The First 500 - A report on London Deanery's Coaching ... - Mentoring

The First 500 - A report on London Deanery's Coaching ... - Mentoring

Coaching and Mentoringong>Theong> ong>Firstong> FiveHundredA Report on London Deanery’s Coachingand Mentoring Service 2008-2010Dr Rebecca VineyProf Elisabeth


ong>Theong> London Deanery’s Approach toCoaching and MentoringCoaching and mentoring have a long history, in politics, sports andin the workplace, in different professions and in different countries.No definitions are universally agreed, but the following have beenmuch quoted in the UK literature:Coaching and Mentoring PrinciplesUnderlying all forms of coaching and mentoring are certainprinciples which generate its powerful impact.“““COACHINGOff line help by one person to another inmaking significant transitions in knowledge,work or thinking.”(Megginson and Clutterbuck, 1995)MentoringTo help and support people to managetheir own learning in order to maximize theirpotential, develop their skills, improve theirperformance, and become the person theywant to be.”(Parsloe, 1992)Coaching and mentoringLearning relationships which help people to takecharge of their own development, to releasetheir potential and to achieve results whichthey value.”(Connor and Pokara 2007)six principles of coachingand>Theong> client is resourcefulong>Theong> coach’s role is to developthe client’s resourcefulness, itis not about giving adviceCoaching addresses the wholeperson, past, present and futureong>Theong> client sets the agendav. ong>Theong> coach and the client areequalsvi.Coaching is about change(Rogers J, 2008)Coaching tends to be short-term process that is more taskorientated, whereas mentoring is usually longer with a moreholistic approach. However, there is a great deal of overlap in theirunderlying principles and the skills required to deliver them (Vineyand McKimm 2010). This overlap is recognised by the EuropeanMentoring and Coaching Council who haverecommended that the inclusive term of “coaching/mentoring”should be preferred. ong>Theong>re should be a clear distinguision betweencoaching/mentoring from other supportive or developmental roles,such as patronage, therapy, counselling, appraising, educationalsupervision, line management or teaching.This supports the London Deanery’s approach of a Coaching andMentoring service which is based on a holistic approach which isdelivered in a very focused fashion.London Deanery Coaching and Mentoring Service 7

Benefits of Coaching and MentoringIn many industries coaching and mentoring are well establishedin the organisational culture, with benefits for the employerby improved company performance and productivity and theemployee in terms of job satisfaction. In a large study of USbusiness school graduates, those experiencing extensivementoring relationships ong>reportong>ed receiving faster promotion, higherincomes, and were more satisfied with their pay and benefits thanindividuals experiencing less extensive mentoring relationships.(Dreher, Ash 1990).A review of the literature on the subject (Garvey B, Garrett-HarrisR, 2005).concluded that the main advantages for those beingmentored were:• Improved performance and productivity• Career opportunity and advancement• Improved knowledge and skills• Greater confidence and wellbeingong>Theong>se benefits have been ong>reportong>ed in studies of mentoring andcoaching in medicine. Mentoring as an undergraduate and asa trainee helped with individuals’ career choice and satisfaction(Ramanan et al 2006). An analysis of six NHS mentoring schemesacross England identified three overarching areas of benefit:professional practice, personal well-being and development.Benefits appeared to go beyond a doctor’s professional role tocross the personal-professional interface (Steven et al, 2008).ong>Theong> Case For A Bespoke Service ForDoctors And DentistsDoctors currently face numerous uncertainties and challenges:policy initiatives by government to reduce NHS spending, changesin the career structure, reduced hours of work by trainees, betterinformed patients demanding higher standards of care andrevalidation. (Abbasi, 2008). Life as a junior doctor can be stressful,and the increasing intensity of work may leave little time to reflecton and discuss concerns as they arise (Paice et al 2002, Iversen etal 2008). Stress levels among consultants also run high (Ramirezat al 1996). Given the benefits identified above, it is not surprisingthat a number of ong>reportong>s, papers and royal college websites haverecommended improved access to coaching and mentoring forsome or all doctors, with similar arguments applying to>Theong> guidance paper Mentoring for Doctors (Department ofHealth, 2004) ong>reportong>ed on the views of a number of doctorswho had been mentored and concluded that the process hadreal benefits for both mentees and their mentors. Menteescommented on improved reflection skills; support for dealing withspecific problems; strategies for coping with change or crisis intheir professional lives; improved self confidence and more jobsatisfaction. Mentors also ong>reportong>ed increased job satisfactionand improved relationships with patients, colleagues and familymembers. ong>Theong> benefits for the NHS as a whole are clear. ong>Theong>ong>reportong> therefore recommended that:• ong>Theong>re is a well publicised contact point forinformation about mentor availability in eachtrust, postgraduate Deanery and medicalroyal college.• Organisations that do not provide their ownmentoring arrangements should facilitatedoctors’ access to appropriate programmesand schemes.8London Deanery Coaching and Mentoring Service

Doctors as mentees value primarily the“dedicated time for reflection during whichsomeone they trust listens ‘actively,’ challengestheir thinking but does not problem solve ontheir behalf. ong>Theong>y work through their problems ina situation of assurance of absolute confidencebut within the ethical framework accepted byall doctors.”(Mentoring for Doctors, Department ofHealth, 2004)A questionnaire survey, open to all doctors in the UK, about whatwould most improve their working lives revealed that improvedaccess to mentoring was important to junior doctors, staff andassociate specialist grades, and doctors from black and ethnicminority groups (Dornhurst et al, 2005)Since the London Deanery service was established, threeimportant ong>reportong>s have called for mentoring to be made morewidely and readily accessible within the health service.RECOMMENDATIONS ABOUTMENTORING FROM RECENT REPORTSWomen Doctors: Making a Differenceong>reportong> of the Chair of the NationalWorking Group on Women in Medicine,Department of Health, 2009Improve access to mentoring and career“advice. In the next round of contractnegotiation there should be an explicit facilityfor appropriately trained and skilled doctors(usually consultants) to undertake mentoringor career counselling as a programmedactivity within their job plan.”Invisible Patients: Report of theWorking Group on the health ofhealth professionals, Department ofHealth, 2010Mentoring and support can be especially“important at points of career transition, forprofessional development and to enableflexible working arrangements. ong>Theong> availabilityof mentors and supervisors throughout ahealth professional’s period of rehabilitationfollowing sickness absence helps to ensurean effective return to work. Those involved inmentoring and supervisory roles need to beappropriately trained and supported.”Time for Training: A review of theimpact of the European Working TimeDirective on the quality of training.Sir John Temple, 2010“Newly appointed consultants requirementoring and support. Mentoring andsupport for trainees must be improved.”London Deanery Coaching and Mentoring Service 9

