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How physician specialty choices change between M2 and graduation
Aug 26, 2024
Coaching is gaining ground in medical education for how it can head off burnout, boost retainment and improve quality of care. But many times in the GME setting, its adoption is thwarted because there is so little room for something new in a jam-packed curriculum.
An AMA textbook called Coaching in Graduate Medical Education: A Faculty Handbook is a repository of best practices and recommendations for creating coaching programs in the graduate medical education (GME) setting.
The third in the AMA’s series of books focused on academic coaching, the textbook was written by experts who have firsthand experience implementing GME coaching programs to transform residents and fellows into self-actualized, adaptive learners.
“Coaching is an increasingly common component of medical education, but existing resources are mostly focused on undergraduate medical education,” the editors noted. “From envisioning goals for a new program, planning logistics, and preparing faculty and learners, the authors of this handbook’s chapters have used their own coaching program expertise and understanding of the literature to create a practical resource that is generalizable to the broader community.”
Guidance tailored to GME
“In undergraduate medical education [UME], learners can block time with their coaches. But in GME, it's much more challenging for both residents and faculty to meet because they’re busy all the time,” said Maya Hammoud, MD, one of the textbook’s editors and director of the Center for Education in the ob-gyn department at University of Michigan Medical School.
“In addition, in UME, it is important to isolate the people who evaluate the learner from the people who are doing the coaching, and it’s easier to put up those guardrails because you have a lot of faculty,” Dr. Hammoud said. “In GME, it’s much harder to do that because programs are much smaller.”
The textbook explores not just the why and how of coaching, but also what to do when you encounter challenging situations.
Chapter 1, “Why coaching? The meaning and purpose of coaching in graduate medical education,” lays out the purpose of coaching in graduate medical education.
“Professional coaching is a tool to guide learners toward the best versions of themselves through deep inquiry, metacognition and psychological safety,” the textbook says.
One area in which coaches can help learners is professional goals, including clinical observation, feedback, performance review and reflective self-monitoring. Another is personal well-being, from burnout to imposter phenomenon and perfectionism.
Chapter 2, “How to establish a coaching program,” introduces the basics of establishing a coaching program. It focuses on who can coach, where and when to use coaching, and how to integrate it into a program’s existing infrastructure.
“This starts with defining the goals and objectives of the coaching program, followed by engaging the stakeholders and recruiting the coaches and coachees while identifying sources of funding,” it says.
Chapter 3, “Coaching for performance improvement,” outlines how to enhance clinical skills, time management and overall competence in medical practice. It covers both academic and clinical coaching.
In this chapter, the authors “introduce the concept of coaching for performance improvement and review the importance of safe learning environments to achieve maximum success,” the guide says. They also “provide practical tips for approaching coaching conversations and identifying performance improvement goals in both clinical and procedural settings.”
Chapter 4, “Professional and career development coaching,” focuses on the benefits of longitudinal career coaching during medical education.
“Residency is the optimal time for professional development coaching, as it marks the transition from a highly structured, assessment-driven educational experience to the unstructured, self-monitored reality of an independent practicing physician,” the textbook says.
Coaching for professional development differs from other forms of GME coaching—such as performance, well-being or remediation—by focusing on cultivating the resident’s long-term career goals and professional identity.
Chapter 5, “Coaching to promote well-being,” provides a deep dive into thought-based coaching to support learners’ well-being and mitigate burnout.
“We explore specific examples of how coaching can enhance well-being, focusing on professional identity formation, time management, and mental well-being and resilience,” it says.
Within each of these areas, the chapter’s authors introduce coaching tools that address challenges that trainees commonly face and discuss how they can be applied to help learners reflect on—and solve—their own problems.
Chapter 6, “Coaching the resident with concerns about unprofessional behavior,” explores how coaching can drive remediation when things go wrong with trainees.
The authors lay out “a definition of professionalism, the importance of goal alignment and the development of processes that help ensure trainees and faculty share a mental model of what success looks like,” they say. “We also address common pitfalls in coaching for this specific purpose and how to avoid them. Lastly, we explore what may happen next if the process does not succeed.”
Each chapter features a vignette of a hypothetical coaching scenario, along with several thought questions to frame the content.
This textbook was preceded by Coaching in Medical Education, a first-of-its-kind, instructor-focused field book that equips educators to coach all learners and run an effective coaching program, increasing the likelihood of learner success. The second book in the series, It Takes Two: A Guide to Being a Good Coachee (PDF), focuses on what medical students, residents and fellows need to know to get the most out of a coaching relationship.
The AMA Academic Coaching in Medical Education Video Series features nine short videos that explore academic coaching competencies through hypothetical situations involving both experienced and inexperienced coaches. All of these videos can be accessed for free on the AMA YouTube channel and the AMA Ed Hub™.
