Available online 2 June 2023

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With the recent implementation of Competency-based Medical Education (CBME) and emphasis on direct observation of learners, there is an increased interest in the concept of clinical coaching. While there is considerable literature on the role of attending physicians as coaches, little data is available on the role of residents as coaches, and residents’ perceptions about effective coaching. We aimed to identify distinct characteristics of residents’ coaching, to examine residents’ perceptions on what they valued most in clinical coaches, and to explore trainees’ ideas about how to optimize this role.

Design

We performed an exploratory qualitative study, using 45 minutes semi-structured interviews. We did a thematic analysis of the interview transcripts using both inductive and deductive coding.

Participants

We invited and interviewed 5 surgical and 5 nonsurgical residents, and 3 surgical and 3 nonsurgical attending staff. Residents were recruited from all post graduate levels and from a variety of programs.

Setting

Our study was done in a large tertiary teaching hospital.

Results

Residents perceived that they have a significant role as coaches for junior learners, different from the attending's role. The proximity between the coach and the coaches leads to a different supervisor-learner rapport. This was of benefit as learners described feeling more comfortable making mistakes and seeking feedback, which potentiates effective coaching. Residents reported feeling that it was easier to coach their recently-acquired skills as the subtleties of the tasks and the troubleshooting were fresher in memory. Residents expressed appreciating a coach who values autonomy and does not intervene except when patient safety is at risk. Strategies identified to further optimize residents’ role as coaches include placing coaching as a priority, ensuring dedicated time, and offering teaching sessions on coaching.

Conclusions

Residents have distinct roles as coaches, driven by their recent experience being coached and as near peers. More research is needed to evaluate concrete measures to optimize residents’ role as coaches and to improve their coaching skills.

Section snippetsINTRODUCTION

With the implementation of Competency-Based Medical Education (CBME) and its emphasis on direct observation and feedback to learners, there has been an increased interest in the concept of coaching.1, 2, 3, 4 Coaching is an important and well-established concept in many disciplines, including sports, art and business, but its application to medicine has only recently been explored.5,6 For the purpose of this study, we used a description of coaching by Landreville et al.7 as a “process that

Study Design

To address these research questions, we performed an exploratory qualitative study. Given the paucity of literature available on residents as coaches, the majority of the data was derived from our findings rather than from preexisting knowledge. Specifically, a qualitative descriptive approach was chosen in order to preserve as much as possible participants’ voice while minimizing as possible the influence of researchers’ interpretation.30,31

Outcomes

Our outcomes were a summary of residents’ and

Research Ethics Approval was Obtained

We conducted a semi-structured individual interview with each participant. An interview guide was used (appendix 1), but it was open to unplanned questions to maximize the unique contribution of each interviewee. Given that no standard interview guide was available in the literature, we developed our own. As our interviewees did not have a background in medical education, the pre-established definition of coaching by Landreville et al.7 was provided in advance for participants to reflect on

RESULTS

We interviewed 16 participants as outlined in Table 1. No major new ideas were raised in the last 3 interviews, suggesting that theoretical sufficiency was reached.

Our results fit into 3 main categories: what residents consider characteristics of effective coaching, opinions of residents and faculty on the role of residents as coaches, and how to optimize resident coaching.

DISCUSSION

When asked about effective coaching practices, residents most value being given autonomy and opportunities to make mistakes and to troubleshoot them. This also implies the creation of a favorable, nonjudgemental learning environment.9,33 Residents appreciate when coaches use their own past experiences to guide them through a task. This was noted to be one of the advantages of resident coaches as they are closer to the expertise acquisition and its subtleties are thereby fresher in memory.34

CONCLUSION

The resident's coaching role was different from and complementary to attendings’ roles as coaches: one cannot replace the other. The results suggest that one of the keys to resident coaching is the unique relationship they have with their peers and with students, which can help promote a positive coaching environment with increased honesty, transparency, and an overall less intimidating setting. Having gone through the learning process for a given task more recently than most attendings, and

CONFLICT OF INTEREST

None.

REFERENCES (41)B LovellBringing meaning to coaching in medical education

Med Educ

(2019)

M Wolff et al.Academic coaching: insights from the medical student's perspective

Med Teach

(2020)

Canada RCoPaSo. CBD and coaching....J Sargeant et al.R2C2 in Action: testing an evidence-based model to facilitate feedback and coaching in residency

J Grad Med Educ

(2017)

H Armson et al.Identifying coaching skills to improve feedback use in postgraduate medical education

Med Educ

(2019)

L Bellaire et al.Coaching and surgical performance

J Pediatr Orthop

(2022)

I Montroni et al.Surgical coaching applied to laparoscopic TME for continuous professional development in rectal surgery: proof of concept

Updates Surg

(2021)

JC Pradarelli et al.Surgical Coaching for operative performance enhancement (SCOPE): skill ratings and impact on surgeons' practice

Surg Endosc

(2021)

JC Pradarelli et al.Optimizing the implementation of surgical coaching through feedback from practicing surgeons

JAMA Surg

(2021)

K Palamara et al.Who benefits most? A multisite study of coaching and resident well-being

J Gen Intern Med

(2022)

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