Indigenous Mentorship for the Health Sciences: An Appraisal of a Contemporary Model by Indigenous Stakeholders

Abstract

Construct: In 2021, Murry et al. put forward a model of Indigenous mentorship within the health sciences based on the behaviors of Indigenous mentors toward their Indigenous mentees. This study explored mentees’ endorsements and/or criticisms of the IM model and how IM constructs and behaviors described in the model benefited them. Background: Models of Indigenous mentorship have been developed previously yet have not yet been empirically examined, restricting our ability to measure or make claims as to their consequences, correlates, and antecedents. Approach: Interviews with six Indigenous mentees asked about their: 1) resonance with the model, 2) stories related to mentors’ behaviors, 3) perceived benefits of their mentors’ behaviors on their journey, and 4) components they felt were missing from the model. Data were analyzed using qualitative content analysis. Findings: Overall, the model resonated with participants. Mentees told stories about mentors engaging in the IM constructs practicing relationalism most frequently, followed by fostering Indigenous identity development, utilizing a mentee-centered focus, and imbuing criticality, advocacy, and abiding by Indigenous ethics. Benefits included improved career and work attitudes, motivation, and overall well-being, engaging in helping behaviors, and enhanced criticality. Recommendations to expand the model included incorporating: 1) additional mentor behaviors (e.g., transference of traditional knowledge), 2) higher-order dimensions (e.g., the impact of the institution), 3) specific mentee characteristics (e.g., age and gender), and 4) additional types of mentoring relationships (e.g., peer, multiple mentors). Conclusions: This study showed that Murry et al.’s model resonated with primary stakeholders (i.e., Indigenous mentees), that Indigenous mentorship behaviors have perceived consequences that are important for adjustment, and ways the model is limited or mis-specified. This information can inform mentor practices, selection and support, and program evaluation.

Keywords:

• Indigenous
• mentorship
• intercultural mentorship
• mentorship model
• health sciences

In Canada, health disparities persist between Indigenous and non-Indigenous peoples^1–5 due to a mixture of heightened exposure to risk factors,^6,7 a history of colonialism that worked to produce environments of heightened risk,^7–9 and a distrust of the medical community due to their participation in oppressive practices and/or assimilationist policies.^10–12 Increasing the number of Indigenous healthcare professionals has been proposed as a solution to improve the health of Indigenous peoples overall, address gaps in competitive employment, and help bridge the gap between Indigenous ways of knowing and Western medical practices.^10,13–18

Unfortunately, the number of Indigenous students graduating with degrees that would qualify them to pursue health careers does not meet the demand.¹⁹ Similar to health disparities, Indigenous students face more barriers to education than the average student,^20–23 and the education system itself has garnered distrust over the past centuries for its role in the oppressive practices and/or assimilationist policies of colonialism.^19,24,25 Additionally, the pedagogy of mainstream education diverges in meaningful ways from traditional education systems of Indigenous societies, inadvertently associating success with the mastery of two cultures at best or assimilation at worst.²⁶

In this context, Indigenous scholars have argued that Indigenous mentors may provide the compensatory support needed for Indigenous students to complete their degrees.^14,26 Mentorship typically describes the interpersonal relationship between someone less experienced (i.e., a mentee) and someone with more experience (i.e., a mentor), where the mentor provides career and psychosocial support to the mentee.^27–31 Meta-analyses have shown that individuals with mentors have higher incomes, motivation, and performance; more positive interpersonal relations, career, and work attitudes; quicker promotion rates, greater helping behaviors, and less stress than those without mentors.^32,33 While Indigenous students are likely to benefit from any mentorship in a manner similar to non-Indigenous students, there is evidence that Indigenous mentorship (IM) involves behaviors and considerations that are unique to Indigenous students and may offer supports that non-Indigenous mentoring does not.

IM models outline the need for culturally relevant program activities (Heimlick³⁴; Windchief and Brown³⁵) and mentor behaviors (Murry et al³⁶), such as incorporating land-based education, hosting webinars on Indigenous scholarship, or mentors facilitating their students’ Indigenous identity. Unfortunately, evidence is lacking as to the effects of IM on Indigenous students. For example, Windchief and Brown and Murry et al. do not assess whether mentee stakeholders endorse or benefit from their model. One exception is Heimlick’s evaluation of an IM program in Saskatchewan, that 1) showed students learned about or became interested in their heritage after being exposed to cultural teachings, 2) culturally grounded teachings and perspectives were relevant to their lives in more ways than their standard coursework, and 3) being surrounded by other Indigenous scholars provided a sense of comfort with their cultural identity, confidence, motivation, and sense of belonging within academia. However, the majority of Heimlick’s report does not distinguish program benefits from mentor behaviors, or between mentor behaviors that are associated with non-Indigenous versus Indigenous approaches. Hence, we explored Murry et al.’s IM model in our study.

Murry et al.’s model was developed from a multi-phase study. This study involved 1) a literature review on Indigenous-specific mentorship, 2) an analysis of critical incidents among the research team (Indigenous scholars), and 3) focus groups and interviews with Indigenous mentors (mentees’ perspectives of IM practices were not part of the original development of this model). The model is conceptualized into six larger behavioral categories that were derived from a cut-and-sort analysis:³⁷ 1) utilize mentee-centered focus, 2) advocacy, 3) imbue criticality, 4) practice relationalism, 5) abiding by Indigenous ethics, and 6) foster Indigenous identity (see Figure 1 for further description into each construct). The model is meant to be descriptive of IM practices, as opposed to prescriptive (i.e., serve as a checklist).

To extend the research currently available on IM, we conducted a qualitative study of mentees’ experiences regarding mentor behaviors associated with IM. Using Murry et al.’s behavioral model, we explored whether and how IM supported Indigenous students’ education, personal life, and career journey. Specifically, our research questions were 1) whether the model resonated with mentees and 2) what benefits IM behaviors had on mentees’ experiences.

Method

This study was approved by the University of Calgary Conjoint Health Research Ethics Board for the Alberta Indigenous Mentorship in Health Innovation Network (AIM-HI) Network (approval number REB17-0806).

