Acceptability of mentor mother peer support for women living with HIV in North-Central Nigeria: a qualitative study.

BACKGROUND: Mentor mothers provide psychosocial and other support to pregnant and post-partum women living with HIV (WLHIV), which has been shown to enhance maternal-infant outcomes in the prevention of mother-to-child transmission of HIV (PMTCT). Our objective was to assess the acceptability of mentor mothers as a PMTCT intervention, and to explore opinions on mentor mother program composition and delivery among stakeholders in North-Central Nigeria. METHODS: We conducted nine focus group discussions and 31 in-depth interviews with 118 participants, including WLHIV, pregnant women, male partners, health workers, traditional birth attendants, community leaders, PMTCT program implementers, and policymakers. Participants were purposively recruited from health facilities and surrounding communities in the Federal Capital Territory and Nasarawa State. Transcripts were manually analysed using a Grounded Theory approach, where theory was derived from the data collected. RESULTS: Most participants were female (n = 78, 67%), and married (n = 110, 94%). All participant groups found  mentor mothers acceptable as women providing care to pregnant and postpartum women, and as WLHIV supporting other WLHIV. Mentor mothers were uniquely relatable as role models for WLHIV because they were women, living with HIV, and had achieved an HIV-negative status for their HIV-exposed infants. Mentor mothers were recognized as playing major roles in maternal health education, HIV treatment initiation, adherence, and retention, HIV prevention for male partners and infants, and couple HIV disclosure. Most WLHIV preferred to receive mentor mothers' services at health facilities rather than at home, due to concerns about HIV-related stigma and discrimination through association with mentor mothers. Key mentor mother needs were identified as training, remuneration, and validation as lay health workers. CONCLUSIONS: Mentor mothers are an acceptable PMTCT intervention among stakeholders in North-Central Nigeria. However, stigma and discrimination for both mentor mothers and their clients remain a critical challenge, and mentor mother needs such as training, pay, and a sustainably supported niche in health systems require focused attention. TRIAL REGISTRATION: Clinicaltrials.gov registration number ( NCT01936753 ), registered on September 3, 2013 (retrospectively registered).

"That's What the Program Is All about Building Relationships": Exploring Experiences in an Urban Offering of the Indigenous Youth Mentorship Program in Canada.

Peer mentorship is an effective approach for delivering health promotion programs that may be particularly useful among underrepresented populations. Advancing the peer-led approach, the Indigenous Youth Mentorship Program (IYMP) is a communal-led program rooted in Indigenous values aimed at the promotion of healthy lifestyles in children and youth. The program includes layers of multi-age mentoring (i.e., elementary students, high school student mentors, and young adult health leaders [YAHLs]) and incorporates three core components: physical activity, healthy eating, and cultural teachings. The purpose of this study was to qualitatively explore elementary student, mentor, and YAHL experiences in an urban IYMP offering. Eleven sharing circles were conducted; six with elementary students (n = 23; grade 4 and 5 students), two with mentors (n = 3; students enrolled in a grade 10 wellness girls class), and three with YAHLs (n = 6; undergraduate university students). Focus groups were also held with respective school teachers and principals. An inductive content analysis generated three themes that represent the perceived impacts of this urban IYMP offering: (1) Fostering Wellness, (2) Strengthening Meaningful Connections, and (3) Exploring Leadership. Findings are positioned within a communal mentorship framework that is circular and multi-directional. By bringing together Indigenous and non-Indigenous peoples, this program offering supports Indigenous cultural relevance in an urban-based wellness program.

Structuring Mentoring in Medicine and Surgery. A Systematic Scoping Review of Mentoring Programs Between 2000 and 2019.

