Well, it's a pleasure to speak to you this afternoon. I appreciate the chairs putting us here in the first few minutes after lunch before you slide into your post-pyramidal drowsiness, so thank you. So mentoring, it's been an interest of mine for some time, no conflicts of interest. My avocation is history, so I always look into a little bit of history when I'm going to talk, and the first mention of the word mentor was in 800 B.C. in Homer's Odyssey. A gentleman by the name of Mentor, who was known for his intelligence and his wisdom, was a guardian in Ithaca, and when the king would go away to war, he would have his son go live with Mentor for instruction and moral guidance. So before mentor, the word mentor was a title, it was actually referred to a person. Sliding down through history, one of our founding fathers, John Witherspoon, was, in addition to being a minister, was president of New Jersey College, which you now know as Princeton University. He donated many books to the library, he too was known for his intellect and his insights in life. His legacy includes one U.S. president, one vice president, 28 senators, and 49 members of the House of Representatives. More current, in his inaugural address in 2007 to the society, Dr. Fred Agabini broke mentorship down into three phases, early, mid, and lasting influences. The early phases basically would be getting people interested, stoking the fire for critical care, recruiting them into training programs, and then midterm influences, just being there, being available, and the importance of teaching the people the importance of details, and also teaching them how to become an avid listener. Lasting influence, of course, was the imparting of personal wisdom and navigating the forks in the road. As one starts the journey as a mentee, it's critical to identify the right mentor. Some of these successful traits include placing relationships before programmatic mentoring. Mentoring is not a checkbox, it's not another step to get to a higher level. It's developing relationships. And Moshe mentioned that I helped establish a residency for NPs and PAs in critical care. We focused on competency, we used Coba-Trice, but competency is one thing, but it's really how you do competency that really matters. And so character is of maximum importance. Good mentors also display frank optimism. This is not a Pollyanna kind of thing, it's an honest, forthright opinion, but it's optimistic. They're more loyal to the mentee than to the institution. And they have blacksmith credentials. I was reading, I forget where it was, but reading about blacksmiths, they were the pillar of the community in the early days. You could tell whether they were experts or not, but by looking at their hands, their hands were grimy, their hair might be a little bit singed, they may have soot on their face, but that stood for their experience. So when you needed something fixed or something made, you went right to the blacksmith. Same thing, metaphorically, with mentors. Condoleezza Rice, former Secretary of State under George W. Bush, makes this statement, but you don't have to have mentors that look like you. And if you read this entire paragraph, you'll see it mainly pertains to skin color, but it certainly can be as well different kinds of people, just in general, to act as mentors. As a mentee begins a journey, some of the things I need to reflect on is just exactly what you want to gain from this relationship. Expect deeper questions, like, you know, who are you? What are the causes you react, what causes you to react in the way you do? What situations cause you to act and react in a certain way? And then be able to present your goals and hopes definitively to the mentor. Respect is huge, and we've mentioned that in another talk here, and just be prompt with communications and seek out multi-professional mentors. We live and work in units, and there are many people there, including dieticians and respiratory therapists from whom we can learn a great deal. And finally, again, getting back to the idea of respect, always convey appreciation. The mentor, too, has considerations. Before you accept a mentee, use good judgment and really be circumspect about the situation. It's important to establish a backup team because you're not always going to be there. Be proactive and head off potential problems before they get bigger and address them. Convey a legacy of information. Be a connector for the person that you mentee. Make sure that he or she is connected with the right individuals to make them successful both in your institution and like our society here nationally. Always practice relational clarity. No smoke and mirrors, straightforward. Do expect interpersonal fluctuations. You have good days, bad days while working through this training, and always be a good listener. Found this slide, which I think it's already been alluded to. As these other talks have gone on, with Shoujo and Kwame talking, it's just very, very interesting. But the most important thing in communication is hearing what isn't said. Always take what you're listening to and put it in context. There are some general expectations for both parties. Horizontal bi-directional interactions. Gone are the days of top to lower grade. It's more bi-directional and horizontal. Mutual respect of time, effort, and qualifications. Just because we're doing it horizontally does not mean there is a little bit of rank and file there, so respect. Strive for the same chemistry. Try very, very hard. Understand each other's interests and values. Case in point here is my own career, the