Dental school is stressful. Dental students. Does Peer Mentoring Work? Dental Students Assess Its Benefits as an Adaptive Coping Strategy

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1 Milieu in Dental School and Practice Does Peer Mentoring Work? Dental Students Assess Its Benefits as an Adaptive Coping Strategy Naty Lopez, Ph.D.; Sara Johnson, M.A.; Nicki Black, M.A. Abstract: Dental students deal with various stressors while in dental school. While some develop adaptive coping skills, others may suffer from damaging effects of constant and increasing levels of stress. This study evaluated a peer mentoring program at a dental school in the Midwest to determine student perceptions of its benefits and to identify areas for improvement. Data were collected through a survey sent out to all dental classes online. The twenty-five-item survey was based on student responses during two focus groups held to elicit student assessment of the peer mentoring program. Sixty-six percent of the student body participated with representation from all four classes. Students find their peer mentoring program an effective tool in helping them deal with stress especially during transition phases of their curriculum, first into dental school and later from preclinic to the clinics. Having a mentor means easy access to an available person who can help students relieve anxieties about dental school. Experiencing dental school enables a student to serve as a mentor, so a non-dental student is seen as not effective. Peer mentoring needs to be loosely structured and flexible and should cover all years in the dental curriculum. Dr. Lopez is Assistant Dean for Admissions and Diversity and Assistant Professor in Community Oral Health, Department of Primary Dental Care; Ms. Johnson is Director of Student Affairs; and Ms. Black is Coordinator for Admissions and Diversity all at the University of Minnesota School of Dentistry. Direct correspondence and requests for reprints to Dr. Naty Lopez, Office of Admissions and Diversity, School of Dentistry, University of Minnesota, Moos Tower, 515 Delaware St. SE, Minneapolis, MN 55455; phone; fax; lopez216@umn.edu. Keywords: peer mentoring, stress, dental students, mentor/mentee Submitted for publication 4/1/10; accepted 5/10/10 Dental school is stressful. Dental students deal with stressors from exams, workload, financial concerns, patient disappointments, faculty-student interactions, limited leisure time, and the type of atmosphere created by clinical faculty. 1-7 Dental students perceive having higher levels of stress than medical students in academic performance, patient and clinical responsibilities, and faculty relations. While the stress level of medical students decreases over the course of four years, that of dental students increases especially in the third year when students begin treating patients. 4 Dental school stressors can be highly damaging if they are not successfully managed. Both dental students and practicing dentists are vulnerable to developing stress-related disorders such as sleeplessness, fatigue, mood disturbances, and other health-related issues. 6-8 Stress in dental school may also play a part in student cheating in dental school 9 and eventually dropping out of the program. 10 So how have dental students coped with stress? And what have dental schools done to help students deal with what is often thought of as an overly stressful learning environment? Dental students are reported to use coping strategies that can be adaptive as well as maladaptive. Examples of adaptive strategies used are involvement in extracurricular activities and use of support services, while worrying and wishful thinking are maladaptive ways to deal with stress. 5,11 Although several studies have looked into the prevalence and nature of stress among dental students, there is a paucity of information on management and coping strategies that have produced positive results. Dental schools have used university counseling services, crisis intervention workshops, and time and stress management programs sponsored by their universities to help students. For example, one dental school compared the effectiveness of progressive relaxation technique (PRT) and the use of a relaxation device, the Synchro-Energizer. 12 Other dental schools have developed faculty-student mentoring programs that allow them to identify students at risk early in their studies. 13 A small study conducted in 1984 on the use of stress management found a reduction in November 2010 Journal of Dental Education 1197

