Tensions in mentoring medical students toward self-directed and reflective learning in a longitudinal portfolio-based mentoring system – An activity theory analysis

Abstract

Background: In medical education, students need to acquire skills to self-direct(ed) learning (SDL), to enable their development into self-directing and reflective professionals. This study addressed the mentor perspective on how processes in the mentor–student interaction influenced development of SDL.

Methods: n = 22 mentors of a graduate-entry medical school with a problem-based curriculum and longitudinal mentoring system were interviewed (n = 1 recording failed). Using activity theory (AT) as a theoretical framework, thematic analysis was applied to the interview data to identify important themes.

Results: Four themes emerged: centered around the role of the portfolio, guiding of students’ SDL in the context of assessment procedures, mentor-role boundaries and longitudinal development of skills by both the mentor and mentee. Application of AT showed that in the interactions between themes tensions or supportive factors could emerge for activities in the mentoring process.

Conclusion: The mentors’ perspective on coaching and development of reflection and SDL of medical students yielded important insights into factors that can hinder or support students’ SDL, during a longitudinal mentor–student interaction. Coaching skills of the mentor, the interaction with a portfolio and the context of a mentor community are important factors in a longitudinal mentor–student interaction that can translate to students’ SDL skills.

Acknowledgements

The authors want to thank Dr Juanita Vernooy, for helpful discussions at the start of the studies.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Sylvia Heeneman, PhD, is Professor of Medical Education at the School of Health Profession Education, Department of Pathology, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.

Willem De Grave, PhD, is a Senior Lecturer and Educational Psychologist in the Department of Educational Development and Research. Faculty of Health Medicine and Life Sciences, Maastricht University.

Glossary

Portfolio-based learning or portfolios: A collection of evidence that learning has taken place, usually set within agreed objectives or a negotiated set of learning activities. Some portfolios are developed in order to demonstrate the progression of learning, while others are assessed against specific targets of achievement. In essence, portfolios contain material collected by the learner over a period of time. They are the learner’s practical and intellectual property and the learner takes responsibility for the portfolio’s creation and maintenance. Because the portfolio is based upon the real experience of the learner, it helps to demonstrate the connection between theory and practice, accommodating evidence of learning from different sources, and enabling assessment within a framework of clear criteria and learning objectives. The use of portfolios encourages autonomous and reflective learning which is an integral part of professional education and development. Candidates are expected to produce evidence and process such evidence with relation to a pre-determined standard. Since the portfolio approach includes both content and a reflective component, one must first determine which components are to be assessed. Portfolios provide a process for both formative and summative assessment, based on either personally derived or externally set learning objectives or a model for lifelong learning and continuing professional development.

Wojtczak A. 2003. Glossary of medical education terms. AMEE Occasional Paper No. 3. Dundee: AMEE.