Professional occupational therapy organizations support the value of mentoring for occupational therapy practitioners. In the United States, the National Board for Certification in Occupational Therapy (2015) has recognized mentoring as evidence of professional development. The American Occupational Therapy Association (2003) has included mentorship in model guidelines for continuing competence for state regulatory boards.
Interdisciplinary evidence, including research involving occupational therapy practitioners, supports the value of peer interactions for continuing competence and job satisfaction among health care practitioners. Health care practitioners have acknowledged peers as important influences on learning and professional development (Gupta, Paterson, Lysaght, & von Zweck, 2012; Ivers et al., 2012; Johnson Coffelt & Gabriel, 2017; Murray & Lawry, 2011; Scanlan, Still, Stewart, & Croaker, 2010; Walden & Bryan, 2011). In a Cochrane Library systematic review of randomized controlled trials involving audit and feedback for physicians, pharmacists, and nurses, Ivers et al. (2012) reported that effective feedback usually comes from a supervisor or colleague. Mentoring has been associated with job satisfaction (Edwards & Dirette, 2010; Ezzat & Maly, 2012; Scanlan et al., 2010; Tran, Davis, Hall, & Jaglal, 2012; Weng et al., 2010; Wilding, Curtin, & Whiteford, 2012; Zannini, Cattaneo, Brugnolli, & Saiani, 2011).
Although current evidence supports the value of mentoring for continuing competence and job satisfaction, home health occupational therapy practitioners in the United States usually have limited interactions with other practitioners. This isolation may be shared among occupational therapy practitioners internationally. In a report on factors that support evidence-based practice among Canadian occupational therapy practitioners, Thomas and Law (2014) found that although 69% of their participants affirmed a connection between mentorship and evidence-based practice, most occupational therapy practitioners did not report active engagement in mentoring. Occupational therapy practitioners in independent, front-line positions, such as the home health setting, may desire mentorship, but opportunities may be limited.
According to a U.S. study, mentoring and minimizing isolation were among the top 10 strategies identified for the recruitment and retention of rehabilitation therapists in home health settings (Tran et al., 2012). In a study of continuing competence practices of U.S. occupational therapists, approximately 81% of participants identified mentoring as one of the most valuable practices for continuing competence, and approximately 47% of participants reported frequent workplace opportunities for mentorship (Johnson Coffelt & Gabriel, 2017). Occupational therapy practitioners require creativity to maintain best practices for professional development and continuing competence. This pilot survey study assessed the effect of peer mentorship on the job satisfaction of occupational therapy practitioners who work in isolation, such as in the home health setting.
A needs assessment was completed in 2014. The first author reviewed the agency's annual colleague satisfaction survey results from 2012 and 2013 and spoke with administrators and occupational therapy practitioners within this organization. The three administrators who were interviewed acknowledged low overall employee satisfaction rates and reported that organizational goals included improving satisfaction. The first author also engaged in conversations with eight occupational therapy practitioners who were hired between 2012 and 2014. All of these occupational therapists reported a desire for professional development opportunities and peer collaboration. They expressed uncertainty and frustration regarding how to facilitate these opportunities because they rarely interacted with other occupational therapy practitioners at the agency.
After we completed a needs assessment and a review of the current literature on job satisfaction and peer mentoring, we planned a 6-week peer mentoring program and designed online surveys with quantitative and qualitative outcomes to measure job satisfaction before and after mentoring. The online surveys were designed to obtain specific information on perceptions of satisfaction and mentoring experiences among occupational therapy practitioners. This technique facilitated efficiency in participant response and data collection because the therapists worked remotely and participated in the intervention for a short time.