2 the stress levels of dental student participants at a three-month follow-up. 8 Another dental school described a comprehensive approach to reducing stress among dental students, but there were no reported outcomes. 14 There are no other studies found that investigated strategies or coping mechanisms that dental students use in dealing with stress. One approach that is used to assist students in coping with stress is peer mentoring. At the undergraduate level, peer mentoring programs are used to increase retention rates 15 and to role-model appropriate behavior. 16 At other levels, peer mentoring programs have been recommended as a method to mitigate the social and professional isolation often experienced by graduate students 17 and in assisting dental hygiene and nursing students during the transition from classroom to clinical practice Peer mentor programs have also been found to be an effective means in the recruitment and retention of underrepresented minority students to dental school. 23,24 However, the extent of their use among dental schools for this or other purposes is not known. This study aimed to determine the effectiveness of a peer mentoring program at a dental school in the Midwest. Peer mentoring in this article is defined as an interpersonal relationship between two students: the mentor is the more experienced student who has been through at least one year of dental school and has faced difficulties and challenges of being a dental student, and the mentee is new to the program. The mentor provides information, advice, encouragement, and various forms of support to assist the mentee in coping with the stresses in dental school. There is no formal training provided to mentors in the mentoring program of the school. Methods In the peer mentoring program evaluated in this study, each student in the incoming class is given the opportunity to sign up for a mentor prior to orientation. The year levels in the school are referred to as D1 for the first, D2 for the second, D3 for the third, and D4 for the fourth. Rising D2s are invited to volunteer as mentors and then matched with an incoming D1 student. The peer mentoring program has been in place for several years, but has never been evaluated to assess its effectiveness and relevance to current students. The Office of Admissions and Diversity, which coordinates the peer mentoring program, and the Office of Student Affairs, which provides student support services, decided to conduct an evaluation of the mentoring program to determine its effectiveness and to identify areas for improvement. Institutional Review Board approval was obtained for the study. The first step in the assessment was to learn from the students about their experiences as mentors and mentees through focus groups. An was sent to all classes by the director of student affairs explaining the nature of the study and requesting participants. Fliers were posted on bulletin boards throughout the school inviting students to the focus groups, and individual s were sent to randomly selected students requesting attendance. Twenty students from various classes who have been mentees and who served as mentors volunteered to take part in the focus groups. Two focus groups were conducted: one for D1s and D2s and the other for D3s and D4s. Responses were transcribed verbatim and then grouped into thematic categories that served as the basis for the construction of a survey questionnaire. Questions used in the focus groups are listed in Figure 1. The questionnaire was revised after a pilot test with a convenience sample of twelve students from various classes. Comments and recommendations from the students were incorporated into the questionnaire. The questionnaire consisted of twenty-five five-point Likert-style items that asked the students to report their perceptions (strongly agree to strongly disagree) about the peer mentoring program, including perceived benefits, length of the mentoring relationship, when mentors are most needed, sources of support besides the mentor, qualifications of a mentor, and preparation needed to serve as mentor. Several of the items were reverse keyed to control for response bias; for example, Dental students need a mentor only during the first year and Having a mentor helps even in the second, third, and fourth years. Additional questions collected demographic information such as gender, year in dental school, if there is a dentist in their family, and if they completed their undergraduate studies in another college/university and state of residence. An was sent to all students informing them of the study. The survey was sent via in the spring semester and was available online. The survey was sent a second time through during summer semester Journal of Dental Education Volume 74, Number 11