Reflexivity Statement

In line with qualitative and Indigenous methods, we offer our reflexivity or positionality statements^38–40 in hopes of preemptively addressing concerns of researcher bias.⁴¹ The first author is of Filipino and Turkish descent and is a doctoral student in Industrial-Organizational (I-O) psychology. They were supervised by the second author during this project. The second author of Irish, Ukrainian, and Apache descent is an assistant professor of Indigenous and I-O psychology and served as a co-principal investigator (co-P.I.) on the AIM-HI network (detailed in the Participants section) as an evaluator. The third author is Métis, a mid-career clinician-scientist in rheumatology and health sciences research, who served as AIM-HI’s P.I. The fourth and fifth authors are of Irish, English, and Scottish descent, and Czech and German descent, respectively, and work as research assistants alongside the first and second authors.

As part of their roles in AIM-HI as Indigenous scholars, the second and third authors were involved in the original inception of Murry et al.’s IM model, which led to the conceptualization and development of this project with the first author. The first and fourth authors were responsible for interviewing participants and were joined by the fifth author in coding the data. We recognize that having our non-Indigenous coauthors directly interact with the participants and code the data may invite comments regarding non-Indigenous people doing research involving Indigenous peoples. Despite the first and fourth authors’ identities in disadvantaged groups (both women, one a woman of color), their experiences of prejudice and discrimination do not translate to those experienced by Indigenous peoples. Thus, the depth of connection possible during interviews with participants may lack compared to having an Indigenous person do the interviews. Differences in Indigenous versus Western communication patterns may also be more apparent (e.g., long pauses before responding to a question indicating thoughtfulness [Indigenous] versus confusion [Western]). Nonetheless, both coauthors were dedicated to being curious and having empathy and compassion for the participants’ stories, especially when participants shared particularly challenging experiences. For the coding team, we recognize that concepts, worldviews, and other experiences familiar to Indigenous peoples may be less readily apparent to them as non-Indigenous peoples (e.g., relationalism). Indeed, reviewing the coding with the second author and participants during member checks provided great educational experiences on the nuances the coding team overlooked (e.g., the spelling of Nation terms on transcripts).

Participants

Participants were recruited through the AIM-HI network and the broader Indigenous Mentorship Network Program (IMNP). The IMNP national network was a federally funded initiative of the Canadian Institute of Health Research (CIHR) launched in 2016 as part of a 5-year plan to create culturally relevant activities for First Nations, Metis, and Inuit (FNMI) trainees and new investigators in health research (https://cihrirsc.gc.ca/e/49453.html). The IMNP had a national hub and seven provincially-based networks, including the Alberta network (i.e., AIM-HI). Activities within these networks included a) community and support network building, b) knowledge transference of mentoring best practices, c) research collaboration on Indigenous health research, d) hosting in-person events and workshops (pre-Covid-19), e) establishing web-based tools for ongoing support, and f) awarding funding for research and education. In total, four participants were recruited through AIM-HI and two from partnering IMNP networks, for a total of six participants (five women and one man; five First Nations and one Metis). Four were current graduate students completing their degrees in the health sciences, and two participants were community members affiliated with a provincial network. All participants had experience as a mentee and were compensated with a $25.00 gift certificate.

Procedure

The recruitment process occurred in two different phases¹ across the AIM-HI and IMNP networks via their electronic newsletters/email correspondence. Interested individuals consented to participate in semi-structured interviews lasting approximately ∼1–2 h (at the end of the study, interviews wound up ranging from ∼36 to 97 min, averaging ∼50 min) during the Fall 2020 and Winter 2021 semesters. Although semi-structured interviews are not an Indigenous research method, qualitative methods are more conducive to traditional knowledge-sharing practices and can provide space for Indigenization and decolonization by honoring Indigenous peoples’ lived experiences and prioritizing their perspectives.^21,38,42 Initial rapport-building between the participants and interviewers occurred first. Next, participants were presented with an 11-minute video clip outlining each IM construct and their associated behavioral elements in Murry et al’s³⁶ model, followed by our interview script. After the interview, participants were thanked, debriefed, and sent their voluntary compensation. For details on additional cultural and ethical protocols of our Procedure, see Appendix A.

Measures

Qualitative data was created via interviews using a script with four questions: 1) Do these ideas [in the model] resonate with you? 2) Do you have any stories related to any of these constructs? 3) What was the benefit² of those behaviors on you? And 4) Is there anything missing from this model? To create codes to analyze the data, we employed a mixed deductive and inductive approach. That is, we distilled meaning from the interviews based on deductive, or a priori, codes taken from the literature as well as codes that emerged inductively from reading the interviews.⁴² A priori codes were based on Murry et al’s³⁶ IM model components and the established outcomes on mentorship.^32,33 The codes were on a scale from 1 (presence) to 0 (absence) and were defined by any mention of mentor behaviors that aligned with a particular IM model component or an outcome of interest. Outcomes counted included income, career and work attitudes, promotion rates, helping behaviors, quality of interpersonal relations, motivation, stress, and performance. Coding definitions and concepts can be viewed in Tables 1 and 2, and Appendix B. Coding was completed using NVivo.

Analysis

Qualitative data were subjected to a content analysis coding process. Content analysis is a method of tracking the presence of important constructs within a corpus of materials, where labels (i.e., codes) that represent units of meaning are counted as they appear and later clustered into higher-order categories.⁴³ Code counts convert qualitative data into quantitative data, which can be analyzed statistically or qualitatively, depending on the type of content analysis one is using. Our analysis used qualitative content analysis⁴⁴ to identify and enumerate outcomes of IM behaviors on mentees. Qualitative content analysis is similar to quantitative content analysis, except codes are allowed to be created inductively during the coding process instead of before, and counts based on the coding process are used to redirect attention back to the qualitative data rather than serve as the final product. The result is both a quantitative summary of the code and category frequencies, along with a deeper inspection of the qualitative data associated with those frequencies.

Intercoder reliability and member checks

The coding team consisted of the first, fourth, and fifth authors, and the work was reviewed by the second author. Coding reliability was assessed among the team across three calibration sessions, where we discussed reasons for disagreement or inconsistencies, clarified meanings, and made refinements to the codebook. After the third session, we proceeded with coding the remaining transcripts based on the revised codebook and process. Data that was coded the same among all three coders was considered the most convincing data (i.e., captured the construct of interest); among two coders was considered relatively convincing, and among one coder was not considered at all. The final review of the coded data was extended to our participants (i.e., member check) as the last stage (refer to Appendix A for details).