INTRODUCTION: Evidence of novice mentoring's successes in having senior clinicians support junior doctors and/or medical students in their clinical, academic, and research goals has spurred efforts to include mentoring in the core medical curriculum. However, lack of effective structuring threatens the viability of mentoring programs, precipitating ethical concerns about mentoring. This review aims to answer the question "what is known about mentoring structures in novice mentoring among medical students and junior doctors in medicine and surgery postings?," which will guide the design of a consistent structure to novice mentoring. METHODS: Levac (2010)'s framework was used to guide this systematic scoping review of mentoring programs in medicine and surgery published between 1 January 2000 and 31 December 2019 in PubMed, ScienceDirect, ERIC, Embase, Scopus, Mednar, and OpenGrey. A "split approach" involving concurrent independent use of a directed content analysis and thematic approach was used to analyze included articles. RESULTS: Three thousand three hundred ninety-five abstracts were identified. There was concordance between the 3 themes and categories identified in analyzing the 71 included articles. These were the host organization, mentoring stages, and evaluations. CONCLUSION: The data reveal the need for balance between ensuring consistency and flexibility to meet the individual needs of stakeholders throughout the stages of the mentoring process. The Generic Mentoring Framework provides a structured approach to "balancing" flexibility and consistency in mentoring processes. The Generic Mentoring Framework is reliant upon appropriate, holistic, and longitudinal assessments of the mentoring process to guide adaptations to mentoring processes and ensure effective support and oversight of the program.

Midwives' experiences as preceptors and the development of good preceptorships in obstetric units.

OBJECTIVE: To study midwives' experience in their role as a preceptor and their perception on how to best support midwifery students in obstetrics units. Obstetric units are an important learning area for student midwives but knowledge on how to become a good midwife preceptor is limited. DESIGN: This qualitative study explores midwife preceptors' experience of supervising midwifery students in three obstetric units in Sweden. Following ethical approval seventeen midwife preceptors were interviewed and data were analysed thematically. FINDINGS: Thematic analysis of the interviews resulted in the identification of two themes and five subthemes: (1) self-efficacy in the preceptor role which involves (a) being confident in the professional position and (b) having the support of management and colleagues and (2) supporting the student to attain self-confidence and independence which entails (a) helping the student to grow, (b) facilitating reflection in learning situations, and (c) "taking a step back". KEY CONCLUSION: Good preceptorship occurs when midwives achieve full self-efficacy, when they master the preceptor role, and when they have enhanced their abilities to help, the student reach confidence and independence. IMPLICATIONS FOR PRACTICE: Health care organisations needs to develop and support midwifery preceptorships.

Whole Person Health: Using Experiential Learning and the ICF Model as a Tool for Introductory Interprofessional Collaborative Practice.

BACKGROUND: The International Classification of Func¬tioning (ICF) model is recommended for interprofessional use to define, measure, and create health and disability policy. Our goal was to expand a uniprofessional student learning experience into an interprofessional experiential clinical learning experience focused on the ICF model. METHODS: An experiential interprofessional education program was developed for Physical Therapy (PT), Physician Assistant (PA), and Pharmacy students. Student teams interviewed a community mentor from a senior living community outside of class to explore their mentor's health journey, assess quality of life, and perform an environmental safety assessment. In this pilot study, students completed an anonymous, unique-identifier electronic survey with open response items pre- and post-experience. Data were coded using inductive thematic analysis. RESULTS: Four themes emerged: learning about other professions (scope of practice), mentor's experiences with health care, treating the whole person, and improving team effectiveness. All four Interprofessional Education Collaborative (IPEC) competencies mapped to the data broadly indicating this learning experience meets interprofessional educational requirements. CONCLUSIONS: Student teams deepened their understanding of their community mentor's health and valued the interprofessional knowledge gained. Using the common lens of the ICF, students' understanding and appreciation of other disciplines emerged and students began to see their mentors from a more holistic perspective.

Prisoners Helping Prisoners Change: A Study of Inmate Field Ministers Within Texas Prisons.

Research on incarcerated offenders trained to help prisoners change is rare because programs that equip inmates with practical capacities for helping others rehabilitate in prison hardly exist. An exception is the Field Ministry program in Texas, which enlists inmates who have graduated from a prison-based seminary to work as "Field Ministers" and serve other inmates in various capacities. We hypothesize that inmate exposure to Field Ministers is inversely related to antisocial factors and positively to prosocial ones. We applied manifest-variable structural equation modeling to analyze data from a survey of a random sample of male inmates at three maximum-security prisons where the Field Ministry program operated. We found that inmates exposed more frequently to the Field Ministry and for a longer time period tended to report lower levels of criminological risk factors and aggressiveness and higher levels of virtues and predictors of human agency as well as religiosity and spirituality.