3 1. Did you sign up for a mentor when you started dental school? If so, what were your reasons for wanting a mentor? 2. What did you expect from your mentor? Did your mentor meet your expectations? 3. What were the advantages or benefits of having a mentor during your first year? 4. What were the advantages or benefits of being a mentor during your sophomore, junior, or senior year? 5. As a mentor, what could have helped you prepare to be a mentor? 6. What problems or difficulties did you experience in your mentor/mentee relationship? 7. What could have helped you deal with these problems or difficulties? 8. How would you describe a successful mentor/mentee relationship? 9. What are the characteristics of a successful mentee? 10. When do you think is the best time for someone to be a mentor? 11. How long should a mentor/mentee relationship last? 12. Would you recommend that the School of Dentistry continue and improve this mentoring program? Why or why not? 13. What types of mentoring relationships outside the program do you have now? 14. What would encourage and increase student participation in the mentoring program? 15. Would you recommend having mentors/mentees from other Academic Health Center schools? Figure 1. Focus group questions Results A total of 256 students (66 percent of the student body) participated in the survey (D1=25 percent, D2=17 percent, D3=18 percent, and D4=36 percent). Of these 51 percent were female and 45 percent were male; 51 percent belong to the twenty-one to twentyfive year age group. Tables 1 5 present a summary of the demographics of student participants. Most (76 percent) of the respondents completed their undergraduate education from a college or university outside of the university where the dental school is located, and 43 percent are residents of other states. Only 25 percent have a dentist in the family. Responses were collapsed to consolidate the strongly agree and agree responses into one agree response and the strongly disagree and disagree response into one disagree response for facility in reporting. The fifth category, not applicable, was retained. Benefits of the Peer Mentoring Program Seventy-seven percent (53 percent strongly agree) of all respondents said they wanted a mentor during their first year to help them transition to dental school, but with significant differences between genders (χ²[4]=10.80, p=<.05) and between age groups (χ²[8]=18.66, p=<.025). Seventy percent of respondents from all classes agreed that having a mentor during their first year helped them transition to dental school, and 58 percent agreed that the mentor/mentee relationship was helpful beyond the freshman year. Having a mentor allowed students to experience relief from their anxieties about dental school (77 percent agreed) with differences between genders (χ²[4]=9.86, p=<.05). Compared to the other classes, more D1s (χ²[12]=32.13, p<.001) and younger students (χ²[8]=15.36, p<.05) agreed that having a mentor made them feel more confident about being in dental school. Sixty percent agreed that having a November 2010 Journal of Dental Education 1199

4 Table 1. Breakdown of respondents by age group Age Group Number Percentage 20 years and below 1 0.4% years % years % years % Over 40 years 5 2.0% No response % Total % Table 2. Breakdown of respondents by year in dental school Year Number Percentage First-year (D1) 64 25% Second-year (D2) 43 17% Third-year (D3) 46 18% Fourth-year (D4) 92 36% No response 11 4% Total % Table 3. Breakdown of respondents by gender Gender Number Percentage Female % Male % No response 11 4% Total % Table 4. Breakdown of respondents by undergraduate education Undergraduate Education Number Percentage College at same university of 50 20% dental school College at different university % No response 11 4% Total % Table 5. Breakdown of respondents as to whether there is a dentist in the student s family Is there a dentist in the student s family? Number Percentage Yes 63 25% No % No response 10 4% Total % mentor means there is someone that the student can always go to for questions, with more students from the same university (80 percent) and those in the twenty-one to twenty-five age group (79 percent) in agreement. However, help was not exclusively found in their mentors; a large majority of the students but more in the twenty-one to twenty-five age group agreed that they were able to find help from other people besides their mentors (χ²[8]=19.44, p<.01). Nevertheless, only 24 percent indicated that they are in supportive relationships outside of dental school. There were significant differences in the responses between students who graduated from the same university where the dental school is located and students who completed their undergraduate program elsewhere. Students who have dentists in their families did not respond differently from those who do not. Perceived benefits from the mentoring program are summarized in Table 6. Qualifications of Mentors and Preparation for Mentorship Fifty-five percent of respondents agreed that all freshman students should be assigned a mentor, and 68 percent felt that sophomores make the best mentors for freshmen. Training