Results

Figure 2 contains the number of mentions (overall percent [within codes under IM model constructs and outcomes of mentorship] and the number of participants [out of six]) of a priori and emergent codes related to the IM constructs and their associated outcomes.

Resonance with the IM model

Overall participants endorsed the IM Model, as reflected in three of the participants’ explicit affirmations (e.g., “Yeah, it, it does. There’s a lot of components that I can resonate with, yes.” – Wasaya). The other three participants expressed mixed opinions about the model; however, they were not based on negative impressions or rejections of the model or its parts. Rather, these participants highlighted there were either components that they felt were missing or additional nuances to consider (addressed later).

Evidence of IM model constructs

Experiences pertaining to practicing relationalism were the most mentioned – in terms of both the number of times mentioned overall and by the most number of participants – followed by fostering Indigenous identity development, mentee-centered focus, and imbuing criticality. Although experiences related to imbuing criticality were mentioned less frequently overall relative to fostering Indigenous identity development and mentee-centered focus, more participants mentioned these experiences compared to the other two constructs. Experiences pertaining to advocacy and abiding by Indigenous ethics were mentioned by a couple of participants, although less so compared to the other IM constructs (see Table 1 for codes, associated IM behaviors, and example quotes for each construct).

Beyond affirmations of the IM model, participants provided evidence for its components with stories from their lived experiences. For practicing relationalism, mentees spoke of their mentors engaging in a variety of behaviors such as sharing personal stories, treating their mentees as equals, and building meaningful relationships with their mentees (see Table 1 for Wasaya’s example). In terms of fostering Indigenous identity development, mentees shared several experiences where their mentors empowered their expression of Indigenous identity, especially when navigating Western institutions. Mentors supported mentees in building their community and fostering Indigenous support systems within the institution, as well as helped mentees to appreciate their Indigenous identity wherever they exist on the continuum (see Table 1, Keith’s experience). Mentors demonstrated utilizing a mentee-centered focus through mentees’ experiences of their mentors taking time to personally connect with them outside of the mentor’s academic responsibilities (e.g., meeting for tea, chatting on the phone). As in Legend’s experience (Table 1), mentors also actively listened to mentees’ needs (e.g., struggles regarding their personal or professional life) and personalized the type of support they would give to the mentee (e.g., emotional support, guidance). In capturing stories of mentors imbuing criticality, mentees mentioned how their mentors engaged in behaviors that evoked deeper thinking about their research perspective and how to situate themselves between Indigenous and Western worldviews (see Wasaya’s experience, Table 1). Further, mentees mentioned how mentors engaged in conversations that addressed decolonization and created safe spaces for mentees to reflect critically and express themselves. As encompassed in advocacy, mentees shared experiences where their mentors supported them in addressing systemic barriers (e.g., serving on panel discussions to address racism, pushing for funding) and finding allies among non-Indigenous mentors and teachers. For instance, Deanna described how her mother – one of her key mentors in life – pushed to preserve their cultural language in their organization, which has contributed to lasting systemic changes (see Table 1). Lastly, mentees shared how their experiences with the mentors from AIM-HI have allowed them to witness different cultural practices and protocols, as encompassed in abiding by Indigenous ethics (see Table 1 for Legend’s example).

Additional Emergent constructs

Experiences with Non-Indigenous mentors

Differing experiences regarding non-Indigenous mentors were shared. One mentee, Legend, spoke highly of a non-Indigenous mentor who engaged in behaviors associated with practicing relationalism. For instance, they described how the mentor took time to engage with Indigenous communities outside of her role as an academic (e.g., attending pow wows; see Table 1) and behaved in a nonhierarchical manner among her Indigenous students. This mentor also worked to create safe spaces for critical reflection – a behavior within imbuing criticality.

Another mentee, Rebecca³, described experiences of non-Indigenous mentors that contrasted with Indigenous mentors. Particularly, these mentors seemed to lack the emotional and spiritual connections felt with (most) Indigenous mentors; also, the mentors’ gaps in cultural understanding and knowledge of the history of Indigenous peoples in Canada seemed to contribute to ambivalent experiences.

Negative mentoring experiences

Negative mentoring experiences with Indigenous as well as non-Indigenous mentors were shared. For instance, Deanna described general experiences seemingly associated with some Indigenous mentors’ negative dispositions, which impeded others’ motivation to learn from them (see Table 1). Rebecca shared several stories related to non-Indigenous mentors who engaged in behaviors that did not support her⁴. For instance, she recalled the lack of enthusiasm her own supervisor had about supporting her desired research approach and the stigmatization she experienced in her supervisor’s class where she felt colonial perspectives were often pushed onto her. There was also a lack of advocacy in terms of creating safe spaces by challenging and breaking down systemic barriers through strategic plans, policy, and funding, which would have supported Rebecca (and other Indigenous mentees) to thrive.

Outcomes related to IM constructs

Refer to Table 2 for the codebook, associated IM codes, and example quotes.

A priori outcomes

The initial codebook was comprised of eight a priori codes based on mentee outcomes described in the literature.^32,33 However, of these codes only three were addressed by Indigenous mentees: 1) career and work attitudes, 2) engaging in helping behaviors, and 3) motivation. Improvements in stress, quality of interpersonal relationships, performance, income, and promotion rates were not covered in mentees’ stories (see Appendix B for definitions of these codes).

Emergent outcomes

Two additional outcomes emerged from mentees’ stories: 1) overall well-being, which was primarily associated with fostering Indigenous identity development, and 2) enhanced criticality, which was linked to practicing relationalism. Loosely related to imbuing criticality, the outcome enhanced criticality refers to mentor behaviors that lead to greater reflection of the mentee’s own- and taught- beliefs, ideas, taxonomies, theories, and labels. To demonstrate, Ashley shared a story of a mentor unexpectedly acknowledging her in front of a large group – a behavior that aligns with practicing relationalism, which led to her reflecting on previous perspectives and ways of being (see Table 2).

