title: Cultural implications of mentoring in sub-Saharan Africa: a qualitative study.
abstract: BACKGROUND
  Although many studies have demonstrated the benefits of mentoring in academic medicine, conceptual understanding has been limited to studies performed in North America and Europe. An ecological model of mentoring in academic medicine can provide structure for a broader understanding of the role of culture in mentoring.
  
  
  OBJECTIVE
  The goal of this study was to explore the role of culture in the development and maintenance of mentoring relationships within the context of the University of Malawi College of Medicine.
  
  
  METHODS
  A qualitative study using in-depth, semi-structured interviews and thematic analysis was conducted to explore the meaning of mentorship at the study institution. Criterion sampling was used to identify and recruit medical students, interns, registrars and faculty members. Study team members developed a codebook through open coding and applied it to all interview transcripts. Thematic analysis was used to identify and categorise themes according to an ecological model.
  
  
  RESULTS
  A total of 46 participants from two major centres in Malawi were interviewed. Themes were identified within three domains: the intrapersonal; the interpersonal, and the institutional. Intrapersonal themes included Malawian politeness, mentoring needs, and friendliness and willingness to help. Interpersonal themes included understanding the role of the mentor, respect for elders, personal and professional boundaries, and perceptions of others. Institutional themes included the supervisor versus mentor, time pressures, tension about the scope of training, and the mentoring cycle.
  
  
  CONCLUSIONS
  This study highlights the strengths of and challenges imposed by culture to the provision of mentoring relationships at the study institution. It also highlights the central role of culture in mentoring and proposes an updated model for mentoring in academic medicine. This model can inform future research on mentoring and may serve as a model in the larger effort to provide faculty development in mentoring across sub-Saharan Africa.
authors.affiliation: Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Sawatsky
authors.affiliation: Internal Medicine Residency, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania, USA.
authors.forename: Natasha
authors.initials: N
authors.lastname: Parekh
authors.affiliation: Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.
authors.forename: Adamson S
authors.initials: AS
authors.lastname: Muula
authors.affiliation: TeamHealth Oak Ridge Methodist Medical Center, Hospitalist Medical Group, Oak Ridge, Tennessee, USA.
authors.forename: Ihunanya
authors.initials: I
authors.lastname: Mbata
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania, USA.
authors.forename: Thuy
authors.initials: T
authors.lastname: Bui
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003469:Culture; D004501:Education, Medical; D005178:Faculty; D033062:Friends; D006801:Humans; D015274:Interdepartmental Relations; D007398:Interpersonal Relations; D007400:Interprofessional Relations; D008295:Malawi; D000071252:Mentoring / Q000592:standards*; D008611:Mentors / Q000523:psychology*; D010465:Perception; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology*; D013997:Time Factors; D014836:Volition; D000072358:Work-Life Balance