Conceptual Framework of Mentoring in Low- and Middle-Income Countries to Advance Global Health

Various adult learning theories have been proposed to understand the complex processes of higher education.1 Whereas these theories look at different aspects of knowledge and skills acquisition, the ultimate task of a learner is to achieve mastery in the chosen field while being a lifelong learner.2 The progression to mastering skills for lifelong learning occurs with a transition from rule-based behavior to a context-based one that enables adaptive learning for emergent knowledge.3 This progression of mastery occurs in the context of increasing changes within individual fields. The field of global health adds further layers of complexity to learning with changing paradigms of diseases, systems, and inter- and trans-disciplinarity, including health and non-health sciences, and cross-cultural challenges.4 This article proposes a conceptual model of mentoring, particularly for the low- and middle-income country (LMIC) setting. It takes into consideration the unique challenges of working across cultures and disciplines, and looks at resource-limited settings in which most mentoring programs are nascent. We draw on the literature from higher education and from cross-cultural studies to provide a framework for designing and evaluating mentorship programs. Although mentoring occurs in informal ways without conceptual models in various settings, including in LMICs, we propose these conceptual models as a framework to let groups of mentors organize their work, generate new ideas, and develop programs within their institutions. The conceptual model also sets expectations for mentees to use these programs to advance their careers and global health. This conceptual model originated from the four aforementioned Fogarty International Center Global Health Program for Fellows and Scholar consortia members “Mentoring the Mentors in Global Health Research” workshops at LMIC institutions detailed earlier in this special issue.5 Critical role of a mentor. The ongoing development of knowledge in each trainee from early training through postdoctoral and early faculty positions is shaped by core adult learning principles: the learner’s need to know, self-concept, experiences, readiness to learn, orientation to learning, and motivation.6 Incorporation of these principles can lead to “transformative” learning which finds meaning from experience, thus providing a basis for action.7 Learners need to critically reflect and engage in a deep conversation or discourse with their life and work experiences, beyond engagement in formal curricular elements, to support transformational learning, but are often ill prepared to undertake this type of reflection without guidance from a more experienced professional.8 This guidance often falls to a mentor, whose essential function is to prompt critical reflection in student learning.9 Mentorship has been defined as—“an experienced highly regarded empathic person (the mentor) guides another individual (the mentee) in the development and re-examination of his or her own ideas, learning, personal, and professional development.”10