The Official Journal of the College of , ; Ekiti State University Teaching Hospital, and the Medical and Dental Consultants Association of (MDCAN) EKSUTH Branch [email protected] e-ISSN: 2714-4305 p-ISSN: 2714-3635

Perception and Attitude of House Officers about Mentoring at Ekiti State University Teaching Hospital, Ado-Ekiti.

Babatola AO 1,4, Olatunya OS, 1,4 Ogundare EO 1,4 Ojo TO2, Ajite AB1,4, Fadare JO3,5, Olaotan TO4, Fatunla OA4 1 Department of Paediatrics, Ekiti State University, Ado-Ekiti, Nigeria. 2Department of Community Health, Obafemi Awolowo University, Ile-Ife, Nigeria.

3 Department of Pharmacology and Therapeutics, Ekiti State University, Ado-Ekiti, Nigeria.

4 Department of Paediatrics, Ekiti State University Teaching Hospital, Ado-Ekiti 5 Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti

Corresponding Author’s E-mail: [email protected]

Received: May 22, 2019 Accepted for publication: January 19, 2020 Published online: May 20, 2020 ______

Abstract Introduction: Mentoring is an established means of providing support for young inexperienced individuals such as house officers who are just starting their medical career and it is meant to assist them to cope with stress and maintain a satisfying work-life balance. The study assessed the attitude and perception of house officers about mentoring at Ekiti State University Teaching Hospital, Ado-Ekiti. Methods: This study was a descriptive cross-sectional survey. Self-administered questionnaires were used for data collection. The questionnaire consisted of sections on the general characteristics of respondents, their knowledge and attitude toward mentoring. Results: Out of the 29 house officers invited to participate in the study, 24 (83%) returned the completed questionnaire. The mean age of respondents was 26.6±2.81 years. Seventeen (70.8%) and 7(29.2%) were males and females respectively. Almost all (95.8%) of the respondents were aware of mentoring. However, only 9(37.5%) of them had mentors. The reasons given for not having mentors included not seeing a need for one, not having opportunity to have one and fear of choosing wrongly (24.0%, 20.8%, 4.2% respectively). All responded that having a mentor was beneficial and 23(95.8%) desired to have a mentor. Twenty (83.3%) stated that the management of their institution should have a role in developing mentoring programs. Time constraints on the part of mentor (91.7%), lack of confidentiality on the part of both mentor and mentee (45.6%), fear of being emotionally abused (20.8%) and being misled (37.5%) on the part of the mentee were identified challenges to a mentoring relationship. Majority (95.8%) believed that a mentee should be allowed to choose his/her mentor and only 9(37.5%) believed in formal matching of mentor to mentee. Sixty–one percent believed that mentor and mentee should hold formal monthly meetings. Possession of good interpersonal skills on the part of the mentors (91.7%) and formal training on mentorship for mentee (66.7%) were some identified factors that could enhance successful mentoring relationship Conclusions This study observed that house officers are desirous of a mentoring relationship with their senior colleagues. There is a need for the hospital management to institute a formal mentoring program for this young cadre of workers.