to become a mentor was not a felt need. Eighty-five percent agreed they have enough knowledge to function effectively as mentors, but there was a difference in age groups about the need for some orientation or training to be a more effective mentor (χ²[8]=29.87, p<.001), with 48 percent of the thirty-one to forty age group in agreement in contrast to only 18 percent and 23 percent in the twenty-one to twenty-five and twenty-six to thirty age groups respectively. Seventy-five percent agreed that mentors should initiate contact with their mentees. To assist them in doing their mentoring well, 62 percent agreed that having a list of frequently asked questions for mentees would be helpful, and 60 percent recommended the dental school create more structured opportunities for mentors and mentees to get to know each other. Fifty-three percent agreed that students should be paired with those who have similar backgrounds, with significant differences between graduates from the same university and those coming from other universities (χ²[4]=12.03, p<.025). There was no consensus among the classes about pairing males and females as mentors and mentees. All the classes disagreed that non-dental students can be effective mentors for dental students. This was the same feeling 1200 Journal of Dental Education Volume 74, Number 11

5 Table 6. Peer mentor benefits identified in study Responses by Students Agreement by Group Who Attended College Agreement Agreement Agreement With or Without in Same or Different Peer Mentor Benefits by Year by Gender by Age Dentist in Family University Q1. I wanted a mentor D1=85% F=82% 21 25=85% No dentist in family=77% From different university=77% during my first year to D2=87% M=72% 26 30=61% With dentist in family=76% From same university=77% help me transition to D3=71% 31 40=83% dental school. D4=69% χ²(4)=10.32, p<.05 χ²(8)=18.66, p<.025 Q2. Having a mentor D1=83% F=55% 21 25=53% No dentist in family=52% From different university=44% helped relieve my D2=79% M=39% 26 30=37% With dentist in family=52% From same university=62% anxieties about dental D3=65% 31 40=52% school. D4=61% χ²(4)=9.86, p<.05 Q14. Having a mentor D1=60% F=51% 21 25=54% No dentist in family=14% From different university=14% has helped me to feel D2=57% M=39% 26 30=33% With dentist in family=18% From same university=19% confident about being D3=35% 31 40=39% in dental school. D4=35% χ²(12)=32.13, p<.001 Q16. Having a mentor D1=72% F=76% 21 25=79% No dentist in family=72% From different university=67% would help in D2=88% M=63% 26 30=57% With dentist in family=63% From same university=80% transitioning to the D3=65% 31 40=62% clinic from the D4=62% preclinics. χ²(12)=24.01, p<.025 χ²(8)=21.23, p<0.01 Q19. Having a mentor D1=70% F=68% 21 25=73% No dentist in family=115/183 (63%) From different university=57% means that there is D2=77% M=55% 26 30=43% With dentist in family=38/63 (60%) From same university=80% someone I can always D3=59% 31 40=59% go to for my questions. D4=51% χ²(8)=22.32, p<.01 χ²(4)=12.15, p<.025 November 2010 Journal of Dental Education 1201

6 expressed during the focus groups. These results are graphed in Figure 2. Time Commitment There were differences in opinion regarding the length of the mentor-mentee relationship: 59 percent of the respondents thought that mentors are needed beyond the first year, with significant differences between age groups (χ²[8]=18.47, p<.025) and between groups with dentists and without dentists in their families (χ²[4]=16.38, p<.001). Sixty-seven percent agreed that having a mentor would help in their second, third, and fourth years as they transition from preclinical to clinical years. However, students differed in their opinion about this according to age group (χ²[8]=18.47, p<0.025) and if they graduated college from the same university where the dental school is affiliated (χ²=9.50, p<.05). Sixty-seven percent agreed that a mentor would be helpful during the transition from preclinical to clinical education. The rate of agreement was highest among D2s with 88 percent in view of their imminent move into the clinical area. Students expressed during the focus groups their preference for clinical groups to be announced early to allow for mentor/mentee relationships to be formed and allow them a smooth transition to the clinics. A summary of the time commitment features of a peer mentoring relationship is listed in Table 7. Discussion The peer mentoring program in our dental school has been in place for several years. The number of incoming freshman students requesting mentors has increased over the past three years. There has been an even more dramatic increase in the number of volunteers to serve as mentors (53/98 in 2007, 60/98 in 2008, and 79/98 in 2009), which may be indicative of the students recognition of the value of the program. The need for mentors goes beyond the general impression that mentees are mainly interested in Q10 Q15 Q21 Q23 Q25 D1 D2 D3 D4 Figure 2. Identification of peer mentor qualifications by percentage of those who agreed in each of four dental classes (D1 through D4) Q10: I feel I have enough knowledge and skills to function effectively as a mentor. Q15: I would probably be a more effective mentor if I have some orientation or training. Q21: Sophomores make the best mentors for freshmen. Q23: Mentors should be paired with mentees who have similar backgrounds. Q25: Non-dental students or non-dentists can be effective mentors for dental students Journal of Dental Education Volume 74, Number 11