Development of the Survey
To measure job satisfaction, the authors designed pre-and postmentoring online surveys, based on custom surveys used in similar research studies (de Janasz & Godshalk, 2013; Desimone et al., 2013; Falzarano & Zipp, 2012; Harmer, Huffman, & Johnson, 2011; Légaré et al., 2013; Scanlan et al., 2010; Tran et al., 2012; Weng et al., 2010). The pre- and postmentoring surveys included the same 10 statements about peer interactions, professional development, job satisfaction, and organizational commitment. The surveys used a 5-point Likert scale that included Disagree Strongly, Disagree, Neither Disagree or Agree, Agree, and Strongly Agree. The prementoring survey included demographic questions. The postmentoring survey included multiple-choice and open-ended questions about the process and perceptions of mentoring (Table A, available in the online version of this article). The surveys prompted each participant to provide a unique six-digit code that included a four-digit number selected by the participant and two letters selected by each mentoring dyad. This code assured confidentiality while allowing the authors to observe relationships between the responses of each mentoring dyad.
This study was approved by the organization's institutional review board. Participants were recruited between November 2014 and January 2015. The sample was limited to occupational therapy practitioners who had been employed by the agency for at least 3 months and had the ability to participate in peer mentoring activities for a minimum of 1 hour per week for 6 weeks outside of normal work responsibilities. The recommendation of 1 hour per week was based on the National Board for Certification in Occupational Therapy Guidelines for Mentoring (National Board for Certification in Occupational Therapy, 2015). An introductory letter informed participants about the study, and participants met as a group to ask questions. All participants provided consent. Participants were given a link to a website ( http://otmentor.weebly.com) created by the first author to provide resources on mentoring.
The literature has shown that the ability to choose a partner is correlated with positive mentoring outcomes (de Janasz & Godshalk, 2013; Ezzat & Maly, 2012). Therefore, each participant self-selected a partner from the group. Participants completed and shared the Occupational Therapy Self-Assessment Skills Checklist, a tool that we designed. This tool was reviewed by two occupational therapy practitioners and one clinical educator who were not involved in the study (Table B, available in the online version of this article). This assessment included information on clinical experience and mentoring preferences to facilitate partner selection. Participants viewed completed checklists and contacted partners directly. All participants confirmed partner selection before they completed the prementoring survey.
Occupational Therapy Self-Assessment Skills Checklist
Implementation began in January 2015 and continued for 6 weeks. During week 1, participants structured their mentoring relationship, for example, how and when to meet and whether the pair would designate a mentor and a mentee or practice mutual mentoring. Each participant completed the prementoring survey. During week 2, the dyads set goals for the mentoring experience and completed the National Board for Certification in Occupational Therapy Mentoring Form (National Board for Certification in Occupational Therapy, 2015). Participants engaged in mentoring activities through their choice of e-mail, telephone, in-person meetings, or a combination of these formats. At the beginning of weeks 3, 4, and 5, e-mails were sent to participants with suggested activities and resources on topics that included client-centered care, assessment, documentation, professional development, and work-life balance. Participants were instructed to allow their own identified needs and goals to guide their professional conversations. During week 6, participants completed the postmentoring survey. The therapists were encouraged to continue their mentoring relationship beyond this study. The time anticipated for each week's activities was 1 hour. Implementation required no monetary cost to the authors, participants, or home health agency.
Approximately 30% of the occupational therapy practitioners at the study organization volunteered to participate in this study. After completion of the prementoring survey, two volunteers did not complete the intervention because of difficulty scheduling time to meet. Ten occupational therapy practitioners completed the mentoring activities, including eight women and two men. Most participants (70%) had practiced occupational therapy for more than 10 years. Length of employment with the study organization ranged from less than 1 year to more than 10 years. Although 70% of participants reported some experience with mentoring, only 30% reported mentoring with an occupational therapy practitioner at the study organization. The Table shows length of practice and reported expertise for dyad partners.
Comparison of Experience Between Mentoring Partners
On the postmentoring survey, 80% of respondents described their role in this study as both mentor and mentee, indicating reciprocal mentorship. Mentoring activities were conducted by e-mail only or with a combination of e-mail, telephone, and in-person meetings. All mentoring dyads spent at least 1 hour each week on mentoring activities. Most participants indicated that they planned to use mentoring hours toward professional certification (80%) and license renewal (67%). In addition, 80% of participants indicated that they were likely to continue a mentoring relationship with their partner beyond this study.
