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The Mentoring Process

Download the full CGDent/ADI guidelines, including templates, here: Mentoring in Implant Dentistry: Good practice guidelines

The aim of mentoring is not to focus purely on the advancement of the mentee’s clinical ability, but to also improve their skills in leadership, management, teamwork and professionalism. Acquiring these skills will consolidate the mentee into a competent clinician, providing improved patient outcomes and care.

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How many Mentored Cases Are Required?

The mentoring process involves the mentee undertaking several cases with some degree of supervision from the mentor. The numbers of cases required to achieve competency within a specific technique may vary between mentees and will be dependent on their previous experience. For example, a clinician with extensive prosthodontic knowledge may require less mentoring in implant prosthodontics. Likewise, a clinician with extensive surgical knowledge may require less mentoring in certain aspects of implant surgery. It is important to remember that mentoring is a process. The number of times a mentee is required to carry out a procedure will be evaluated by the mentor through structured assessments.

The number of cases to be completed during the mentoring process should be decided between the mentor and mentee. It is worth noting, however, that in many implant training courses where mentoring is involved, a mentee would be expected to complete a minimum of 20 mentored cases. We consider this a reasonable number of mentored cases if the mentee was undertaking a completely new or complex procedure, with no previous experience or evidence of competency, and progressing from assisted to unassisted work.

The involvement of the mentor might not be in direct clinical supervision in every case, or at each stage of treatment, although this will be likely when a mentee is carrying out a procedure that is new to them or of significantly increased complexity.

Direct supervision will be required when the mentor or mentee deem it necessary; this may not be in every case. Both the mentor and mentee must consult with their indemnifiers or insurers and check that they both have cover to provide implant dentistry and in particular the types of procedures being undertaken.

The mentor must also ensure they have indemnity cover for mentoring.

 

The Stages of the Mentoring Process

For the purposes of this document, we have considered the model of mentoring demonstrated by Alred and co-workers, which defines three clear stages:

1) Exploration

The mentee takes the lead in identifying goals. Aims and objectives are established, and an agenda is drawn up.

2) New understanding

An understanding is gained of the mentee’s strengths and weaknesses. The skills that need to be developed are identified. Constructive feedback is provided.

3) Action planning

An action plan is agreed on and facilitated. Outcomes are evaluated and problems that may have been encountered are solved.

 

We suggest these stages should be flexible and will likely need to be completedmultiple times throughout the mentoring relationship.

 

Work Based Assessment (WBA)

WBAs are widely used during training in medicine and dentistry to help evaluate outcomes. They are designed to be used with a logbook of cases to formulate a portfolio of evidence. WBAs include Case Based Discussions (CBDs), Direct Observational Procedures (DOPs) and Clinical Evaluation Exercises (CEXs). Examples of these are provided in the Appendices.

We suggest that mentors and mentees make use of WBAs in the mentoring process, and that these assessments are retained. It is important to progress in a sequential manner, undertaking, assessing and documenting basic techniques first before moving on to cover more advanced techniques.

The most appropriate WBAs to be used will depend upon the individual requirements of the mentee. Mentoring based on specific clinical skills requires an exploration of the mentee’s previous clinical and academic capabilities. Furthermore, ensuring that clinicians maintain self-assessment and reflective behaviour throughout and beyond their mentoring processes remains an important element of the personal development processes.

To facilitate this, each WBA has an area for the mentee to write reflective commentary.

Clinicians who provide extra-maxillary implants, such as zygomatic implants, will usually work in a multi-disciplinary team. A dentist undertaking this type of complex work single-handedly would be expected to have an extensive portfolio of evidence and qualifications in both prosthodontics and oral surgery.

 

The Mentoring Agreement

To ensure clarity in the mentor-mentee relationship a mentoring contract or agreement should be created before initiating the mentoring process.

Ideally, such a contract should outline details of the relationship and goals, frequency of meetings and what type of mentoring will be provided with any associated fees. Informal mentoring is more prone to problems because goals, outcomes and boundaries are not set.

Overfamiliarity or a lack of rapport can be issues in any mentoring process, but revisiting the contract and discussing any problems can help move the relationship forward. If differences are irreconcilable, it may be best to end the relationship and to learn from the experience. The mentee may then find a new mentor and explain the situation to them.

An example of a mentoring agreement can be found in the guidelines in Appendix 6.4.