Abstract
It is a little over 2 years since I was released into the wild as a fully fledged GP. It is quite a peculiar feeling. At the age of 14, I was choosing my ‘options’ for General Certificates of Secondary Education (GCSE). These choices were my first step on the path to where I find myself now. At each stage the decisions and motivations have been focused on progressing to the next checkpoint.
The challenge of Advanced (A) levels flowed, after a brief respite for an enriching year out, into seemingly ubiquitous exams at medical school. The expectations were precisely defined, and the means to achieve them were clear. Emerging from this intense period of clinical and anthropological learning, I became a House Officer. Most of that year was about survival and the focus was largely on primum non nocere, with my main assessment target simply being deemed competent.
At the end of that year I reached a junction and for the first time had to decide which path to take. Although mine was meandering, ultimately bridges were crossed, and my expeditions culminated in achievement of the MRCGP.
I have always found the stepping stones lain out in front of me reassuring throughout the gentle blow of life and circumstance. The next step ahead has always been visible, and I have known what was required to get there.
Now I am there.
What I do next is down to choice, not necessity. Despite my by now well-developed skills of managing unfamiliarity, it has never been about me before. This shock has gradually subsided, and I am now excited by the opportunities I see.
The expediting factor for this transition was a recent mentor-ship training course. Before attending I thought I knew what mentoring was—not so. It has been a revelation, and I can see why coaching and mentoring is so widely embraced by corporate organisations. My impression was that mentoring was an activity undertaken in a reactive fashion, addressing current or potential difficulties. In fact true formal mentoring is proactive. Using a well-defined framework (several exist), an individual is supported, challenged and encouraged to identify their own strengths, values and desires that drive them forward.
My preferred framework uses Egan's skilled helper model. This strategy looks at an issue, as major or trivial as the individual wishes. Active listening, which we are so used to doing, is then utilised to allow the mentee to explore it further. The end of this stage culminates in identification of one defined aspect to be taken forward.
Stage two is all about ‘blue sky thinking’—identifying ideals to the extremes of imagination, with no constraints, no ‘yes but…’. This process is enormous fun, generating enthusiasm and optimism. The second stage ends with generation of a specific, measurable, achievable, relevant and time (SMART)-based goal, giving a sense of the individual being accountable for a defined action. To complete the stage the mentee can write the sentence: 'By … I will have … and I will feel…’.
The final stage revisits creative thinking, exploring ways of achieving the target. Realism and contingency planning are then applied, and a time line can be drawn detailing the actions needed to move from here to task completion. By the end of stage three the mentee has generated a well-defined plan with a clear objective and an appropriate strategy. All that is left is to implement it.
Once you have a grasp of the process it can be a phenomenally powerful tool. It is not about providing answers or giving advice—it is about empowering individuals to identify and utilise their own resources. You can use the skills to informally ‘self-mentor’ and there is certainly a role for mentoring in health care. This approach encourages individuals to take control of their own health, in the context of their own life, and in a way that is acceptable to them. It is rarely a single jump to a conclusion, but instead a series of steps that can be repeated as necessary.
Mentoring skills give me back my place of familiarity. The steps are again laid out in front of me—the only difference is that I have put them there myself this time.