Does being a coach benefit clinician-educators? A mixed methods study of faculty self-efficacy, job satisfaction and burnout

'It's more like checking in with an old friend': A qualitative study of medical students' experiences with longitudinal coaches throughout medical school

PURPOSE

Coaching in medical education facilitates learners' growth and development through feedback, goal-setting and support. This study explored how coaching relationships evolve throughout medical school and the impact of longitudinal coaching relationships on medical students' approach to feedback and goal setting in the clinical years.

METHOD

In this qualitative study using a constructivist paradigm, authors purposively sampled 15 senior medical students at University of California, San Francisco, to participate in individual semi-structured interviews (October-November 2021). The authors used an inductive approach to thematic analysis.

RESULTS

The authors identified four themes: First, the student-coach relationship deepened over the course of medical school. Second, students identified factors that sustained and strengthened the student-coach relationship over time: a strong foundation to the relationship, the non-evaluative nature of the relationship, coach supportiveness and responsiveness, and coach knowledge of the institutional landscape. Third, coaches provided individualized advice, assessed trajectory, and guided feedback interpretation. Lastly, students applied skills of soliciting and responding to feedback and creating learning goals, originally learned through coaching experience.

CONCLUSIONS

Coaching relationships, grounded in trust, evolve to meet students' changing needs as they grow into physicians. Students apply feedback and goal-setting skills learned with the coach in clinical settings with other supervisors.

'We're like Spider-Man; with great power comes great responsibility': Coaches' experiences supporting struggling medical students

BACKGROUND

Medical students can experience a range of academic and non-academic struggles. Coaching is a valuable strategy to support learners, but coaches describe working with struggling learners as taxing. Transformative learning theory (TLT) provides insights into how educators grow from challenging experiences to build resilience. This study explores how coaches evolve as educators through supporting struggling students.

METHODS

This qualitative study grounded in an interpretivist paradigm used interviews of longitudinal medical student coaches at two academic institutions. Interviews, using TLT as a sensitizing concept, explored coaches' experience coaching struggling learners. We performed thematic analysis.

RESULTS

We interviewed 15 coaches. Coaches described supporting students through multi-faceted struggles which often surprised the coach. Three themes characterized coaches' experiences: personal responsibility, emotional response, and personal learning. Coaches shouldered high personal responsibility for learners' success. For some, this burden felt emotional, raised parental instincts and questions about maintaining boundaries with learners. Coaches evolved their coaching approach, challenged biases, and built skills. Coaches learned to better appreciate the learner point of view and employ resources to support students.

DISCUSSION

Through navigating learner struggles, educators can gain self-efficacy, learn to understand learners' perspectives, and evolve their coaching approach to lessen their personal emotional burden through time.

"It's All About the Trust And Building A Foundation:" Evaluation of a Longitudinal Medical Student Coaching Program

Coaching is increasingly implemented in medical education to support learners' growth, learning, and wellbeing. Data demonstrating the impact of longitudinal coaching programs are needed.

We developed and evaluated a comprehensive longitudinal medical student coaching program designed to achieve three aims for students: fostering personal and professional development, advancing physician skills with a growth mindset, and promoting student wellbeing and belonging within an inclusive learning community. We also sought to advance coaches' development as faculty through satisfying education roles with structured training. Students meet with coaches weekly for the first 17 months of medical school for patient care and health systems skills learning, and at least twice yearly throughout the remainder of medical school for individual progress and planning meetings and small-group discussions about professional identity. Using the developmental evaluation framework, we iteratively evaluated the program over the first five years of implementation with multiple quantitative and qualitative measures of students' and coaches' experiences related to the three aims.

The University of California, San Francisco, School of Medicine, developed a longitudinal coaching program in 2016 for medical students alongside reform of the four-year curriculum. The coaching program addressed unmet student needs for a longitudinal, non-evaluative relationship with a coach to support their development, shape their approach to learning, and promote belonging and community.

In surveys and focus groups, students reported high satisfaction with coaching in measures of the three program aims. They appreciated coaches' availability and guidance for the range of academic, personal, career, and other questions they had throughout medical school. Students endorsed the value of a longitudinal relationship and coaches' ability to meet their changing needs over time. Students rated coaches' teaching of foundational clinical skills highly. Students observed coaches learning some clinical skills with them - skills outside a coach's daily practice. Students also raised some concerns about variability among coaches. Attention to wellbeing and belonging to a learning community were program highlights for students. Coaches benefited from relationships with students and other coaches and welcomed the professional development to equip them to support all student needs.

