Mechanisms of Change: Qualitative Analysis of a Group Peer Mentoring Intervention for Academic Medicine Research...

Despite the recognized need for effective mentoring for faculty in academic medicine, mechanisms driving successful mentoring interventions remain underexplored. Two consecutive cohorts of 20 academic medicine mid-career research faculty from 27 US medical schools participated in a randomized controlled trial of the yearlong C-Change Mentoring & Leadership Institute intervention. Participants convened quarterly for 2- and 3-day intensive sessions in 2020 to 2022.

We examined how this complex group peer-mentoring intervention produced positive changes in the perspectives, attitudes, and practices of individual faculty participants and the group. Qualitative data included ethnographic observations, participant writings, and semi-structured interviews. We used codebook thematic analysis to characterize changes in individuals and the group, paired with a realist evaluation framework to identify essential functions and activities within the C-Change Institute.

The mechanisms that produced change consisted of four key functions, each involving multiple forms (or activities): (1) forming group culture through participatory activities, establishing psychological safety and mutual affirmation; (2) encouraging self-reflection through introspective exercises and structured storytelling; (3) forming empathic relationships, telling life stories, and discussing experiences of difference and power; and (4) envisioning a successful future through aligning personal values and professional goals, using structured stepwise short and long-term career planning. The authors illustrate the interactions of these functions and activities.

This successful mentoring experiment of learning and career development in a changed culture provides a blueprint for broader culture change in academic medicine that must honor values, encourage reflective practice, team building, and relational leadership in career development.