Missing components, nuances, and Potential constructs for the model

Participants shared a variety of components they felt could have been addressed more in the model or that provide nuances to existing constructs (see Table 1). These components included 1) constructs they felt were missing, such as individual-level characteristics (e.g., age and gender), transference of traditional knowledge, spirituality, resiliency, and addressing trauma, and 2) recommendations for the IM model, such as the impact of the institution and other forms of mentoring dynamics. For some mentees, these components were related to their mixed resonance.

Missing components

Although the model was introduced as a behavioral model, some mentees mentioned that differences in lived experiences might need to be incorporated to make the model more holistic. In terms of individual-level characteristics, Legend – speaking from her experience as a woman and grandmother – explained how gender identity and age could influence which mentor behaviors may be more relevant to the mentee at their stage of development. In terms of higher-order components, one mentee (Keith) mentioned that the transference of traditional knowledge, which is embodied in behaviors such as practicing and sharing traditional language and stories, seemed to be missing. Spiritual practices, such as engaging in prayer (Deanna) and resiliency (Ashley) were also mentioned. However, the former might have been due to Indigenous “protocols” (which include prayer) within the Indigenous ethics construct not being clearly articulated during the introduction IM video. A final component that was both explicitly mentioned and indirectly inferred as missing was how mentors address trauma (e.g., intergenerational trauma). One participant (Wasaya) directly expressed the experiences of intergenerational trauma that Indigenous students shoulder in their lives, whereas another participant (Legend) noted how trauma-informed practices seem to be present in Indigenous mentors’ approaches.

Potential constructs and ideas

Some mentees also conveyed potential recommendations for the model. For instance, Ashley and Rebecca emphasized that the institution impacts mentorship beyond what occurs between the mentee and mentor. Further, Legend suggested distinguishing the types of mentorship dynamics the model applies to (e.g., having multiple mentors vs. one-on-one). Although Keith did not directly suggest this as a recommendation, he did mention having learning experiences through other mentees in the program (i.e., peer mentorship).

Discussion

Our study ascertained the credibility of Murry et al’s³⁶ IM model with mentee stakeholders and provided preliminary evidence of the impacts IM behaviors on Indigenous students. Indigenous mentees endorsed the IM model for the most part, recollecting stories that exemplified those mentor behaviors and the ways they were meaningful or impactful. Indigenous mentees were aware of IM when it occurred and attributed positive benefits to it when it occurred.

Theoretical implications

These findings have several theoretical implications pertaining to culturally appropriate mentoring practices, their functions, outcomes, and currently available IM models. Our qualitative evidence provides directions for future hypothesis-testing (Figure 2) and supports the unique contributions that localized, culturally-responsive programming offers over more mono-cultural or universalist methods of mentoring.^32,33,38

Mentoring functions and forms

Kram’s well-established mentorship taxonomy describes mentor behaviors as serving two functions: career support and psychosocial support.^27–29,31 Although Murry et al’s³⁶ IM model does not fully correspond to Kram’s two-factor conceptualization of mentorship, interviewees in our sample spoke about psychosocially supportive functions of IM more than career supportive functions. The constructs of practicing relationalism, fostering Indigenous identity development, and mentee-centered focus came up the most among interviewees, all of which center on students’ sense of belonging, adjustment, and well-being.³⁶ This may be due to the increased support Indigenous students may need to counteract the systemic and social barriers they experience.^19–24 Conversely, behaviors less obviously related to psychosocial development, i.e., advocacy and abiding by Indigenous ethics, were less mentioned by mentees. It is possible that mentors generally serve more psychosocial functions since mentees likely have academic advisors and supervisors to provide career-related support.⁴⁶ Alternatively, advocacy and abiding by Indigenous ethics may be less cognitively salient to mentees compared to the other behaviors, as mentees may not be able to witness their mentors engaging in these behaviors compared to the other behaviors, which are more interactive, personal, and visible.

Mentorship is generally defined as the relationship between an expert and a protégé, and as such, can be described as a hierarchical dyadic relationship.²⁷ In Murry et al.,³⁶ mentors said they encouraged mentees to find other mentors and practiced egalitarianism. As seen in our study, several of the mentees attributed their experiences to multiple mentors throughout the network in a variety of different relationship dynamics – whether through listening and learning from faculty mentors serving on panels, having different mentors personally connect with them during challenging times, or having the opportunity to hear stories and learn from their peers during weekly Connection Circles. That is not to say that hierarchical dyadic mentoring relationships do not exist between Indigenous students and their mentors, but instead that mentoring is viewed in more communal terms and does not rely on a fixed position where one person is above and the other below. This coincides with the suggestion that mentees can benefit more academically, professionally, and personally from the variety of skills and traits available to them from several mentors.⁴⁷

IM Model and theory augmentation

Despite how the IM model and its associated behaviors resonated with participants, there were multiple complaints about missing content or restrictive category labels. For example, participants claimed that practicing spirituality was not appropriately categorized under “abiding by traditional ethics” or that the title “ethics” was too restrictive. While ceremony and spirituality may have an ethical dimension, it is more than ethics. Example behaviors include smudging, talking circles, gifting, song, starting with prayer, and reflexive introductions. Similarly, one participant mentioned that knowledge transfers, which is a traditional practice, are neither present nor easily categorized even if it were added. Participants suggested a new dimension specific to cultural practices outside of ethics or etiquette.

Outside of culture, participants also mentioned other mentor behaviors that were not included in Murry et al.’s model despite their importance for Indigenous populations. For example, trauma-informed practices are not in the current model. Although Murry et al account for mentor behaviors that address Indigenous mentees’ unique experiences (e.g., mentee-centered focus, practice relationalism, fostering Indigenous identity development), supporting those who have experienced trauma or building resiliency is more implied than explicitly stated. This is significant because Indigenous people are at heightened risk for immediate and intergenerational trauma, which is likely to surface during mentoring interactions.⁴⁸

Higher-Order dimensions of mentor behaviors

Several mentees mentioned the impact of the institutional setting on their mentoring experiences. This aligns with Chan et al’s⁴⁹ multicultural, ecological, and relational model of mentoring. As iterated by these authors, mentoring behaviors address one of three dimensions: 1) individual (e.g., career and personal support), 2) relationship (e.g., trust and relationship building), and 3) institutional and sociocultural (e.g., protection, validation, network building). However, there are also several interacting contexts (e.g., family and community; university; field and profession; society and culture) that encompass the mentee and mentor’s individual experiences, which affects the reciprocal relationship between both parties.⁴⁹ Based on Chan et al’s framework, distinguishing behaviors within IM constructs from Murry et al.’s model by dimension (i.e., individual, relationship, and institutional/sociocultural) may be more informative than broadly listing behaviors in the overarching construct.

