Applying the realist evaluation framework to a faculty mentorship program: a context–mechanism–outcome analysis at a private medical university

The value of mentoring is crucial for the growth of faculty, and assessing its effectiveness is essential to ensure the retention of faculty members. CMO is a conceptual framework used in realist evaluation to understand the context (C), mechanisms (M) and outcomes (O) of any implementation strategy. The faculty mentorship program was initiated at Aga Khan University Medical College (AKU- MC) in 2019 to foster faculty development through structured mentor-mentee partnerships, centralized support, and systematic evaluation of mentoring outcomes. The objective of the study was to identify contextual factors (C) that initiate specific mechanisms (M) contributing to particular outcomes (O) in this program, using the CMO framework. A qualitative exploratory study using purposive sampling was conducted at AKU-MC involving program leadership, administrators, mentors and mentees who were invited for in-depth interviews and focus group discussions. All interviews were transcribed; codes, categories and themes were identified as per CMO configuration. Thirteen faculty members participated in 8 IDIs and 4 FGDs. Context was covered by theme: “Gaining Insights from Mentorship Experiences” based on; Existence of mentorship culture, Initiation of formal mentorship, Mentor- Mentee Pool, Administrative Support, Lack of protected time, challenges of unsuitable pairing and preparation of mentors. The ‘mechanisms’ theme in AKU-MC mentorship program was “Transformative Journey of Mentorship” comprising of mentor mentee matching process, mentor mentee dynamics emerging reflective practices, developing connections, increasing motivation/rewards and recognition, replenishing mentors pool and change in pairing and sharing success stories. Nurturing bonds, Research productivity skill development and improvement in confidence constituted the ‘Outcome’ theme; “The Power of Mentorship: Building a Legacy of Growth”. The mentorship program functioned within a strong cultural and administrative context supported by mentor-mentee matching and leadership commitment. Mechanisms like reflective dialogue, informal engagement, and recognition promoted mentor–mentee relationships. Despite professional development challenges such as time constraints, limited mentor preparation, and mismatching persisted. Overall, mentorship emerged as a transformative process enhancing confidence, collegiality, and a culture of academic excellence.