THE CASE FOR A DEANERY-LED SERVICEong>Theong> mission of London Deanery is to improve the quality ofpatient care by ensuring the supply of doctors and dentistswho are educated, trained and motivated to play a full part in afirst class modern health service. It is therefore a core Deaneryfunction to develop doctors and dentists to the maximum oftheir potential, as leaders, team players and champions forlocal quality improvement. This is particularly pertinent at atime of major challenge and financial stringency in the NHS. Analternative means of development is through leadership courseswhich may be enlightening experiences but they do not offerthe individually tailored approach of coaching/mentoring thatsupports the individual in their unique environment to enable themost appropriate solution to be found. It is much more powerfulto experience coaching whilst being in the process of managingchange yourself, than to attend a theoretical course on thesame subject.A centrally provided Deanery-led coaching andmentoring service results in many benefits tohealthcare in London as follows:• Planning a coherent London-wide approachto the training and development of medicaland dental mentors• Ensuring equality of access for menteesacross London• Ensuring objectivity and confidentiality formentees by providing a service outside theemploying organisation• Providing continuity of mentoring/coachingfor trainees on rotational programmes• Exercising purchasing power to access highquality training and supervision• Developing a critical mass of enthusiasm,experience and expertise to drive theservice forward• Providing one voice for coaching andmentoring of doctors and dentists in London• Supporting London’s healthcare strategy• Providing a focal point for discussionswith national organisations eg GMC, RoyalColleges, Department of Healthong>Theong> benefits to the deanery are also manifold:• Supporting the Deanery’s mission to improvethe quality of patient care by ensuring thesupply of doctors and dentists who areeducated, trained and motivated to play theirpart in a first class modern health service• Enhancing the careers and job satisfaction ofstaff and hence the reputation of London as aplace to train and work• Helping doctors and dentists to achievework/life balance and avoid dropping out oftraining or burning out• Engaging doctors and dentists in improvingthe quality of education and service topatients in London• Enabling doctors and dentists from diversebackgrounds to maximise their potential• Strategies to prevent burnout such assupporting flexible working and work/lifebalance• Encouraging doctors and dentists in difficultyto find strategies to overcome their problems• Developing a culture of active listening,support and encouragement among agentsof the Deanery• Releasing leadership potential at every level10London Deanery Coaching and Mentoring Service

ong>Theong> Deanery believes to run the service optimally the mentoringshould be delivered by appropriately trained and supporteddoctors or dentists. It is considered that a shared understanding ofthe context and values of the medical environment will encouragetrust in the service and rapidly enable rapport to be established.Confidentiality is more readily assured by offering mentors fromdifferent specialties and organisations which will give the menteethe confidence in the system to share personal information. Inaddition the mentor will be likely to bring a fresh light upon issueswhich should encourage creative thinking and there should be lesstemptation to offer the Mentee inappropriate advice or solutions. Itis important that the mentor has the knowledge and understandingon accessing other sources of help for the mentee, such ascareers information, counselling, psychotherapy or medical>Theong> Deanery, with its wide educational networks, is ideally placedto ensure the availability of experienced mentors from differentspecialties and different organisations across London.LESSONS LEARNED FROM OTHERSong>Theong> lessons learned by others helped to inform the way theLondon Deanery service was set up.• A review of publications about mentoringprogrammes for medical students or doctorsconcluded that most offered evidence ofsatisfaction with the programme but failed toprovide a short- and long-term evaluation ofthe individual successes of the participatingmentors and mentees. (Buddeberg-FischerB, Herta KD, 2006). ong>Theong> London Deaneryprogramme has been designed from the startwith systems to capture feedback from eachencounter between mentor and mentee;reflection on the impact of the experiencesome time after conclusion; and the views ofstakeholders such as medical directors anddirectors of medical education about anyeffect in the workplace.• Another review of the subject highlights theproblems of having a mentor who is seniorto the mentee and working in the samedepartment “problems exist, such as conflictbetween the mentoring and supervisoryroles of the mentor, confidentiality breaches,mentor bias, lack of “active listening” androle confusion.” (Taherian K, Shekarchian M,2008). ong>Theong> London Deanery service matchesmentees to mentors from outside theemploying organisation and specialty.• A successful programme in North EastEngland also described problems with “levelsof confidence in providing mentoring; culturalfactors, such as juniors not wishing to beseen to need help, and organizational factors,such as lack of time allocated for mentoring.”(Connor et al, 2000) ong>Theong> training andsupervision of mentors and the assuranceof confidentiality for mentees are centralto the London Deanery’s Coaching andMentoring Service.London Deanery Coaching and Mentoring Service 11

Establishing THELONDON DEANERYSERVICE12London Deanery Coaching and Mentoring Service

SECURING RESOURCESong>Theong> funding for starting up the service came from the ‘transitional’money made available to deaneries by the Department of Healthto support doctors whose careers had been adversely affected bythe flawed Medical Training Application Service (MTAS) recruitmentscheme. In order to help these individuals, the Deanery trained acadre of mentors who then went on to provide the nucleus of aservice open to all doctors and dentists working in London’s NHS.Based on discussions with colleagues who had set up mentoringarrangements in their own organisations, and looking to the privatesector where successful leadership assumed that new leaderswould be supported in their role by skilled and remuneratedcoaches. It was clear that to sustain the service the mentors mustbe paid and supported to grow their skills. ong>Theong> Deanery comparedthe funds paid to GP appraisers and other mentoring schemesbefore deciding to pay £150 for 90 minutes of mentoring. Generallythe mentors provide the meeting rooms and updates, supervision,forums and training are all unpaid. Those doctors and dentistswho mentor in their working time invoice on behalf of theiremploying>Theong> facilitators of the supervision evenings are paid for theevenings, their own supervision is not funded.Assessing colleagues, matching mentor to mentee, and runningtaster events is paid at similar rates. However some mentors donot invoice the service.BUILDING A TEAMDr Rebecca Viney was appointed to lead the service in February2008, the service sits within the newly established FacultyDevelopment Unit. One of her early tasks was to build a team.Administrative support was essential and a variety of talents andinnovations were brought to the service by administrators. Thosementors with the most experience matched mentors to mentees,ran taster sessions, facilitated the supervision evenings, ran a bookclub on coaching and mentoring, helped to develop strategy andassessed new mentors.A formal Mentoring Advisory Group (later to be renamed theCoaching and Mentoring Advisory Group or CMAG) was setup after the first six months, once the decision had been madeto continue to support the service after the transition moniesran out. CMAG was set up to provide advice to the service byincluding mentoring experts and the stakeholders; supporting thedevelopment of strategy and policies, and aligning them to thestrategic objectives of the Deanery. ong>Theong> membership of the CMAGincludes representatives of the Deanery, local education providers,trainees, a lay member and external experts in the field. A broadernetwork of support was developed by identifying interestedcolleagues within the Deanery and other education providers bothin London and more widely. This wider group proved a valuablesource of practical support and championship, helping to spreadthe word about the service among their>Theong> service appointed a mentoring tutor for 18 months, to assistthe lead with matching of mentees to mentors and then morespecifically with doctors in difficulty.London Deanery Coaching and Mentoring Service 13

