A theory-informed structured mentorship program for first-year otolaryngology-head and neck surgery residents: A mixed-methods pilot evaluation

Mentorship programs in otolaryngology have rarely been structured, theory-based, or evaluated beyond participant satisfaction. We describe a one-year structured mentorship program designed with professional identity formation (PIF) as the developmental goal, legitimate peripheral participation (LPP) as the social process, and self-regulated learning (SRL) as the scaffolded individual mechanism, and report a pilot evaluation of the program in first-year otolaryngology residents from both resident and mentor perspectives, using assessment items developed from the same theoretical framework.

This was a single-center retrospective observational pilot study at a university hospital in Japan. The program comprised three pillars delivered within ordinary clinical work: weekly one-on-one mentor dialogues with mentors rotating every three months, operative participation with direct verbal and written feedback from the operating surgeon, and an electronic portfolio reviewed at each mentor handover. Seven first-year residents and ten mentors completed a nine-item questionnaire (five-point Likert scale, three domains) at the end of the program year using a retrospective pre-test design, rating both the recalled pre-program status and the current status. Residents rated themselves, and mentors rated the resident cohort. In addition, the mentor responsible for each three-month block prospectively rated the resident's entrustment level on 23 routine clinical tasks at the end of each quarter. The primary outcome was the change in total score (range 9-45). Free-text responses underwent qualitative content analysis.

The total score increased from 18.0 ± 5.3 to 37.9 ± 2.3 in resident self-assessments (P = 0.016) and from 19.7 ± 3.9 to 38.5 ± 2.9 in mentor assessments (P = 0.002), improving in every participant. All nine items improved in both rater groups. Quarterly mean entrustment ratings increased from 3.26 ± 0.57 at month 3-3.73 ± 0.54 at month 12 (P = 0.002), improving in all seven residents. Qualitative analysis yielded five themes, including mentor-observed behavioral changes-preoperative imaging review, increasingly sophisticated intraoperative questions, and consultations containing the residents' own assessments-and implementation burdens related to time and documentation.

In this pilot study, a theory-based structured mentorship program embedded in routine clinical work was associated with consistent improvements in indicators of professional development, as rated from both resident and mentor perspectives and supported by mentor-observed behavioral changes and prospectively recorded quarterly entrustment ratings. The program requires minimal resources and offers a transferable model for otolaryngology resident development. Controlled, multicenter studies with consecutive cohorts are warranted.