Nonparametric statistical analysis was used to compare prementoring and postmentoring survey scores on the 10 Likert scale items (Figure 1). Significant improvement in the level of agreement was noted for two items, satisfaction with the frequency of interactions with other occupational therapy practitioners and feelings of connectedness with other occupational therapy practitioners within the organization. No significant change was noted for the other eight Likert scale items, including the item that directly measured job satisfaction.
Data reported as percentage of respondents in each Likert scale category on the pre- and postmentoring surveys. One-sided p value from the Wilcoxon signed rank test is reported as not significant (NS) if p > .05; actual value is reported if it is statistically significant. OT = occupational therapist(s).
The directions for the four open-ended questions on the postmentoring survey invited participants to reflect on the mentoring experience. Based on the open-ended responses, we were able to reach some conclusions concerning the mentoring relationships. For the first open-ended question, participants were given a simple definition of a successful mentoring relationship, based on current evidence, and asked whether the relationship they experienced within this study was successful. Eight of the 10 respondents indicated that they had a successful mentoring relationship. Participants attributed successful mentoring relationships to the following factors: sharing of ideas and resources, similar work issues and problems, clear expectations, and weekly meetings.
One occupational therapy practitioner who reported a successful mentoring relationship noted, “We had very similar work issues and problem solved them through our discussions” and “We followed the recommended topics and stated our goals at the beginning of our meetings.” Another participant remarked, “It was good to hear how other occupational therapists handle documentation and work-life balance.” Participants who did not perceive a successful relationship reported unclear expectations and unfocused sessions as limiting factors.
The authors examined responses to the open-ended questions on specific facilitators and barriers to mentoring. Figure 2 and Figure 3 show these factors. Facilitators included flexibility in how to meet, consistent communication, commitment, and clear goals and specific examples. Of the six respondents who mentioned flexibility in how to meet, two indicated a preference for face-to-face meetings and four noted the accessibility of online meetings. One occupational therapy practitioner stated, “We performed sessions over the phone and face-to-face, and I felt like face-to-face was more productive.” Another occupational therapy practitioner remarked that “e-mail made it easier.” Consistent communication included meeting at least weekly. The therapists identified commitment to occupational therapy practice and mentoring as helpful to mentoring success. One participant acknowledged “commitment to the process” as a facilitator, and another participant commented, “We made mentoring a priority.”
Facilitators of a successful mentoring relationship as reported by participants on the postmentoring survey.
Barriers to a successful mentoring relationship as reported by participants on the postmentoring survey.
In the section for additional comments, one occupational therapy practitioner remarked, “I know and work closely with physical therapists rather than occupational therapists. It was refreshing to strictly think about occupational therapy and talk with a fellow occupational therapist.” Another participant recognized this as a unique opportunity to network with a colleague from a different branch location. Most participants had similar perceptions of the mentoring relationship; however, a contrast was noted between the responses of partners who identified their experience levels differently. The two participants who did not report a successful experience had identified themselves as more experienced than their partners on the prementoring survey. The experienced occupational therapy practitioner in dyad 1 reported that it was difficult to schedule time to meet with the novice occupational therapy practitioner, and the expert occupational therapy practitioner in dyad 5 noted that the experienced occupational therapy practitioner offered unsolicited feedback.
The results showed a positive influence of peer mentorship on participants' satisfaction with the frequency of interactions and the connectedness to occupational therapy practitioners within this work setting, but did not indicate a change in job satisfaction. This experience may have assisted occupational therapy practitioners to address the challenge of limited peer interactions in a home health setting. Although previous research (Gupta et al., 2012; Scanlan et al., 2010; Tran et al., 2012) found that both connecting with peers and reducing isolation were related to the satisfaction and retention of health care professionals, these factors may only partially contribute to job satisfaction. For occupational therapy practitioners, job satisfaction may depend on a variety of factors other than peer mentoring.