Students perceive that a comprehensive medical student coaching program can achieve aims to promote their development and provide support. Within a non-evaluative longitudinal coach relationship, students build skills in driving their own learning and improvement. Coaches experience a satisfying yet challenging role. Ongoing faculty development within a coach community and funding for the role seem essential for coaches to fulfill their responsibilities.

The Effects of Coaching Pediatric Residents on Faculty Coaches' Relationships, Learning, and Professional Identity Formation

PURPOSE

Coaching programs have been implemented in medical education to improve skill development and feedback for trainees. As more faculty take on coaching roles, it is critical to understand how being a coach affects faculty as well as trainees. This study examined the effects of coaching residents on faculty members' relationships, learning, and professional identity formation (PIF), as they move through intersecting communities across landscapes of practice.

METHOD

From July 2020 to January 2021, the authors conducted a mixed-methods study of current and former coaches at 2 institutions with longitudinal pediatric resident coaching programs. They used a concurrent triangulation design in which qualitative and quantitative data were collected simultaneously and integrated during data analysis. A survey explored the impact of coaching on faculty members' learning, relationships, and PIF, and semistructured interviews further examined coaches' experiences. The interview transcripts were analyzed inductively guided by the sensitizing principles of PIF and landscapes of practice.

RESULTS

Of 43 eligible coaches, 32 (74%) completed the survey, and 18 completed interviews. Four themes emerged from the interviews. (1) Coaches' relationships supported belonging in multiple communities. (2) Coaching enabled multidimensional learning. (3) Relationships served as mechanisms of learning for coaches. (4) Coaches' relationships and learning catalyzed PIF. Furthermore, there was a significant difference in the effects of coaching on career growth by faculty rank ( P = .02). Coaches' strengthened PIF increased a sense of purpose, meaning, and professional fulfillment, and inspired new career directions. Survey data further supported these findings.

CONCLUSIONS

Being a coach deepened faculty members' professional identities through their varied relationships, multidimensional learning, and sense of belonging in intersecting communities. This study introduces a framework to understand the factors mediating coaches' PIF and highlights how investing in coaching leads to important benefits for coaches.

Faculty motivations for leading clinical clerkship electives: A qualitative study

PURPOSE

Faculty are motivated to pursue clinician-educator careers out of a sense of purpose, duty, connectedness, satisfaction, and mastery. Yet, many suffer from burnout due to a lack of funding, resources, and competing clinical demands. Reasons for clinician-educator participation in unfunded educational leadership positions are underexplored. This study examined faculty members' reasons for volunteering and remaining as clerkship elective directors, an unfunded leadership position.

METHODS

In this qualitative study, the authors conducted 17 semi-structured interviews with clerkship elective directors in March 2021. The authors conducted a thematic analysis of deidentified transcripts using motivation theories as a lens.

RESULTS

Directors' motivations to engage in this unfunded educational leadership position stemmed from their existing clinician-educator identity and a sense of purpose and duty. Directors are sustained by the satisfaction derived from witnessing the positive impact they have on learners' career development and skills building, the impact of learners on the clinical environment, as well as personal benefits in the mastery of educator skills and enhanced visibility as educators.

CONCLUSIONS

Unfunded educational leadership positions can advance clinician-educators' commitment to learners and alter the learning environment. Strategies for faculty recruitment and retention in unfunded leadership positions include ensuring meaningful contact with learners, as well as opportunities for personal career development through skills building and enhanced visibility through recognition.

Positive Behavior Values to Improve Student Self-Efficacy: A Case Study in Islamic Boarding Schools

Student self-efficacy is related to the belief of individuals doing daily activities in boarding schools. This study aims to describe the positive behavior performed by Kiai and Nyai to improve student self-efficacy. Research Methods use qualitative methods with case studies. Data is obtained by interviews, observations and documentation. Data analysis uses content analysis. The results showed that Kiai and Nyai's positive behavior could improve students' self-efficacy. Examples of Kiai and Nyai's behavior include giving positive values such as honesty, patience, gratitude, self-acceptance, and self-assessment. The increase in student self-efficacy can start with oneself solving problems encountered in school. Kiai and Nyai as role models and behaviors of Islamic values can be applied by counselors to change students in a better direction to be happy. The implication is that counselors need to set an example, strengthening students' positive values so as to increase self-efficacy