Principles of the ServiceBased on a review of the literature about coaching and mentoringand discussions with colleagues who had set up mentoringarrangements in their own organisations, a set of principles for theservice was agreed (Viney and Bhatti, 2010). ong>Theong>se included:Voluntary participationong>Theong> full benefits of coaching and mentoring are realised only if bothparties come to the process as willing volunteers, and feel able towithdraw if it is not working out.ConfidentialityBoth parties must be able to trust each other and speak openlyand honestly without fear of being quoted. Some mentees mightprefer the very fact that they are being mentored to be keptconfidential. Disclosure of information to another body will onlybe made in those rare circumstances where there is a seriousconcern about the safety of the practitioner-patient, their patientsor the public, or where there is concern about criminal>Theong> Mentee would be informed that the disclosure was about tohappen and every effort would be made to gain their consent first.ExternalityExternality is accessing a mentor who is not from the mentee’sspeciality or place of work .Whilst many organisations, inhealthcare and outside it, have set up successful internal schemes,there is strong evidence that people benefit in being able to talkto someone outside the employing organisation, and outside thespecialty in which they are working. In this way, the mentorcan remain purely objective and can listen fully to the menteewithout his/her own experience potentially leading to pre-judging.In addition, the outside perspective is often valuable. Wherepossible therefore, mentees should not be matched with mentorsfrom their own specialty or employing organisation. In this wayconfidentiality is ensured and the mentee gains the benefits of anoutside perspective.Choiceong>Theong> mentee must have a choice of mentors, with the option, wherepossible, to have one from the same sex or ethnicity, a similarbackground, or who has had to deal with similar issues. However,the mentee should be discouraged from choosing a mentor on thebasis of patronage. This may involve the mentee hoping that thementor may give directive advice that may not be the best solutionto this individual case or use their influence in promoting theinterests of their Mentee.Mentee preparationCoaching and mentoring are not currently embedded in theNHS culture. Applicants to be mentored may have little previousexperience of the type of service being offered. Information shouldbe readily available on the dedicated website and further detailprovided by the matchers and mentors by telephone. ong>Theong> menteesshould be clearly instructed in their responsibilities to prepare forsessions beforehand, to identify problems to work on and concordwith any agreed change from the mentoring sessions.Trained mentorsong>Theong> central plank of the service is that the skills required forsuccessful coaching and mentoring have to be learned and that allmentors in the scheme will have had at least 3 days of hands-ontraining and successfully passed an assessment of competence.This in conjunction with the ongoing support is a means ofensuring uniformity of approach and good practice.Ongoing supportMastery of coaching and mentoring skills involves training,supervised practice and reflective practice facilitated with expertprofessional support. ong>Theong> service should provide these elementsand require its mentors to participate.Contractingong>Theong> Deanery/mentor and mentor/mentee contracts shouldbe explicit and signed by both parties. ong>Theong> ground rules andboundaries were covered in the training of mentors. ong>Theong>y will beset out in the written material supplied to mentees who be askedto state that they have read it before their applicationis progressed.Ethicsong>Theong> ethical framework within which the service operates will bemade clear to all parties through training and via written guidelinessupplied on the website.Avoidance of dependenceong>Theong> mentoring should be restricted to 4 sessions in order to focusminds and discourage an on-going dependent relationship, sincethe aim of the service to foster self-resourcefulness.No blameA mentoring relationship can be intense and interpersonal frictionor lack of rapport may interfere with its effectiveness. Either mentoror mentee will be able to withdraw from a mentoring relationshipat any time without blame or repercussions. ong>Theong> mentee may bere-matched in these circumstances.14London Deanery Coaching and Mentoring Service

Monitoring, evaluation and reviewAs with any service funded by public money, there must be asystem of quality control and quality improvement, with regularfeedback from participants and other stakeholders.Equal opportunitiesAll mentors must have evidence of having undertaken recent equalopportunity training.Website developmentong>Theong> website was intended to be the shop window for the service.It was important that it should be prominently displayed on theDeanery home page to advertise the service and facilitate ease ofaccess. ong>Theong> Deanery’s web team with the mentoring lead havedesigned a well-structured home page that clearly presents theservice and enables navigation to relevant information. Feedbackfrom users has been very positive. Importantly, anyone enteringthe keywords “mentoring” and “London” into Google will find thewebsite in the first few>Theong> London Deanery Coaching and MentoringService HomepageLondon Deanery Coaching and Mentoring Service 15

Written MaterialsRegular updates, overviews and handbooks for mentors andmentees, have been published explaining the underlying coachingand mentoring concepts, the service and its boundaries. ong>Theong>seresources have proved to be a vital ingredient in the success of theventure. ong>Theong>y have helped to ensure that all parties have a sharedexpectation of the mentoring relationship and the responsibilitiesof all parties. ong>Theong> handbooks, ethical guide, and answers tofrequently asked questions (FAQs) about the service providethe practical details that help individuals find their way throughthe system with a minimum of misunderstanding, confusion orfrustration (Mentor agreement).It makes a huge difference having people come“with a good idea of what to expect and whatthe ground rules are from reading the website –it means we don’t have to spend too much timeon the preliminaries and can get stuck rightinto the work.”(mentor)ong>Theong> written material was based on published material (Clutterbuck,1991, Rogers, 2004, Connor and Pokara 2007), and on materialsused by colleagues running mentoring in their own organisations.Mentor agreement• Mentors will fit with the personspecification and job descriptioncore competencies.• Mentors will attend 3 day mentoringcourse /unless they have attended anapproved equivalent.• Mentors will be self employed for theirmentoring sessions except by prioragreement with the Deanery.• Mentors will attend a minimum of 50%of local support group meetings annually.• Mentors will be prepared to take aminimum of one Mentee at anyone time.• Mentors will see each new Mentee foran introductory session, and if theyagree they will send back a ong>reportong> afterfirst meeting session and set datesfor further meetings not more than 3months apart.• ong>Theong> commitment to 4 sessions needs tobe undertaken within 12 months (unlessextensions have had prior agreementfrom the Deanery).• After each session the mentor will returnan invoice and Mentor and Menteerecording sheet to the>Theong>y may also choose to complete amentor development reflectivepractice form.16London Deanery Coaching and Mentoring Service

• It is the responsibility of mentors toretain contact with the mentee andmake a record of all attempts to contact.If the appointment is cancelled, thementor should arrange a new date. It isimportant that a signed Mentor contractis submitted along with invoices. Pleasesee the Mentor Contract in the nextsection.• Mentors will tell the administrator whenthe mentoring contract is completed, sothat an Exit Evaluation Questionnaire willbe sent to the departing Mentee.• Mentors should be prepared to travel areasonable distance to meet the Mentee.• Mentors should keep a PersonalDevelopment Plan (PDP) in relation totheir own learning needs as mentors.• Mentors will sign the Declarationform for the selection and reselectionpurposes.• Mentors will inform the Mentoring Leadshould he/she be involved in a complaintby the Mentee (see declaration form).RECRUITING AND SELECTING MENTORSAwareness of the service was raised through flyers, taster sessionsto the educational networks in primary and secondary care, andby word of mouth. Further information and application formswere provided on the website. ong>Theong> online application form wasdesigned to identify which candidates had previous experienceand to capture candidates’ views and expectations of mentoring .A few applicants argued that they did not require training as theywere working as a mentor, had previous training or their experiencehad already provided them with the required skills. However theprinciples of the service required all applicants to be trained ina consistent manner and undergo an assessment. Those whostated in their application that they were already trained wererequired to attend a “gateway day” to refresh their training and beassessed. Unless the applicant had both passed the assessmentand previously undertaken at least three days of a substantiverecognised training course they were required to undertake theDeanery’s three day training course in mentoring skills. A handfulof applicants with extensive mentoring experience but less than3 days training were allowed to start mentoring after passing theassessment provided they agreed to undertake the three daytraining course within the next>Theong> recruitment process targeted doctors and dentists who hadeducational roles, and encouraged applicants from a wide rangeof specialties and settings. ong>Theong> intention was to embed a cultureof coaching and mentoring across London’s NHS. In the secondrecruitment round applicants from over-represented specialitiesand Trusts were not accepted for training while extra efforts weremade to recruit from the under-represented areas.• Mentors will be prepared to appraise amentor colleague.• Where mentors and mentees decideto continue with their sessions afterdeanery funding expires (e.g. with theclient or a trust paying) the arrangementsshould be approved by the Deanery.Mentor Handbook, London DeaneryCoaching and mentoring website11 Sep 2010London Deanery Coaching and Mentoring Service 17