last part of my career in developing that training program. I worked with a physician who was about as different from me as possibly could be, but we have the same vision, and we shared the same interests, and we worked beautifully together. Attempt to create an enduring relationship. It won't always happen, but that's kind of the goal. And then expect some evaluations. You have to figure out how well this is working. So what about evaluations? Always perform the evaluation with openness and full disclosure. Be as analytical as possible to avoid these judgmental comments that quite often come from people in the unit or other individuals that there are problems with, but as much as possible use analytical assessment. I think it was Kwame that talked about real-time feedback. Very, very important that you get feedback as close to the event as possible. And beware the compliment sandwich. This is a thing that came out of the Wall Street Journal talking about how Gen Zs don't appreciate the compliment sandwich. That is the compliment, the hammer, and then another compliment. It's seen as superficial, and it's seen as just a prop, so to speak. So beware of that. And in all capital letters, be consistent in your evaluations. Some benefits for mentees. Certainly facilitated entry into the department or group, expanded ways of thinking and problem-solving. Hopefully greater career satisfaction and greater retention. Keeping the good ones around. And then hopefully a more rapid rise in productivity and confidence. Mentor benefits, which will keep you on your toes. Being thrown new ideas and new questions. Sense of personal accomplishment and a fulfillment of giving back. I retired several years ago, and I think these second and third points here are the greatest for me as I look back on my career. They're right. You've heard it said that you remember the people and you miss the people. You don't really miss the work, and that's absolutely true. I was blessed to have a wonderful career. Collaboration and meeting goals and interests. And then, of course, building in new colleagues. Institutional benefits as well. Again, prompt solutions to ground-level problems. A pipeline for potential new colleagues. Greater workforce engagement. Hopefully a more satisfied faculty and staff. We've talked a lot about that this morning. And better collaboration among colleagues. As I reflected on this slide this morning when I was looking at it, for those of you that watch college sports and they interview coaches and players afterwards, they talk about quite often they refer to themselves as the brotherhood or the family. I'm hoping this is what we can do with proper mentorship and coaching in our institutions where it's more than just a place to work. And finally, you may have heard this and said, well, this is all great, but you didn't know what my schedule was last week. So how do we do this? Well, the example, and I'm going back to history again, is Lincoln's Gettysburg Address. It took approximately two minutes to deliver. It was given 162 years ago, and it's still quoted in the curriculum in schools today. So the conclusion we can draw from that is that a few well-chosen comments, perhaps even in the hallway or at the desk, can leave a lasting impression and build a better clinician, so thank you. A little, some references for you. So I guess I'll start with, all of you are either leaders in development or already currently in a leadership position. Some of you are quite high up in your organizations. I'm curious, by raise of hands, who has ever had a mentor before? I think this should be 100%, awesome. Who currently has a mentor? Awesome. Who has a coach? Look at that, sounds good, awesome, great. So coaching is a little bit different from mentoring. Mentoring is much more well-established in most organizations, especially in the healthcare, and coaching is what you can be thought of as support for forward action, sometimes forward action that actually is not yet created, not yet a path already well-defined, a career trajectory that you're not 100% sure of. So it's actually defined by the International Coaching Federation, which accredits coaches internationally, partnering with clients in a thought-provoking and a creative process to inspire them to maximize their personal and professional potential. And the purpose of coaching is to actually go through, find the previously untapped sources of imagination, productivity, and leadership. And so when you look for a coach, having the stamp of approval of accreditation from the ICF is an important, at least benchmark. I mean, we graduate people after their degrees in whatever field of study with rigorous, with competencies and all their measurements. Why would you expect anything less from your coach? And yet, when we think about all the different roles for our professional development, there's some similarities and there's some differences. And so the most common question I get asked is, well, what is the difference between mentoring, which is why Rob and I are paired here today together, and also, how does this fit into the gamut of what's available already within your organization and your schools of training? So most commonly, students in the undergrad and onward will find something called advising, right? You probably remember this, if you have any kids in college, they first start with just getting some advice in terms of how do you really just get to the very next step. And it's super small in terms of what its purpose is. It's just to fill out the application, get into the program, matriculate from