Opening up communication across generations as medical technology, best practice and attitudes change is critical, say SA Raju and DS Sanders of the Academic Unit of Gastroenterology, Royal Hallamshire Hospital, UK.
Writing in the The BMJ, the authors say reverse mentoring is a way to keep in tune with colleagues and maintain a human touch, reducing burnout risk, and increasing job satisfaction for senior doctors, among many other benefits.
"The healthcare workforce currently consists of up to five generations and is becoming more diverse as it includes under-represented groups, they write.
The Multisource Feedback, also known as a 360 degree feedback system, is used in numerous healthcare systems internationally. Feedback is obtained from various colleagues, including senior and junior staff, allied healthcare professionals, and clerical staff.
This sounds ideal, but it remains an inflexible, one-way, written feedback and risks becoming a bureaucratic “tick-box” exercise, rather than opening a conversation.
There must be a better way to reward senior individuals with constructive feedback, to enable them to continue growing and learning.
In 1999, General Electric became the first organisation to implement reverse mentoring. It has since become an industry “best practice”, ensuring the transfer of skills and knowledge from junior to senior workers.
Despite growing interest in the private sector, reverse mentoring is underused in healthcare. A recent small study of reverse mentoring at a UK medical school showed improved awareness in senior staff of the challenges faced by students from under-represented backgrounds.
But reverse mentoring can be used for more than raising awareness of social and racial injustice. It can build social capital within the healthcare workplace by providing a bi-directional learning process between individuals. Through this process, senior doctors are able to learn from their juniors and remain in the know about the ideas and issues facing younger generations of doctors.
One method of reverse mentoring in a clinical setting employs a group of junior doctors (mentors) to undertake a semi-structured interview discussing the senior doctor (mentee). An anonymous report is collated and fed back to the mentee in a one-to-one, in-person meeting with a nominated junior. This approach opens a conversation and explores feedback with the mentor.
Reluctance to adopt reverse mentoring may be rooted in concerns about challenging hierarchy and the risks to junior doctors’ careers. Evidence shows that hierarchical structures can obstruct safety, therefore speaking up should be encouraged, and reverse mentoring could help support this.
The first NHS feasibility study of reverse mentoring in a clinical setting using the method described found that reverse mentoring helped reduce hierarchical differences, and that relationships were not negatively affected.
Furthermore, senior doctors reported that they gained awareness of others’ honest views of them as a result of this process. Doctors felt that the feedback received would positively influence their practice. This feasibility study of reverse mentoring offers an opportunity for senior clinicians to stay relevant in the modern healthcare setting if they are willing to embrace the process.
We believe staying up to date can help bridge the growing gap in experiences and perspectives between leaders and their colleagues. Reverse mentoring can guide change and allow growth via a bottom-up approach, but key to this is staying relevant by understanding the new and evolving perspectives. It can help prevent “stale thinking, blind spots, and having policies that could alienate under-represented groups”.
Reverse mentoring could go beyond keeping senior doctors up to speed. Health services need people who are confident speaking to senior colleagues and management, who can mentor future generations of doctors. Reverse mentoring can achieve this. Doctors of all levels have benefited from traditional mentorship. Reverse mentoring offers a valuable new approach, by empowering both the mentor and mentee.
Today, burnout is experienced by 17% to 42% of senior doctors globally, and the number of doctors considering early retirement is increasing. The reasons for this include work related pressures, loss of job autonomy, and poorer training in communication and management. The current trajectory indicates an increase in early retirements, with no easy fix in sight.
But giving back, and observing junior doctors grow, can be rewarding and invigorating. The link between burnout and reverse mentoring is little explored in the literature, but burnout is linked to depersonalisation.
The reverse mentoring system could be a way to keep in tune with colleagues and maintain a human touch, thereby reducing the risk of burnout, and a way to increase job satisfaction for senior doctors.
Senior clinician presence was invaluable during the Covid-19 pandemic, and the healthcare service cannot afford to lose these doctors and their expertise. As with all new initiatives, concerns will be raised regarding the implementation of reverse mentoring and how it will benefit junior and senior doctors. However, if done well, reverse mentoring could improve job satisfaction for doctors at all levels.
The BMJ article – Reverse mentoring—never stop learning (Open access)
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