TRAINING, SUPERVISION ANDDEVELOPMENT OF MENTORSTrainingong>Theong> next step was to make sure the Deanery’s coaching andmentoring service provided excellent training for mentors. Trainingpartners were required who would ensure that all mentors wereequipped with the competence required. See below.EIGHT COACHING/MENTORINGCOMPETENCE CATEGORIES1. Understanding SelfDemonstrates awareness of own values,beliefs and behaviours, recognises howthese affect their practice and uses this selfawarenessto manage their effectiveness inmeeting the client’s, and where relevant, thesponsor’s objectives.2. Commitment to Self-DevelopmentExplores and improves the standard of theirpractice and maintain the reputation ofthe profession.3. Managing the ContractEstablishes and maintains the expectationsand boundaries of the coaching/mentoringcontract with the client and, whereappropriate, with sponsors.4. Building the RelationshipSkilfully builds and maintains an effectiverelationship with the client, and whereappropriate, with the sponsor.5. Enabling Insight and LearningWorks with the client and sponsor to bringabout insight and learning.6. Outcome and Action OrientationDemonstrates approach, and uses theskills, in supporting the client to makedesired changes.7. Use of Models and TechniquesApplies models and tools, techniques andideas beyond the core communication skillsin order to bring about insight and learning.8. EvaluationGathers information on the effectiveness oftheir practice and contributes to establishinga culture of evaluation of outcomes.European Mentoring and CoachingCouncil, 2009Initially the Coaching and Mentoring service partnered with MTASto establish a service. To achieve the rapid roll-out of a highquality service, doctors and dentists who were known to be activementors were approached. Selected companies’ training wasdirectly observed; training materials and the training experiences ofmentors were compared. Three potential partners were identifiedand approached to explore a training programme and its costs. Bythe end of the first year, training requirements had been outlinedand tenders sought widely against our specifications. Basedon this process Management Futures was selected to be theprovider partner for a three day intensive hands-on course with anassessment at the end of it.“What I liked about the course was that it washands-on right from the start. You got theopportunity to try things out as soon as youlearned about them, and you got immediatefeedback on how you were doing.”(GP mentor)18London Deanery Coaching and Mentoring Service

Supervision and developmentong>Theong> service has a strong emphasis on supervision and furtherdevelopment of mentors, in line with the concepts described byHay, Supervision and development encourages reflective practiceand continuous improvement and keeps interest alive (Hay, 2007).Mentors agree in their contract to undertake a minimum of twosessions of mentoring development per annum, most undertakeconsiderably more. Individual annual reviews of all mentors takesplace to quality assure the pool of mentors and to plan their furthermentoring development. Mentors are invited to attend quarterlysupervision evenings, half day skills boosters and forums onspecific topics through the Deanery. In addition NHS London hasoffered some telephone supervision.All mentors are actively encouraged to undertake the Instituteof Leadership and Management (ILM) Certificate or Diploma inExecutive Coaching and Leadership Mentoring. An additionalbenefit of the ILM programme is that participants have access to apeer mentor and personal supervision by>Theong> importance of supporting trained mentors with ongoingsupervision was recognised from the start. ong>Theong> Tavistock Clinic,which already provided training in clinical supervision for theDeanery, agreed to facilitate group supervision at a centrallocation. Four supervision groups (one for each geographicalquarter of London) were run by psychotherapist facilitators onceevery eight to ten weeks. At the start only one facilitator was adeanery mentor. Over time five of the facilitators became trained asmentors.After about six months, mentors requested that the groups meetnearer their homes. Two Deanery mentors from the MaudsleyHospital in south London offered to facilitate the two South Londongroups , supported by a professional coach and a highly skilledmedical director. However the attendance was patchy and somementors missed the connection with other mentors andthe Deanery.Since then supervision has been provided approximately every 2months at a central location chosen for its accessibility. As well assupervision, the mentors and facilitators have the opportunity tonetwork over a light meal, join in with a coaching and mentoringbook club and catch up on Deanery news. ong>Theong> aim is to enhancereflection and develop skills rather than review “cases”, - alwaysremembering that the mentee is resourceful and is not a patient.‘Mentor Forums’ were also provided, their purpose being tointroduce the mentors to techniques and issues that were notaddressed in the initial training. ong>Theong>y were also an opportunityto provide an update on the development of the service. ong>Theong>seevents have included themes such as;• Helping the doctor in difficulty• Leadership skills and coaching andmentoring• Emotional intelligence and the tools tomeasure itMARKETING THE SERVICELondon Deanery is the largest Deanery in the country, responsiblefor commissioning and managing the postgraduate educationof over 12,000 doctors and dentists. It also has responsibilityfor supporting the continuing professional development of staffand associate specialist grades (SASGs), GPs and consultanteducators. An important initial consideration related to which ofthese should be eligible for the service, given our finite resources.From the start it was agreed that all doctors and dentists workingin the NHS in London were eligible to apply to be mentoredthrough the service, though not necessarily funded by the Deanery.Funding eligibility initially included only those doctors and dentistswho were in training or in the first two years after completion oftraining, and also GPs on the Induction and Refreshment Scheme.After a few months, in response to demand and because fundingwas available, SASGs were added. It did not seem appropriate tooffer the service to doctors not working in the NHS or in London.Start-up funding had been made available to provide trainedmentors for doctors in career difficulty following MTAS, and thosewere the first group targeted. Once the decision was made toextend the service, the challenge was to rapidly publicise it to thepeople who would most benefit hear about it quickly, enablingthe mentors to put their new skills into practice without delay.However, the level of uptake of the service by mentees wasuncertain, and the Deanery did not want to leave applicantsdisappointed or disillusioned by stimulating demand beyond thecapacity to meet it. ong>Theong> initial marketing strategy was therefore toadvertise on the Deanery website and send flyers out through theeducational networks, ie a soft launch to test the water. Once itwas agreed that all SASGs would be eligible, individual invitationswere sent to their email addresses and the service was promotedvia the flyers to medical directors. Further promotion was achievedthrough presentations given by the mentoring lead, mentors andmembers of CMAG at a range of educational events aroundLondon, including the Deanery’s SASG and through SASG tutors.New consultants and GPs were reached through the deanery’sannual conferences. Taster sessions at which people couldexperience a brief mentoring encounter were organised at severaleducational events, most notably as part of the 2009 BMJCareers Fair.London Deanery Coaching and Mentoring Service 19

