- SECOND Toolkit

WHAT?

The goals of this intervention are:

󠄀 Identify residents to coordinate a resident-to-resident mentorship program
󠄀 Identify residents to mentor peers
󠄀 Match mentors to mentees
󠄀 Develop and communicate expectations for peer mentoring
󠄀 Provide resources to support the peer mentoring relationship
󠄀 Gauge success and adjust the program accordingly

WHY?

Peer mentoring offers the opportunity for mentees to receive support and guidance from those who have recently undergone similar personal and professional experiences and may better empathize with their challenges and pressures. Formalized peer mentorship programs are associated with increased resident satisfaction with mentoring and may be especially beneficial for the retention and success of female and minority surgeons. [1-5]

Resident Camaraderie	By creating structured opportunities throughout the year for junior residents to solicit advice from and establish meaningful relationships with senior resident mentors may increase the sense of group identification and cohesion in the program, as well as increase social support available to residents.
Organizational Culture and Values	Establishing and supporting a formal, peer mentorship program communicates that your program cares about creating a supportive work environment for residents. Organized social events in the context of a mentoring program may boost morale and improve the team dynamic, in addition to promoting individual resident well-being.

How?

Step 1: Conduct a needs assessment.

1. Consider focus groups and/or asking your Wellness Committee or Resident Council members to discuss the following with their classmates and report back:
    a. How satisfied are residents with the mentorship they currently receive in residency?
    b. What are some of the issues with faculty mentorship? If hierarchy is a barrier (i.e., residents are reluctant to speak openly with faculty), a peer mentorship program may be particularly beneficial.
    c. Are residents informally mentored by peers?
    d. What should a formal peer mentoring program provide?
2. Review your SECOND Trial Resident Well-Being and Learning Environment Report, specifically the items about Faculty Engagement and Resident Camaraderie. If your residents are disagreeing that there is a faculty mentor who genuinely cares about them and their careers or your program has a low Resident Camaraderie score, a peer mentorship program may be particularly beneficial.

Step 2: Identify residents to coordinate the mentorship program and to act as mentors.

1. For coordinators, consider the administrative chief residents, lab residents, and Wellness Committee members. These coordinators should be socially familiar with most of the residents and demonstrate high emotional intelligence.

2. For mentors, identify a system to determine which residents will contribute to the pool of mentors for the resident mentees:

Residents volunteer to be mentors:
1. At UTSW, all PGY4 residents are queried to determine their interest in being a peer mentor. The majority of residents take on the role and are assigned an incoming intern mentee.
2. At the University of Maryland, residents attend a voluntary “speed-dating” event to be matched into a mentorship pairing (more details on “speed-dating” event below).
All residents of a certain PGY class (e.g. PGY5s) or threshold (e.g. PGY4 and greater) are mentors:
1. At the University of Arizona, all PGY4/5s are enlisted as potential senior mentors to incoming interns. In addition to resident-resident mentorship, University of Arizona also has a faculty-resident mentorship program.
2. At the University of Chicago, research residents, PGY4s and PGY5s are all included as senior mentors, but have the option to opt out. The University of Chicago is providing formal training for their PEER mentors this year.

Step 3: Determine the structure of your peer mentorship program.

Determine which residents will be mentees and which will be mentors.

1. All incoming interns are matched with a senior resident
a. At the University of Chicago, the PEER (Professional Empowerment and Education of Residents) program pairs each intern with either a research resident, PGY3, PGY4 or PGY5. This resident is responsible for welcoming the intern and providing assistance/support for the duration of the year. They are currently re-designing their mentorship system to create mentoring “families” where interns and PGY2s are paired with a mid-level resident such as a PGY3 or research resident as well as a senior resident (PGY4/5s).
b. At UTSW, each incoming intern is assigned to a fourth year resident. This relationship is maintained over the years, such that PGY2s remain paired with their PGY5s the following year.
c. The University of Arizona has a “big brother/big sister” program, in which incoming interns are paired with PGY 4s and 5s.
2. Junior residents are matched with lab residents, as they are likely to have more time.
a. At the University of Pennsylvania, the resident-to-resident mentorship program pairs each intern and 2nd year resident with a lab resident.

Step 4: Match mentors with mentees.

1. The resident coordinators of the mentorship program may pair mentors with mentees on the basis of:

Commonalities (e.g., hometown, medical school, etc): University of Chicago, University of Arizona, University of Maryland
Career/specialty interests: University of Pennsylvania, University of Maryland
Requests from either the mentors or the mentees: University of Pennsylvania

2. This information may be gathered by:

Residency Coordinator: At the University of Arizona, incoming interns provide a non-school email address to the program coordinator (PC), who then gathers information about their history. This information is then given to the senior residents who choose their own intern matches based on commonalities from information gathered by the PC.
ERAS application: The University of Chicago pairs their residents based on information from their medical student applicants to the program, using the hometown, medical school, and hobbies fields from their applications.
Survey: A brief survey may be administered by email, Qualtrics, Google Forms, RedCap, SurveyMonkey, etc, assessing residents’ professional interests/goals, personal attributes, and mentoring goals/needs. Check out this example from the University of Maryland.
A brief meet-and-greet: At the University of Maryland, a “speed-dating” style event is held annually where the residents get to know one another over food and drinks. The residents are asked to fill out a survey before the event (see previous bullet point) which assesses residents’ personality traits, professional goals, and mentoring needs. During the event, residents rotate from table to table in order to get to know one another. There are questions to stimulate conversation on each table. Many of these questions are the same as from the pre-event survey, but also include some “fun” questions such as “What’s your favorite cartoon character?” Each resident is given an index card where they can make mentoring requests, denote who they had a connection with, and other comments. These cards and the survey are ultimately used to pair junior residents with senior residents.

Step 5: Establish objectives/expectations and provide resources.

1. Set and distribute/communicate guidelines for:

Goals/objectives: Sample guidelines outlining expectations for mentors and mentees can be found here [coming soon].
1. At University of Chicago, the stated objectives of peer mentoring are to act as a role model, counselor and advocate with the goal of cultivating competent, confident and committed surgeons.
2. At UTSW, mentors are specifically instructed to fulfill three mentorship domains for their resident mentees: personal development, professional/career advancement, and clinical development.
Frequency of mentors/mentees meetings.
1. At University of Chicago, mentors are expected to meet with their mentees once every 1-2 months or more.
2. At UTSW, mentors are encouraged to take their mentees out for lunch at least twice per year.
Topics to cover:
1. At the University of Chicago, peer mentors support mentees through the challenges of surgical residency including career progression, exam performance, clinical skill, clinical confidence, personal life and working relationships.

2. Provide resources:

At UTSW, the department funds lunch vouchers for the faculty club, which offers a restaurant-style sit down lunch.

3 .Create pathways for escalating concerns.

Outline methods for troubleshooting any issues that arise (e.g., a process for either party to air grievances without retaliation and/or rematch if the relationship becomes unbeneficial).
Provide mentors with a way to escalate concerns about mentee wellness (e.g., compile a list of local health resources [coming soon]).
Consider designating a resident ombudsperson; this person serves as an additional resource for all residents and may be a means of accomplishing both (a) and (b).

Step 6: Assess implementation.

Check in with mentors and mentees periodically (e.g., with semiannual reviews) to assess use of the peer mentorship program. Are they meeting? Do they find it helpful? Are there some mentors that are more successful than others, and what tips/tricks can they share with their colleagues? Consider this example of a mentorship follow- up survey from the University of Maryland.