Dilshan Pieris,¹ Kevin JQ Chen¹

¹Temerty Faculty of Medicine, University of Toronto, Ontario, Canada

Corresponding to: Dilshan Pieris; email: dilshan.pieris@mail.utoronto.ca

COVID-19 has disrupted many aspects of medical education, including mentorship for medical students. Mentorship programs provide career guidance and support systems, especially benefiting students without pre-existing relationships in medicine.¹ Pandemic-related restrictions have forced mentorship programs to rely on virtual platforms.² The value of these programs prompts consideration of the impacts of this transition. We explore tensions in engagement; equity, diversity, and inclusion (EDI); and logistics arising from this shift through our lens as program coordinators.

For engagement, this year’s virtual program had substantially more participants (e.g., e.g., 410 in 2020-2021 vs. 256 in-person in 2019-2020), likely due in part to capabilities afforded by online platforms. Zoom, the platform adopted at many institutions, including ours,² can host hundreds of individuals whereas in-person capacity is often constrained by room booking policies. Virtual platforms also remove geographical barriers, facilitating engagement through flexibility across time/space (circumventing travel) and expanding the catchment for mentor recruitment.^2,3 However, despite more participants, virtual platforms challenged the quality of engagement. Mentors and mentees had more options for events in-person (e.g., shared meals), providing valuable face-to-face interaction to establish mutual trust/safety. Virtual environments hindered such connections by introducing new social norms (turning off microphones/cameras, multitasking), technical difficulties (poor internet connection, asynchronous audio/video), and issues interpreting non-verbal cues.^2,4 Moreover, with students spending hours online for classes,^2,3 many experienced videoconferencing burnout (“Zoom fatigue”),⁵ contributing to attrition in mentee engagement.

From an EDI perspective, the virtual setting enabled mentor recruitment from outside institutions, improving diversity and facilitating inclusivity for mentees. This option was an attractive benefit since medical students value diversity and a sense of community and shared identity from mentors.¹ While mentor diversity is always a priority; it can be challenging to achieve in-person due to regional constraints on recruitment. Furthermore, in-person iterations often carried financial barriers. Many groups met at restaurants or venues requiring entrance fees. Mentees often paid out-of-pocket, placing undue financial stress on those from lower socioeconomic backgrounds, potentially dictating how often they met with mentors. This problem was partially offset in the virtual program as there were more cost-free options (e.g., videoconferencing, free online games).

Logistically, our virtual program had fewer administrative costs. Though groups organized their own meetings throughout the year, we also hosted large events to facilitate socialization and debrief with participants. With an online program, many aspects of these larger events (e.g., catering, room bookings) and their associated fees no longer applied. The funding, therefore, could be reallocated toward subsidies to address the financial inequities or carried forward for future iterations. However, despite lower administrative costs virtually, there was a greater logistical burden of planning. We had to organize a larger number of participants into groups while still ensuring mentor-mentee compatibility by closely aligning their professional, academic, and personal interests. Additionally, with more participants came more intra-group conflicts (e.g., unresponsive mentors) requiring case-by-case resolution.

Amidst changes imposed by COVID-19, we learned that transitioning online offers several advantages for mentorship programs, though not without challenges. These programs help students catch their footing on the journey of career exploration and development, whose uncertainties/anxieties are exacerbated by the pandemic.^1,3 Virtual programs provide an equitable alternative with a greater capacity for participation. Thus, program coordinators should learn to pivot online as the pandemic continues to evolve.

While increased virtual enrolment may bring optimism, coordinators should prepare for tapering engagement. One potential solution is to create incentives. For example, in our virtual program, we implemented photo contests wherein groups won by having the most social media engagement (likes, comments). We also created nomination-based awards to recognize participants who actively engaged in their groups. Winners received gift cards that were funded, in part, by money saved from hosting the large events online.

As coordinators, we felt especially disconnected from groups during the virtual program, likely due to reduced face-to-face interaction. To overcome this, we incorporated frequent check-ins (emails, social media postings, surveys) that became useful logistically; proactively seeking feedback rather than waiting for it helped us identify and address conflicts more quickly. Checking in with groups often also enabled real-time, needs-based adaptation. For example, we cancelled our mid-year event in response to Zoom fatigue identified in participants.

Overall, shifting online revealed a need for mentorship programs to adapt to resultant changes in engagement, EDI, and logistics. Incentivization and more frequent (active) communication with participants are easily implementable strategies to improve virtual program delivery while providing the career guidance and support sought by students.

References

1. Zhou S, Balakrishna A, Nyhof-Young J, Javeed I, Robinson L. What do participants value in a diversity mentorship program? Perspectives from a Canadian medical school. EDI. 2021;ahead-of-print(ahead-of-print). https://doi.org/10.1108/edi-12-2020-0348
2. Serhan D. Transitioning from Face-to-Face to Remote Learning: Students’ Attitudes and Perceptions of using Zoom during COVID-19 Pandemic. IJTES. 2020;4(4):335-342. https://doi.org/10.46328/ijtes.v4i4.148
3. Abdelhamid K, ElHawary H, Gorgy A, Alexander N. Mentorship resuscitation during the COVID-19 pandemic. AEM Educ Train. 2020;5(1):132-134. https://doi.org/10.1002/aet2.10538
4. Dias M, Lopes R, Teles A. Will Virtual Replace Classroom Teaching? Lessons from Virtual Classes via Zoom in the Times of COVID-19. J Adv Educ Philos. 2020;4(5):208-213. https://doi.org/10.36348/jaep.2020.v04i05.004
5. Bailenson J. Nonverbal Overload: A theoretical argument for the causes of Zoom fatigue. TMB. 2021;2(1). https://doi.org/10.1037/tmb0000030