key: cord-0861245-73ke6ygv authors: Santiesteban, Luis; McKenney, Mark; Elkbuli, Adel title: Mentorship: A Millennia-Old Remedy for Learner Success Amidst the COVID-19 Pandemic date: 2021-06-18 journal: J Surg Res DOI: 10.1016/j.jss.2021.06.038 sha: 6d3baf00ff0ab9b5394df539c2a801f65d1cb00b doc_id: 861245 cord_uid: 73ke6ygv nan The ongoing pandemic has severely disrupted medical education and graduate medical training. Coronavirus disease 2019 (COVID-19) has rendered long-established educational paradigms and traditional teaching modalities obsolete. The threat of students and educators falling ill resulted in the temporary suspension of most, if not all, face-to-face educational interactions 1 . Consequently, medical schools and hospitals had to promptly adopt new strategies to continue meeting institutional as well as national pedagogical milestones. For millennia, mentorship has been an integral component of medical education and an indispensable tool in shaping the professional character of young students and medical graduates. Currently, no one-size-fits-all mentoring program exists. On the contrary, there are dozens of distinct mentorship * Corresponding Author. Adel Elkbuli, MD, MPH, Department of Surgery, Kendall Regional Medical Center, 11750 Bird Road. Miami, FL E-mail address: Adel.Elkbulli@HCAHealthcare.com (A. Elkbuli). models, each geared towards satisfying unique institutional objectives 2 , 3 . Regardless of program structure, high-quality mentor-mentee interactions has been demonstrated to increase student scholarly productivity, future career satisfaction, and improve student acclimation to new learning environments 2 . Importantly, mentorship has shown to positively impact the professional outlook of minority students, particularly for those interested in pursuing surgical careers 4 ship help supplement the current professional and personal needs of medical students, residents, and fellows? Likewise, how will mentors operate in the ongoing COVID-19 pandemic environment, and will the functional role of mentors change? The authors will address the important interplay of mentorship in the current COVID-19 pandemic educational environment. As such, this work will discuss: (1) significant effects of the COVID-19 pandemic on undergraduate and graduate medical education; (2) how mentorship may help to address current learners needs; (3) how peer-mentoring can help mitigate the effects of social isolation and increase group morale. As it stands, the United States is trending towards 34 million reported coronavirus cases with a harrowing death toll north of 590,000 citizens 6 . While the immediate and long-term consequences of the COVID-19 pandemic on the American healthcare system are vast, it is imperative to recognize that medical education was profoundly affected as well 7 , 8 . Table 1 demonstrates some of the major sequelae of the COVID-19 pandemic across medical education and postgraduate training. The current pandemic has severely interrupted trainees' educational experiences across the board 9 . Medical schools have been affected as their curricula have been dramatically interrupted. For example, medical students have had to rely on virtual sessions to learn what was originally designed for the clinic, hospital, or classroom. To protect faculty and students, medical schools initially decided to withdraw senior students from clinical settings as suggested by the Association of American Medical Colleges. Limitations such as decreased number of non-essential workers from hospitals, lack of senior supervision, and the threat of students being COVID-19 vectors prompted many schools to suspend practically all inperson clinical experiences 10 . For third-and fourth-year students, the clinical years serve to transition from classroom didactics to bed-side learning and it is an essential period for developing their professional identity. The clinical training years are a gateway for students to explore career options, cultivate clinical acumen, and interact with faculty and residents in prospective residency programs. Of urgent concern is the adequacy of substituting bed-side learning with other contactless modalities and the potential deleterious effect on the competency of recently graduated senior medical students 11 . Postgraduate trainees have also encountered a series of challenges to include reassignment towards providing immediate patient care. Fellows and residents were called upon to supplement a chain of overstrained physicians who were faced with limited supplies in overcrowded hospital units 12 . Many learning opportunities for residents and fellows such as academic conferences, research projects, elective surgical procedures as well as national and international collaborations were sus- The magnitude of stress generated by COVID-19 continues to strain the mental health of students and junior physicians. Recent reports and publications note a significant rise in physician stress and anxiety, exacerbating the pre-pandemic national crisis of student and resident burnout 14 , 15 Presently, medical education is facing a shortage of mentors, particularly for women, minorities, and students from disadvantaged socioeconomic backgrounds 3 , 8 , 16 . Alike, mentors many of whom are frontline workers, have been forced to take on additional clinical and administrative responsibilities depleting their time to participate in mentorship, research, and other educational activities 17 . Nevertheless, mentors are uniquely suited to help guide mentees along their professional paths amidst these stressful times. Historically, mentors have served to impart wisdom, provide critical feedback, council on pivotal professional decisions, and act as role models for students and budding physicians 18 . The COVID-19 pandemic has created substantial hindrances in how traditional mentor-mentee dyads operate. The classical mentor-mentee model relies heavily on personal contact, student networking, and institutional collaborations all of which have been disrupted. Table 2 summarizes