Keywords: House officers, Perceptions, Mentoring, Mentee, Mentor

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between mentor and mentee, misunderstanding regarding roles, boundaries and goals, communication gaps, lack of 1.Introduction. time, and personality clashes,11. House officers (interns) are newly qualified medical doctors Formal mentoring programs have been introduced in practicing under supervision in hospitals during the first year medicine with emphasis on under- graduate medical education after graduation. They undergo a structured training to enable especially in the western world12-16. Some medical specialties them to consolidate and extend theoretical and clinical also have formal mentoring program in place during residency knowledge and technical skills into practice under supervision training,10,17-19 However, there is paucity of works on during their internship. House officers are just starting their mentoring amongst house officers or interns. One of the few medical career and like many other professions, this may be studies on mentoring amongst intern was done in Korea by daunting and demanding. Mentoring has been established to Han et al 20 which reported 42% prevalence rate of mentoring provide support for young inexperienced individual (mentee) relationship amongst medical interns in a teaching hospital in in the mentoring relationship for personal development, to 2011. The study also found that medical interns who had cope with stress and to establish a satisfying work-life mentors had increased job satisfaction when compared with balance1,2. The benefits of mentoring are not negligible their counterparts who do not have mentors. Han and co- especially to young professionals who are just starting up. It is workers then concluded that mentoring programs during well recognized as a key to successful and satisfying careers internship should be expanded and supported20. in medicine, business and many other professions3. The advantages of mentoring also include development of Because of the obvious benefits of mentoring especially to negotiation skills, conflict management, academic writing and young inexperienced professionals, House officers being one presentation skills, team-working skills and networking4. of such, should be engaged in mentoring relationships. This Lack of mentorship was reported to be one of the challenges study therefore seeks to assess the perception and attitude of facing young African scientists in their efforts towards house officers in Ekiti State University Teaching Hospital on contributing to the development of Africa continent through Mentoring. research and it has been documented that the most important form of support they needed was mentorship from senior 2. Method 5 researchers . Study design: A descriptive cross-sectional survey was Mentoring involves the process whereby an experienced, conducted using self-administered questionnaires. The study highly regarded, empathetic person (the mentor) guides was conducted between February and May 2018. another (usually younger) individual (the mentee) in the Study location: Ekiti State University Teaching Hospital development and re-examination of their own ideas, learning, (EKSUTH), Ado-Ekiti personal and professional development6. Mentoring is known to be a very old practice7 and everyone has been mentored one Sample size: All house officers at EKSUTH during the study way or the other8. The main focus of the mentoring period were recruited using total sampling relationship is on the development of the mentee. Mentoring can be loose (informal) or structured (formal)8. In informal Study Procedure and data collection: mentoring, there is no standardized structure, often individuals The study instrument was a self-administered questionnaire. are drawn together by mutual interests. Many times, the The first section comprised of age, sex, qualifications, monetary cost involved is not much, often bore by the mentor, designation, years of practice and department. The second mentee and minimally by the organization if at all. Most section comprised of general questions on mentoring and the mentoring relationships are informal. However, the third section comprised of questions that assessed participants drawbacks of informal mentoring include that it is more 8 knowledge on mentoring and mentoring program. difficult to monitor, standardize, advertise and evaluate . The formal mentoring relationship however is well established, there may be written guidelines for the relationship9 highly Data analysis: Data were analyzed with SPSS version 20 and structured with specific aims usually defined by the results presented as prose, tables and charts. Ethical organization. Its advantages include that it is easier to monitor consideration: Ethical approval was obtained from the Ethics and evaluate. The drawbacks include that it may cost more in and Research Committee of the Ekiti State University terms of resources and time, as well as its complex and Teaching Hospital. sustainability issues8,10. There are varying mentoring styles which depends on the individuals involved, setting in which 3. Result mentoring occurs and the stage of career of both individuals9. The response rate was 83% (24/29). The mean age of To ensure successful mentoring relationship, there is the need respondents was 26.6±2.81 years. Seventeen (70.8%) and for dedication, substantial investment of time, energy and 7(29.2%) were males and females respectively. Males to resources (physical, emotional and intellectual)9. Mentoring Female ratio of 2.4: 1 Ninety-two percent of them were single can also face some challenges which includes competition (Table 1).

