Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
BMC Med Educ. 2024 Jul 5;24(1):726. doi: 10.1186/s12909-024-05707-5.
Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring's personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS).
A systematic scoping review using Krishna's Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion.
Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring's CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes.
Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.
有效的指导是医学教育的一个重要组成部分，对所有利益相关者都有益。近年来，指导的概念已经超越了传统的导师-新手关系，包括小组和同伴指导。现有的指导理论没有认识到指导的个性化、不断发展、目标驱动和特定于情境的性质。鉴于传统因果概念的局限性，本综述的目的是系统地搜索文献，以确定指导是否可以被视为复杂适应系统（CAS）。
采用 Krishna 的系统循证方法进行系统范围的综述，以研究医学学生和住院医师在一般内科和相关亚专业中关于指导和一般内科的文献中的指导和 CAS 的描述，研究年限为 2000 年 1 月 1 日至 2023 年 12 月 31 日，检索数据库包括 PubMed、Embase、PsycINFO、ERIC、Google Scholar 和 Scopus。纳入的文章进行了主题和内容分析，确定和合并主题以创建框架讨论的领域。
在审查的 5704 篇摘要中，评估了 134 篇全文文章，纳入了 216 篇文章。这些领域描述了指导关系和指导方法如何体现 CAS 的特征，以及指导通常表现为实践社区（CoP）。指导的 CAS 特征通过 CoP 表现出来，具有明显的边界、螺旋式的指导轨迹以及纵向的指导支持和评估过程。
将指导视为 CAS 需要重新思考指导的设计、支持、评估和监督以及导师的角色。需要进一步研究以更好地评估指导过程，并为导师提供最佳的培训和支持。
