Clinical education (mentorship program) is one of the most important aspects of education in the medical sciences. Therefore, this study was conducted to investigate the effect of a mentorship program on self-esteem, anxiety, and learning clinical skills of emergency medical students.

 

This study was a quasi-experimental study in which 24 emergency medical students of Dezful University of Medical Sciences were enrolled by available sampling. Data collection scales were Coopersmith Self-Esteem Inventory, Spielberger State-Trait Anxiety Inventory and Clinical Skills Questionnaire. Data analysis was performed using SPSS-20 software (SPSS Inc., Chicago, Ill., USA) and descriptive and analytical statistics.

The analysis results showed that the average self-esteem increased after clinical training compared to before training; Which is consistent with the results of the study of Mohammadpoory et al. and Nohi et al. [23,22]. In a quasi-experimental study performed by Mohammadpoory et al., one clinical nurse was trained as a mentor for every 6-7 students in the intervention group. The control group was prepared by a faculty instructor. Self-esteem was measured by the Cooper-Smith questionnaire, and the results showed that mentorship training programs could reduce stress and increase students' self-esteem [22].
Other findings of this study were to evaluate the level of anxiety before and after using mentorship method and training method with an instructor in emergency medical students, which shows that the average score of anxiety after instructor and mentorship training courses was 102.92 and 70.50, respectively. Therefore, the average score of students' anxiety after coach training is higher than the average score of anxiety after mentorship training. In this regard, the results of the study of Bagherieh et al. and the Gisi study showed that students who worked with mentors during the internship (experimental group) experienced less anxiety than students without mentors (control) [25, 24]. Learning from mentors in a safe and controlled environment makes students more interested in the learning process and reduces stress and anxiety caused by the clinical environment [25, 26].
The study of Sharifi et al., which was conducted to investigate the most effective method of clinical education on nursing students' anxiety in the clinical environment, showed that the use of clinical instructors reduced students' anxiety in the nursing environment. Due to the significant differences in the methods of conducting clinical education and the lack of studies that have compared different methods of conducting this education, it was impossible to judge which method is more effective  [27]. Because students are very anxious at the beginning of their internship due to unfamiliarity with the clinical environment, which affects their learning, the use of learning methods that reduce students' anxiety in the clinical environment improves the quality of education [26, 28, 29]. During the study, the use of students working or with experience in medical emergencies as mentors caused students to become familiar with the process of patient management and the internal organizational climate of medical emergencies in the clinical environment, which can be a factor that makes a compromise. Students become more involved with the internship environment and reduce anxiety. A clinical instructor also made it easier for students to express problems. In the study of Sharifi et al., mentorship is a good model for people who are looking for a safe place to express problems [27]. In the study of Jakubik et al., all 6 students received clinical training in the hospital for 60 days by a nurse mentor. The results showed that the mentorship method reduced students' anxiety and increased nurses' self-efficacy [30].
In this study, the comparison of clinical skills after using the mentorship method showed that the average score of clinical skills of students after training with an instructor is lower than the average score of clinical skills after training by the mentorship model. Independent t-test also showed that this difference was statistically significant. In this regard, Ravanipour et al. studying facilitators and inhibitors in the mentorship method of nursing students showed that teaching and learning of students with an effective mentorship lead to improving knowledge in various areas, improving communication, achieving cognition, and helping to adapt better [31].
In addition to benefiting from the results of this study, the present study has the feature of benefiting from a clinical instructor with clinical work experience with different working conditions and work experience in different areas, which led students to acknowledge that using mentors' work experience not only reduces anxiety but also increases the experience. In the study of Cheek et al., nurses mentored nursing students in nine internship sessions. The results of this study showed that one of the most important aspects of the mentorship method is to create an effective relationship and increase the quality of learning that the teacher provides through an effective relationship and effective feedback [33].
One of the limitations of this research is the small number of samples and the lack of follow-up of students after graduation. Also, the inappropriate behavior of some patient companions and lack of trust in the student at the scene of the accident were other limitations of the study that were likely to affect the student's self-esteem and anxiety, which was beyond the control of researchers. 

 

After using the mentorship program, an increase in clinical skills, a decrease in anxiety and an increase in students' self-esteem were observed. Therefore, it is necessary to develop a clinical education program that provides a path for scientific growth to acquire clinical competencies. 

 

The authors thank all the colleagues of the Vice Chancellor for Research and Technology of Dezful University of Medical Sciences, the Islamic Azad University of Dezful, and all students who participated in our study.
 
 

The authors declared no conflict of interest.