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Table 1: Personal characteristics of the respondents 80 Numbers(n=24) Percentage (%) 60 Sex 17 70.8 Male 40 7 29.2 Female 20 Marital status: 22 91.7 Single 0 1 4.2 Sources of Information Married 1 4.2 Divorced Figure 1: Distribution of respondents’ sources of information Qualification 21 87.5 about mentoring MBBS 3 12.5 BDS Proposed specialty Table 2: Goals/benefits of mentoring and possible challenges Surgery 5 20.8 to mentoring program Internal 4 16.7 medicine Benefits *Number(n=24) Percentages Family 2 8.3 (%) medicine Having someone to turn 22 91.7 Obstetrics 2 8.3 to in case of difficulty &Gynaecology Support in one’s 18 75.0 Paediatrics 2 8.3 endeavour 2 8.3 Increase self confidence 17 70.8 Opthalmology To have a role model 15 62.5 Oral 3 12.5 &Maxillofacial surgery Increased chance of 11 45.8 Public 2 8.3 having job satisfaction health Possible challenges to Undecided 2 8.3 mentoring program Lack of time on the part 22 91.7 of the mentor Knowledge and perception about mentoring Personality 16 66.7 conflict/clashes Almost all (95.8%) respondents were aware of mentoring and Lack of time on the part 15 62.5 79% of the respondents stated that they learnt about mentoring of the mentee from the medical school (Figure 1). Only 9 (37.5%) of them Fear on the part of the 11 45.8 had mentors at the time of the interview and 11(45.8%) have mentee never had mentors. The reasons given for not having mentors Problem of 11 45.8 included not seeing the need for one (24.0%), not having confidentiality on the opportunity to have one (20.8%) and fear of choosing wrongly part of both mentee and (4.2%). All responded that having a mentor is beneficial and mentor 23(95.8%) desired to have a mentor. Twenty (83.3%) stated Perception that mentor 8 33.3 that the management of their institution should have a role in might have a role in developing mentoring programs. About 90% (22/24) of the evaluating job respondents said that having someone to turn to in case of performance difficulty is one of the benefits of mentoring. Lack of time on *multiple responses by respondents the part of mentor (91.7%), confidentiality on the part of both mentor and mentee (45.6%), fear of being emotionally abused Majority (95.8%) believed that a mentee should be allowed (20.8%) and being misled (37.5%) on the part of the mentee choose his/her mentor and only 9(37.5%) believed in formal were identified challenges to a mentoring relationship. Table matching of mentor to mentee. The most common factor that II shows the summary of the responses on the benefits of should be considered in matching mentor with mentee as mentoring and possible challenges to mentoring program. indicated by most respondents was the area of specialization (91.7%). Sixty-one percent of the respondents believed that

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The Nigerian Stethoscope Babatola et al mentor and mentee should hold formal monthly meetings. Twenty-two (91.7%) of the respondents stated that one of the Career planning 23 95.8 factors that could enhance successful mentoring /mentoring program is for mentors to possess good interpersonal skills. Skills of scientific 21 87.5 research Table 3: Factors to be considered in matching mentor to mentee and factors that can enhance successful mentoring Development of 23 95.8 Factors to be considered *Number(n=24) Percentage clinical skills in matching mentor to (%) mentee Networking 18 75.0 Area of specialization 22 91.7 Research interest 18 75.0 Development of 24 100 Personality of both 17 70.8 leadership skills mentor and mentee Balancing work 20 83.3 Marital status 10 41.7 and family life Gender 9 37.5 Economic/financial 4 16.7 Acquiring 16 66.7 considerations knowledge about Ethnicity 2 8.3 organizational system and Factors that can enhance culture successful mentoring

Mentors should possess 22 91.7 good interpersonal skills 4. Discussion The atmosphere should 19 79.2 It is well documented that mentoring is a veritable tool for be conducive for personal and professional development. Mentors assist mentee mentoring to gain emotional and intellectual growth to become Mentee should have 16 66.7 independent practicing physicians21 among some other seminars on importance benefits of mentoring. In the medical profession, the mentees and qualities of a mentee include House Officers, Resident Doctors, Medical Officers Mentors should have 15 62.5 and young consultants21. Many works have been done on formal training in mentoring relationship/program amongst medical students mentorship and resident doctors particularly in developed countries 3,12-16. *multiple responses by respondents However, there seems to be a gap, there is paucity of data on mentoring amongst House Officers. Our survey was amongst Most (95.8) of the respondents had good knowledge of the House officers at a Teaching hospital in southwestern, definition and attributes of mentoring. About 83% of them had Nigeria. good knowledge of the types of mentoring. However, only about 50% of them had good knowledge of the duties of a We had a high response rate of about 83% as 24 of the 29 mentor. All the respondents agreed that development of House Officers rotating through various units in the hospital leadership skills is a relevant area of focus in mentoring. during the period of study completed and returned our Table IV shows responses on the relevant areas of mentoring. questionnaires. There are no local works to compare our results with. This response rate is however similar to the report 22 of Tsai et al in Tennessee from their study amongst resident physicians in ophthalmology. Han et al20 also reported a similar response rate in their study amongst interns in South

Korea. The mean age of our respondents was 26.6± 2.81 years. This is similar to the finding of Han et al20 in South Korea.

