A Systematic Scoping Review of Ethical Issues in Mentoring in Surgery

Abstract

Background: Mentoring is crucial to the growth and development of mentors, mentees, and host organisations. Yet, the process of mentoring in surgery is poorly understood and increasingly mired in ethical concerns that compromise the quality of mentorship and prevent mentors, mentees, and host organisations from maximising its full potential. A systematic scoping review was undertaken to map the ethical issues in surgical mentoring to enhance understanding, assessment, and guidance on ethical conduct. Methods: Arksey and O’Malley’s methodological framework was used to guide a systematic scoping review involving articles published between January 1, 2000 and December 31, 2018 in PubMed, Embase, Scopus, ERIC, ScienceDirect, Mednar, and OpenGrey databases. Braun and Clarke’s thematic analysis approach was adopted to compare ethical issues in surgical mentoring across different settings, mentee and mentor populations, and host organisations. Results: A total of 3849 abstracts were identified, 464 full-text articles were retrieved, and 50 articles were included. The 3 themes concerned ethical lapses at the levels of mentor or mentee, mentoring relationships, and host organisation. Conclusions: Mentoring abuse in surgery involves lapses in conduct, understanding of roles and responsibilities, poor alignment of expectations, and a lack of clear standards of practice. It is only with better structuring of mentoring processes and effective support of host organisation tasked with providing timely, longitudinal, and holistic assessment and oversight will surgical mentoring overcome prevailing ethical concerns surrounding it.

Assessing mentoring: A scoping review of mentoring assessment tools in internal medicine between 1990 and 2019

“…Two recent reviews into the potential sources of ethical issues in mentoring in medicine and surgery found that mentoring assessment tools continue to intermix of mentoring with coaching, supervision, tutoring and role-modelling and conflate distinct mentoring practices such as novice, near-peer, peer, group, mosaic, network and e-mentoring and mistakenly [20,[37][38][39][40][41]. In addition Lee et al (2019) [42] and Cheong et al (2019) [43] found that prevailing assessments of mentoring processes are too reliant upon "Cartesian reductionism and Newtonian principles of linearity" [28] and fail to contend with mentoring's longitudinal, competency based, evolving, adapting, entwined, goal-sensitive, context-specific, mentor-, mentee-, mentoring relationship and host organisation-dependent nature (henceforth mentoring's nature) [44,45]. These shortcomings compromise effective evaluations of mentoring processes and relationships and reiterate the need for urgent review of assessments of mentoring processes [42,43].…”

“…In addition Lee et al (2019) [42] and Cheong et al (2019) [43] found that prevailing assessments of mentoring processes are too reliant upon "Cartesian reductionism and Newtonian principles of linearity" [28] and fail to contend with mentoring's longitudinal, competency based, evolving, adapting, entwined, goal-sensitive, context-specific, mentor-, mentee-, mentoring relationship and host organisation-dependent nature (henceforth mentoring's nature) [44,45]. These shortcomings compromise effective evaluations of mentoring processes and relationships and reiterate the need for urgent review of assessments of mentoring processes [42,43].…”

A systematic scoping review of ethical issues in mentoring in medical schools

“…Yet, mentoring has come under increased scrutiny amidst suggestions that mentoring relationships are poorly assessed and supported [2][3][4]. These gaps are seen to aggravate power dynamics between mentee and mentor [2] and predispose to grave issues such as bullying and even sexual harrassment [3,4]. These reports have curtailed mentoring's role in medical school education, hampering the provision of personalised, longitudinal and holistic support [5][6][7], career guidance [8][9][10][11][12][13][14][15], and research opportunities [16][17][18][19][20][21][22] to medical students.…”

“…With mentoring playing a key role in training medical students and with many ethical issues poorly described [2,23], a systematic scoping review (SSR) is proposed to map prevailing descriptions of ethical issues in mentoring in medical schools to guide a structured and evidence-based response [24][25][26][27][28][29][30].…”

“…Mentoring’s success in nurturing “dynamic, context dependent, goal sensitive, mutually beneficial relationships between an experienced clinician and medical students that is focused upon advancing the development of the mentee” has seen its role in medical school education grow [ 1 ]. Yet, mentoring has come under increased scrutiny amidst suggestions that mentoring relationships are poorly assessed and supported [ 2 – 4 ]. These gaps are seen to aggravate power dynamics between mentee and mentor [ 2 ] and predispose to grave issues such as bullying and even sexual harrassment [ 3 , 4 ].…”