December 19, 2012

Preceptor, Mentor, or Both?

by Carmen Nobre, Pharm.D., PGY2 Oncology Resident, University of Maryland

Lines between being a preceptor and mentor often blur.  To be a preceptor is to participate in a prearranged role where one assumes the responsibly of fostering and building the core professional skills of a trainee.  As outlined by American Society of Health-System Pharmacists for pharmacy post-graduate residency programs1, a preceptor is one that models, coaches, and facilitates a trainee's performance as a professional. 

To be a mentor is to function as a role model within your given profession.  Research on mentoring indicates that a mentor should:2
·      be nurturing
·      be a role model
·      function as teacher, sponsor, encourager, counselor and friend
·      focus on the professional development of the mentee
·      sustain a caring relationship over time

This type of relationship is traditionally freely entered by both parties (i.e. not as a requirement of a curriculum or program).  The mentor and mentee build a closer, more personal relationship than that of a preceptor and student.  Of no surprise, this often means that the two parties share similar interests and characteristics.  A mentor may participate in professional activities with the trainee, and may also engage in discussions relating to the trainee as an individual and not solely as a member of a larger group of professionals.  Topics of discussion often include families, hobbies, frustrations, and ambitions.3

Despite their differences, the terms preceptor and mentor are often interchanged.  This may be due to their shared goal of fostering the development of a young professional.  Yes, both roles have the common goal of guiding a trainee in their professional development, and coaching them through their journey.  Each role may also serve to challenge the trainee, evaluate their performance, or offer advice.  However, there exists a different tone between these relationship.  Most obvious are the differences in the goals and benefits of these relationships, their duration, the socialization process, the support for learning and feedback given.4  Simply put, a preceptor is more of an authoritative figure while a mentor acts more like an older sibling.

Can these lines ever be blurred?  Should they be blurred?  If so, when is it appropriate to play this dual role?  Furthermore, how do you juggle between the two?  Playing this dual role can be tricky.  As a preceptor there is a responsibility to evaluate the trainee, and provide constructive feedback to further their growth.  But as a mentor there is an expectation that you offer support and advice in how to handle even the worst of situations.  Is it possible to provide necessary criticism while being supportive?

In my experience, it can be difficult for both the preceptor / mentor to have this overlapping relationship.  From the trainee's perspective, it is difficult to maintain a goal-oriented working relationship with a preceptor, and then switch modes and disclose personal thoughts and feelings to that person.  In addition to identifying when it is appropriate to have a mentoring discussion, it is also difficult to reveal your weaknesses and frustrations (or even pleasant feelings) to a person who will be evaluating your performance.  From the preceptor’s perspective, it must be difficult to transition between nonjudgmental casual conversations and to formal discussions and evaluations of the trainee's performance.  Although it may be possible to carry this dual role, it requires a certain degree of balance.

Nonetheless, the benefit of having a mentoring relationship with a resident outweighs the risk of blurring the line between being a preceptor or a mentor.  There is much to gain.  There are opportunities to exchange ideas, improve job satisfaction, and build networking relationship.  Many institutions have developed formal mentoring programs where the mentor and mentee are paired and given guidance about how to develop an effective relationship.5   

Creating a formal mentoring program is one way of incorporating this fundamental practice into a resident's experience.  Another way is to purposely integrate it into the objectives of the residency curriculum.  By including instruction about mentoring, it will clarify the intent and expectations of the mentor-mentee relationship, and would also ensure that important professional development topics are addressed during the year.  This would serve to establish goals and clarify expectations (such as frequency of meetings).  An example: mentors should set aside time to discuss potential career opportunities after residency.  It is important to keep in mind the fundamental distinction between being a preceptor and a mentor, and that any relationship requires effort from both parties to be successful.6

Learning to be an effective preceptor and mentor requires training for a successful and positive experience.  As a recent graduate and having precepted my first student, I commend those who are able to fulfill these dual roles.  However, I would encourage new preceptors and mentors to have an open exchange with their trainees about expectations, and even seek advice from more experienced mentors (i.e. become a mentee yourself).

1.  American Society of Health-System Pharmacists. Education and training.   Accessed 2012 Oct 22
2.  Kerry T, Mayes AS.  Issues in Mentoring,   Routledge Publishing Company in association with The Open University; New York, New York: 1995.
3.  Wensel TM. New Practitioners Forum:  Mentor or preceptor: What is the difference? Am J Health Syst Pharm 2006; 63:1597.
4.   University of Medicine & Dentistry of New Jersy (UMDNJ) Center for Teaching Excellence. Teaching Portfolio: Precepting and Mentoring [Web page]. Accessed 2012 Oct 22
5.  Johnson MO, Subak LL, Brown JS, et al. An Innovative Program to Train Health Sciences Researchers to be Effective Clinical and Translational-Research Mentors.  Acad Med. 2010; 85: 484–9.
6.  Sambunjak D, Straus SE, Marusic A. A Systematic Review of Qualitative Research on the Meaning and Characteristics of Mentoring in Academic Medicine  J Gen Intern Med 2009; 25: 72–8.

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