Matching Mentees to MentorsAs the principle of choice is important, it was decided to offerpeople applying to be mentored a choice of mentors. All mentorssuccessfully completing the assessment.Are asked to write a brief ‘pen portrait’ of themselves, includingbrief details of their background, specialty and interests. ong>Theong>Deanery keeps a register of trained mentors, the number ofmentees they are working with, where they prefer to meet menteesand any other preferences. Applicants to be mentored are advisedbefore applying to familiarise themselves with the material on thewebsite. Once the application is received, it is checked againstthe GMC or GDC website and the mentee’s funding eligibility isconfirmed. ong>Theong> administrator then passes the application to theMentoring lead and Mentoring Tutor who contact one of the smallteam of ‘matchers’ - experienced mentors who undertake thisadditional work on behalf of the Deanery. ong>Theong> matcher telephonesthe applicant and referring to the mentee’s application exploreswhat the issue is that they want to work on and what they canexpect to get out of being mentored. ong>Theong> nature of mentoring isexplored, and distinguished where necessary from advice-giving,information provision, patronage or therapy. This discussion servestwo purposes, first in managing the expectations of those whogo on to be mentored and second in identifying those for whomcoaching and mentoring will not meet their needs. In such casesthe applicant may be directed towards a more appropriate sourceof support, locally or via other Deanery services such as the Careers Unit>Theong> pen portraits of 3-5 mentors that would seem to suit theirpreferences are then emailed across and the applicant has time toconsider and make a choice. ong>Theong>y are reminded of the ‘no blame’policy and that they can decide that they would prefer anothermentor if issues arise. ong>Theong> matcher gently reminds potentialmentees to respond and is able to gauge the level of commitmentto being mentored. ong>Theong> matcher with the deanery may agreenot to pursue further once a certain level of non-response hasbeen reached.Feedback and EvaluationFeedback about the service was encouraged from the start, fromboth mentors and mentees. Evaluations are an intrinsic part ofeach of the training and supervisory events provided for mentors,and the comments have been used to improve the content andsetting of these events. Regular meetings to discuss feedbackwith the training and supervision partners ensured the quality andcontext of the training improved over time. Records are kept of thetraining and supervision accessed by each mentor. At the simplestlevel, records are kept of how many mentees each mentor hasand how many sessions have occurred. Evaluating the successof the relationship is necessarily more difficult. While what goeson in the sessions is confidential, the Deanery team are awareof who is being mentored and by whom, and can reasonablyask for feedback on the success of the mentoring in its closuredocumentation and also by telephoning individual mentors andmentees to hear how they are getting on. This feedback is regularlydiscussed at meetings of CMAG in order to encourage continuousquality improvement.A formal evaluation of the first year of the service was carried outbetween January and July 2009. ong>Theong> evaluation was carried outby the Coaching & Mentoring Research Unit at Sheffield BusinessSchool. ong>Theong>y carried this out by interviewing stakeholders withinthe Deanery and CMAG; surveying mentors and mentees;conducting case studies with 8 mentor:mentee pairings andreviewing the Deanery’s documentation relating to the governanceand management structures, processes and procedures of theservice. ong>Theong> results of this evaluation were the subject of a ong>reportong>(Chadwick-Coule and Garvey, 2009) available on request fromthe Deanery. In brief, stakeholders were very positive about theleadership, the training, the service and the way it was organised.Both mentors and mentees ong>reportong>ed that their expectations weremet or exceeded. Mentors and to a lesser extent mentees, noteda beneficial impact on their listening skills, their management of selfand others, and their response to a challenging situation.20London Deanery Coaching and Mentoring Service

THE PARTICIPANTS21London Deanery Coaching and Mentoring Service

MISSINGong>Theong> MentorsCHART 1 AGE 1% GROUPING OF MENTORSOVER 6030-40A mentor does not give advice, rather helps“ 8%11% MISSINGthe mentee to weigh up situations, through a1%process of reflection, questions, challenge andOVER 6030-40feedback allowing the mentee to come to a8%11%decision themselves. It is crucial to remember50-60that in any mentoring relationship it is the30%mentee who drives the agenda, notthe mentor. 50-60”30%(London Deanery Coaching andMentoring website)ong>Theong> success of a coaching and mentoring service depends heavilyon having a cadre of capable mentors who are approachable, wellinformedand skilled at helping their mentees think through howbest to achieve their goals. ong>Theong> Deanery was fortunate in attractinga strong group of mentors, with a sufficient range of personalities,styles and backgrounds to present mentees with a real choice. ByMarch 2010, 140 had completed the initial training programme and104 were actively mentoring.Demographics of mentorsWomen made up 55% of those trained, and 60% of thoseactively mentoring. 68% of mentors were white and the remainderwere from a wide range of ethnic backgrounds, reflecting thedemographics of London’s GPs and consultants. Nearly halfof the trained mentors were GPs. ong>Theong> rest were from a widerange of specialties (Chart 2). Almost all the mentors were GPsor consultants. At this stage trainee groups were not targeted.SASGs were targeted, and 8 undertook the training, of whomfour were actively mentoring. ong>Theong> mentors came from 58 differenthealthcare organisations in London.40-5050%40-5050%CHART 2 SPECIALTY OF MENTORSTRAINEDO&G2%PHM EMO&G1% 3%2%GPDENTAL PHM EM46%5% 1% 3%GP PSYCH DENTAL46% 7% 5%ANAESTHPSYCH7%7%ANAE7%22London Deanery Coaching and Mentoring ServiceMEDICINE13%SURGERY8%PAEDS8%MEDICINE13%SURG8%PAEDS8%

Previous experience of mentoringApplicants to become a mentor in the service were asked abouttheir previous experience or training. While only 39/152 (26%) hadbeen on some form of formal training in mentoring, most felt thatthey had carried out a mentoring role, formal or informal, usuallywith junior colleagues or students at their place of work. After thethree day training many recognised that their previous ‘mentoring’largely related to patronage or advice giving and this differed, fromthe model of mentoring promoted within the Deanery’s service.I have not done any official mentoring training“up do date but as a senior doctor in my trustand having finished my training a while ago Ialways find myself in a position of giving careeradvice and help to other people.”(Consultant)Motivation to become a mentorWhen asked on the application form to give their reasons forwanting to become a mentor almost everyone referred to theirdesire to help others, give something back, make a difference.Several saw this as an extension of their role as a doctor -improving patient care through supporting colleagues. Somecommented on the help they had themselves received at difficulttimes, or they wished they had received. ong>Theong>re was a strongsense of empathy with younger colleagues facing careercrossroads, making important career transitions, or coping withorganisational change.I would like to be a “Yoda” or “Mr Miyagi” to an“aspiring or young consultant, hopefully passingon what experience I can impart in guiding/developing someone else’s career. Professionalloneliness or lack of guidance can be a problemin senior positions.”(Consultant)I think general practice can be a very isolating“job and the more we can do to bring in formalnetworks to decrease this the better, peoplebecome very set in their ways, even in largegroup practices as partners, and often don’tlook at their way of work.”(GP)A few made the point that they expected the relationship would beenriching for them too.I have always enjoyed supporting my colleagues“and peers in their personal and professionaldevelopment and the development of theirpractices. This aspect of my work has enrichedmy own personal/professional developmentover many years.”(GP)That the mentors’ own performance might benefit initially came assomething of a surprise to mentors. However during the trainingsessions it was clear that mentors were struck by the differencein impact between a problem solving, advice-giving approachand an actively listening, questioning approach, and readily madeconnections to the way they dealt with their own staff and patients.Doing mentoring has changed the way I talk to“people – patients, juniors, colleagues. Even myfamily has noticed!”(Consultant)ong>Theong> benefit to mentors was confirmed in a questionnaire surveysent to active mentors during the second year, of whom 49responded. (Charts 3 and 4)London Deanery Coaching and Mentoring Service 23