Age, gender, and intersectionality on Indigenous mentoring experiences

Addressing varying aspects of mentees’ identities may be beneficial to expanding the IM model. Older mentees’ needs may correspond more to socialization and networking, whereas younger (less developed) mentees may require mentoring centered around skill and career development,⁵⁰ implying generational differences in the types of support needed for Indigenous mentees.⁴⁷ Vulnerabilities associated with those with historically disadvantaged gender and racial identities (e.g., see the final report on Missing and Murdered Indigenous Women and Girls [MMIWG]).⁵¹ is also especially important to consider, given the higher proportion of Indigenous women attaining university degrees.¹⁹

IM Constructs as mentor behaviors vs. Outcomes

A final important theoretical distinction is the presentation of IM constructs as mentee outcomes versus mentor behaviors (e.g., a mentee experiencing enhanced criticality versus a mentor intentionally imbuing criticality). We cannot assume this distinction follows simple directionality (i.e., X mentor behavior → X mentee outcome, e.g., a mentor imbuing criticality will lead to their mentee’s enhanced criticality) but that more complicated relationships may exist (i.e., X mentor behavior → Y, Z, W mentee outcomes, e.g., practicing relationalism leading to enhanced criticality). These distinctions can allow us to expand terminology within IM theory, as well as assess the relationships between Murry et al’s IM constructs.

Applications

Murry et al’s IM model provided several applications that are still viable following the results of this study. These include informing training materials for mentors of Indigenous students, selecting mentors for IM programs, evaluating mentors in IM programs, use as a self-assessment tool, and a behavioral strategy for decolonizing institutional spaces. In terms of mentee perceptions, our results suggest that some IM behaviors are more important or salient than others. Programs and individuals dedicated to IM might consider emphasizing relationalism, fostering Indigenous identity development, mentee-centered focus, and imbuing criticality in their practices.³⁶ We also expand on these applications in several ways, including 1) making space for spirituality and ceremony, 2) incorporating trauma-informed perspectives, 3) considering intersectionality, 4) being open to a multi-mentor model of mentorship, and 5) emphasizing psychosocial support over career support when others are available to fulfill the career support role. Future work may consider developing, implementing, and formatively evaluating IM training modules based on the revised model.

Limitations and future directions

Although the study presents interesting findings that will inform IM theory and application, there are several limitations. Firstly, while the sample was within the suggested qualitative sample ranges for interviews (i.e., 6–15),⁵² it was at the lowest value. Recruitment was hampered largely due to the global Covid-19 pandemic that took place at the same time as this evaluation of the network⁵. In addition to the stresses of quarantine, adjusting to the movement online, and Zoom fatigue,⁵³ network members were also kept from national and provincial gatherings that were originally planned sites for data collection (e.g., the National Gathering of Graduate Students, an annual event that congregates Indigenous graduate students who research Indigenous well-being and health).

Further work with a larger sample size is needed to corroborate our findings in samples with more heterogeneity, as important contextual or demographically dependent trends may surface. For example, AIM-HI participants tended to reflect relatively amicable perceptions toward the network overall, whereas the two participants from the broader IMNP discussed professional mentoring experiences outside of academia (e.g., mentorship within nonacademic communities and at work), including negative mentoring experiences. Mentees in AIM-HI made voluntary connections with mentors through word-of-mouth referrals or gatherings hosted by the network. We do not know how the broader IMNP members were matched up with their mentors. It is unclear whether network characteristics influenced differences between participants, and the sub-sample size does not justify extrapolation. While the sample size met our purpose of assessing whether the IM model described behaviors Indigenous mentees were familiar with and benefited from, it is insufficient for describing the totality of Indigenous experiences of mentorship. Our findings should be interpreted in the context of IM model development rather than as a theoretically exhaustive mapping of mentee experiences.

Also, research mapping Indigenous mentee experiences should consider more diversity within the Indigenous mentees. For example, our sample was predominately women. Indigenous gendered issues, such as patriarchy, sexism, and misogyny,⁵⁴ may influence the mentor behaviors they need, receive, or find salient. Perspectives across more demographic characteristics (e.g., youth/adult, men/two-spirit/women, urban/on-reserve), network structures (e.g., formal and informal; horizontal mentoring), and sector (academic or professional) are needed to show where continuity or differences in IM reside.

For our analysis, our final calibration session determined that the average Kappa was at an acceptable level for us to code all the data; however, it was still barely above the minimum threshold (i.e., 0.42, with a percent agreement of 93%) likely due to a combination of mentor behaviors having varying degrees of overlap between IM constructs and discrepancies in coder interpretation. The interview and coding teams were also non-Indigenous, which may have hindered some interactions with participants and interpretations of the data, respectively. We attempted to mitigate these issues by being transparent with participants about our positionality, having multiple coding reviews with the second author (an Indigenous investigator on the team) and conducting a member check with participants to verify that our interpretations were accurate. Additional Participatory Action Research (PAR) approaches, such as having mentee input on the study design, may support future work.⁵⁵

A third way to expand on this study would be to test the relative impact of IM to mainstream mentorship using quantitative methods and other qualitative methods and analyses. For example, quantitative assessments of both IM and non-Indigenous mentorship behaviors on mentee outcomes could be measured simultaneously to assess the incremental benefits of IM practices or the factor structure of the IM model.⁶ Another potential value of quantitative investigations of IM is between-group comparisons. For example, mentorship benefits may differ depending on its sources, such as peers compared to faculty or staff, mentor ethnicity, gender, or age. Comparisons could test whether hierarchical or intersectional dynamics affect the rates and types of benefits mentorship offers, and pre-post tests could assess intervention impact and efficacy and provide recommendations for programs that seek to match mentees with mentors. Given the study’s purpose and our choice of analysis (i.e., content analysis), we were limited regarding nuances we could elaborate on in our findings. Although a more complex and nuanced interpretation of participants’ stories is covered in a supplemental study by Sawyer et al, ⁵⁶ which used Polkinghorne’s (1998) narrative analysis and Archibald’s (2008) Indigenous Storywork method to analyze the data, other researchers could elaborate on the richness and depth of mentees’ mentees using other qualitative methods and analyses (e.g., narrative inquiry). On this note, further quantitative and qualitative work is needed to establish the impact of the institutional environment on the mentoring dynamic, as was suggested by participants.

