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研究生医学教育中导师指导的范围综述:一个拟议的概念框架

A scoping review of mentorship in Graduate Medical Education: a proposed conceptual framework.

作者信息

Abdelmannan Dima, Buhumaid Rasha, Salman Hira, Ba Madhaf Wail A Abdulrahman Hasan, AlRajaby Hafidh Mohammad Khamis, Zary Nabil, Guraya Shaista Salman

机构信息

Graduate Medical Education, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates.

Emergency Medicine, Dubai Health, Dubai, United Arab Emirates.

出版信息

Front Med (Lausanne). 2025 Aug 18;12:1616148. doi: 10.3389/fmed.2025.1616148. eCollection 2025.

Abstract

INTRODUCTION

Mentorship is increasingly recognized as a foundational stone within Graduate Medical Education (GME), contributing to clinical competency, scholarly engagement, professional identity formation, and psychological well-being. Despite its growing recognition, mentorship in GME remains inconsistently structured, under-theorized, and variably evaluated. This conceptual and structural ambiguity hampers the ability to design, compare, and scale mentorship efforts meaningfully across settings. This scoping review aimed to systematically explore the structure, theoretical foundations, evaluation approaches, and reported outcomes of mentorship programs in GME, and to develop a conceptual framework to guide the design of context-sensitive, outcome-aligned mentorship interventions.

METHODS

The scoping review followed Arksey and O'Malley's five-stage methodology and the findings were reported according to PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, CINAHL, and Embase was conducted in January 2025, covering studies published between 2015 and 2025. Eligibility was defined using the Population-Concept-Context framework. Data were extracted using a structured template and synthesized thematically.

RESULTS

A total of 94 studies were included. Mentorship programs varied widely in structure, with formal, informal, peer, and near-peer models observed. Only 27 studies reported use of theoretical frameworks, and evaluation approaches were often limited to non-validated tools and descriptive outcomes. Four main analytical clusters emerged: program structure, theoretical/conceptual frameworks, evaluation approaches, and reported outcomes. Outcomes commonly reported included career development, academic productivity, clinical competency, leadership, well-being, and professional growth. However, the main highlight was a lack of theoretical underpinnings, standardized outcome measurement and mentor training. Cultural responsiveness and equity were rarely considered in mentorship programs.

CONCLUSION

This scoping review highlights the need for mentorship programs in GME to be more systematically designed, theory-informed, and rigorously evaluated. Key gaps include the underutilization of conceptual models, the lack of validated evaluation tools, and insufficient attention to mentor training and equity considerations. Building on the findings of this scoping review, we propose a conceptual framework that aligns mentorship models with learner level, skill focus, and mentoring format across psychological and sociological domains. This framework is intended to guide the development of robust, context-sensitive, and theory-informed mentorship programs with measurable outcomes, ultimately fostering sustainable mentorship cultures that enhance learner development and improve healthcare practice in Graduate Medical Education (GME).

摘要

引言

导师制在毕业后医学教育(GME)中日益被视为一块基石,对临床能力、学术参与、职业身份形成和心理健康都有促进作用。尽管其认可度不断提高,但GME中的导师制在结构上仍不一致,理论化不足,评估方式也各不相同。这种概念和结构上的模糊性阻碍了在不同环境中有意义地设计、比较和扩大导师制工作的能力。本范围综述旨在系统地探索GME中导师制项目的结构、理论基础、评估方法和报告的结果,并建立一个概念框架,以指导设计与背景相适应、与结果相一致的导师制干预措施。

方法

本范围综述遵循了阿克西和奥马利的五阶段方法,并根据PRISMA-ScR指南报告研究结果。2025年1月对PubMed、Scopus、CINAHL和Embase进行了全面检索,涵盖2015年至2025年发表的研究。使用人群-概念-背景框架定义纳入标准。数据通过结构化模板提取并进行主题综合。

结果

共纳入94项研究。导师制项目的结构差异很大,观察到有正式、非正式、同伴和准同伴模式。只有27项研究报告使用了理论框架,评估方法通常仅限于未经验证的工具和描述性结果。出现了四个主要分析类别:项目结构、理论/概念框架、评估方法和报告的结果。常见报告的结果包括职业发展、学术产出、临床能力、领导力、幸福感和职业成长。然而,主要问题是缺乏理论基础、标准化的结果测量和导师培训。导师制项目很少考虑文化适应性和公平性。

结论

本范围综述强调了GME中的导师制项目需要更系统地设计、以理论为依据并进行严格评估。主要差距包括概念模型利用不足、缺乏经过验证的评估工具,以及对导师培训和公平性考虑不够。基于本范围综述的结果,我们提出了一个概念框架,使导师制模式与学习者水平、技能重点以及心理和社会学领域的指导形式相匹配。该框架旨在指导开发强大的、与背景相适应且以理论为依据的导师制项目,并取得可衡量的成果,最终培育可持续的导师制文化,促进毕业后医学教育(GME)中学习者的发展并改善医疗实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a5/12400154/7944a8ee3364/fmed-12-1616148-g001.jpg

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