ong>Theong> MenteesDemographics of menteesFemales made up 62% of applicants for mentoring. 52% werewhite and the remainder from a variety of ethnic backgrounds;75% were aged 40 or less. Just under half the applicants weretrainees, distributed fairly evenly across the grades (Chart 5).ong>Theong>y came from a wide variety of specialties and employingorganisations across London.Reasons for applying to be mentoredApplication reasons were dominated by dilemmas over careerdecisions, progression and development. ong>Theong>y ranged from thevery general to the very specific. In a few cases the main or onlyreason given was that they had been referred, ie someone else hadrecommended they apply, whether a friend, supervisor, trainingprogramme director or even the GMC (Charts 6 and 7).I recognise not only in myself but in colleagues“that there are currently many questions aboutmotivation with regards to our vocation, andbelieve strongly in the mutual need for supportamong doctors.”(New consultant)I am at the point in my training where I have to“decide what path I want my career to take. I amfinding this decision very challenging and I’vebeen struggling with it for some time. I’d likea mentor as an objective sounding board so Ican work through my options. Conversationswith consultants in my field always end up withadvice rather than what I actually need.”(Specialty trainee)I would like advice on issues surrounding“consultations, and patient doctor relations.”(GP trainee)CHART 5. CAREER LEVEL OF APPLICANTSCONSULTANT8%GP24%NOT WORKING4%FOUNDATION13%SAS GRADEHIGHER SPECIALTY16% 21%CHART 6. REASON FOR APPLYINGCAREER ENHANCEMENT44%NO ANSWER1%WORK/LIFE BALANCE6%REFERRED6%CORE SPECIALTY14%PROBLEM OR HURDLE12%CRISIS OR CHANGE13%CAREER DECISION18%London Deanery Coaching and Mentoring Service 25


Outcome of applicationAs of March 2010, just over half of the applicants had embarkedon mentoring or completed it and another 20% were goingthrough the matching process. Of the rest, 13% failed to respondto attempts to make contact, 9% withdrew their application and4% were ineligible for Deanery funding and unable to alternativefunding. 3% were ineligible because they were not working in theNHS or in London - we had a handful of applicants from the rest ofthe country or abroad. (Chart 8).CHART 8. OUTCOME OF APPLICATION TOBE MENTOREDCOMPLETED14%IN MENTORING37%INELIGIBLE3%NO RESPONSE13%NO FUNDING4%IN PIPELINE20%WITHDRAWN9%Feedback from menteesConfidential feedback from every mentee was sought after theirmentoring was completed. This has been very positive, whereavailable, though getting the evaluation pro-formas completedand returned has proved a challenge. Below are some typicalemail quotes:It was very valuable to be able to discuss some“difficulties with someone outside my departmentand specialty and enabled me to re-find myfeet on a training rotation at a point where I wasfinding things very difficult.”I felt although brief and only 2 sessions I felt“an amazing sense of support and enjoyedthe chance to discuss career progressionand decision making with a non anaesthetistincredibly useful. I would like to find out moreinformation on becoming a mentor myself inthe future when I have settled into my newconsultant post.”She provided me reflective space in a non“threatening manner to consider my careeroptions and to examine and challenge my preconceived ideas about the obstacles in mycareer path.”Topics discussed in sessionsong>Theong> topics discussed during the mentoring sessions reflectedthose the applicants said they wanted help with, though with moreemphasis on work/life balance (Gabbard G 1985) and less ontechnical and professional knowledge. ong>Theong> views of mentors andmentees of the topics discussed did not diverge significantly. ong>Theong>mentors’ views are presented here, based on 49 respondents toan early survey (Chart 9).London Deanery Coaching and Mentoring Service 27


Considerations forthe Future29London Deanery Coaching and Mentoring ServiceLondon Deanery Coaching and Mentoring Service 29

Lessons learnedong>Theong> first two years of the service have proceeded to plan and theservice has recruited and trained its full capacity of mentors whichhas kept pace with mentee applicants. A number of lessons werelearnt regarding what went well, and what requires improving thatwill guide the planning for the future.Planning aheadong>Theong> transitional funding to support those affected by MTASprovided the opportunity to kickstart this programme. However,uncertainty over the availability of further funding made planningahead difficult. It is considered that funding for a minimum of threeyears is required to enable constructive forward planning.Keeping recordsCommunication between the Deanery mentoring team and thementors and mentees has mostly been via email and the>Theong> website contains a number of useful downloadable forms thatprovide a structure for contracting, recording sessions, reflectingand feeding back. Mentors are expected to sign and get thementee to sign, a brief record about the themes of the sessionand any action points agreed, and to return this to the mentoringoffice. This is important as it forms the basis for invoicing forthose mentors, e.g. GPs, who are self-employed and paid by theDeanery directly for their time. Retrieving this paperwork has notalways been easy and participants have expressed discomfort withreturning notes that may have sensitive information on them. Adecision has now been taken to exclude any record about themesand actions agreed. However mentor and mentee may keep thisanonymised information if jointly agreed as helpful in the process.Marketingong>Theong> service was deliberately given a relatively soft launch, so asnot to create demand beyond capacity. After about 18 months itbecame clear that there were insufficient mentees for the numberof mentors trained, and marketing of the service was stepped up.Mailshots to trainee groups through their specialty schools, to newGPs through the Deanery database of recent trainees, throughtheir PCTs, the LMC, their trainers and programme directors andto new consultants via their medical directors have been effectivein increasing demand. For example a recent mailshot to a largecohort of new consultants, via the Deanery database, yielded over50 applications in a week.Data collection and analysisIn times of economic stringency services will be scrutinised closelyfor delivering value for money. It is vital that accurate records arekept on an electronic database to enable regular review and audit.Data collection and recording, including feedback and evaluation,should be an explicit responsibility in the job description ofadministrative staff.30London Deanery Coaching and Mentoring ServiceCommunicationsEffective communication, through an attractive user friendlywebsite, group emails and newsletters are essential. Support fromthe Deanery communications team made an important contributionto the success of the service. It was also important to have anumber of mentors who had high profile ‘day jobs’ and were ableto be influential ambassadors for the service.Future decisionsCentralised vs DevolvedBased on the size of London’s NHS, it would be reasonable to planfor the service to expand year on year for the foreseeable future,so that every doctor or dentist can access a mentor during timesof challenge or change. Although larger hospital trusts may beable to develop in-house services, based on similar principles it isviewed that a high quality service would be impossible to deliverfor the following reasons. ong>Firstong>ly, it would be difficult to reassurementees on confidentiality and prevent prejudgement of issues bymentors. In addition, there is strong evidence that people benefit inbeing able to talk to someone outside their employing organisationand from a different specialty. This separation of function assiststhe mentor in remaining purely objective, concentrating on thementee’s story without their own experience prejudicing the issues.In addition, an outside perspective is often>Theong>re are strong reasons for having a centrally organised servicesince this enables equity of provision, enables effective promotionof the service and minimises any negative influence from individualorganisations who may not perceive the benefits to their trust. Itpermits the service to be more responsive to change and take onnew roles such as focusing on leadership skills in coaching andmentoring. It enables quality improvements to be implementedwidely and consistently.TrainingIn the future it may be possible as medical and dental mentorsbecome more experienced and acquire recognised qualifications,to provide mentor training in house.Individual vs. Teamsong>Theong> coaching skills can be utilised in team building and teamcoaching. Current mentors would require little additional trainingto deliver this. ong>Theong> ultimate aim of mentoring is to improve patientcare. ong>Theong> proposed changes as outlined in the White Paper willrequire highly effective team working across the health service andit is anticipated that team coaching will have a valuable contributionto make.Team leaders whether established or recently appointed willbenefit from coaching as they face the challenges ahead which areunprecedented in the NHS.

