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REVIEW ARTICLE
Year : 2022  |  Volume : 49  |  Issue : 3  |  Page : 229-232

Strengthening the process of implementation of coaching in medical education settings


1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission11-May-2021
Date of Acceptance02-Jul-2021
Date of Web Publication27-Dec-2022

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
MD, FAIMER, PGDHHM, DHRM, FCS, ACME, M.Phil. (HPE), Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_55_21

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  Abstract 


The branch of medicine is quite complex and it requires a wide range of teaching–learning innovations, student support activities, and faculty motivation to ensure that the goals of medical education are accomplished. The purpose of the current review is to explore the role of coaching in improving the learning and skill acquisition in the field of medical education. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 22 articles were selected based on the suitability with the current review objectives. The ultimate aim of coaching in medical education is to unearth the real potential of the students to optimize their performance by helping them to learn instead of teaching them. Coaching is a strategy to help medical students to become competent and reflective practitioner. In addition, coaching plays an important role in the refinement of technical skills (like surgical skills) and nontechnical skills. To conclude, coaching in medical education has significant scope to improve the learning outcomes among students and even make them lifelong learners. The need of the hour is to implement a coaching system in each of the medical colleges after considering the local logistics and with the active support of faculty members.

Keywords: Coaching, faculty, medical education, students


How to cite this article:
Shrivastava SR, Shrivastava PS. Strengthening the process of implementation of coaching in medical education settings. J Sci Soc 2022;49:229-32

How to cite this URL:
Shrivastava SR, Shrivastava PS. Strengthening the process of implementation of coaching in medical education settings. J Sci Soc [serial online] 2022 [cited 2023 Jan 26];49:229-32. Available from: https://www.jscisociety.com/text.asp?2022/49/3/229/365173




  Introduction Top


The branch of medicine is quite complex and it requires a wide range of teaching–learning innovations, student support activities, and faculty motivation to ensure that the goals of medical education are accomplished and at the same time aid the medical institutions to be socially accountable.[1] To improve teaching–learning activities, emphasis has been given toward making conventional modes of teaching interactive (through the employment of brainstorming, questioning, buzz groups, concept maps, etc.,), promotes adoption of innovative methods (namely online learning, use of applications, problem-based learning, flipped classrooms, etc.), and reforms in assessment by giving more emphasis to formative assessments, encouraging the delivery of constructive feedback, employment of a number of assessment methods to warrant assessment of all the learning domains, etc., The purpose of the current review is to explore the role of coaching in improving the learning and skill acquisition in the field of medical education.


  Methods Top


An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on the role of coaching in improving the skill acquisition among medical students published in the period 2009–2021 were included in the review. A total of 24 studies similar to current study objectives were identified initially, of which, two were excluded due to the unavailability of the complete version of the articles. Overall, 22 articles were selected based on the suitability with the current review objectives and analyzed. Keywords used in the search include coaching and medical education in the title alone only (namely coaching [ti] AND medical education [ti]; coaching [ti] AND undergraduate medical education [ti]; coaching [ti] AND medicine [ti]; coaching [ti] AND medical students [ti]; and coaching [ti]). Only the articles published in the English language are enrolled in the study. The collected information is presented under the following subheadings, namely Student support activities, Coaching in Medical education, Coaching and its merits, Effective coaching in medical education, Ensuring resilience and optimal well-being, Refinement of technical skills, Augmentation of nontechnical skills, Measurement of coaching, Potential challenges and recommended strategies, Implementation of coaching in a medical college, and Implications for research.