Conclusion

Disparities in Indigenous health and education warrant a need to rectify issues of inequity and underrepresentation of Indigenous peoples participating within these institutions. Mentorship has been proposed as an effective strategy to address these issues. The use of theoretical models encompassing an Indigenous context may be beneficial for informing mentorship programs. In our study, Murry et al’s IM model was credible among Indigenous mentees overall. Our study provided a space for Indigenous mentees to voice their stories and perspectives about mentorship, which contributed insight to the model beyond Murry et al.’s original development. By gaining insights from mentees to refine our understanding of IM, more effective mentor training and evaluation can be done for future generations of Indigenous scholars and health practitioners.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability Statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

The work was supported by the Institute of Aboriginal Peoples Health [MN3-152407]. Grant #385011

Notes

1 We initially aimed to only recruit mentees within the AIM-HI (provincial) network; however, due to low recruitment numbers during the first phase of recruitment, we expanded our reach to the rest of the IMNP (nationwide) in a second phase.

2 We originally used the term “”impact” during the interviews, as it was understood colloquially between interviewers and participants to refer to the positive outcomes participants perceived from their mentors’ behaviors. However, as an anonymous reviewer mentioned, the term “impact” connotes summative program or intervention evaluations, which is not the intention of this study. Hence, we have adjusted the verbiage to refer to participants’ perceived “benefits.”

3 No direct quotes from this participant’s interview were included in the manuscript per their request.

4 This participant did not necessarily target negative experiences with non-Indigenous mentors, as they did explicitly mention in their interview that not all experiences with Indigenous mentors are positive. Rather, of the negative experiences they shared, the coding team happened to have more agreement on the ones involving non-Indigenous mentors.

5 This study was initially conducted as part of a formal evaluation of the AIM-HI network. Due to stipulations on how AIM-HI funding was to be used (e.g., paying for initiatives that support Indigenous mentees within the network), we were limited to recruiting within AIM-HI and the IMNP.

6 A survey with questions based on the IM model constructs and their associated behaviors is undergoing further study through a crowdsourcing platform. Indigenous mentors’ responses to the questions will be factor analyzed with validated scales of mainstream mentorship practices (e.g., Tepper et al., 1996). A similar study could be done with Indigenous mentees.

7 The Connection Circle was a weekly virtual gathering between Indigenous mentees and mentors within the network.

Appendix A

Method – Additional cultural and ethical protocols

Procedure

Interested individuals were asked to provide their contact information and coordinate interview sessions. Once sessions were confirmed, participants received an invitation to the study with a link to an electronic consent form and video conferencing platform. Participants were required to fill out the consent form before officially starting the session. Sessions commenced once all members (i.e., the researcher, participant, and research assistant) arrived at the scheduled meeting. After rapport building and opening the session with a smudge, participants were informed that the session would be audio-video recorded once they were ready to begin the formal interview and that the undergraduate research assistant would take down notes intermittently. Participants were provided with the option of using a pseudonym or, in line with Indigenous methods, the option to be named and connected to their data,^38,39 and access to, copies of, or control of their data was offered. If participants had any questions, they were addressed prior to the start of the session.

The video detailing the IM model was played first and any clarifying questions were answered after. Subsequently, sessions were audio recorded as the researcher followed questions from the interview guide. Given that participants were primed of the interview questions from the IM model video, they could answer questions and share their experiences in whatever order they pleased – provided that responses remained within the scope of the questions included in the interview guide.⁴⁴ Once participants shared their story, perspective, or input for each question, they were invited to share any last comments regarding any of the previous points. Once the final comments were shared, participants were debriefed verbally and notified they would be sent an electronic debriefing form. In line with the value of noninterference, they were invited to indicate with a “thumbs up” or “yes” in the chat whether they were open to the researchers contacting them at a later point if clarification was needed. Honorarium for time provided for research was accepted on a voluntary basis.

Analysis

Member check

In qualitative research, member checking is a process of consulting participants to ascertain the trustworthiness of the results.⁵⁷ In our study, participants were contacted via email to inquire whether they would be interested in reviewing our findings and clarifying the interpretations prior to including the content in the manuscript. In line with Carlson’s⁵⁸ recommendations on performing member checks, we provided participants three levels of involvement (from low to high): 1) reviewing a summary of themes we derived from and agreed on from their interview, 2) reviewing both themes and codes, 3) reviewing specific quotes and the themes/codes we interpreted from them. Participants who requested the last option were provided their full transcript with comments indicating where and what we coded. The summary of themes and codes was also provided at the bottom of each document in case participants were shorter on time than they anticipated. All participants provided input to their interview. Interpretations were revised based on the input and additional considerations were factored into the development of this article (e.g., one participant requested to not use direct quotes from their interview).

Appendix B

Codebook for Additional outcomes

*These outcomes were not covered in mentees’ stories.

Stress: Having less stress since being mentored.

Quality of interpersonal relationships: An improvement in the quality of their relationships with others since being mentored.

Performance: An improvement in their performance since being mentored.

Income: An increase in their monetary earnings while being mentored

Promotion rates: Moving up in their organizational hierarchy quicker than they initially thought they would since being mentored.

Figure 1. Indigenous mentorship model.

Note. Indigenous mentorship behaviours grouped into six overarching categories. Reprinted from “Indigenous Mentorship in the Health Sciences: Actions and Approaches of Mentors,” by A. T. Murry, C. Barnabe, S. Foster, A. S. Taylor, E. J. Atay, R. Henderson, and L. Crowshoe, 2021, Teaching and Learning in Medicine, p. 6. Copyright 2021 by The Authors.