Poor performance vs High performanceTargeting the service at poor performance or at enabling highperformance requires careful consideration. Although these are acontinuum, and the same skills are likely to be helpful to both, itis important to have a service that is aspired after. If a service isseen to provide support for poor performance only, high-fliers, whomay gain the most benefit from input as they may be more ableto carry out change, will not apply. It is important that participatingis perceived as a mark of success and an essential part of furtherprofessional development.Fees vs FreeHistorically those schemes that have not paid their mentors havewithered over time. ong>Theong> time mentors invest in order to work for theLondon Deanery is considerable since it includes not only the faceto face mentoring time but additional travelling time, administrativework, as well as fitting in supervision and refresher sessions.Most mentors are working full time and deliver the service in theirown time at evenings or weekends. This highly skilled work isdevalued if the time and effort to acquire and deliver these skillsis not recognised. ong>Theong> provision of free coaching and mentoringplaces the mentor and mentee on an unequal power base, withthe Mentee indebted to the mentor for their contribution to theprocess. This tends to encourage ineffective mentoring techniquessuch as paternalism, patronage and advice giving disempoweringthe mentee further.Sustaining and embedding theserviceong>Theong> challenge for the service is to encourage and embed a cultureof coaching and mentoring across London’s NHS. Initiatives thatthe service will be pursuing to promote this aim include:• Training in mentoring and coaching forteams of senior staff from the same NHSorganisation• Training for multi professional groupsincluding Human Resources, MedicalEducation Managers and Nurse Practitioners• Forming partnerships with other organisationsencouraging coaching and mentoring suchas royal colleges and medical schools• Training of some mentors in team buildingand team coachingImproved working practices - Leanand GreenLeanIn keeping with London Deanery’s drive to encourage Leanworking, the CMAG and the mentors will consider how theprocess of application, choosing a mentor and arranging meetingscan be simplified and made more efficient for mentees and howcontracting, documentation of sessions and seeking feedback andbe made more efficient for mentors.GreenPaperless communication will be the norm either by telephone orelectronic, unless an individual specifically requests a paper copy,and records will be stored electronically. Catering for coursesand meetings will be kept modest and healthy, using eco-friendlysuppliers wherever possible.London Deanery Coaching and Mentoring Service 31

Response to the White Paper Equityand Excellence: liberating the NHSong>Theong> recent white paper, Equity and Excellence: liberating the NHShas called for new leadership and better integration of learning andworking. London Deanery’s Coaching and Mentoring Service hasresponded by:• Raising awareness of the service with medicaldirectors and encouraging new consultantsand GPs to apply• Funding coaching and mentoring for anydoctor or dentist in a new leadership role - atany stage of their career• Planning to develop a select cohort ofmentors with the skills to coach teams andhelp them work more effectively together• Encouraging ARCP and RITA panels to offercoaching and mentoring to trainees who arestruggling for any reason• Offering funded coaching and mentoring tothose with leadership roles in education andtraining• Attended national coaching conf• Exploring new models and training32London Deanery Coaching and Mentoring Service

Conclusionong>Theong> first five hundred mentees have confirmedour conviction that this service is needed andappreciated by a significant number of doctorsand dentists. This is confirmed by the feedbackthe service has received from both mentors andmentees. It is expected that demand will continue togrow as personal recommendations spread the wordand the benefits accrue from the new competenciesgained. This should drive even higher standards ofteam working and patient care, whilst delivering aholistic approach that reduces the risk of>Theong> Deanery’s Coaching and Mentoring service iswell prepared to help deliver the changes describedin the White Paper Equity and Excellence: liberatingthe NHS.What is needed is not just a handful of allocated“or even fully trained mentors but an overallparadigm shift to a culture of coaching, with rolemodels, positive constructive feedback, andgood staff management principles.”(Hutton Taylor, 1999)33London Deanery Coaching and Mentoring Service

REFERENCES1. K. Mentoring and the meaning ofsoul. J R Soc Med 2008;101:523Buddeberg-Fischer B, Herta KD. Formalmentoring programmes for medicalstudents and doctors-a review of theMedline literature. Medical Teacher, 2006;28:248-257Chadwick-Coule, Tracey and Garvey,Bob. London Deanery MentoringService: A Formative and DevelopmentalEvaluation of Working Practices andOutcomes. Coaching & MentoringResearch Unit, Sheffield Business Schoolat Sheffield Hallam University 2009Clutterbuck D (1991) Everyone needs amentor:fostering talent at work. Instituteof Personnel and Development, LondonConnor M, Pokora J (2007) Coaching andMentoring at Work: Developing EffectivePractice. Open University Press,Milton Keynes8., George F.; Ash, Ronald A.A comparative study of mentoringamong men and women in managerial,professional, and technical positions.Journal of Applied Psychology. 1990; B, Garrett-Harris R (2005) ong>Theong>Benefits of Mentoring: A LiteratureReview, A Report for East mentors>Theong> Coaching and Mentoring ResearchUnit, Sheffield Hallam University, SheffieldGabbard G. ong>Theong> role of compulsivenessin the normal physician. JAMA 1985;254:2926-2929Hay J. Reflective practice and supervisionfor coaches. Open University Press,Maidenhead, 20076.7.Connor MP; Bynoe AG; Redfern N;Pokora J; Clarke J. Developing seniordoctors as mentors: a form of continuingprofessional development. Report of aninitiative to develop a network of seniordoctors as mentors: 1994-99. MedicalEducation, 2000; 34: 747-53Dornhurst A, Cripps J, Goodyear H,Marshall J, Waters E, Boddy S-A.Improving hospital doctors’ working lives:online questionnaire survey of all grades.Postgrad Med J, 2005;81:49-5413.14.15.16.Hutton-Taylor S. Cultivating a coachingculture. BMJ, 1999;318: Career FocusInvisible Patients: Report of theWorking Group on the health of healthprofessionals, Department of Health,2010Iverson A, Rushforth B, Forrest K. ong>Theong>Competent Novice: How to handle stressand look after your mental health. BMJ2009;338:b1368Mentoring for Doctors34London Deanery Coaching and Mentoring Department of Health, 2004

