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Journey to the millennium: mentoring in the clinical laboratory.

Downsizing, right-sizing, continuous quality improvement, quality assurance, capitation, increased workflow, cross-training, robotics, health systems, marketing on the Internet. Will these terms have any meaning for the laboratory of the new millennium? No one can predict with certainty what the laboratory of the future will be like, but it is clear that out of the current chaotic healthcare environment, change will emerge as a constant.

How will clinical laboratories survive the inevitable changes on the horizon? How will the profession of medical technology and clinical laboratory science evolve? How will new graduate medical technologists learn to adapt to a work environment that is rapidly changing?

To remain viable as a profession, laboratory science professionals, including medical technologists, must utilize every available resource. Of our resources, human resources will continue to be most valuable overall, for it is the expertise and dedication of clinical laboratory professionals that will shape the laboratory of the future.

Yet, as most healthcare changes are dollar driven, the funding for laboratory employee development programs such as continuing education is dissipating, as is funding for medical technology education in general. Because of such cost constraints, the pressing question is how can we foster motivation and dedication among laboratory personnel in the future.

Why is mentoring necessary?

Mentoring has recently become a buzzword in business and healthcare management circles because of the instability in both fields; its importance has been emphasized in particular for difficult or uncertain work environments. The transitional nature of today's healthcare environment, including that of laboratory testing, demands that education continually evolve and therefore accents the need for continual mentoring and guidance.

In addition, healthcare executives must often adjust to new challenges because mergers and restructuring often force those with too little time and experience to enter the "Indiana Jones" school of management - effectively making it up as they go. For this reason, mentoring is strongly encouraged among healthcare executives because "behind every successful executive, there is likely to be a good mentor, or maybe two or three." In fact, the American College of Healthcare Executives has issued a statement encouraging their 30,000 members to actively mentor early career professionals for two years.(1)

Nursing is another field in which mentoring has existed both formally in apprenticeship programs and informally. Dynamic mentoring relationships in the nursing profession have fostered a positive environment for nurses to focus on their career development.(2)

Clearly, mentoring can take more than one form. The versatility of this tool makes it useful in developing the clinical lab of the future. The mentor-protege relationship has particular applicability in the clinical lab because lab professionals must learn to update their knowledge and skills rapidly to adapt to healthcare changes.

In today's world, a mentor's role (see "The ABCs of mentoring") can be divided into three categories, identified as ABC: advisor/advocate, broker/buffer, coach/counselor.(3) It is important to note, however, that although there are benefits to this dynamic process, potential drawbacks, such as unrealistic expectations, power and trust issues, and cross-gender issues also exist. To help address these problems, clarify expectations at the beginning of the process.

Mentoring in our laboratory

As an educational coordinator for a hospital-based medical technology curriculum, I proposed creating an informal apprenticeship/mentoring program to help integrate medical technology students into a changing lab environment. I noticed that as the laboratory workload increased and as the teaching staff became more burdened, role modeling seemed to stop altogether. It was this void that I proposed to fill with an unofficial mentoring program.

As I searched the literature for information, I discovered little research-based data on mentoring in the clinical lab, probably because as a whole, lab professionals are somewhat reluctant to "blow their own horns" about their accomplishments, including mentoring. I did discover that laboratorians (and I am one myself) possess general personality characteristics compatible with mentoring relationships - our typically type-A personalities usually drive us to be highly competitive, yet eager to serve.(4)

Set up. Armed with a few nursing journal articles on mentoring and having reread my management textbook chapters, I designed a plan to help establish role-modeling relationships for the incoming medical technology students. I used some of the guidelines established by healthcare executives, nurses, and dietitians to select laboratory personnel to function as a "match" or mentor.(l,2,5,6) I selected mentors with good leadership skills and a professional commitment to excellence as well as patience, and I sought laboratory personnel who demonstrated a sincere interest in the well-being of the medical technology students. To facilitate involvement in the student program from areas in the laboratory normally not involved with students, I also tried to identify personnel from the second and third shift and from lab sections where students do not spend a significant amount of time.

To my delight, many staff medical technologists were eager to volunteer their time as informal mentors. i asked that mentors function as preceptors in helping to establish the student in a new and somewhat chaotic laboratory. I asked mentors to perform three specific functions: (1) to acknowledge the student's presence in the lab either in person, by e-mail, or through another form of communication; (2) to be a good role model; and (3) to help the student find interesting case studies to share at student gatherings. I gave the mentors the laboratory rotation schedule of the students and a few basic facts about the student including name, university, and e-mail address.