7 securing old exams from their mentors. 13 Rather, the results of this study demonstrate a general consensus among students of the value of having support during adjustment to dental school from a fellow student who has gone through the same process of transition. Comments made in the focus groups show that students derive benefits from the program. Mentoring is seen by mentees, in the words of one focus group member, as having someone to turn to when you have a question, someone who has been through it so the mentor is telling you how to succeed in classes, how much time to spend on each class, how to use time better. Mentors, on the other hand, look at it as the passing on of our knowledge of all that we had been exposed to the previous year, as one said. The added benefit of enriching one s educational experience was aptly described by a D2 student: It made my education feel a little more enriched to have that extra side to do things, acting as a pseudo-leader for someone who has not been exposed to it. It felt rewarding. It may be easy to assume that students who graduated from a different university would have more of a need or appreciation for mentoring than those who graduated from the same university where the dental school is located. The results show, however, a stronger agreement on the benefits from the latter group. Students from the same university may have accessed more information about the dental school, toured its facilities, and had contact with current dental students. They may have already been familiar with the campus and the city environment. In spite of this, it is possible that dental school is still perceived as stressful so that information acquired about it did not allay anxieties about the transition to dental school, so these students still feel the need for a personal mentor. The greater agreement of students from the same university about peer mentor benefits may be an indication of supportive relationships they experienced at the university prior to dental school or that they were able to start forming relationships with dental school mentors earlier than students at other institutions given their physical proximity. These findings demonstrate that most students value having a mentor to make the necessary adjustment to the overly stressful learning environment in dental school regardless of where they completed their undergraduate program or whether they are in-state or out-of-state students. Other student responses suggest there are benefits in offering peer mentor programs to all students and not offering targeted programs for specific Table 7. Time commitment for mentoring: frequency and length of peer mentor contact Agreement by Group Agreement by Group Agreement Agreement Agreement With or Without from Same or Different Peer Mentor Benefits by Year by Gender by Age Dentist in Family University Q9. Dental students need a D1=10% F=15% 21 25=13% No dentist in family=14% From different university=20% mentor only during first year. D2=18% M=22% 26 30=22% With dentist in family=32% From same university=12% D3=18% 31 40=32% D4=25% χ²(8)=18.47, p<.05 χ²(4)=16.38, p<0.001 Q12. Having a mentor helps D1=82% F=77% 21 25=76% No dentist in family=112/156 (72%) From different university= even in the second, third, D2=83% M=62% 26 30=63% With dentist in family=35/54 (65%) 108/165 (65%) and fourth years. D3=66% 31 40=66% From same university= D4=61% 38/44 (86%) χ²(4)=15.23, p<.01 χ²(4)=9.50, p<.05 Q13. I would love to continue D1=61% F=56% 21 25=58% No dentist in family=51% From different university=47% my relationship with my D2=63% M=45% 26 30=38% With dentist in family=52% From same university=65% mentor/mentee for as long D3=49% 31 40=52% as possible. D4=40% Q11. As a mentee, I expect D1=13% F=14% 21 25=9% No dentist in family=14% From different university=14% my mentor to contact me D2=10% M=14% 26 30=17% With dentist in family=18% From same university=19% on a regular basis. D3=7% 31 40=32% D4=18% χ²(8)=15.36, p<.05 November 2010 Journal of Dental Education 1203

