MENTORING IN THE FIELDS OF PHYSIOTHERAPY AND INTEGRATED CARE

A survey on the opinion of students studying Rehabilitation as a major subject on the role of their mentors and their qualities in the “Student Practice project.” The aim of the study is to investigate the point of view of the students, involved in the “Student Practice” project, about the role and the qualities that mentors and academic coaches (physiotherapists) should possess in order to be created a selection criteria. Subject of the survey are 14 students studying at the Medical College of MU-Varna which study “Rehabilitation”. These students participated in the “Students practice” project for the period November 2016 March 2017. A feedback was sought from them through a questionnaire method with an exclusively prepared for the survey questionnaire. The results of the feedback from trainees showed their increased confidence in dealing with patients and their better integration within the work team. The knowledge and skills acquired by students in the “Student practices” project are a prerequisite for the development of mentoring as a priority for the state’s education policy, with clear indications for choosing the most appropriate mentor and setting clear tasks for the acquisition of specific knowledge.

Improving the quality of care for patients from all ages with severe or multiple chronic diseases demands a working model of integrated care in a hospital environment and outside of it.Gröne O. and M. Carcia-Barbero (2001) define integrated care as a "concept of cohesion, cooperation, delivery, management and organization of the services related to diagnosis, treatment, care, rehabilitation and health promotion."The implementation of these objectives requires trained professionals, including physical therapists that provide complex and prolonged rehabilitation care.The training of specialists performing healing through movement suggests that physiotherapy should be studied, practiced and taught according to the worldwide and European experience [1,2].
In this sense mentoring in its various dimensions is a priority for the education policies in many countries and there are clear indications that it should happen professionally and efficiently.The term "mentor" appears for the first time in Greek mythology and is associated with the concepts of "wise", "strong" and "trustworthy guardian".
Mentoring programs in the "Student practices" project link the mentor and the student based on their shared interests, needs, goals, strengths and personal qualities and give them an opportunity to create long-term, mutually beneficial relationships and shared experiences [3].
The mentor is a professional expert in the field, with whom the student can share their problems, build on his/ hers practical experience and discuss questions about future career opportunities [4].
Mentorship is defined as a long-term relationship between people, one of which is significantly more proficient than the other.The essence of the mentorship can be defined as a process of interaction between two or more individuals where one person has a personal superiority in a given area and exercises qualificational and professional impact on the thinking and professional activity of the other person.The mentoring project "Student Practice" suggests creating a working relationship between the student and the mentor for the acquisition of soft and hard skills in 240 hours [5].
The goal of the mentorship is to shorten the adaptation period in the workplace and to provide independent and qualified performance of the obligations and to enable the rapid adoption of the operational model of an organization.In the learning process of the "Student Practice" project are created opportunities for acquisition of the following practical skills: -questioning the patient; -preparation of a patient's functional assessment; -preparation of a physiotherapeutic plan; -execution of the rehabilitation plan: independently or through the "mentoring" of the rehabilitation therapists in this process; -assessment of the patient's rehabilitation potential at the beginning and at the end of the rehabilitation; -execution of physiotherapeutic procedures appointed by a doctor-physiotherapist and others [6,7].https://doi.org/10.5272/jimab.2018241.1923The implementation of the mentorship principles consists of constructive and professional interaction, voluntarism and mutual interest.Such implementation is supposed to clarify the selection criteria for the mentortherapists who have mastered to perfection the aforementioned soft and hard skills.The lack of extensive research that would help for the establishment of basic selection criteria for mentors in the physiotherapeutic integrated care prompted us to conduct this empirical study.

MATERIAL AND ÌETHODS:
Clarifying the role of the physiotherapist and his qualities as a mentor in this project is possible by examining the physiotherapists' own clinical experience in the Department of Orthopedics and Traumatology at the University Hospital "St.Marina" EAD, Varna, where during the 2016/2017 academic year were implemented activities under the "Students practice" project with participants who were students with "Rehabilitation" as their major subject and mentor-physiotherapist.A feedback was sought from these students through a method using a questionnaire that was exclusively made for the survey.
The object of this study: the opinion of 14 students from the "Rehabilitation" major (MC of MU-Varna) involved in the "Students practice" project for the period November 2016 -March 2017.
Choosing a centre for the project activities: highly technological level of the Department of Orthopedics and Traumatology, University Hospital "St.Marina" EAD, Varna and providing integrated care by a multidisciplinary team with physiotherapist as a participant -early postoperative rehabilitation continued at home with the help of a patientcentered approach.

RESULTS AND DISCUSSION:
The study involves 14 students from the "Rehabilitation" major (MC of MU-Varna) who were participants in the "Students practice" project for the period November 2016 -March 2017.The activities had been done in the Department of Orthopedics and Traumatology, University Hospital "St.Marina "EAD, Varna.A feedback was sought from the students regarding their views on the role of the mentor-physiotherapist and the qualities that he/she should possess.

