MENTORSHIP IN PRACTICE
Practical strategies for developing better clinicians
A Highbar Clinical Education Series
The Best Mentors Don’t Always Give You the Answer
Knowing the answer is clinical expertise. Knowing when to give it—and when to hold back—is mentorship.
Being an experienced clinician does not automatically make you an effective mentor. Effective clinical mentorship requires something different: knowing when your expertise should lead the interaction and when it should get out of the way.
The more experience we gain, the faster we recognize patterns. We see the unnecessary test. We know which intervention we would choose. We can often predict where a less experienced clinician is headed before they get there.
We see the problem, so we solve it. We answer the question. Correct the technique. Redirect the examination. Give the treatment recommendation.
Clinically efficient. Educationally, maybe not.
Sometimes the learner genuinely needs the answer.
Sometimes giving it too quickly removes the exact reasoning opportunity they needed.
The fastest way to solve the clinical problem is not always the best way to develop the clinician.
Being helpful is not the same as developing someone
Imagine a resident asks, “What exercise would you use here?”
You can probably answer in ten seconds.
But before you do, ask a different question:
What is the developmental opportunity hiding inside this question?
Maybe the learner truly needs an exercise recommendation. Or maybe they need to work through:
- What are you trying to change?
- Why is that the priority?
- What options do you have?
- What do you expect to happen?
- How will you know whether it worked?
- What will you do with the response?
The answer gets them through this patient.
The reasoning prepares them for the next one.
That is the difference between simply being useful and actually developing someone.
The same behavior can require a completely different response
A learner selects a test that does not seem particularly useful.
From the outside, the problem looks simple:
They chose the wrong test.
But there may be very different problems underneath that decision.
- They do not know which test is appropriate. They may need teaching.
- They know the test but cannot perform it well. They may need coaching and practice.
- They perform it correctly but cannot explain why it matters. They may have a reasoning problem.
- They make the right decision and immediately ask, “Was that right?” They may need less guidance, not more.
Same outward behavior.
Different developmental problem.
Different mentor response.
And if the learner is about to do something unsafe?
Step in. Patient safety is not the time for Socratic questioning.
Good mentors need range
Mentorship is not one teaching technique.
It is a developmental relationship in which the strategy should change depending on what the learner needs.
The problem is not being directive.
The problem is being directive when the learner should already be reasoning independently.
The problem is not asking questions.
The problem is questioning a learner who genuinely lacks the knowledge needed to answer them.
There is no prize for using the same mentorship style in every situation.
The more useful question is:
What does this learner need from me right now?
You cannot develop reasoning you cannot see
Clinical reasoning is mostly invisible.
We see the test. The exercise. The manual technique. The management decision.
But we do not automatically see the thinking behind any of it.
Two clinicians can choose the exact same intervention for completely different reasons.
One may have identified a meaningful target, formed a hypothesis, predicted a response, and planned a reassessment.
The other may simply be doing what they always do for that diagnosis.
Same intervention. Very different reasoning.
If we want to develop reasoning, we have to make the thinking visible.
What do you think is happening?
Why?
What are you trying to change?
What do you expect to happen?
How will you reassess it?
What would make you change course?
These questions are not about interrogating the learner.
They allow you to see the reasoning process well enough to develop it.
You cannot effectively coach thinking that remains hidden.
Make uncertainty safe without making standards optional
Learners need to be able to expose uncertainty.
- “I don’t know.”
- “I’m not sure what I’m seeing.”
- “I think I made the wrong decision.”
- “I expected that treatment to help, and it didn’t.”
If every mistake feels threatening, learners can become more focused on looking competent than exposing where development is actually needed.
But psychological safety does not mean lowering the bar.
Uncertainty can be discussed.
Mistakes can be examined.
The learner can admit what they do not know.
Preparation still matters.
Clinical standards still matter.
Follow-through and patient safety still matter.
Uncertainty should be safe to expose. Standards should not become optional.
The learning environment needs both.
Psychological safety without accountability can drift toward complacency. Accountability without psychological safety can create hiding.
The learner should need you less over time
This may be one of the most uncomfortable measures of successful mentorship.
A knowledgeable, available mentor becomes extremely useful. The learner discusses every difficult decision with them, checks every plan, asks for confirmation, and receives immediate feedback.
Eventually, the clinician can become very good at practicing with the mentor nearby.
But that is not the same as independence.
Early in development, substantial support may be exactly what the learner needs.
Mentor-led → Guided → Learner-led → Independent
Early on, you may need to show, tell, and structure.
As capability develops, that should shift toward prompting, questioning, and observing.
The learner begins committing before hearing your opinion. They recognize their own errors. They decide what matters. They determine what should happen next.
Eventually, they should be able to recognize the problem, make a decision, execute it, evaluate the response, and adjust without you walking them through the process.
Good mentorship should gradually make the mentor less necessary.
That is not losing your value.
That is evidence that the development worked.
You don’t need an hour to mentor well
Everything about mentorship sounds easier when we imagine unlimited time.
That is not clinical reality.
Most mentorship happens while treating patients, documenting, managing schedules, and trying to stay on time.
The goal is not to teach everything during every encounter.
Find the highest-value learning moment.
“What are you trying to figure out?”
“What is your current plan?”
“What do you want me to watch?”
Observe first.
Intervene for safety.
Otherwise, identify the most important reasoning or performance issue.
“How do you think that went?”
“What did you learn?”
“What would you change next time?”
Then add one or two targeted pieces of feedback.
That may be enough.
Mentorship does not require constant talking. It requires intentional observation and selective intervention.
Stay curious before you correct
Experienced clinicians recognize mistakes quickly.
That is useful clinically.
It can short-circuit mentorship.
We see what went wrong and immediately explain how to fix it.
Before correcting the behavior, ask one more question:
Why did they do that?
Was it a knowledge gap? A reasoning problem? A skill problem? A confidence or independence problem? Did they simply fail to notice something important?
Those are different developmental problems.
They deserve different responses.
Take this question into your next mentorship session:
When should I step in—and when should I get out of the way?
The next time a learner struggles, resist the urge to immediately solve the problem. First determine whether they need you to teach, coach, question, direct, support—or simply let them commit.
The goal of mentorship is not to create clinicians who are excellent at following their mentors.
The goal is to develop clinicians who eventually no longer need them.
Continue the Mentorship Conversation
This post is part of Highbar’s Mentorship in Practice series. The next articles build from this foundation by looking more closely at how to identify what is actually limiting a learner and how to turn that information into focused development.