  Student Support Activities Top


It is worth noting that multiple steps have been taken at the institutional level to ensure that students' inclination toward medical education is maintained throughout the training period.[2] These strategies include the conduction of a foundation course that provides an opportunity for all the students to get acclimatized to the environment of medical schools and understand their roles and responsibility toward the profession and society.[2],[3] In addition, strategies like an initiation of elective courses, training targeted toward noncognitive skills in a stepwise manner, specific measures to promote delivery of the hidden curriculum, has been planned and implemented in different settings. Moreover, mentoring by faculty members, counseling, and coaching had also found a significant place to ensure academic learning and comprehensive development of the medical students.[1],[2],[3]


  Coaching in Medical Education Top


The term coaching has been quite common in the field like music and sports, but its scope and utility has been realized in the field of medical education in the last decade only.[4] It is a process that envisages human development by means of promoting interaction between the coach and the medical student, wherein a wide range of strategies or techniques are employed to facilitate cognitive, emotional, and behavioral modifications so that students can attain the set educational goals and at the same time, move forward in personal life.[4],[5] The ultimate aim of coaching in medical education is to unearth the real potential of the students to optimize their performance by helping them to learn instead of teaching them.[2],[3]


  Coaching and its Merits Top


Coaching is a strategy to help medical students to become competent and reflective practitioner. However, in contrast to the other student-support strategies (namely mMentoring, counseling, or advising), coaching is a student-centered approach.[1],[2] This helps the students to be more actively involved in the process and take steps for self-improvement so that the set goals can be accomplished without the external pressure from faculty members. Coaching has been associated with improved levels of resilience and well-being among the medical students as evidenced by the increase in levels of emotional intelligence, professionalism, and improvement in interpersonal skills.[2],[3],[4]

As the medical knowledge continues to advance with each day, it is a must that in order to be effective, we all should also keep taking steps to improve our knowledge and skills. Coaching has emerged as one of the cost-effective approaches to facilitate this overall process of self-improvement learning progression.[6] In addition, coaching plays an important role in the refinement of technical skills (like surgical skills) and nontechnical skills (namely, decision-making, teamworking, etc.).[4],[5],[6],[7]


  Effective Coaching in Medical Education Top


With reference to coaching in medical education, it is a process wherein the students meet periodically with the faculty members to set goals, devise strategies to achieve the set goals by dealing with the potential challenges, and in the overall process enhance their academic performance and professional identity.[6],[7],[8] The process of effective coaching has to begin with the establishment of a good relationship between the students and faculty members, wherein the goals are set and expectations from both are defined.[5],[6] This is followed by the conduction of personal assessments (namely to help the student to identify their learning style and style of interpersonal management) and systemic assessments (the usual academic assessments as a part of the curriculum). These assessments should be supported by the provision of appropriate feedback, with an aim to encourage students to monitor their own learning progression and also reflect upon the entire process.[6],[8],[9]

Once we are ready with the results of assessment, we have to formulate and implement the action plan for optimizing the learning. However, this has to start with goal setting, identification of strategies that will aid in the accomplishment of goal, and identify the learning experiences or measures that will either aid in the journey of achieving the goals or in monitoring the learning progression.[8],[9],[10] The proposed plan should have specifics pertaining to the timelines and the targets that need to be achieved at separate points of time.[9] We must realize that mere coming up with a comprehensive plan will not do much good unless it is accompanied with periodic review and evaluation of the student. There has to be always a provision to modify the action plan based on the needs with a solitary intention to benefit the students.[9],[10],[11]


  Ensuring Resilience and Optimal Well-being Top


Coaching in medical education has been linked with the development of better resilience and maintenance of well-being among undergraduate students and postgraduate residents.[12],[13] The findings of studies have indicated that depending on a defined timeframe of coaching, the students demonstrated better professionalism, academic skills, and interprofessional skills.[6],[9],[11] In addition, students also demonstrated improvised skills to be proactive and adapt to the challenging scenarios.[10],[11],[12] It was also reported that psychological coaching played an important role in minimizing the exam-related stress or their desire to leave the profession due to excessive stress among the coached students. Further, coached students were found to be better at specifying goals, setting priorities, being more compassionate, confident, reflective, and being self-aware.[11],[12],[13],[14]