Figure 2. Frequency of indigenous mentorship constructs and their outcomes.

Note. The number of mentions is based on segments of text coded consistently among at least two coders. Percentage of mentions refers to the number of times each construct within the overarching category was mentioned among the sample overall (i.e., IM model constructs [total = 43 mentions] and outcomes of mentorship [total = 15 mentions]); IM = Indigenous mentorship; * = Emergent code.

Table 1. Codes and additional example quotes for IM constructs, emergent codes, missing components and potential constructs for the model.

IM Model Construct	General Definition	Associated Mentor Behaviors/Concepts	Additional Example Quotes
Practicing Relationalism	Sense of connection and interdependence with others, including non-living entities	Building a meaningful connection with the mentee Sharing one’s story with the mentee Treating the mentee as an equal Encouraging reciprocity Modeling relationalism.	“What I appreciate about from my mentors is they didn’t have that hierarchal thinking. You know, and title didn’t play a huge role. They came in as human beings. As people that you can relate to some of the mentors had experiences themselves of what it meant to be an Indigenous student within the institutions which made it real, and that helped me to, you know, like to build trust to allow some trust to establish that relationship. And I really appreciated that these Indigenous mentors left the eagle at the door, so to speak. And they practice, which was really important.” (Wasaya)
Fostering Indigenous Identity Development	Supporting mentees to recognize the tremendous diversity in Indigenous identity.	Supporting the mentee’s positive identity development in general Building the mentee’s community Introducing the mentee to Indigenous communities Understanding oneself as an Indigenous mentor Facilitating mentee reflexivity Unpacking Indigenous identity continuums.	“Even though I'm super white coated like I look very white but I loved how [one mentor] talked about like, blood, quantum and skin tone as not being necessarily measures of your Indigeneity, and that’s been a huge piece for me because I've been white coded my whole life and in my family that was like a good thing… [describes receiving different treatment compared to family members with darker features] … Um I don’t know. Yeah, so that sort of stuff has been really important learning for me and just connecting with other scholars that are Indigenous and openly proud.” (Keith)
Mentee-Centered Focus	Serving the unique needs of the mentee beyond developing professional skills, including considerations for the mentee’s psychological, social, spiritual, and cultural realities.^36	Personalizing the mentorship approach to the student’s needs Taking a holistic approach to mentee development Sharing responsibilities with mentee Being invested in the mentee Developing a respectful connection with the mentee beyond the professional relationship.	“And so I think too, they do a really good job when they’re speaking with us to learn about some of what our challenges are without imposing us, or making us feel like we have to describe, ‘well this is what we’re going through.’ Um, and so -you know- ‘this is why I need help.’ I feel that they -because of the way they, sort of explore our situations with us because they know so much already about our backgrounds –‘cause they’ve taken the time to learn about us um, helps us to be able to, feel safe –to ask for help if we really do need it.” (Legend)
Imbuing Criticality	Supporting mentees’ reflections on their own- and taught- beliefs, ideas, taxonomies, theories, and labels.^45	Expanding the mentee’s research perspective Teaching mentee to situate oneself between Western and Indigenous worldviews Creating safe spaces for critical reflection Addressing decolonization Helping the mentee “play the game” in academic environments.	“What I struggled with was when I wrote my dissertation, initially it was very subjective. And I struggled with that. With writing the Chapter 1-2-3-4-5 in a very linear form. And I was writing to – that’s where impostor syndrome really set in. It can cripple you, you know? Where the Western ideology, and way of doing things sets in and, but then you’re resisting at saying, ‘well, no, I wanna write in a way that’s for community.’ And so when I finish that, I presented it to- Oh, I told the Elder Council and they said, ‘well don’t think of writing it as a linear form. Take your 1-2-3-4-5 and put it in a circle. And think of it as a holistic methodology. You know you don’t have to think linear, it’s all interconnected.’” (Wasaya)
Advocacy	Encompasses direct and indirect behaviors the mentor engages in to support mentees in being confident and assertive in academic and professional settings.	Direct: Taking action to prepare the mentee for the outside world Empowering the mentee’s sense of self Encouraging the mentee to find allies. Indirect: Working to improve their own mentoring skills Advocating for the mentee (and students similar to the mentee) outside of their interactions Working to change the system for future mentees (e.g., working to include Elders on a dissertation committees).	“Um, so we have three generations working in here -so this is like my mom like she’s advocated to us like our, community responsibility. So we’ve come, to this center, and -you know our main thing that we do is advocate for the language and culture, through here -you know, trying to save the culture and the language -especially because we have less than uh one percent of our people that still speak the language -So our job is to continually advocate for saving the language, documenting the language, disseminating the language and the culture – I mean they go hand in hand – language, culture, and history. Um, so that’s our job, so there’s my mom who is the founding person of this, society.” (Deanna)
Abiding by Indigenous Ethics	Modeling respect for culturally bound behavioral expectations in the contexts of research, traditional proceedings (e.g., smudge), and when in communion with community members.	Guiding Indigenous ethics in research Practicing traditional protocols Modeling traditional communication etiquette	“I think that the incorporation of ceremony that they do in the mentorship is really important too. I mean like they always make sure they acknowledge the territory of where the event is. They always bring an elder from that territory. They try to incorporate teachings from the territory – of wherever we’re getting the learning from. And they make sure that we have access to ceremony because I know a lot of Indigenous students don’t have that access.” (Legend)
Additional Emergent Codes	General Description	Overarching Behaviors/Concepts	Example Quotes
Experiences with non-Indigenous mentors	Describing experiences with non-Indigenous mentors.	Positive experiences Ambivalent experiences with non-Indigenous mentors Negative experiences^a	“…I'm more impressed when I actually see them at our community events. Being a part of the community, coming to our pow wows, our round dances, our ceremonies, and she [referring to non-Indigenous mentor] does that. I ran into her at a pow wow and I was like, ‘what are you doing here?’ She’s like, ‘I heard it was on I thought I'd come by and just check it out.’ I said, ‘well, who do you come with?’ She’s like, ‘nobody.’ I said, ‘so you’re just gonna stand around talk to nobody?’ She’s like, ‘well I thought I'd eventually meet some friends or make some friends.’” (Legend)
Negative mentoring experiences	Describing negative mentoring experiences from Indigenous and non-Indigenous mentors	Criticism from mentor(s) Re-addressing trauma Not conveying realistic expectations	“Not everybody can be a teacher, we know that [laughs] – or advocate or mentor or whatever. Not everybody can do that. Sometimes we’ve had other grandmas that come and they’re chastising us for not pronouncing something right, not getting them a coffee… And like, we don’t know all of these things, the protocols and things that have happened in the past. Especially for people who’ve been in foster care or grew up not in the community.” (Deanna)
Missing Components and Potential Constructs	General Description	Overarching Constructs (if applicable)	Example Quotes
Missing Components	Individual-Level Characteristics	Age	“In terms of my age, I think there’s this some gaps there.” (Legend)
		Gender	“I don’t see a space for being able to situate one’s own gender identity.” (Legend)
	Transference of traditional knowledge		“Under the abide by Indigenous ethics. There might be something about traditional knowledge? That doesn’t, it doesn’t look like it’s super captured there.” (Keith)
	Spirituality		“Maybe prayer? [laughs] Yeah, I know like prayer actually is a big part of what we’re trying to teach the kids here too.” (Deanna)
	Resiliency		“Yeah, I really don’t think that there’s… Anything like massive that I would, that I would say is missing. Um resiliency…” (Ashley)
	Addressing trauma		“I guess this could maybe fit in on the Indigenous identity part. I don’t want to […] make this negative in any way or lead to pathology with the Indigenous graduate student’s experience. However, some of us really do carry intergenerational trauma in our lives. And that trauma really affects how we carry ourselves in life, and we carry that trauma with us into these spaces.” (Wasaya)
Potential Constructs	Addition of institutional impact		“… If I'm thinking of the self in the center and then you maybe have like the actual mentor-mentee relationship, then you have the institutional mentee relationship, then you have societal… Like if there’s […] like ripples […] think circle.” (Ashley)
	Distinguishing mentor dynamics		“… The mentorship came from the programming that they offered, or the learning opportunities or other engagement opportunities […], so the way that I've been mentored by AIM-HI is by a lot of different mentors. The ones that are leading the AIM-HI – who applied for the funding, but also different mentors that they bring in. So mentorship has occurred through a lot of those ways.” (Legend)

