Challenging the deficit discourse in medical schools through reverse mentoring—using discourse analysis to explore staff perceptions of under-represented medical students

Abstract

IntroductionDespite the increasing diversity of UK medical students, students from low-socioeconomic backgrounds, some minority groups and members of communities with protected identities remain under-represented in medicine. In trying to ascertain why this under-representation persists, literature focuses on the barriers and challenges faced by under-represented students as opposed to the institution’s responsibility to remove or mitigate these obstacles. One UK University created a reverse mentoring scheme enabling students to mentor senior members of the medical faculty to help them understand the perspectives and experiences of students from minority backgrounds. This paper explores whether changes in staff perceptions of under-represented students resulted from engaging with reverse mentoring.MethodsThis qualitative study explored the impact of the reverse mentoring scheme. Staff mentees were required to write a narrative text about the Higher Education journey of an under-represented medical student before and after the reverse mentoring intervention. These texts were compared using discourse analysis to identify shifts in language use that demonstrated a change in perceptions.ResultsThe key themes from five senior staff members indicate a positive change in staff characterisation of the students and an acceptance of institutional responsibility for challenges faced. Initial texts revealed a superficial understanding of the student journey that focused on individual deficit but had fairy tale endings depicting the medical school as benevolent. The follow-up texts revealed a deeper understanding reflected by the portrayal of students as capable agents and containing pragmatic endings acknowledging the responsibility of the medical school.ConclusionThese findings highlight how removed senior staff can be from the reality of the student experience and that engaging with reverse mentoring helps to raise awareness and challenges the students face. This suggests a route for constructive change in medical schools and endorses the benefits of facilitating open discussion around educational inequity.

Does reverse mentoring work in the NHS: a feasibility study of clinicians in practice

“…There have been concerns expressed by trainees about its implementation and while consultants will be keen to support trainees, without accurate feedback from trainees their support may be misdirected similar to that shown at undergraduate level. 14 27 40 41 Therefore, it is crucial that senior consultants, often policy makers, are aware of the perspective of junior doctors to assure that postgraduate training continues to reflect the needs of trainees. One of the reasons trainees chose to leave medicine is the belief that better training opportunities are available elsewhere, therefore, it is crucial to reverse this trend and policy makers understanding the motivations of junior doctors will be key to this process.…”

“…13 Within medical school, reverse mentoring has been shown to improve the awareness of senior staff to the challenges faced by under-represented medical students. 14 Through this process, senior staff have better realised their responsibilities as leaders to support institutional changes in culture to address inequalities. [15][16][17][18] There are no reverse mentoring studies undertaken in the National Health Service (NHS).…”

Évaluer les besoins de mentorat pour les personnes noires dans les programmes de résidence au Canada

“…Comme solutions plus immédiates, on pourrait créer des alliances collaboratives, et donner de la formation sur le racisme structurel et les préjugés inconscients aux personnes qui ne sont pas noires et qui souhaitent mentorer des médecins noirs en résidence. On a également eu recours au mentorat inversé, une mesure d'aide où c'est un membre de la population étudiante qui sensibilise un membre facultaire d'expérience aux vécus et aux perspectives des minorités sous-représentées qui poursuivent des études en médecine, pour changer les perceptions du personnel sur les expériences de ces personnes 31 . Ce type de mentorat s'est révélé utile pour mieux comprendre les expériences négatives des étudiantes et étudiants en médecine racisés, ce qui peut mener à une expérience de mentorat interracial plus favorable 31 .…”

Assessing the need for Black mentorship within residency training in Canada

“…Reverse mentorship, a process in which students mentor their senior faculty on the experience and perspectives of underrepresented minorities who are completing their medical degrees, has also been used to address staff perception of the experiences of underrepresented medical students. 31 This type of mentorship has been shown to improve awareness of the negative experiences of racialized medical students, potentially leading to a more favourable racially discordant mentorship experience. 31 Although individualand interpersonal-level interventions, such as implicit bias training, are necessary to address these issues, racism within an institution can only truly be dismantled through structural changes, which requires systematic evaluation of the problem coupled with antiracism policies, ongoing monitoring and re-evaluation.…”

“…31 This type of mentorship has been shown to improve awareness of the negative experiences of racialized medical students, potentially leading to a more favourable racially discordant mentorship experience. 31 Although individualand interpersonal-level interventions, such as implicit bias training, are necessary to address these issues, racism within an institution can only truly be dismantled through structural changes, which requires systematic evaluation of the problem coupled with antiracism policies, ongoing monitoring and re-evaluation. 32 Second, mentorship relations can be complex and it is important to match pairs based on multiple traits beyond race (e.g., socioeconomic status).…”