications. While only 43.6% of departments had formal mentoring programs, many augmented faculty mentoring with project or skills-based mentoring (66.7%), peer mentoring (53.8%), and mentoring committees (18%). Although the majority of departments expected faculty to participate in mentoring relationships, only half offered some form of mentoring training. The mean number of faculty publications per department per year was 52.8, and 11 departments fell within the top 35 NIH-funded EM departments. There was an association between higher levels of perceived mentoring success and both higher NIH funding (p = 0.022) and higher departmental publications rates (p = 0.022). In addition, higher NIH funding was associated with mentoring relationships that were assigned (80%), self-identified (20%), or mixed (22%; p = 0.026). Our findings help to characterize the variability of faculty mentoring in EM, identify opportunities for improvement, and underscore the need to learn from other successful mentoring programs. This study can serve as a basis to share mentoring practices and stimulate conversation around strategies to improve faculty mentoring in EM.
Rekha KN et al (2019) the primary objective of the present study is to understand mentoring relationships in Indian organizations from the mentors' perspective. In particular, the study examines whether the learning goal orientation of a mentor can significantly influence the mentoring process and outcomes for the mentor in a mentoring relationship. Two hundred and thirty-six participants were selected using purposive sampling. Data were gathered using standardized questionnaires. Mediating effects were investigated using the PROCESS model by Hayes, Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression Based Approach. The results indicate high levels of support for several hypotheses examining the direct effects of learning goal orientation on willingness to engage by the mentor, mentoring functions provided and mentor outcomes (personal learning and self enhancement). The overall findings of the study suggest that mentors are not only ‗providers' but also ‗receivers of learning'. Limitations and directions for future research are also discussed in the paper.

Materials & Method:-
A descriptive and observational, multicentric, hospital-based, questionnaire based study was conducted. The focus of the study is to determineis mentoring of emergency residents necessary or imposition through a multiple choice questionnaire. This information was obtained through a descriptive correlation analytical survey design. Essentially, descriptive and correlation are classed as non-experimental research and in a survey; its purpose of is to observe, describe and document aspects of a situation.

Sample Size Justification:
The incidence of emergency medicine residents is high, widely varies ranging between 25% and 77.8%. 66 So for this study p=0. 25 Thus the number of emergency medicine residents required for this study was 200.00~ 200 with power 90% of 95% Confidence Interval. The formula used for sample size calculation was as follows:n = 4pq / (L 2 ) Where n= required sample size p= 0.25 (as per the study) q = 1 -p L = Loss % (Loss of information)

Inclusion Criteria
All residents of emergency medicine evaluating the effect of mentoring on career choices and academic advancement.

Exclusion Criteria
Residents of all other disciplines.

Method of data Collection:-
Information through questionnaire survey is the most common method of data collection in medical research. One study describes the questionnaire as the quickest and cost effective approach when collecting large amounts of information from a large number of people scattered over a wide geographical area. A questionnaire allows a degree of objectivity to the data collected as it is unobtrusive and offers the possibility of complete anonymity of the participant. . This study is confined among the resident doctors of emergency medicine working at India govt and non govt sectors. The questionnaire included the questions regarding their opinion of mentoring, they are part of any mentoring programme and how mentoring is beneficial for their academic carrier etc. The questionnaire will be Emailed to the emergency residents all over India by using -SURVEY MONKEY‖ software .The responses was noted, coded and entered in an excel sheet and analyzed accordingly. The result which was obtained was expressed in terms of percentages and proportions.

Questionnaire Format (Appendix I)
For the purpose of this proposal, a closed question format to collect data will be used. Closed questions yield data that allow for comparison between respondents as all the responses are in the same format, this additionally allows for the collection of valid and reliable data. They can be answered quickly and therefore improve response rates and can be pre-coded, thereby making analysis easier. To determine knowledge level a multiple-choice format was used. One study suggest that this format is appropriate in cases where there is more or less fixed number of alternatives.

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Multiple-choice offers the participant a list of responses, from which they select the one most appropriate. The questionnaire that was used in this study is a already validated questionnaire that has been used by a study in their study done in Australia.

Anticipated Benefits
This study is being conducted to help us in the following: 1. What is the view of the residents towards the mentoring programme 2. Is there any mentoring programme available for emergency residents. 3. What is the potential benefits of mentoring programme . 4. What more we can do to improve mentoring programme or start a mentoring if it is not available.

Statistical Analysis:
For statistical analysis data were entered into a Microsoft excel spreadsheet and then analyzed by SPSS (version 27.0; SPSS Inc., Chicago, IL, USA) and GraphPad Prism version 5. Data had been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables Z-test (Standard Normal Deviate) was used to test the significant difference of proportions. p-value ≤ 0.05 was considered for statistically significant.  We found that 4(2.0%) emergency residents were understood by counselor, 140(70.0%) emergency residents were understood by guide, 39(19.5%) emergency residents were understood by motivator and 17(8.5%) emergency residents were understood by supervisor.

Result And Analysis:-
Our study showed that 56(28.0%) emergency residents had prior experience of mentoring before joining the current program and 148(74.0%) emergency residents were familiar with the concept of mentoring. In our hospital 144(72.0%) emergency residents had designated mentor and only 56(28.0%) emergency residents had chosen their mentor.
Our study showed that 126(63.0%) emergency residents had mentoring scheme that helped them with the difficulties. 98(49.0%) emergency residents had mentoring scheme that met them with expectations and 49(24.5%) emergency residents had limited role of mentors to consultants only. We found that 97(48.5%) emergency residents had the time and commitment problems.
It was found that 120(60.0%) emergency residents had mentoring system as it exists now was beneficial. 110(55.8%) emergency resident's monitoring had helped them in formulating career goals. Present study showed that 76(38.0%) emergency residents had discussed their personal problems and 163(81.5%) emergency residents had think compulsory part of their emergency medicine residency.

Mean±SD
Worked after passing MBBS in Years