something. Mentoring, as Rob has already alluded to, is a much more holistic relationship for the long-term to eventually become colleagues in a field of specialization that you probably both have interest in. Like, so my mentees are all simulation educators or teach communication skills or do something in relation to the things that I already like in my own personal body of work. But it is also holistic. Some people also choose me just because I happen to be a woman in critical care medicine. So mentoring is a much more holistic relationship in their board of directors that they develop for themselves. As most of you will probably have, your own personal board of directors, you have many mentors in different aspects and realms of the things that you're trying to accomplish, whether you're in a leadership position, you may have a mentor, and then in your research career, you have a mentor. It shares projects, it shares a relationship, it shares your professional community for things like SCCM, for example. Coaching is usually more of a process by which questions are asked so that you can tap into yourself to find the way forward because only you can live your own individual, unique lived journey with the intersectionality of all of your choices you've made to actually become the thing that you are. There probably is no other you in the world. I think I can safely say that. And so the coach actually partners with an individual to be the guide on the side to help you find your goals. And I think Kwame really pointed out, we barely even know our strengths sometimes, much less our goals. And so we help people find their own solution, be an accountability partner, and to be able to figure out what the next step is. Because let me just say, most people, when they come to me as a client, as a coach, they literally don't know. They might not even know their values. And that's actually very normal, and that's actually totally fine. And then this last piece, which many of you also are aware of, is a thing called sponsoring. And that's really about recommending others, and we use our own social capital to say, hey, you'd be great to give this talk. Hey, you'd be great to serve on this committee at SCCM. So sponsoring's another activity that we often do for each other across professions, through our disciplines, in our department, to help make our team stronger, to help our organizations perform better. And so all of these characteristics are really important to have as a leader. Another question I often get asked is, well, how is coaching different from therapy? My therapist does all of this for me. And that's probably not true. Therapy generally heals past trauma. You look backwards to sense make, become whole, and reconcile all of those things. Then obviously that's a clinical relationship between a physician and patient, and coaching is not a clinical relationship between my client and myself. And then you also obviously diagnose based on the DSM criteria. Coaching really is just about goal orientation towards your future, and your individual place where you want to go. It's a co-creative partnership. And then consulting. So a lot of times people also get a little bit confused on what is actually a consultant. As an organization or as a leader, you actually may have a very unique problem that needs to be fixed. So for example, a revenue supply chain for your division or your department, for the entire healthcare system, and you want to make sure there isn't some kind of process that some other organization uses a consultant for to optimize. You'll bring in someone to fix a very strategic problem. So consultants do a very different thing. And so we just want to make sure that that's also clarified. So why is this important? In medicine, coaching is becoming much more popular. One application of this is using coaching in medical education. So people have discovered that the supervisor, the curriculum developers, the people who are actually teaching may not actually get the most out of the learning experience for each learner. And so wouldn't it be better for each learner to have a coach that helps them learn the best way for themselves? As we know, everyone learns differently. And depending on what's necessary for the outcome, meaning the clinical performance, people vary in the efficiency by which they get there. So in many medical schools now, there's a whole category for medical educators to just become the coach for the students and the learners to actually become the best version of themselves as a learner and to really foster growth mindset and begin to instill some of these concepts way earlier on. So we obviously offer these types of workshops and leadership conferences and growth mindset and development because there's a gap in the need. This is all now being pushed into the undergraduate medical education side of things, which is excellent. We're hoping that this will normalize and have people have a very different experience as they come through the experience of medical education in general. Coaching can be delivered in many different ways for your organization. It can be group or it can be one-on-one. There are different types of coaching that you'll see out there. So executive leaders, so many of you probably do have coaches because as requirement of your executive leadership position, you have to have a coach. It gets very lonely at the top and the only other person who probably can help you is a coach because you really can't share publicly a lot of the things and the concerns and the worries that you have. And there's just less people out there to