8 student populations. Over half of students from both dental families and non-dental families (no dentist in family=52 percent, dentist in family=52 percent) and students across age groups (twenty-one to twentyfive=53 percent, twenty-six to thirty=37 percent, thirty-one to forty=52 percent) indicated that having a mentor helped relieve their anxieties about dental school. The lack of significant differences in the agreements of peer mentor benefits between students who have dentists in their families compared to those who do not may result from the trend among students to go to informal peer resources for support. 10 This may also be due to pressure from parents who are dentists for students to do well. Regardless of the causes, these findings, in conjunction with those pertaining to students who graduated from a different or the same institution as the dental school, imply that mentor programs are of benefit to everyone. Students may still be matched with a mentor who shares a similar background or characteristics once they elect to participate in the program, but the opportunity should be available to all students. In addition, participation in the program should be optional, not required. The students believed their own experiences in dental school make them able to mentor. An interprofessional peer mentor program may not be perceived as being effective by students given their belief that the mentoring relationship focuses on knowledge and skills specific to the dental program. Students agreed that a formal training program may not be necessary to prepare them as mentors. A majority (D1=89 percent, D2=86 percent, D3=73 percent, D4=76 percent) feel they have enough knowledge and skills to be an effective mentor and prefer flexibility in structuring mentoring relationships. However, students in the older age groups expressed preference for more formal training. This may indicate a different level of perception of the responsibility of a mentor among this group of students. Some of the older students are nontraditional, and some have undergone formal training programs related to their previous jobs. Nevertheless, there was general agreement among the students in their recommendations to improve the program: a) provide clear expectations for both mentees and mentors at the start of the program, b) create more opportunities for mentors and mentees to mix together, and c) make available a list of frequently asked questions from mentees in order to increase the effectiveness of mentors. Students may not need a great deal of formal preparation to build a successful mentoring relationship. Maintaining a structured but flexible program is an important part in ensuring student participation. The study shows that students agree a mentor would likewise be helpful during the transition from preclinical to clinical education. Similar to the initial adjustment to dental school, transitioning to the clinics requires having someone who has gone through that stage and has the knowledge and skills needed to maneuver through the system. One senior student in the focus group aptly described the benefit of having a mentor in the long term: I know every semester brings a ton of questions because there are new experiences coming along and it would be nice to have someone to ask those to. A junior student commented, Through my involvement in the student mentor program for the last two years as well as being a mentee, I recognize the enormous benefits of peerto-peer interaction and the exchange of sound advice. [It helps students face] the emotional challenges and triumphs that are destined to be experienced in both the preclinical and clinical settings. These statements suggest that clinical group assignments should be made early and in conjunction with mentor assignments so that mentors can assist with the transition to clinic. Students also expressed a desire to have a practicing dentist as a mentor prior to graduation to help them transition to the next stage. A majority of senior students agreed with the value of having mentors beyond the first year (61 percent), which may indicate the need for support during their transition from dental school to full-time practice. Conclusion Dental students in our study find peer mentoring an effective tool in helping them deal with stress in dental school. The mentoring relationship is valuable in all stages of the dental curriculum and even after students have completed their studies. Students recommend a semiformal structure of the program: the school provides the basic organization in terms of pairing mentors and mentees, but students have the flexibility to continue the mentor-mentee relationship as needed. Mentees who find that they prefer another or an additional mentor are free to find another who meets their needs. Our study identified a need for an increase in informal gatherings where mentors and mentees can interact with others in a more relaxed setting and share experiences. The need for mentoring relationships with dental practitioners is also 1204 Journal of Dental Education Volume 74, Number 11