18.19.20.Megginson D, Clutterbuck D (1995)Mentoring in Action: a practical guide formanagers. Kogan Page, LondonPaice E, Rutter H, Wetherell M, WinderB, McManus IC. Stressful incidents,stress and coping strategies in the preregistrationhouse officer year. Med Educ2002;36(1):56-65Ramanan RA, Taylor WC, Davis RB,Phillips RS. Mentoring Matters:Mentoringand Career Preparation in InternalMedicine Residency Training J Gen InternMed. 2006;21:340–34526.27.28.Standing Committee on PostgraduateMedical and Dental Education.Supporting doctors and dentists at work:an enquiry into mentoring.SCOPME, 1998Steven A, Oxley J, Fleming WG.Mentoring for NHS doctors: perceivedbenefits across the personal-professionalinterface. J R Soc Med 2008;101:552-7Taherian K,Shekarchian M. Mentoringfor doctors. Do its benefits outweighits disadvantages? Medical Teacher,2008;30:e95-e9921. AJ, Graham J, Richards MA,Cull A, Gregory WM. Mental healthof hospital consultants: the effects ofstress and satisfaction at work. Lancet1996;347:724-8Rogers J. Coaching Skills—a handbook .2nd Edition. Open University Press, 2004.Royal College of Obstetricians andGynaecologists. Mentoring for all. RCOGPress, College of Paediatrics and ChildHealth. A charter for paediatricians.RCPCH, College of Psychiatrists. ong>Theong> role ofmentor for newly appointed consultants,2002, for Training: A review of the impactof the European Working Time Directiveon the quality of training. Sir John Temple,2010Viney R, Bhatti N. Coaching andmentoring. BMJ Careers, July 14, 2010Viney R, McKimm J. Mentoring.British Journal of Hospital Medicine,2010;71:106-9White Paper: Equity and Excellence:Liberating the NHS’. Department ofHealth. Doctors: Making a Differenceong>reportong> of the Chair of the NationalWorking Group on Women in Medicine.London Deanery Coaching and Mentoring Service 35

AppendixFeedback and soundbites[My mentor] built up a rapport with me with“ease whilst maintaining a real objectivity. I foundthat this enhanced our sessions by allowing meto talk and think freely. She gave me time tothink and organize my thoughts. I felt that shemaintained a good momentum in our sessionswith a solution based method that targeted myproblems specifically. [My mentor] is instantlylikeable and fair. I think that she balanced outthe sessions nicely whilst adding a reassuringsense of realism with regards to my objectives.[My mentor] also made me feel empoweredby the sessions by allowing me to vocalize myconcerns with ease. I looked forward to oursessions because I did not feel that I was in ahighly pressured situation. Our sessionswere positive.”Honesty and a keen sense of empathy is at the“forefront on reflection during these sessions.[My mentor] gave me a steady desire to facemy issues head on, and now rather than later.More clearly, during these sessions I was giventhe opportunity to initiate breaking the cycle oflearned negative behaviours. This stands outthe most. [My mentor] was particularly good atproviding a framework to initiate positive change– so that I could continue to make progressoutside of these sessions. I felt receptive duringour sessions and most importantly I felt that [mymentor] showed a genuine interest in my lifewith a view to making it better.”I honestly feel that my sessions with [my“mentor] suited me completely. It’s difficult to saywhere she could improve apart from continuingto harness her skills as a great communicator.”I think that [my mentor] could only add in a“positive sense to one’s life experience. It’s thetruthful objectivity which stuns me – and asense that solutions often lie within theso-called problem.”I think that my coaching experience has“affirmed what I suspected already, that is, forcertain individuals it clarifies life. I feel settled,and more assured. Sometimes you need36London Deanery Coaching and Mentoring Servicethat voice of objectivity to help organize yourthoughts and understand your emotions. I thinkthat coaching has helped to focus on areas ofmy life that can be improved. This makes theday to day problems change into challengeswhere solution-based thinking allows for apositive outcome. Coaching helps to simplifyevery day life challenges for me.”My mentor has helped me work through a“few concerns I had about my training as wellas helping me understand more about myself– how I learn and how I like to work. Insteadof feeling I’m just one of many trainees, I’vefelt the advice and support has been verymuch centered around me and my needs. I’ddefinitely recommend others to give [mentoring]a try, especially if they have a work or trainingdilemma that they’ve been wrestling with or justwant to try and make the most of theircurrent opportunities.”Although I have mentored several other doctors,“I reached the tender age of 52 without everhaving been a mentee. ong>Theong> London Deaneryprovided me with the opportunity, which Iseized. I only had a vague idea of what I wantedto achieve from the 4 sessions on offer, buthave always had the strong feeling that I couldachieve more. Mentoring enabled me to reflecton my career, both the positive points and thosethat needed addressing since I was not satisfiedwith them. To my surprise, the mentoring wasnot just limited to the traditional careers model,but explored all the facets of my life examiningwhich aspects I was content with and thosethat were unsatisfactory. Various points cameout of the discussions, most of which I’d alreadyidentified for myself but due to time pressureshad not put into place. ong>Theong> mentoring enabledme to break down aims into achievable goals.Sessions ended with agreements on whatshould be undertaken before the next>Theong>se were negotiated between my mentor andmyself in order to meet the objectives I had setwhilst still keeping the workload in reasonablelimits. I am now working a few additional hours,1 to 2 per week, in order to meet my aims,but I am more content and satisfied now that

I am addressing my training and educationalrequirements. In addition, points wereaddressed outside my working life, these werecritical for me in order to achieve a balancedhome/work balance despite voluntarily doingfurther unpaid hours.”Mentoring has given me peace of mind since I“now have a plan to tackle areas where I haveless confidence in my abilities.”Mentoring has enabled me to create personally“targeted learning objectives.”Mentoring has refreshed the aims of my“medical career.”Mentoring has helped me address issues in my“personal life that have impacted my medicalcareer and my personal well-being.”This has been a very useful and creative“reflective space. It has allowed me to reflect onwhat is happening in our practice, what couldand should change, and how to facilitate this.It has also helped me decide on aspects of myown career development.”[Camden GP]I think that appraisal and revalidation“procedures should make mentoring free andavailable at the point of need in keeping withNHS principles to those professionals who needit, which is probably a lot more thanrecognise it!”I think that this was an appropriate use of my“trainers CPD grant and have recommended theprocess to other GP trainers and colleagues.”[London GP][Mentoring] has made a significant difference to“my professional development.”[London FY2 trainee]Mentoring is all about the application of“common sense, guided by experience andwisdom, and applied to an individual’s owncircumstances.”[GP, Kent]Mentoring sessions have helped to improve“knowledge and skills, regain confidence andwellbeing, improve performanceand productivity.”[GP, Kent]When asked whether the mentee wouldrecommend their mentor to other clients?“ Absolutely ”What stands out for you in [your mentor’s]coaching?Ability to get to the point and understand the“detail of the problems.”“ Empowering approach. ”[Associate Specialist in Paediatric Dermatology]What are your views on coaching now?Should be offered to most people in“their training.”[Associate Specialist in Paediatric Dermatology]Although I only had two sessions, I found these“extremely useful, as they gave me a frameworkfrom which to approach problems. ong>Theong>yencouraged me to self-reflect, which I havefound invaluable.”I would consider a mentorship programme“again in the future. It has given me invaluableskills, that need constant development, butthat I have found useful to practice in day today life.”[ACF in Public Health]This is an excellent & prompt service that the“deanery is offering and my best wishes for a1000th applicant soon!”[Consultant Paediatrician]I felt although brief and only 2 sessions I felt“an amazing sense of support and enjoyedthe chance to discuss career progressionand decision making with a non anaesthetistincredibly useful. I also talked about my fearsand social discrimination of being dyslexic in themedical profession and pertinently at interview.I felt utterly supported and respected theconfidentiality enormously. I would like to findout more information on becoming a mentormyself in the future when I have settled into mynew consultant post. Thank you ong>Theong> LondonDeanery for this opportunity.”

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