peer mentor you forward in that process when you're only dealing with a handful of people at the leadership level. Education already gave the application. There are other types of coaches. So life coaches or business coaches, relationship coaches, and also mindset coaches. So people will have different specializations as Kwame is using the positive psychology. That's a particular modality that the framework for what you can expect from them as a coach. And I'll also argue that just like anything else, being a leader means you actually have to have your own primary coaching skills yourself. That many times you are actually the coach for your own team, for the people who report to you, and you're not always their mentor and you're not always their supervisor. And this is a different type of relationship. So fundamental to the coaching practice is curiosity. We actually do not have any presumed expectations of what that might look like. So sometimes in a mentoring relationship, we do have some expectations, right? We have to give feedback about, this is how you should write this paragraph better, or this is how I want the data analyzed, or that's not actually how I would teach this particular section. Being a coach would actually mean that you're just curious and more open-ended, but trying to figure out why the person who's coming to you with a problem might be feeling that way. Listening, as we've already talked about many of the sessions today, is that listening is extremely important in terms of just actively reflecting back to make sure that you've interpreted and heard what was given to you. Acknowledgement and reflection, meaning that sometimes people just want you to hold space with them, to just know that they're not alone, and just to also know that maybe you've actually experienced it too. For many people who are burned out, part of the most important thing about sharing the story or those with mental illness or substance use disorders is just to know that they're not alone, actually, in having had that experience. And then action-oriented accountability. The most important thing that I would say the coaches probably do is the very first thing and the last thing, which is just be curious for why the person is feeling or thinking or doing the things that they're doing, and then at the end, when you've had, at the end of the coaching session, we almost always close with, what are we gonna do before, between now and the next session to actually change, do, hold you accountable to actually making things different, right? Because people don't get coaching just for no reason. People get coaching because they want to actually do something to either get clarity or take the next right step. So you as a leader actually do all of these things for your team and for all the people who report to you. And the question is, the only way to get better at individual skills that you are presenting yourself as a leader is to think separately about what's in these different buckets and what ways you might actually be able to practice and exhibit them. So we have a case that you're gonna get to practice today at your tables. And when we think about what leadership really means within your sphere of influence, in the clinical teams, in the administrative teams, in the organizational teams, research teams, teaching teams, right? You're a part of many teams in your organization. It's really about empowering other people to succeed and it takes lots of skills to do so. And so in our case today, we're gonna ask you to think about what types of mentoring behaviors, which is the point and advise questions and language you're going to use, and then what kinds of coaching languages will you use, which is the explore and be curious types of language. So our case is a gentleman who is halfway through his APP critical care residency. He's technically very competent. He's well-liked by staff. He's increasingly more withdrawn on rounds and now he's starting to seem to struggle with complex decision-making, which you had never seen before, in family meetings especially, about goals of care. When you finally meet with him as his supervisor, he reveals that he's feeling overwhelmed by the demands of critical care actually, including all the data, patient integration, the interactions with the senior physicians. He's beginning to question whether he's actually cut out for critical care. He used to be really passionate about it and he's actually considering switching to a less acute specialty, such as outpatient perioperative medicine. So you are the program director for this particular APP resident and are meeting for just routine, scheduled performance check-in and you check on his evaluations beforehand. You see that everything is slightly below average for someone at his level and his time in training and this is a change actually from his first quarter's evaluations. So something's a little up. So in your small groups, we're gonna ask you for the next five, I think. Yeah, we have like 10 minutes. 10 minutes, 15 minutes. What mentoring approaches could help Alex? What exactly do you say? So this time we want only just, not analysis, it's just what actual questions might you use and then what coaching approaches could support his development? Exactly what could you say? And then as a group, as you think through these sentences, how do these approaches differ and what unique things might you get out of approaching this situation slightly differently?

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medical education

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