Mentoring stages: A study of undergraduate mentoring in palliative medicine in Singapore.

BACKGROUND: Mentoring nurtures a mentee's personal and professional development. Yet conflation of mentoring approaches and a failure to contend with mentoring's nature makes it difficult to study mentoring processes and relationships. This study aims to understand of mentee experiences in the Palliative Medicine Initiative (PMI). The PMI uses a consistent mentoring approach amongst a homogeneous mentee population offers a unique opportunity to circumnavigate conflation of practices and the limitations posed by mentoring's nature. The data will advance understanding of mentoring processes. METHODS: Sixteen mentees discussed their PMI experiences in individual face-to-face audio-recorded interviews. The two themes identified from thematic analysis of interview transcripts were the stages of mentoring and communication. RESULTS: The 6 stages of mentoring are the 'pre-mentoring stage', 'initial research meetings', 'data gathering', 'review of initial findings, 'manuscript preparation" and 'reflections'. These subthemes sketch the progression of mentees from being dependent on the mentor for support and guidance, to an independent learner with capacity and willingness to mentor others. Each subtheme is described as stages in the mentoring process (mentoring stages) given their association with a specific phase of the research process. Mentoring processes also pivot on effective communication which are influenced by the mentor's characteristics and the nature of mentoring interactions. CONCLUSION: Mentoring relationships evolve in stages to ensure particular competencies are met before mentees progress to the next part of their mentoring process. Progress is dependent upon effective communication and support from the mentor and appropriate and timely adaptations to the mentoring approach to meet the mentee's needs and goals. Adaptations to the mentoring structure are informed by effective and holistic evaluation of the mentoring process and the mentor's and mentee's abilities, goals and situations. These findings underline the need to review and redesign the way assessments of the mentoring process are constructed and how mentoring programs are structured.

CFHA Don Bloch Award acceptance speech, 2018.

Provides John S. Rolland's acceptance speech for the 2018 CFHA Don Bloch Award. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Multiple-role mentoring: mentors' conceptualisations, enactments and role conflicts.

INTRODUCTION: Outcome-based approaches to education and the inherent emphasis on programmatic assessment in particular, require models of mentoring in which mentors fulfil dual roles: coach and assessor. Fulfilling multiple roles could result in role confusion or even role conflicts, both of which may affect mentoring processes and outcomes. In this study, we explored how mentors conceptualise and enact their role in a multiple-role mentoring system and to what extent they experience role conflicts. METHODS: We conducted a constructivist grounded theory study at one undergraduate medical school. A purposive sample of 12 physician-mentors active in a programmatic assessment system was interviewed. Data analysis followed stages of open, axial and selective coding through which themes were constructed. RESULTS: Three predominant mentoring approaches were constructed: (i) empowering (a reflective and holistic approach to student development); (ii) checking (an observant approach to check whether formal requirements are met), and (iii) directing (an authoritative approach to guide students' professional development). Each approach encompassed a corresponding type of mentor-mentee relationship: (i) partnership; (ii) instrumental, and (iii) faculty-centred. Furthermore, mentors' strategies, focus, agency provided to students and perception of the assessment system characterised mentoring approaches and relationships. Role conflicts were mainly experienced by mentors with a directing mentoring approach. They used various coping mechanisms, including deviation from assessment guidelines. CONCLUSIONS: In multiple-role mentoring in the context of programmatic assessment, mentors adopted certain predominant mentoring approaches, which were characterised by different strategies for mentoring and resulted in different mentor-mentee relationships. Multiple-role mentoring does not necessarily result in role conflict. Mentors who do experience role conflict seem to favour the directing approach, which is most at odds with key principles of competency-based education and programmatic assessment. These findings build upon existing mentoring literature and offer practical suggestions for faculty development regarding approaches to mentoring in programmatic assessment systems.