9 highlighted in this study. Students feel the need for mentors at every turn in their dental education and after graduation. Any form of mentoring, however, needs to be flexible, on-demand, and long-term. A peer mentoring program is a cost-effective way of helping students deal with stress in their curriculum. Resources required to facilitate peer mentoring are limited to the costs associated with informal gatherings and staff time to coordinate the program. These requirements could be reduced by annually electing a student to plan mentor/mentee events. Dental schools need to cultivate a culture and environment where students feel comfortable asking for help from peers, faculty, and staff as they cope with dental school stress. Based on these findings, a peer mentor program is effective in reducing stress in dental school and relevant to students at this institution. Future studies on mentoring programs may focus on the effects of peer mentoring program on levels of stress experienced by dental students. REFERENCES 1. Cardall WR, Rowan RC, Bay C. Dental education from the students perspective: curriculum and climate. J Dent Educ 2008;72(5): Westerman GH, Grandy TG, Ocanto RA, Erskine CG. Perceived sources of stress in the dental school environment. J Dent Educ 1993;57(3): Tedesco LA, Anders PL, Davis EL, Brewer JD. Dimensions of student perceptions of dental educational stress. (Abstract). J Dent Educ 1985;49(1): Murphy RJ, Gray SA, Sterling G, Reeves K, DuCette J. A comparative study of professional student stress. J Dent Educ 2009;73(3): Stewart DW, de Vries J, Singer DL, Degen GG, Wener P. Canadian dental students perceptions of their learning environment and psychological functioning over time. J Dent Educ 2006;70(9): George JM, Whitworth DE, Sturdevant JR, Lundeen TF. Correlates of dental student stress. J Dent Educ 1987;51(8): Davis EL, Tedesco LA, Meier ST. Dental student stress, burnout, and memory. J Dent Educ 1989;53(3): Tisdelle DA, Hansen DJ, St. Lawrence JS, Brown JC. Stress management training for dental students. J Dent Educ 1984;48(4): Andrews KG, Smith LA, Henzi D, Demps E. Faculty and student perceptions of academic integrity at U.S. and Canadian dental schools. J Dent Educ 2007;71(8): Burk DT, Bender DJ. Use and perceived effectiveness of student support services in a first-year dental student population. J Dent Educ 2005;69(10): Dahan H, Bedos C. A typology of dental students according to their experience of stress: a qualitative study. J Dent Educ 2010;74(2): Howard CE, Graham LE, Wycoff SJ. A comparison of methods for reducing stress among dental students. J Dent Educ 1986;50(9): Lopez N, Black N. Student assessment of mentor-mentee relationships: towards developing a student mentoring program to ensure success in dental school. Lunch and Learn Presentation, 2010 ADEA Annual Session, Washington, DC, March 1, Schwartz RM, Eigenbrode CR, Cantor O. A comprehensive stress-reduction program for dental students. J Dent Educ 1984;48(4): Budge S. Peer mentoring in postsecondary education: implications for research and practice. J Coll Reading Learning 2006;37(1): Harmon BV. A qualitative study of the learning processes and outcomes associated with students who serve as peer mentors. J First-Year Experiences Students in Transition 2006;18(2): Hyun JK, Quinn BC, Madon T, Lustig S. Graduate student mental health: needs assessment and utilization of counseling services. J Coll Student Development 2006; 47(3): Blanchard SB, Blanchard JS. The prevalence of mentoring programs in the transition from student to practitioner among U.S. dental hygiene programs. J Dent Educ 2006; 70(5): Furgeson D, George M, Nesbit S, Peterson C, Peterson D, Wilder RS. The role of the student professional association in mentoring dental hygiene students for the future. J Dent Hyg 2008;82(1): Gray MA, Smith LN. The qualities of an effective mentor from the student nurse s perspective: findings from a longitudinal qualitative study. J Adv Nurs 2000;32(6): Theobald K, Mitchell M. Mentoring: improving transition to practice. Aust J Adv Nurs 2002;20(1): Olson RK, Nelson M, Stuart C, Young L, Kleinsasser A, Schroedermeier R, Newstrom P. Nursing student residency program: a model for a seamless transition from nursing student to RN. J Nurs Admin 2001;31(1): Veal K, Perry M, Stavisky J, Herbert KD. The pathways to dentistry for minority students: from their perspective. J Dent Educ 2004;68(9): Wadenya RO, Schwartz S, Lopez N, Fonseca R. Strategies for recruitment and retention of underrepresented minority students at the University of Pennsylvania School of Dental Medicine. J Dent Educ 2003;67(9): November 2010 Journal of Dental Education 1205