Although participant job satisfaction did not change significantly in this study, all participants agreed or strongly agreed with the Likert scale item on job satisfaction before and after mentoring. Responses on both surveys showed that all therapists agreed or strongly agreed that peer interactions are an important factor in job satisfaction. These findings suggest that occupational therapy practitioners who have a high level of job satisfaction and value peer interactions may be more likely to engage in mentoring.
Participants concurred with evidence from the literature on mentoring indicating that clear expectations and perceived similarities between partners contribute to successful outcomes (de Janasz & Godshalk, 2013; Ezzat & Maly, 2012; Straus, Johnson, Marquez, & Feldman, 2013). The same occupational therapy practitioners identified flexible meeting formats, including the use of technology and in-person meetings, as important to mentoring success. Additional factors that supported success included forming goals, sharing specific examples, providing consistent communication, and making a commitment to both the occupational therapy profession and the mentoring process. Interdisciplinary researchers have found that time is seen as a barrier to mentoring (Falzarano & Zipp, 2012; Hanson, 2011; Javernick-Will, 2012; Légaré et al., 2013). In our study, time was the most frequently reported barrier to mentoring.
The study by de Janasz and Godshalk (2013) concluded that electronic mentoring and traditional mentoring can result in similar outcomes. Participants in our study identified technology as a key facilitator for mentoring, but also identified lack of face-to-face mentoring as a barrier. The participants supported the role of technology in providing opportunities for mentoring, but preferred a combination of electronic and face-to-face interactions. It may be worthwhile to evaluate the influence of video conferencing on the mentoring relationship. Stewart and Carpenter (2009) reported that physical therapists valued face-to-face electronic interaction through iChat sessions as an effective tool for clinical support. In a study of e-mentoring in an occupational therapy doctoral program, students indicated that face-to-face interactions, whether in person or by Web camera, were beneficial to their mentoring relationships (Jacobs, Doyle, & Ryan, 2015).
Although participants' perceptions correlated with the current evidence, some unexpected findings may add to the understanding of peer mentoring in the occupational therapy community. First, our findings suggested the value of intraprofessional peer interactions. This group of home health occupational therapy practitioners reported a distinct value of mentoring within their profession. Second, our findings suggest the complexity of peer mentoring between practitioners with different experience levels. The two participants who did not report successful mentoring relationships were the more experienced partners in dyads with partners of mixed experience levels (expert-experienced and experienced-novice). This finding suggests that the professional experience and self-perceived expertise of mentoring partners can affect mentoring relationships. Additional research is needed on this topic.
Implications for Occupational Therapy
Our findings were congruent with current evidence that shows that occupational therapy practitioners value professional interactions with their peers and may incorporate mentoring as a mode of professional development and continuing competence. Those who plan, deliver, and fund clinical education for occupational therapy practitioners may include peer mentoring as a cost-effective professional development strategy for the current and future health care landscapes. Whether facilitating a mentoring partnership or planning a mentoring program, it is important to consider factors that promote successful mentoring relationships, such as clear goals, commitment to the process, and consistent communication in flexible formats. We recommend further research on the use of mentoring to promote satisfaction among occupational therapy practitioners, especially those who work in isolated settings, such as home health. Understanding the relationship between peer mentoring and job satisfaction could benefit the global community of occupational therapy practitioners.
Limitations and Future Research
No generalizations can be made from the study findings. The results were reported as counted percentages and nonparametric statistics. The study did not include qualitative themes or quantitative methods but did report participant comments and their frequency. We could only report the similarity between our findings and those reported in the literature. Limitations of this study include a small sample size, short duration of the intervention, and lack of standardized assessments. Long-term mentoring relationships may have a different effect on job satisfaction than this 6-week mentoring program.
The authors recommend research on mentoring relationships over a longer period, although the length of time needed for a successful mentoring relationship may vary by mentoring dyad. In addition, this pilot study may be redesigned on a larger scale through the use of the first author's website to conduct a broader survey with home health occupational therapy practitioners across the United States. Other recommendations concern the method of data collection. In our study, the authors could not clarify participant survey responses. Although the online survey design protected confidentiality, alternative data collection procedures, such as interviews or focus groups, may increase the richness of the data. Finally, research to identify a valid and reliable assessment of mentoring outcomes is recommended.
