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1 Date of Submission: 9 June 2020 1 Senior Editor Shahzma Merani Mabel Leow Proofreader Annora Kumar Pabasha Nanayakkara Senior Proofreader Emily Feng-Gu Date of submission: 9 June 2020 Date of acceptance: 29 December 2020 Date of online publication: 30 December 2020 2 Title Page Original research Exploring the reasons for medical student participation in peer mentoring programs First author: Warren Policha Doctor of Medicine Currently in year 4 of 4 University of Wollongong Student Warren Policha has a background in physiotherapy and has been working in health for over 10 years. After working in Extended Scope Physiotherapy roles for several years, Warren enrolled in the Doctor of Medicine course at the University of Wollongong, where he is currently in the process of completing his final year. His interests include Primary Care, Emergency Care, Orthopaedics, and clinical education. Second author: Dr Pippa Burns, PhD, MPH (Dist), BSc(Hons) University of Wollongong Graduate Medicine Lecturer, Research, and Critical Analysis Pippa Burns has a background in public health and has worked in health for over twenty years. Pippa has extensive experience in the planning and management of research projects, including experience evaluating programs conducted in real-world settings such as schools, hospitals, and the community. Pippa is currently involved in research across three main areas: health communication, medical education, and dementia. Third author: Dr Darryl McAndrew, PhD, MSc (OH&S) University of Wollongong Graduate Medicine Senior Lecturer Darryl McAndrew is a clinical anatomist and exercise physiologist. His research includes the neural control of eccentric muscle contractions, non-invasive identification of muscle fibre types, control of voluntary muscle activation and generation of muscle force, and how humans maintain balance and posture during normal everyday tasks. He also collaborates on research focusing on surgical techniques (anatomical approaches) and medical education. 3 ● Corresponding author details: Warren Policha, Graduate Medicine, University of Wollongong, [email protected]. ● Source of submission: Warren Policha ● 160-character summary of article: Reasons why students participate in an existing student lead peer-mentorship program were explored. Tailoring a mentoring program may improve participation rates. ● Keywords: mentoring, medicine, students, wellbeing ● Number of tables: 1 ● Number of figures: 7 ● Word count (excluding title page, abstract, references, figures): 3086 4 Abstract Background: Peer mentoring in medical programs can result in improved academic performance and personal wellbeing. This is important as medical students function within a competitive environment and have a relatively high risk of burnout, mental illness, and suicide in comparison to age-matched controls. Despite recognition of the benefits of mentorship, medical students often don’t participate in available mentoring programs. In order to optimise medical student uptake of peer mentoring programs it is important to explore the factors that influence participation. Materials and Methods: An online survey was distributed to current and former students of a graduate medicine program to explore the factors that influence medical students’ participation in student-led peer mentoring programs. Results: A total of 77 students completed the online survey. The majority of respondents had positive experiences with mentoring (82%, n=56). Older students, those in a relationship, and those with dependents were less likely to participate in peer mentoring programs. Respondents identified improved academic performance and overall wellbeing as positive factors associated with mentoring, which is consistent with previous research. The structure of the degree requires many students to relocate after 18 months, which influences participation in mentoring. The most common reason for peer mentoring relationships ending was due to the mentor moving away for university placements. Conclusion: Age, relationship status, previous experience with mentorship and structure of the medical degree were all shown to influence medical student participation in mentoring programs. Tailoring mentoring programs to the student cohort and course structure may improve participation rates and subsequently personal wellbeing and academic performance of students. These benefits may assist medical students to navigate the competitive and often stressful profession of medicine. Keywords: mentoring, medicine, students, wellbeing, medical education Three learning points: 1. Participation in peer mentoring is influenced by participant age, relationship status, previous experience with mentorship, and structure of medical degree. 2. Peer mentoring programs should be individually tailored to suit the cohort and course structure. 3. Formal evaluation of each peer mentoring program should be undertaken to identify strengths, weaknesses, and possible alterations that may improve participation as associated benefits for students. 5 Introduction Mentoring can be defined as a symbiotic, dynamic relationship whereby a more experienced individual provides a novice with knowledge, skills, and guidance to help them succeed [1]. Research has shown that mentoring can be a valuable tool in many different environments and can lead to a greater sense of wellbeing and satisfaction for the mentee and the mentor [2]. In the medical profession, having a mentor can lead to greater job satisfaction and be valuable in helping guide students in areas such as professionalism, ethics, curriculum navigation, and the art of medicine [3]. Benefits of being mentored extend to doctors-in-training, with mentored junior doctors experiencing higher rates of confidence, career progression, and improved exam performance [4]. The availability of mentoring programs is of particular importance for the profession of medicine. Medical school has a demanding workload and is a challenging environment that can leave students and doctors feeling pressured and overwhelmed [5]. High rates of stress, burnout, and mental health issues amongst medical students are well documented [6]. Rates of depression, anxiety, and attempted suicide are significantly higher in medical students than those within the general population [7]. Therefore, mentoring programs can decrease personal and academic burdens, as well as guide students through the challenging, competitive environment of medicine [3,4]. Current evidence supports the implementation of formal mentoring programs for students [8]. Many schools have successfully implemented student-to-student peer mentoring programs using a variety of strategies such as incoming students being assigned a more senior student mentor [9]. However, despite research demonstrating that there are benefits associated with mentoring and the availability of mentoring programs, only 50-60% of medical students participate in the available mentoring programs [10-12]. This low participation rate is somewhat surprising, as 80% of medical students identified mentoring as being important to them [10]. As mentoring has potential benefits for medical students both academically and personally, it is important to understand the reasons why students engage or fail to engage in peer mentoring programs. This knowledge will aid the development, implementation, and adaptation of successful mentoring programs. In turn, this may help improve the quality of peer mentoring, overall wellbeing, and academic outcomes of medical students, as well as decrease the stress and mental health issues that are prevalent within the competitive environment of medicine. Improved academic performance has been identified by students as a potential reason to participate in mentoring programs [8,13]. This is supported by studies that found that students’ academic performance improved when they were mentored [14,15]. However, academic benefit was not found in all research, suggesting that the academic benefit from mentoring may be influenced by student demographics, stage of their education, mentor characteristics, and the delivery and style of the mentoring program [10]. Another potential reason that medical students participate in mentoring programs is to make personal connections with professionals in the field. Furthermore, medical students identified desirable qualities in mentors as sincerity, honesty, understanding, and good active listening skills as well as viewing mentors as role models, friends, and a safe place to talk about moral and ethical issues [16,17]. Additionally, mentoring has been found to decrease stress in medical students which may help manage the high workload and demands of medical education [9,14,18]. 6 Nevertheless, despite research suggesting that mentoring can benefit medical students in multiple ways, the literature also demonstrates that there are difficulties in the recruitment and retention of mentee students to these programs [10-12]. The low participation rates for medical students in mentoring programs suggest that there are factors that can prevent some students from engaging with mentors. The literature suggests that mentors should ideally be selected by the mentees and not assigned, as selection by mentees based on knowledge, competence, and a willingness to teach and share provided better outcomes and increased participation rates [13,19,20]. Other potential barriers to engagement with mentoring programs include lack of time, lack of funding, inadequate training for mentors, students feeling that they don’t need a mentor,
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