several barriers imposed by the COVID-19 pandemic on traditional mentorship along with potential solutions. However, the pandemic has also generated new opportunities to build upon the strengths of traditional, fact-to-face guidance, as well as a chance to remedy some of the inefficiencies of typical mentoring strategies. The advent of new technological resources, particularly in the realm of digital communication, have re-invigorated medical education during the pandemic. Despite some unique drawbacks, virtual education has proven to be an effective platform brimming with collaborative capabilities 19 . Mentors can seize this opportunity and utilize digital platforms to restore fractured mentor-mentee relationships as well as help reach students and trainees in need of guidance. For instance, a typical barrier to traditional mentorship is the difficulty of aligning busy mentors schedule with student availability. Furthermore, traditional mentorship relies on students actively seeking willing faculty mentors. The latter is particularly challenging for minority students and for those without experience in previous mentormentee collaboration. Team mentorship is another advantage of virtual communication. Using a team mentorship format, a single mentor may provide guidance to a group of mentees, thus optimizing outreach and simultaneously building a system of support amongst mentees 20 . In essence, mentorship may in fact thrive in the age of digital interactive platforms by restituting its most coveted premise: communication. Mentors can make their presence felt by contacting students and junior doctors to discuss ongoing concerns and help ease apprehension. Faculty-mentors can help reduce trainee's anxiety by reaffirming their loyalty to resume pre-pandemic research projects, clinical opportunities, and assistance with important professional activities. Moreover, institutional initiatives can play a key role in the effectiveness and outreach capabilities of mentorship programs. Medical schools and post-graduate training programs will benefit from creating a mentorship infrastructure intended to maximize mentormentee interactions as well as capture the needs of vulnerable and underrepresented learners 8 , 16 . This can be achieved by identifying faculty liaisons, creating mentorship groups, matching faculty with students/trainees based on mutual interest, empowering minority faculty to take on mentorship roles, and encouraging peer mentorship at all institutional levels. The practice of medicine mainly occurs in a team environment where the sum total of individual skills and experiences are key to producing optimal patient outcomes. Peer-to-peer mentorship may be at the core of restituting individual and group morale. As it stands, peer mentorship confers academic as well as psychosocial advantages independent and often complementary to faculty mentorship 21 . The peer-to-peer dynamic presents a seamless opportunity for students to create a web of personal support and academic resources within and outside of their organizations. Utilizing peer mentorship programs during the COVID-19 pandemic can help drive camaraderie by reconnecting a fractured student body. Most importantly, peer mentoring can promote academic collaboration by introducing students and trainees to each other's professional and scientific interests. Peer-to-peer mentoring can be a powerful asset in regenerating student enthusiasm, engagement, and leadership between the student ranks. As vaccine efforts make headway and physicians become more adept with different management options COVID-19 will eventually cease to be a threat. Consequently, student and medical graduates are likely to resume their respective pre-pandemic training curricula. In the meantime, committed mentors will be essential in helping young learners mitigate some of the deleterious effects of COVID-19. Mentorship works best in a continuum. It has become evident that some aspects of traditional mentorship, such as frequent in-person meetings and intimate one-on-one guidance, were barriers and led to greater isolation during the pandemic. Thus, in a post-pandemic world we ought to build on what we have learned. First, digital communication platforms allow for efficiency and greater collaboration. In addition, institutions should continue to encourage more group and peer-to-peer mentorship to improve outreach and generate robust support networks. Lastly, empowering minority mentors and junior faculty-educators will grow the mentor pool and serve to uplift medical students and young graduates as well as ensure their professional realization. None The Impact of COVID-19 on Orthopaedic Residency Training Mentorship of US Medical Students: a Systematic Review Medical student mentoring programs: current insights Mentorship of underrepresented minorities and women in surgery Mentoring during Uncertain Times COVID-19 in the USA The Evolving Impact of COVID-19 on Medical Student Orthopedic Education: Perspectives From Medical Students in Different Phases of the Curriculum New Age Mentoring and Disruptive Innovation-Navigating the Uncharted With Vision, Purpose, and Equity Medical Education During the Coronavirus Disease-2019 Pandemic: Learning From a Distance Impacts and challenges of United States medical students during the COVID-19 pandemic The Transformational Effects of COVID-19 on Medical Education Impact of the COVID-19 pandemic on orthopaedic and trauma surgery training in Europe Impact of the COVID-19 pandemic on anaesthesia trainees and their training Physician Burnout, Interrupted Mental Health of Young Physicians in China During the Novel Coronavirus Disease 2019 Outbreak Mentorship strategies to foster inclusivity in surgery during a virtual era COVID-19 and the Early-Career Physician-Scientist. Fostering Resilience beyond the Pandemic Making the most of mentors: a guide for mentees Effectiveness of Virtual Medical Teaching During the COVID-19 Crisis: Systematic Review Perceived Benefits of a Peer Mentoring Program for First-Year Medical Students