Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Teaching & Learning

First Advisor

Dr. Myrna Olson


The purpose of this qualitative research study was to better understand how currently enrolled American Indian (AI) medical students and recently graduated physicians in residency experienced mentoring during medical school. This study consisted of 19 participant-recorded interviews that were later transcribed, analyzed, and coded for thematic outcomes. Participants were all current AI medical students in the same Northern Midwest Medical School (NMMS) in years one, two, three, or four, or they were recent AI graduate physicians from the same institution and were in years one or two of residency. The theoretical frameworks that guided this research were Kalbfleisch’s Mentoring Enactment Theory (2002) and Schooler’s Native American College Student Transition Theory (2014).

A phenomenographic design was used as the qualitative research method for this study. This design required data analysis similar to a grounded theory approach, in that the interview data was thoroughly analyzed and organized with open codes and categories, subcategories in second cycle axial coding, and thematic analysis toward the study’s assertion. The following three themes emerged from analysis of the data:

1. Theme One: Significant challenges among American Indian medical students contribute to extreme anxiety, stress, and the need for unique support mechanisms, such as mentoring relationships and American Indian culturally supported programming.

2. Theme Two: American Indian medical students use a variety of healthy/positive and unhealthy/negative coping mechanisms in response to immense challenges in medical school.

3. Theme Three: American Indian medical students are more likely to initiate and sustain successful mentoring relationships when the initiation is informal, in a natural or culturally based setting, with someone who is American Indian and/or has similar interests/experiences, and commits to relational maintenance through communication over time.

The study’s three themes established the following assertion:

1. Related to the significant challenges and unique support needs of American Indian medical school students, their likelihood of success is significantly reliant upon the initiation and sustainment of successful informal mentoring relationships with mentors who are AI and/or who have similar interests and experiences, and who commit to relational maintenance through communication over time.

Conclusions from this study draw attention to AI medical students’ significant academic and personal challenges, which contribute to the need for support from meaningful mentoring relationships. This study’s findings establish implications for successful mentoring relationship’s initiation and sustainment in natural and culturally based settings, through homogenous and diversified dyadic relationships, and perseverance through communicative and invested relational maintenance.

As medical schools and administrators seek ways to support medical students through informal and formal mentoring relationships (which aid their educational and career success), recommendations from this study provide valuable guidance for better practices when serving AI and other minority students in mentoring capacities. This study also suggests the likelihood of AI medical students’ success in medical school is partially reliant upon the success of informal mentoring relationships. Thus, further recommendations to current and future AI medical students suggest that the way in which they respond and cope to the academic, personal, and cultural challenges of medical school is vital to their well-being and overall success.