The authors attempted to understand the effect of peer mentorship on job satisfaction, with a focus on those practitioners working independently in front-line positions within a home health setting. Although participation in a 6-week intraprofessional mentoring program did not significantly change the overall job satisfaction of participants, satisfaction with the increased frequency of interactions was noted, which led to feelings of connectedness to other occupational therapists within the study organization. Connecting with peers can contribute to improved job satisfaction. Results were congruent with current evidence, which notes that choice, clear expectations, and consistent meetings between partners contribute to successful mentoring relationships.
- American Occupational Therapy Association. (2003). Model continuing competence guidelines for occupational therapists and occupational therapy assistants: A resource for state regulatory boards. Retrieved from https://www.aota.org/-/media/corporate/files/advocacy/state/resources/contcomp/modceguidelines.pdf
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|Thank you for participating in this survey. Your feedback is important.|
|This survey will be used to collect your responses after your participation in an introductory mentoring relationship. The survey includes ten Likert items, four open-ended questions, and six multiple choice questions. The author estimates completion of the survey will take about 30 minutes. Please read the directions at the start of each page.|
|A process has been designed to protect confidentiality of questionnaire responses. Each participant has been asked to create a four-digit numeric code for himself or herself. Additionally, each mentoring pair has been asked to select a two-letter combination to add to their individual number. This six-digit code (your personal number + the two letters you and your partner selected) will be used on this survey to allow the author to observe comparisons without using identifying information. This is the same code that you used on the Pre-Mentoring Survey during Week 1.|
| 1. Please enter your six-digit code (the 4 numbers you have selected + the two letters that you and your partner selected) – e.g. 1234abLikert Items 2. Please evaluate the following ten statements by circling one of the provided choices.|
|Strongly Disagree||Disagree||Neither Disagree or Agree||Agree||Strongly Agree|
|I am satisfied with my profession as an occupational therapist.||⃝||⃝||⃝||⃝||⃝|
|I am satisfied with my job as an occupational therapist with this organization.||⃝||⃝||⃝||⃝||⃝|
|I am satisfied with the frequency of my interactions with other occupational therapists in my work setting.||⃝||⃝||⃝||⃝||⃝|
|I am satisfied with my work-life balance.||⃝||⃝||⃝||⃝||⃝|
|I feel connected with other occupational therapists within this organization.||⃝||⃝||⃝||⃝||⃝|
|Peer interactions are important to my practice of occupational therapy.||⃝||⃝||⃝||⃝||⃝|
|Peer interactions are important to my job satisfaction.||⃝||⃝||⃝||⃝||⃝|
|This organization provides me with opportunities for professional development.||⃝||⃝||⃝||⃝||⃝|
|One year from now, I envision myself working for this organization.||⃝||⃝||⃝||⃝||⃝|
|I would recommend this organization to others as a good place to work.||⃝||⃝||⃝||⃝||⃝|
|Please reflect on your experience in this project and answer Questions 3 to 6 using your own words.
3. Evidence shows that successful mentoring relationships include mutual respect, clear expectations, and personal connection. Do you think that you and your peer had a successful mentoring relationship during this project? Please explain why or why not. 4. Please share any facilitators to a successful mentoring relationship that you recognized during the project. 5. Please share any barriers to a successful mentoring relationship that you recognized during the project. 6. Please share any additional comments about your experience in this project on mentoring.|
|Please mark one answer for Questions 7–11|
| 7. How would you describe your role in the mentoring relationship during this project?|
○ Both mentor and mentee
| 8. How much time did you and your peer spend on mentoring activities during this project?|
○ Less than 1 hour per week
○ 1 hour per week
○ More than 1 hour per week
| 9. How likely are you to continue a mentoring relationship with your peer after this project?|
○ Very likely
○ Somewhat likely
○ Not likely
| 10. Do you plan to use the time that you have spent in this mentoring relationship toward continuing competency credit for your Pennsylvania OT license?|
| 11. Do you plan to use the time that you have spent in this mentoring relationship toward professional development unites for the National Board for Certification in Occupational Therapy?|
|Please mark all responses that apply for Question 12.|
| 12. Please describe the format for your mentoring activities during this project.|
Thank you for completing this survey.
