2 Cultivating Exceptional Professionals: The 3 W’s of Effective Coaching

By: Dr. Jessica Trier

What is it?

Coaching in Health Professions Education: A goal-oriented, relational process involving mutual engagement between a learner and a coach, focused on learner growth and development, with bidirectional conversation, facilitated reflection, and specific actionable feedback to optimize learning and performance.^1,2 “While teaching and mentoring are more instructional and directive, coaching is facilitative and guides the recipient in identifying their own needs and goals and in developing a realistic plan.”³

Can be used for nearly any clinical or non-clinical task:

• Procedural skills
• Communication and collaboration skills
• Leadership roles
• Professional identity formation
• And more

Coaching in the Moment vs. Coaching over Time

• Coaching in the Moment can be done daily between a teacher and learner
• A useful framework for Coaching in the Moment is RX-OCR⁴:
  •  Developing Rapport and setting clear eXpectations
  • Observation of a learner is essential to providing credible feedback
  • Engaging in a Coaching conversation and Recording a summary
• Coaching over Time can be done by a regular preceptor, academic advisor, or program director, for example
  • Frameworks such as the R2C2 model⁵ can help guide longitudinal coaching
  • Build rapport and relationship (R), explore reactions to feedback data (R), explore understanding of content (C), and coach for performance chance (C)
• The relationship between coach and learner is important in both settings

Barriers to Coaching in the Learning Environment

• Time
• Competing responsibilities
• Lack of shared expectations or goals
• Fear of vulnerability, admitting challenges/failures
• Power differential between teacher and learner

Who is doing it and how?

• Learners and teachers should clarify the purpose of the encounter
  • Make explicit whether the encounter is for assessment, coaching, or both
• As a teacher, get to know your learners and understand their goals and expectations.
• A teacher who demonstrates vulnerability and embraces a growth mindset⁶ helps to narrow the power differential between teacher and learner

Why does it matter?

• The overarching goal of health professions education is to educate and train not only competent but exceptional healthcare professionals
• Coaching recognizes the developmental progression of a learner by embracing a growth mindset6
• An effective coaching relationship lays the groundwork for a safe learning environment, and ultimately, improved patient safety

Tip: Coaching employs a lot of the same strategies we already use to develop relationships. Knowing your learner as a person goes a long way in establishing a trusting, respectful, bidirectional coaching relationship.

Photo by McGill Library on Unsplash

References

1. Watling CJ and LaDonna KA. Where philosophy meets culture: exploring how coaches conceptualise their roles. Med Educ. 2019 May;53(5):467-476.
2. Janes WC, Silvey D, Dubrowski A. Are educators actually coaches? The implication of teaching and learning via simulation in education in healthcare professions. Cureus. 2016;8(8):e734.
3. Sargent J, Bruce D, Campbell C. Practicing physicians needs for assessment and feedback as part of professional development. J Continuing Edu Health Professions. 2013;33(1):S54–S62.
4. http://www.royalcollege.ca/rcsite/cbd/implementation/wbas/coaching-and-cbd-e
5. https://www.mededportal.org/publication/10387/
6. Dweck, Carol S. Mindset: The New Psychology of Success. New York: Ballantine Books, 2008.