A Qualitative Study of an Employment Scheme for Mentors with Lived Experience of Offending Within a Multi-Agency Mental Health Project for Excluded Young People.

The use of peer intervention schemes is increasingly popular within services for offending groups and there is growing evidence of their benefit for peers delivering the interventions. The current study explores staff and peer experiences of an employment scheme for peer mentors within a community project for young people involved in offending. Semi-structured interviews were conducted with full time staff (n=4) and peer mentors employed on the scheme (n=2). Thematic analysis revealed three themes of "Opportunity and Empowerment", "Supportive Processes" and "Role Definition and Structure". The results suggest that meaningful employment opportunities, with holistic support and processes for reflection and mentalisation of self and others, contribute to the personal and professional development of ex-offenders in peer mentoring roles.

Nurse link lecturers' perceptions of the challenges facing student nurses in clinical learning environments: A qualitative study.

In the United Kingdom student nurses spend approximately half of their education programme in a practical setting commonly referred to as the Clinical Learning Environment (CLE). The significant amount of time student nurses spend in CLEs, combined with reports of negative experiences, indicate that it is important to consider the challenges of learning within this environment. Nurse Link Lecturers spend up to 20% of their teaching time supporting student nurses in CLEs. Link lecturers' proximity to the CLE means that they are well-placed to articulate the challenges facing student nurses in this context. This paper reports on a study that used interviews and focus groups to collect experienced adult field Link Lecturers' views on the challenges facing student nurses in CLEs. Link Lecturers reported that students often find themselves in polarised positions of either 'fitting in' with the pressures of the environment and thereby potentially gaining 'access to learning' opportunities or 'falling out' and merely 'learning to get through' their placement. Mentors were thought to have a significant influence on student nurses' negotiation of learning. This insight is timely due to the changes in supervisory and assessment arrangements required by the new Nursing and Midwifery Council Standards (NMC, 2018).

Feedback in clinical practice: Enhancing the students' experience through action research.

Feedback within clinical practice is known to be central to the learning and development of student nurses and midwives. A study that focused on student experience of assessment identified that a high proportion of students reported that they had received insufficient feedback whilst on clinical placement. In response to this academics and members of the clinical education team set out to explore this with a view to improving the student experience using action research. Key findings indicated that responsibility for feedback on clinical placement lies with both students and mentors, distinct factors can enable effective feedback and that positive outcomes for mentors and students resulted through engaging with the project. The process, outcomes and actions taken to improve practice are the focus of this paper.

Midwifery students in health visitor placements: the importance of student-mentor relationships.

OBJECTIVE: The aim of this study was to explore midwifery students and health visitor practice mentors experiences of a health visiting placement for midwifery students, focusing on the student-mentor relationship. DESIGN: Interview study SETTING: East London, United Kingdom PARTICIPANTS: Eighteen students and eighteen mentors were invited to take part in an interview. Ten midwifery students (55.5%) and fifteen health visitor practice mentors (83.3%) took part in interviews or provided information via email. Thematic analysis was used to analyse findings. FINDINGS: The main study finding was that students reported valuing practice mentors who took the time to get to know them, were welcoming and enthusiastic and planned their time in advance. The mentors in turn spoke highly of the students who were keen and enthusiastic about the placement, but noted that not all students had appeared interested. KEY CONCLUSIONS: The findings from this small interview study show that taking time to make the students feel welcome was important to facilitate a student-mentor relationship. Another important factor in whether a student enjoyed their placement was the mentors' advance planning.

How Mentor Identity Evolves: Findings From a 10-Year Follow-up Study of a National Professional Development Program.