○ My partner and I met in person
○ My partner and I communicated by phone
○ My partner and I communicated through email
○ Other (please specify)
Occupational Therapy Self-Assessment Skills Checklist
|CODE: _____________________________ DATE: _____________________________|
|Competent||Need Guidance||No Experience|
| BLOOD PRESSURE|
| HEART RATE|
| RESPIRATORY RATE|
| PULSE OXIMETRY|
| INTERPRET NORMAL AND ABNORMAL PARAMETERS|
| EVIDENCE-BASED ADL ASSESSMENT (Please specify tools that you use proficiently):|
| ADL EQUIPMENT|
| BATHROOM EQUIPMENT|
| EVIDENCE-BASED IADL ASSESSMENT (Please specify tools that you use proficiently):|
| EVIDENCE-BASED COGNITIVE ASSESSMENT (Please specify tools that you use proficiently):|
|SENSORY PERCEPTUAL ASSESSMENT|
| EVIDENCE-BASED SENSORY PERCEPTUAL ASSESSMENT (Please specify tools that you use proficiently):|
|MOTOR AND PRAXIS SKILLS ASSESSMENT|
|FUNCTIONAL MOBILITY ASSESSMENT|
| BED MOBILITY|
| FUNCTIONAL TRANSFERS|
| EVIDENCED-BASED FALLS/BALANCE RISK ASSESSMENT|
| POSITIONING AND W/C ASSESSMENT|
| STANDARD W/C|
| POWER W/C|
|HOME SAFETY ASSESSMENT|
| EVIDENCE-BASED HOME SAFETY ASSESSMENT (Please specify tools that you use proficiently)|
|SKIN ASSESSMENT - WOUND STAGING AND TYPES|
| UPPER EXTREMITY|
| LOWER EXTREMITY|
|MENTAL HEALTH DIAGNOSES|
|CARDIO PULMONARY DIAGNOSIS|
|CHRONIC DISEASE MANAGEMENT|
|DEVELOPMENT OF CLIENT-CENTERED PLAN OF CARE|
|COMMUNICATION WITH PHYSICIAN – SBAR|
|DEVELOPMENT OF APPRORIATE THER EX PROGRAM|
|TEACH BACK/HEALTH LITERACY|
| BATHING AND HYGIENE|
| BOWEL AND BLADDER MANAGEMENT|
| MEDICATION ROUTINE|
| FINANCIAL MANAGEMENT|
| MEAL PREPARATION|
|FUNCTIONAL MOBILITY/TRANSFER TRAINING|
|GAIT BELT USE|
|USE OF LIFT SYSTEMS (Hoyer, Sara-Lift, etc.)|
|HOME SAFETY MODIFICATION|
|PAIN MANAGEMENT INTERVENTIONS|
|PHYSICAL AGENT MODALITIES|
|APPLICATION OF ORTHOTICS/PROSTHESIS|
|INDIVIDUALIZED PLAN OF CARE|
|GOAL WRITING WITH FUNCTIONAL RELEVANCE|
|OASIS (SOC, ROC, RE-CERT, TIF, DC)|
|TruChart (program only)|
|Are there any areas besides those listed in which you have expertise or certification?
Are you most interested in participating as a mentor or mentee during this project?
Do you have a preferred format for mentoring activities (in person, email, phone, etc)?
What is the best way to reach you?|
Comparison of Experience Between Mentoring Partners
|Dyad||Years of occupational therapy practice||Reported level of expertise|
|Partner 1||Partner 2||Partner 1||Partner 2|