In our study, about 95% of the respondents were aware of mentoring. This high level of awareness is not unexpected considering the respondents’ level of literacy. Our study Table 4: Areas of Mentoring revealed that only 9 (37.5%) of our respondents had mentors at the time of the interview. Han et al20 in South Korea reported similar observation. However, this is higher than Areas *Number(n=24) Percentage (%) 13.5% reported in a study amongst orthopaedic resident

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The Nigerian Stethoscope Babatola et al doctors in Nigeria23. We also observed that 11(45.8%) of the relationship as they indicated that mentoring provides an house officers have ever had mentors in their life. Akinmokun opportunity for a faster and more robust professional and et al23 reported that only 27% of the orthopaedic residents had personal development. It is recommended that the hospital participated in a mentoring programme since they began the management should institute a formal mentoring program to residency programme. In our study, the reasons for not having cater for the mentoring needs of these young medical mentors as identified by the respondents included not seeing a professionals. need for one (24.0%), not having opportunity to have one (20.8%) and fear of choosing wrongly (4.2%). Han et al20 Limitation reported that lack of a need for mentoring was among the The small sample size of the study which may it difficult to reasons given by the respondents for not having a mentor. translate the findings to a general populace Other reasons reported were lack of time for mentoring, difficulty in developing mentoring relationship with their Acknowledgements superiors, not being comfortable to expose themselves to others and lack of qualified mentors. The authors appreciate all the house officers who participated in the study. In our study, all (100%) responded that having a mentor was beneficial which is similar to the report of Ramanan et al17 References who documented that 93% of their respondents stated that 1. Levy BT, Katz JT, Wolf MA, Sillman JS, Handin RI, having a mentor was important. Twenty-three (95.8%) of our Dzau VJ. An initiative in mentoring to promote respondents desired to have a mentor. This finding is in residents' and faculty members' careers. Acad Med. consonance with the report of Akinmokun et al23 who reported 2004;79(9):845–50. that 90% of their respondents desired to be mentored. Twenty (83.3%) of our respondents stated that the management of 2. Sambunjak D, Straus SE, Marusic A. Mentoring in their institution should play its role in developing mentoring academic medicine: a systematic review. JAMA programs. This finding is in agreement with the report of 2006; 296(9):1103–15 Akinmokun et al23 amongst orthopaedic residents. 3. Frei E, Stamm M, Buddeberg-Fischer B: Mentoring In our study, lack of time on the part of mentor, programs for medical students - a review of the confidentiality on the part of both mentor and mentee, fear of PubMed literature 2000 - 2008. BMC Med Educ. being emotionally abused and being misled on the part of the 2010;10: 32. doi:10.1186/1472-6920-10-32. mentee were identified challenges to a mentoring relationship. 10 Quaas et al in their study amongst residents of obstetrics and 4. Pololi LH, Knight SM, Dennis K, Frankel RM. gynaecology in Massachusetts reported similar findings Helping medical school faculty realise their dreams: concerning lack of time on part of mentor and mentee as a an innovative collaborative mentoring program. perceived barrier to successful mentoring program. Acad Med 2002; 77: 377–384 Our study revealed that majority (95.8%) of our respondents 5. Kumwenda S, Niang HA, Orondo PW, William P, believed that a mentee should be allowed to choose his/her Oyinlola L, Bongo GN, Chiowona B, Challenges mentor, and this is in consonance with the findings of Quaas facing young African Scientists in their research et al10 in Masachussett. In our study, we found that, important areas to focus on in mentoring includes development of careers: A qualitative exploratory study. Malawi leadership skills (100%), career planning (95.8%) and Med J. 2017;29:1-4 development of clinical skills (95.8%). Quaas et al10 reported 6. Standing Committee on Postgraduate Medical and that career planning was found to be most important area to Dental Education. Supporting doctors and dentists at focus on in their study, followed by scientific research and work: An enquiry into mentoring. London: then development of clinical skills. The difference in the order SCOPME; 1998 as noted is probably due to priorities at particular stages in one’s professional life. For example, scientific research is 7. Irby BJ, Boswell J. Historical Print Context of the more important to residents than house officers. Andrades et Term “Mentoring” Mentoring and Tutoring: 19 al also found that the main areas of focus in mentoring as Partnership in Learning. 2016;24:1-7 reported by family medicine resident doctors in their study were problem solving and research. 8. Taherian K, Shekarchian M. Mentoring for doctors. Does its benefits outweigh its disadvantages? Med

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