Mentoring in Chinese medicine
Are we progressing?
by Glenys Savage
The Lantern: Volume VI, Issue 1 - Article #1
“How can I be sure that I’m doing the right thing for patients after I graduate? Who will be around to ask? What if I make a mistake?”
These are daunting thoughts, and often occur to students reaching the end of their courses when they face the scary prospect of commencing practice alone. Sometimes these thoughts are so daunting that students fail to take the next step after graduation, and do not begin to practise. They may tell themselves that “it is just a short break, I’ll start to practise in a few months” but as the months go by the prospect is still scary, and worse, the memory of points, techniques, and herbs has begun to fade. Confidence plummets. Avoidance sets in. The profession has just lost a potentially valuable practitioner.The pity is that it is so avoidable. All we need to do is to establish a support network for mentoring graduates and new practitioners.
Mentoring means different things to different people. To some it means following a practitioner closely to copy what they do, to others it means having the opportunity to interact with practitioners with more experience to help themselves grow and develop in their work. Mentoring is also a means by which the practical application of professional ethics and standards of practice is disseminated.
A mentor acts as a teacher or someone who can be modelled in their role as a practitioner. In this situation they lend support to the less experienced practitioners and assist them in their professional development, in their application of knowledge, skills and attributes. In some situations they may also serve as counsellors. Mentors provide support, someone else to talk to and with whom to bounce ideas around. This is most important for new practitioners. In older times the apprenticeship style of learning Chinese medicine served this purpose. Can you remember your own early days in practice and how you could have benefited from a relationship with a trusted professional mentor? Were you lucky enough to have someone who served in this role for you? How did you find them? These are some of the important things to consider in any formalised mentoring programs.
Our job needs to be satisfying, and we need to be healthy, happy and fed. A mentor can help with all that: giving a hint regarding a successful treatment strategy, how to organise your files, how to charge a reasonable fee, how to make a living without working yourself to death. How to stay healthy when you are constantly surrounded by illness.
After all, we claim to practise holistic medicine. The Nei Jing emphasised that we are integrally related to the environment in which we live. New practitioners are influenced by their relationships and what happens about them. They benefit from positive influences. This is what holistic medicine and education is all about.
Originally, Chinese medicine teaching followed the apprenticeship style. It was the typical way for teaching, learning and exchange of knowledge and skills. The student would sit with the teacher who explained theories and case examples to illustrate. In the herb dispensary or clinical setting, the student would observe, repeat, practise, observe, repeat and practise until they remembered and correctly demonstrated the skills. Meanwhile, they were themselves observed and gently (or not so gently) corrected until they got it right.
In today’s education system we talk about demonstrating competence. It is a similar approach, only we set it out clearly in terms of learning outcomes, aims, objectives, performance criteria, skills to be learnt. Assessment of progress is based on objectives or criteria. All of this is fine for the fundamentals of Chinese medicine education, ensuring that larger numbers of students reach a determined level before they begin to practise. But it is all wasted if they never go on to practise.
A healthy and successful profession “nurtures its young”. Mentoring is an effective method of providing much needed assistance to both students and new practitioners, some of whom may otherwise flounder. Nurturing and developing new graduates’ skills and confidence is a marker of a healthy, mature profession. The Chinese Medicine Registration Board of Victoria has identified that professional isolation is a risk factor for poor practice and that new graduates can be especially vulnerable.
“But I don’t want to teach anyone my secret prescriptions! That is just cutting my own throat. Why should I create competition for myself?!”
Some people advance arguments like these as reasons to avoid mentoring. Besides betraying evidence of what Confucius would have called “petty-mindedness” this type of thinking is short-sighted. Chinese medicine has reached nothing like saturation levels in Australian society, and in fact the more effective practitioners we can produce, the more demand there will be. What really hurts the profession is practitioners who do not get results, those who have perhaps been struggling on their own just to re-invent the wheel, when a few helpful words here and there may have been enough to make them effective. One patient who goes out and says “I tried Chinese medicine and it worked!” leads to referrals for many practitioners, not necessarily only the one she saw.
Mentoring is where membership of professional associations can play an important role. Mentors can be found through contact with associations and continuing professional education (CPE) activities. While some practitioners consider it a chore to gain CPE points each year, it is continuing education that keeps us abreast of research and developments. It enables us to share our knowledge and experience, develop supportive and educative professional relationships, assist colleagues and it keeps us aware of and involved in current professional issues, which is essential for effective ongoing practice. Another possibility is discussion groups where new practitioners meet to discuss problem patients, in effect mentoring themselves.
In my case, I was extremely lucky to have as a mentor one of the grandfathers of the profession in Australia, Professor Lun Wong, recently retired at 88 years of age. He dedicated some 67 years of his life to practising Chinese medicine and training practitioners. In December 2007, 250 students, practitioners and patients attended a dinner in his honour to celebrate his 34 years of work and teaching in Melbourne. Professor Wong was the founder of the Academy of Traditional Chinese Medicine Australia and a long-standing mentor and inspiration for many who studied not only at the academy but also at other institutions.
Professor Wong, like many others, has always been happy to assist new graduate practitioners in their practice. He would hold special clinical sessions where new practitioners could bring patients when they wanted additional input into their diagnosis and treatment, and later feedback from these practitioners showed that they found the sessions useful in developing their confidence and skills.
Of course many other practitioners have willingly served in the role of mentor to assist newer practitioners for various lengths of time. Most of us will remember such help with affection and gratitude. The best way to pay it back is to pay it forward: help younger practitioners get a leg up.
Some associations are taking this seriously and looking to develop formal mentoring programs in addition to continuing education. In other cases students can seek out experienced practitioners. We could learn some lessons from liaising with some of the other health professions about the way they establish their internships or mentoring programs.
There is no doubt that best practice results are obtained when a practitioner feels confident, supported and valued in their work. This also assists the profession to grow in effectiveness and reputation. So, we need experienced practitioners who are willing to participate in case conferences related to patients or to take other approaches, and practitioners who are willing to share their expertise, their knowledge and skills in order to assist the new, upcoming practitioners who will be the mentors of tomorrow.
If you are interested in mentoring, talk to your professional association or Chinese medicine schools and let them know.
There is no shortage of students needing a hand.