PURPOSE: Despite academic medicine's endorsement of professional development and mentoring, little is known about what junior faculty learn about mentoring in implicit curricula of professional development programs, and how their mentor identity evolves in this context. The authors explored what faculty-participants in the Educational Scholars Program implicitly learned about mentoring and how the implicit curriculum affected mentor identity transformation. METHOD: Semistructured interviews with 19 of 36 former faculty-participants were conducted in 2016. Consistent with constructivist grounded theory, data collection and analysis overlapped. The authors created initial codes informed by Ibarra's model for identity transformation, iteratively revised codes based on incoming data patterns, and created visual representations of relationships amongst codes to gain a holistic, shared understanding of the data. RESULTS: In the implicit curriculum, faculty-participants learned the importance of having multiple mentors, the value of peer mentors, and the incremental process of becoming a mentor. The authors used Ibarra's model to understand how the implicit curriculum worked to transform mentor identity: Faculty-participants reported observing mentors, experimenting with different ways to mentor and to be a mentor, and evaluating themselves as mentors. CONCLUSIONS: The Educational Scholars Program's implicit curriculum facilitated faculty-participants taking on mentor identity via opportunities it afforded to watch mentors, experiment with mentoring, and evaluate self as mentor, key ingredients for identity construction. Leaders of professional development programs can develop faculty as mentors by capitalizing on what faculty-participants learn in the implicit curriculum and deliberately structuring postgraduation mentoring opportunities.

Effectiveness of an Evidence-Based Practice Nurse Mentor Training Program.

BACKGROUND: Multiple reasons are cited for why nurses do not incorporate evidence into clinical practice, including lack of knowledge and skills, training, time, and organizational support. AIMS: To investigate the effectiveness of a mentor training program on mentors' perceptions of knowledge, attitude, skill, and confidence levels, and organizational readiness related to evidence-based practice (EBP) and research utilization; and to investigate the effectiveness of creating a formalized structure to enculturate EBP in order to prepare nurses to incorporate EBP into clinical practice on nurses' perceptions of knowledge, attitude, skill levels, barriers, nursing leadership, and organizational support related to EBP and research utilization. METHODS: A two-group pretest-posttest quasi-experimental, interventional design was used. A convenience sample of 66 mentors and 367 nurses working at a five hospital integrated healthcare system located in the Southeastern United States participated. FINDINGS: Nurse mentors' knowledge, attitude, skill level, and organizational readiness related to EBP, t = -8.64, p < .001, and confidence, t = -6.36, p < .001, improved after training. Nurses' knowledge, attitude, and skill level related to EBP, t = -19.12, p < .001, and barriers to research utilization, t = 20.86, p < .001, EBP work environment t = -20.18, p < .001, and EBP nurse leadership, t = -16.50, p < .001, improved after a formalized structure was implemented. LINKING EVIDENCE TO ACTION: EBP mentors are effective in educating and supporting nurses in evidence-based care. Leaders should use a multifaceted approach to build and sustain EBP, including developing a critical mass of EBP mentors to work with point of care staff.

Appreciative Advising in Nursing Education.

The 6-phase Appreciative Advising framework for academic advising has been incorporated into a nursing program in the southeast United States, with promising initial results. Historical perspectives of academic advising, an overview of Appreciative Advising, and implementation of the framework are presented.

Support for mentors-an exploration of the issues.

Nursing and midwifery mentors are fundamental to the process of ensuring future practitioners are adequately prepared and supported during the practice element of their degrees. However, there is evidence to suggest that the infrastructure and support for the mentoring role is not always adequate. This article provides a review of some of the issues including the emotional labour associated with supporting pre-registration students, difficulties in accessing protected learning time for mentoring, and lack of supportive networks for mentors to develop within the role. The authors make recommendations on what is required to ensure that the mentor role is better acknowledged, supported and resourced.

Assessment and accountability: part 3 - sign-off mentors.

Assessment in clinical practice is a complex role undertaken by mentors and practice teachers. This article is the third of three articles about assessment in practice. Part one focused on the importance of assessment and identified assessment methods used in clinical practice, while part two discussed the importance of feedback and managing failing students. This article examines the concepts of responsibility and accountability as well as ethical issues for mentors and practice teachers in relation to the assessment process. The role of the sign-off mentor, the issue of due regard, and ethical principles are discussed. The meaning of competence and partnership working when making assessment decisions are explored. This article relates to the third domain and outcomes of the Nursing and Midwifery Council's Standards to Support Learning and Assessment in Practice on assessment and accountability.