NDLI: Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned

Content Provider	Springer Nature : BioMed Central
Author	Alidina, Shehnaz Sydlowski, Meaghan M. Ahearn, Olivia Andualem, Bizuayehu G. Barash, David Bari, Sehrish Barringer, Erin Bekele, Abebe Beyene, Andualem D. Burssa, Daniel G. Derbew, Miliard Drown, Laura Gulilat, Dereje Gultie, Teruwork K. Hayirli, Tuna C. Meara, John G. Staffa, Steven J. Workineh, Samson E. Zanial, Noor Zeleke, Zebenay B. Mengistu, Abraham E. Ashengo, Tigistu A.
Abstract	Background A well-qualified workforce is critical to effective functioning of health systems and populations; however, skill gaps present a challenge in low-resource settings. While an emerging body of evidence suggests that mentorship can improve quality, access, and systems in African health settings by building the capacity of health providers, less is known about its implementation in surgery. We studied a novel surgical mentorship intervention as part of a safe surgery intervention (Safe Surgery 2020) in five rural Ethiopian facilities to understand factors affecting implementation of surgical mentorship in resource–constrained settings. Methods We designed a convergent mixed-methods study to understand the experiences of mentees, mentors, hospital leaders, and external stakeholders with the mentorship intervention. Quantitative data was collected through a survey (n = 25) and qualitative data through in-depth interviews (n = 26) in 2018 to gather information on (1) intervention characteristics including areas of mentorship, mentee-mentor relationships, and mentor characteristics, (2) organizational context including facilitators and barriers to implementation, (3) perceived impact, and (4) respondent characteristics. We analyzed the quantitative and qualitative data using frequency analysis and the constant comparison method, respectively; we integrated findings to identify themes. Results All mentees (100%) experienced the intervention as positive. Participants perceived impact as: safer and more frequent surgical procedures, collegial bonds between mentees and mentors, empowerment among mentees, and a culture of continuous learning. Over 70% of all mentees reported their confidence and job satisfaction increased. Supportive intervention characteristics included a systems focus, psychologically safe mentee-mentor relationships, and mentor characteristics including generosity with time and knowledge, understanding of local context, and interpersonal skills. Supportive organizational context included a receptive implementation climate. Intervention challenges included insufficient clinical training, inadequate mentor support, and inadequate dose. Organizational context challenges included resource constraints and a lack of common understanding of the intervention. Conclusion We offer lessons for intervention designers, policy makers, and practitioners about optimizing surgical mentorship interventions in resource-constrained settings. We attribute the intervention’s success to its holistic approach, a receptive climate, and effective mentee-mentor relationships. These qualities, along with policy support and adapting the intervention through user feedback are important for successful implementation.
Related Links	https://bmcmededuc.biomedcentral.com/counter/pdf/10.1186/s12909-022-03691-2.pdf
Ending Page	15
Page Count	15
Starting Page	1
File Format	HTM / HTML
ISSN	14726920
DOI	10.1186/s12909-022-03691-2
Journal	BMC Medical Education
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2022-08-31
Access Restriction	Open
Subject Keyword	Medical Education Theory of Medicine Bioethics Mentorship Surgery Ethiopia Implementation Safe Surgery 2020 Workforce Theory of Medicine/Bioethics
Content Type	Text
Resource Type	Article
Subject	Education Medicine
Journal Impact Factor	2.7/2023
5-Year Journal Impact Factor	3.4/2023

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