Fig. 1. Role of the mentor
The data presented on Figure 1 displays the respondents' views on the four issues in the field "Role of the mentor".The answers to this topic do not contain the marks 1 ("disagree") and 0 ("completely disagree").The feedback reveals that more than 50% "completely agree" (a score of 4 on the Likert scale).Physiotherapist -mentor has accepted the student and gave him the opportunity to join the real working environment -50.01%"totally agree" on this is-sue and only 7.1% "do not know" (score 2).Regarding the creation of practical skills, 64.29% of the surveyed students have assessed it with score of 4. The skills of the mentor-physiotherapist to organize training are evaluated in 71.46% of all cases with a score of 4. Trainees are convinced that their mentor is an established specialist in its field in 85.72% of the cases -score of 4. In the "Hard skills" section 50% of all respondents have assessed the mentor's qualities positively with a score of 3, whilst only 7.14% of respondents gave a score of 2 ("do not know").Ratings 1 and 0 were not selected.In 42.86% of all cases, the respondents believe that their mentor had successfully prepared a plan for tasks (assessed with 4).The skills of the mentor-physiotherapist in terms of monitoring the execution of the tasks and making recommendations for improvement, respondents rate in 57.14% with "agree" (score of 3 on the Likert scale) to both questions.

Fig. 3. Soft skills which a good mentor should possess
The average total score in the soft skills section is in more than 60.5% in all cases evaluated excellently (score of 4).The ability of the mentor-physiotherapist to answer all questions asked by students-practitioners (64.79%) and its ability to actively seek and give feedback (64.29%) obtained a score of 4 to both questions.The use of suitable examples from the practice in 50.01% of the cases were rated with "4" on the five-point Likert scale.Respondents answered with "completely agree" (score of 4) also to the question whether the mentor-physiotherapist was able to present a large amount of information clearly and concisely.
The mentor's personal qualities are assessed through the questions "Desire to support the professional development of others"(78.6% with a score of 4) and "Perceives their colleagues as professionals in their field " (71.46% with a score of 4).
The feedback from the students-practitioners allows an opportunity for identification of the main qualities that a mentor-physiotherapist should possess in order to pass them on to the students in the following areas: the mentor's role -to accept and integrate the student, to create practical skills, to organize training, to be an established specialist in the field of physiotherapy; hard skills -preparation of a plan for executing the tasks, monitoring performance, recommending steps for improvement [8]; soft skills -clearly and concisely presenting large amounts of information using appropriate examples, answering questions, actively seeking and giving feedback [9,10]; personal skills -is willing to support the professional development of others and is perceived by his colleagues as a professional in his/hers field.
Based on the survey examining the students' opinions participating in the "Student practices" project, we offer the selection of mentors according to this project in the future to be carried out by criteria in accordance to the areas with the issues of our study: -"the role of the mentor" -"hard-skills" -"soft-skills" -"personal qualities" Recommendations: -The selection of mentors to should be made by the Department of Educational Activity and the Human Resources Department of the respective universities based on the results of the performance evaluation of the staff; -After completion of the assessment, the specialists from the departments should prepare a database of potential mentors according to their majors; -Upon the occurrence of a need of a mentor the aforementioned departments should prepare a suggestion based on already compiled lists of mentors; -The final choice is made after talks with potential mentors and compliance with their personal desire and workload; -The candidates-trainees are offered the final lists of the mentor-candidates from their respective major; -Contracts for the "Students practice" project are being seigned according to the designated project order.
All potential mentors should be encouraged to improve their skills in the designated courses such as: communication skills, organizational skills, different approaches to teaching students of all ages, leading discussions, etc.

CONCLUSIONS:
The responses in the "Role of the mentor" section are over 50% "strongly agree" (a "4" on the Likert scale).The physiotherapist-mentor has accepted the student and has given him the opportunity to join real working environment -50.01%have answered with "totally agree" and only 7.1% "do not know" ("2" on the Likert scale).Regarding the creation of practical skills, 64.29% of the surveyed students have given "4" as an answer.The skills of the mentor-physiotherapist in organizing training are evaluated in 71.46% of the cases with a score of 4 on the scale.Trainees are convinced that their mentor is an established specialist in its field in 85.72% of the cases with an answer equal to 4 on the Likert scale.In the "Hard skills" section, 42.86% of the respondents believe that the mentor has successfully prepared a plan for tasks (assessed with a score of 4).Regarding the tracking of the tasks and making recommendations for improvement, the respondents have answered with "agree" to both questions (score of 3 on the Likert scale) in 57.14% of the cases.The average total score in the region of soft skills is evaluated with more than 60.5% with an excellent score (score of 4 on the scale).The ability of the mentor-physiotherapist to answer all questions raised by the students-interns (64.79%) and its ability to actively seek and give feedback (64.29%) obtained a score of 4 on both questions.The use of suitable examples from the practice were rated "4" with 50.01%on all occasions.The participants gave "totally agree" answers (score of 4 on the Likert scale) to the question whether the mentor-physiotherapist presented clearly and concisely large amount of information.The personal qualities of the mentor-physiotherapist are expressed on two questions: "Desire to support the professional development of others "(78.6% with a score of 4) and "Perceive the colleagues as professionals in their field"-71.46%with a score of 4.
The acquired knowledge and skills increase the confidence of the trainees when contacting and working with patients.They are given the opportunity to experience the real working environment and to see how decisions are made by professionals working in the structure.The good preparation of the students in the clinical setting and the results displayed during practice present an opportunity for the development of the mentorship as a priority for the education policy of the state, with clear indications for choosing the most appropriate mentor and setting clear tasks for the acquisition of purposeful knowledge .The combination of shared interests on both sides, professional and social skills of the mentor as well as his personal qualities, enable the integration of students in the team that is part of the organization.Mentorship programs in various projects enable the creation of long-term, mutually beneficial relationships and shared experiences between the mentors and the students.

Fig. 2 .
Fig. 2. Hard skills that a good mentor should possess