I explained this informal matching process to the incoming students, encouraging them to seek out their mentors if they had questions about finding case studies. I also suggested that the students use this system as a resource to help them through their challenging internship period.

Results. As an observer and creator of this process, it was interesting to watch relationships develop between the new students and their experienced partners. At first, the students were just happy that there was another person in the lab who knew their faces and names. This feeling was especially apparent at shift change, when the pairs actually crossed paths. As the internship period progressed, it became obvious that the mentors provided much more than a friendly face as the students worked toward becoming medical professionals. For example, many students went to their mentors for assistance in preparing for their senior case presentation forums. The mentors provided guidance on issues from topic approval to setting up and critiquing overhead materials. In addition, the mentor's presence during the actual case presention was a source of invaluable emotional support.

It has been three years since this informal mentoring process was first incorporated. Feedback from graduate evaluation forms has demonstrated a range of feelings about the student-mentor relationships. Some students reported that they derived little benefit from having an additional support person; others felt they gained much in the way of career and personal development. As the educational coordinator for these students, I observed that the students were integrated more quickly into the laboratory because they had been assigned a mentor. At the 10-week and 6-month student evaluation conferences, each student would persistently mention his or her mentor, citing what this person had said or done to help the student. The most common function of the mentors seemed to be their role as a "sounding board" for the students during this period. Although other specific functions of each mentor varied, their presence was consistently positive. As the close of the internship period came nearer, the mentor's name would also be brought up in conversations about career goals and possible employment.

A surprising result of this trial was that the mentors felt they also benefitted from the experience. Several reported increased involvement in the medical technology program and personal satisfaction derived from helping students develop their careers. In coordinating this program, I have seen the potential that the mentoring process can have for medical technology students and for other lab professionals. As a result, I have become an advocate for mentoring, particularly in the clinical lab where these professionals must be able to adapt to survive.

The laboratory of the future will not be fueled by robotics, instrumentation, or procedures alone. Mentoring in the laboratory can provide guidance and leadership, enhance teamwork, and smooth difficult transitions that result from working in a constant state of change.

The ABCs of mentoring

Advisor/advocate

Acknowledges and validates presence in organization Shares wisdom and experience Offers unfailing confidence and support

Broker/buffer

Connects the protege with education and employment opportunities Acts as a sounding board for ideas and concerns Provides insight into the environment

Coach/counselor

Leads by example; provides a role model Strengthens by challenging Motivates and inspires

History and models of mentoring

Models of mentoring are prevalent in history and literature. Greek mythology gives us Homer's epic poem The Odyssey, where Odysseus sets off for the Trojan War and entrusts the guardianship and care of his son, Telemachus, to his servant and friend, Mentor. It is Mentor who becomes the son's teacher, guide, and "counselor-to-life" in the father's absence, establishing a model for the first mentoring relationship.' This form of apprenticeship can provide us with some direction for the laboratory of the new millenium.

Mentoring has existed for centuries. In its earliest form, mentoring was structured as an apprenticeship in which a novice learned a skill under the direction of a wise and learned master. Many skilled trades began in this manner; even today, tradesmen acquire and master their vocations in apprenticeship arrangements.

As with earlier models, today's mentoring relationships are by nature transitional and diverse. Almost everyone has had a mentor of some sort - from the next door neighbor who encouraged us to practice the piano to the chemistry professor who challenged our minds with chemical equations. Years ago, I would not have taken the time or the risk to write and publish my first article if it had not been for the encouragement of a kind and seasoned laboratory professional who motivated me to want to see my name in print.

Source: Yoder, L. Mentoring: A concept analysis. Nursing Administrative Quarterly. 1990;5(1):9-19.

References

1. Lute, S. The vanishing art of mentoring. Mod Health Care. 1995;11 (37):25.

2. Walsh C, Clements C. Attributes of mentors as perceived by orthopaedic nurses. Orthop Nursing. 1995;14(3):49-56.

3. Yeatts, A. Mentoring in the man-age. Administrative Radiology Journal. 1995;14(6):37-40.

4. Bickford, G. Redirect stress to increase energy. MLO. 1997;(4):60-64. 5. Routh B. Becoming a mentor. Nursing. 1995;25(7):75-77.

6. Schatz P, Darling L. Mentoring needs of dieticians: The mentoring self-management program model. J Am Diet Assoc. 1991;91 (4): 454-458.
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Title Annotation:includes related article on history and models of mentoring
Author:Kapanka, Amy R. Hamilton
Publication:Medical Laboratory Observer
Date:May 1, 1998
Words:1779
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