  Refinement of Technical Skills Top


Coaching plays a significant role in acquisition of technical skills, especially surgical skills.[15] The available review of literature suggests that coached students are more skilled to deal with intraoperative problems, reduced chances of mistakes during surgery, and were more prompt in identifying the need when to seek help. Another study reported that coached students were better at performing suturing skills in simulated settings.[15],[16],[17] The primary reason for the augmentation of technical skills is the feedback which these students receive while and after doing the procedure and the discussion that happens with the coach.[17],[18]


  Augmentation of Nontechnical Skills Top


To become a successful clinician, it is equally important that the medical students are trained and exposed to nontechnical skills. These nontechnical skills can range from decision-making, leadership, teamwork, reflective practitioner, improved communication skills, etc.[19],[20] In fact, the available literature clearly justifies the role of coaching in ensuring the delivery of quality assured patient care by encouraging the development of professional identity. Further, it was reported that coaching played an instrumental role in augmenting the self-insights and development of positive feelings among students.[6],[9],[19],[20] Moreover, coaching was also useful for the students with regard to their practice of evidence-based medicine.[15]


  Measurement of Coaching Top


In a Health Science University in Portland, a specific model was adopted for coaching, wherein five students were assigned to each of the coaches, and then, they worked with the allocated students to formulate goals and take measures to accomplish the same.[21] However, to assess the effectiveness of the coaching, two instruments were developed and validated, namely an instrument that allowed assessment of coaches by the students and the second instrument to allow assessment of students by the coach.[21] It is the need of the hour to design such an instrument as it will give useful insights into the longitudinal attributes of coaching and the ways in which coaching aids in academic growth, professional satisfaction, patient care services, improvement of patient outcomes, and eventually the well-being of the community. These designed instruments have questions pertaining to the self-monitoring, relationship building, and facilitation of reflective behavior.[19],[20],[21]


  Potential Challenges and Recommended Strategies Top


The success of coaching depends on the extent of dedication and commitment demonstrated by the faculty members toward the entire process.[22] This in itself presents a major logistic and financial challenge for the administrators. The best way to respond to the given challenge is to organize capacity-building programs and sensitize all the faculty members about what is coaching and how it differs from mentoring or advising or counseling.[22] The teachers have to be explained about their roles and responsibilities, in terms of setting goals and formulating strategies to accomplish the set goals, in collaboration with the students. However, we must remember that the entire process of coaching has to be student driven and all efforts should be taken to ensure that they make significant progress in both technical and noncognitive skills.


  Implementation of Coaching at a Medical College Top


Acknowledging the scope of coaching programs in improving the academic performance of the students, development of the traits of professionalism, and the formation of professional identity in the students, there is a definite need to implement coaching programs in all the medical colleges.[10],[11],[12] We totally understand that a standard program cannot be implemented universally in all the institutions, as there will be variability in terms of the nature of the program, coach attributes, the nature of training imparted to coaches, the planned assessment, and finally, the evaluation program.[11],[12]


  Implications for Research Top


There is an immense need to understand and estimate the relationship or impact of coaching in improving the learning outcomes and self-improvement. In addition, research activities can very much target the role of coaching in encouraging students to become self-directed and lifelong learners. Further, we can also conduct qualitative or mixed-methods research to explore the pros and cons of coaching and the ways in which it helps a student or coach to become better in their personal and professional life. Finally, there is definite scope to explore the implementation of coaching in medical colleges and to identify the various facilitating factors and the inherent challenges.


  Conclusion Top


Coaching in medical education has significant scope to improve the learning outcomes among students and even make them lifelong learners. The need of the hour is to implement a coaching system in each of the medical colleges after considering the local logistics and with the active support of faculty members.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Wolff M, Hammoud M, Santen S, Deiorio N, Fix M. Coaching in undergraduate medical education: A national survey. Med Educ Online 2020;25:1699765.  Back to cited text no. 1
    
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Maini A, Saravanan Y, Singh TA, Fyfe M. Coaching skills for medical education in a VUCA world. Med Teach 2020;42:1308-9.  Back to cited text no. 2
    
