Medical Educator Minute - "Coaching" in medical education

What is “coaching” in medical education, and how is it different from traditional teaching and feedback?

Coaching helps learners recognize their growth potential and fosters responsibility in finding their own path to improvement. Unlike traditional teaching, which focuses on telling, coaching emphasizes asking, enabling learners to develop lifelong adaptive skills (Hammound et al., 2022). While formal coaching programs exist, “impromptu coaching” is gaining attention for its ability to support trainee growth through brief, focused interactions based on a specific area, skill, or patient encounter that has been directly observed by the coach.

Five factors for effective impromptu coaching:

Identify coachable moments – this can be any observed moment of patient care
Create a supportive setting – ensure appropriate time and space for conversation
Use time wisely – focus on a specific skill or area
Ask questions – the hallmark of coaching – to help the learner uncover their own mental processes, strengths, and gaps
Build a trusting relationship – coaching is grounded in growth mindset, ensure the learner feels capable of improvement

So, what does this look like in practice?

You’ve just finished rounds with your learner. During the last patient encounter, the patient’s family member became upset when discussing the plan of care. The learner seemed uncomfortable and ended the encounter quickly, seemingly dismissing their concerns.

“Before we move on for the day, do you have a minute? I’d like to debrief that last encounter.”
“I felt it got a little tense at the end, what was your experience?”
“What part made you uncomfortable?”
“Why do you think the family member responded that way? How might you have approached the conversation differently?”
“Conflict can be very uncomfortable. What do you think you can do to make the conversation more comfortable?”
“How can I help you work on these skills?”

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