IM: Indigenous Mentorship.

^a Not all negative mentoring experiences pertain to non-Indigenous mentors. Missing components and Potential Constructs were emergent codes that were explicitly stated as missing from the model by participants or summarized into a theme by the researchers.

Table 2. A priori and emergent outcomes, associated im codes, and additional example quotes.

Mentee Outcome	Definition	Associated IM Codes	Additional Example Quotes
Career and work attitudes	Having more positive attitudes regarding their career path and work experience.	Practicing relationalism	“… It’s definitely shaped who I am as a manager and a boss. I always want to try and be kind like that elder that is a teacher to me. I want to treat my employees with respect and look out for their mental health and their wellness, and their wanting to stay here. So, we have very little turnover in our center.” (Deanna)
		Fostering Indigenous identity development	“… It helped me to realize some of my responsibilities […] as Ashley, as someone of mixed ancestry, as an Indigenous health researcher. as an Indigenous academic, I have responsibilities not only to my professional designation but to the people who share their teachings with me…” (Ashley) “… My like experience with the Indigenous mentorship program has been very, very positive. Like that idea of situating my own Indigenous identity, it’s huge. It’s like completely reshaped the way that I interact with my research and my work.” (Keith)
Engaging in helping behaviors	Engaging in behaviors that benefit others – outside of practices they previously engage in.	Advocacy	“But I no longer sitting quietly in meetings with my faculty when people say racist stuff about Indigenous folks. And it’s had a trickle down to my like sexual and gender identity as well… Yeah, I think it’s probably just like feeling better about who I am as a whole person because I’m much more vociferously advocating for things that directly impact me and my Kin.” (Keith)
		Practicing relationalism	“… As like the uncles and aunties of the kids […] we have to look out for their wellbeing just as we would anybody have our own bloodline. So, I think that is something that I've learned too through the elders that worked here that have taught us.” (Deanna)
Motivation	Greater motivation to succeed in their studies or career.	Global resonance with the model	“… We can honestly say that this model works because I graduated from start to finish with them. You know you have… these concepts here. And, you look at success rate. You know having this in place for an Indigenous graduate student can work. It works, […] having a support system there, there’s times so many times where you just wanna quit.” (Wasaya)
Overall well-being*	Greater overall well-being (including mental health and balance).	Fostering Indigenous identity development	“Yeah, it’s been interesting, and I think because of Covid, we also started the AIM-HI Connection Circle^7 which has been absolutely like essential to my surviving the pandemic.” (Keith)
		NA	“I think it’s actually helped me to […] live more balanced life. It’s helped me to acknowledge that […] I cannot fix all of the world problems in one day. Maybe that someone’s definition of success, but today that’s not Ashley’s definition of success.” (Ashley) “You know, […] I just feel I felt better supported this time around.” (Wasaya)
Enhanced criticality^a	Greater reflection of one’s own- and taught- beliefs, ideas, taxonomies, theories, and labels.	Practicing relationalism	“And so that day I left thinking… […] I left feeling heavy, but a good sense of heavy […] I felt like all of this weight was put on me but good weight, that was giving me the strength to keep moving forward even though I am a student or I’m a mentee. It really helped me to acknowledge what my responsibilities are -not only in that moment, during that gathering on that day, but as I go forward 10 years from now Ashley, 30 years from now Ashley, and things to remember when I may be a mentor one day.” (Ashley)
		Imbuing criticality	“So I would say like on a purely academic sense, my reading has changed like I'm reading a lot more critically around Indigenous. When things are written about Indigenous people and also things, I'm reading a lot more things that are published by Indigenous people like Braiding Sweetgrass… You know and like so it’s just. You know it’s enhancing my ability. I guess maybe that would fall back into that imbue criticality thing like it’s helping us to read more critically and also read more Indigenous.” (Keith)

Outcomes are based on mentees’ experiences since being mentored. IM: Indigenous Mentorship.

^a Indicates an emergent outcome. NA: non-applicable.