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Thorn PM, Raj JM. A culture of coaching: Achieving peak performance of individuals and teams in academic health centres. Acad Med 2012;87:1482-3.  Back to cited text no. 5
    
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Reynolds AK. Academic coaching for learners in medical education: Twelve tips for the learning specialist. Med Teach 2020;42:616-21.  Back to cited text no. 7
    
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Iyasere CA, Baggett M, Romano J, Jena A, Mills G, Hunt DP. Beyond continuing medical education: Clinical coaching as a tool for ongoing professional development. Acad Med 2016;91:1647-50.  Back to cited text no. 8
    
9.
Hur Y. Development of a career coaching model for medical students. Korean J Med Educ 2016;28:127-36.  Back to cited text no. 9
    
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Deiorio NM, Carney PA, Kahl LE, Bonura EM, Juve AM. Coaching: A new model for academic and career achievement. Med Educ Online 2016;21:33480.  Back to cited text no. 10
    
11.
Rego P, Peterson R, Callaway L, Ward M, O'Brien C, Donald K. Using a structured clinical coaching programme to improve clinical skills training and assessment, as well as teachers' and students' satisfaction. Med Teach 2009;31:586-95.  Back to cited text no. 11
    
12.
Armson H, Lockyer JM, Zetkulic M, Könings KD, Sargeant J. Identifying coaching skills to improve feedback use in postgraduate medical education. Med Educ 2019;53:477-93.  Back to cited text no. 12
    
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Lovell B. What do we know about coaching in medical education? A literature review. Med Educ 2018;52:376-90.  Back to cited text no. 13
    
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Artenstein AW, Higgins TL, Seiler A, Meyer D, Knee AB, Boynton G, et al. Promoting high value inpatient care via a coaching model of structured, interdisciplinary team rounds. Br J Hosp Med (Lond) 2015;76:41-5.  Back to cited text no. 14
    
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George P, Reis S, Nothnagle M. Using a learning coach to teach residents evidence-based medicine. Fam Med 2012;44:351-5.  Back to cited text no. 15
    
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Greenberg CC, Klingensmith ME. The continuum of coaching: Opportunities for surgical improvement at all levels. Ann Surg 2015;262:217-9.  Back to cited text no. 16
    
17.
Bonrath EM, Dedy NJ, Gordon LE, Grantcharov TP. Comprehensive surgical coaching enhances surgical skill in the operating room: A randomized controlled trial. Ann Surg 2015;262:205-12.  Back to cited text no. 17
    
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Cole SJ, Mackenzie H, Ha J, Hanna GB, Miskovic D. Randomized controlled trial on the effect of coaching in simulated laparoscopic training. Surg Endosc 2014;28:979-86.  Back to cited text no. 18
    
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de Lasson L, Just E, Stegeager N, Malling B. Professional identity formation in the transition from medical school to working life: A qualitative study of group-coaching courses for junior doctors. BMC Med Educ 2016;16:165.  Back to cited text no. 19
    
20.
Könings KD, van Berlo J, Koopmans R, Hoogland H, Spanjers IA, ten Haaf JA, et al. Using a smartphone app and coaching group sessions to promote residents' reflection in the workplace. Acad Med 2016;91:365-70.  Back to cited text no. 20
    
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Carney PA, Bonura EM, Kraakevik JA, Juve AM, Kahl LE, Deiorio NM. Measuring coaching in undergraduate medical education: The development and psychometric Validation of new instruments. J Gen Intern Med 2019;34:677-83.  Back to cited text no. 21
    
22.
Orr CJ, Sonnadara RR. Coaching by design: Exploring a new approach to faculty development in a competency-based medical education curriculum. Adv Med Educ Pract 2019;10:229-44.  Back to cited text no. 22
    




 

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  In this article
Abstract
Introduction
Methods
Student Support ...
Coaching in Medi...
Coaching and its...
Effective Coachi...
Ensuring Resilie...
Refinement of Te...
Augmentation of ...
Measurement of C...
Potential Challe...
Implementation o...
Implications for...
Conclusion
References

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