E-mentoring: does it have a place in medicine?

M entoring for doctors is clearly an important issue and has been the focus of recent debate. We would like to add our own thoughts in one of the more controversial areas— e-mentoring. Over the past decade there has been a substantial increase in work into e-learning support, such as e-moderating, and other mentoring and support systems such as online communities of practice. It is not the intention here to explore these literatures but to concentrate specifically on one area—e-mentoring. E-mentoring has been defined by Bierema and Merriam as ‘‘a computer mediated, mutually beneficial relationship between a mentor and a protégé which provides learning, advising, encouraging, promoting, and modeling, that is often boundaryless, egalitarian, and qualitatively different than face-toface mentoring’’ (page 212). This definition has two elements that distinguish it from traditional mentoring—the boundaryless configuration and the egalitarian quality of the exchange. Although there has been much work on the effectiveness of non-electronic mentoring, less is understood about the dynamics, context, or results of e-mentoring. Many educators and organisations (including the medical profession) remain suspect about the new and growing field of e-mentoring. However, research by Preece and her colleagues has shown how the internet can be used to express empathy, particularly in online patient support communities. Furthermore, Griffiths has argued that online relationships can be just as real and intense as those in the offline world, and there should be little surprise that psychologists and educators are beginning to establish online therapeutic relationships. The argument also holds for e-mentoring. The time has come to embrace the new technology and to carry out evaluative research into this potentially innovative form of mentoring within medical—and other— sectors. People in the medical profession have offered each other electronic support ever since the internet was formed and bulletin boards became popular forums. E-mail can be received and responded to either immediately (that is, in real time) or it can be stored and responded to at the convenience of the user (that is, asynchronous time). It is probable that the most popular form of e-mentoring in medical settings occurs by e-mail. Other e-mentors may use text based chat rooms that permit some sort of conversation in real time and provides almost immediate feedback (albeit by typing rather than talking to each other). A common form of e-mentoring is when older students participate in electronic classrooms, in which they can communicate with each other and with various instructors by e-mail, computer conferences, and chatrooms. A faculty member or other educational professional takes the role of e-moderator, whose job is to make sure interactions progress smoothly. The title ‘‘e-moderator’’ used by those who write about this role shows that it is not entirely a mentoring role, but aspects of the role like acculturation, building confidence, and modelling effective behaviour overlap with conventional definitions of mentoring. E-mentoring can also be used in supporting career development for professionals within an organisation (such as medicine). It is probable that much of this work is either not publicly visible, or if visible, is not much publicly analysed or reported. There are a number of very good reasons why the internet is an excellent medium for most forms of help. For instance, research has consistently shown that the internet has a disinhibiting effect on users and reduces social desirability. This may lead to increased levels of honesty and therefore higher validity in the case of self disclosure. However, there is research that shows there are subtle interactions between anonymity, honesty, and self disclosure on line. 12 Through examination of the literature, e-mentoring seems to be advantageous for a number of reasons. Furthermore, all the advantages of e-mentoring are equally applicable in medical settings: