TEACH and repeat: Deliberate practice for teaching

Participation in a Resident-as-Teacher Rotation: Motivations of and Impacts on Faculty Coaches

PURPOSE

Coaching in medical education is increasingly used for trainee development for a variety of skills, including improving trainee teaching skills through resident-as-teacher programs. Faculty who serve as coaches commit significant effort to the coaching role, often without protected time or support. Little is known about faculty motivations to participate in coaching programs or how the coaching experience affects the faculty. This study explored faculty coaches' motivations to participate as coaches in a resident-as-teacher rotation and the impacts they experienced as a result of their participation.

METHOD

In this qualitative study, authors conducted 14 semistructured interviews in 2019 with faculty coaches from a single resident-as-teacher program in Boston, Massachusetts. Authors analyzed the transcripts using thematic analysis to develop a conceptual framework.

RESULTS

Faculty coaches' motivations for initial participation included a sense of honor; a sense of duty; perception of competence; interest in promoting medical education; and desire for increased connectedness. These motivations all related to a larger theme of educator identity. Coaches identified 3 main impacts from participation: improvement in their own teaching, personal satisfaction from helping others and seeing improvement in their learners, and increased connectedness. These impacts affirmed the coaches' educator identity and led to ongoing motivation to participate. They also contributed to the coaches' well-being at work.

CONCLUSIONS

Faculty were initially motivated to participate as coaches in a resident-as-teacher rotation based on their identity as educators. The benefits achieved-improvement in own teaching, personal satisfaction, and increased connectedness-affirmed their educator identity and led to ongoing participation and increased well-being at work. These motivations and impacts are important to consider as future programs are developed and coaches are recruited for programs across undergraduate, graduate, and continuing medical education settings.

Bridge Builders: A Qualitative Study of Fellows' Successful Supervision of Residents

PURPOSE

Clinical fellows, those training to become subspecialists in a program certified by the Accreditation Council for Graduate Medical Education, supervise residents on inpatient subspecialty rotations. Unlike for supervising residents or for faculty, there is a paucity of literature describing fellows' supervision of residents. The aim of this study was to understand residents' and fellows' perception of successful supervision of residents by fellows on inpatient subspecialty rotations to inform the development of curricula to support fellows as supervisors.

METHOD

Using grounded theory methodology, the authors held focus groups in May 2020 of pediatric residents and pediatric subspecialty fellows at Boston Children's Hospital, Boston, Massachusetts. Focus groups were conducted until thematic saturation was achieved. Deidentified transcripts were independently coded by 2 authors. The author team consolidated the codes into themes and developed an interpretive model for fellows' successful supervision of residents. Key results were confirmed via member checking.

RESULTS

The authors conducted 4 resident focus groups, composed of 16 pediatric residents, and 4 fellow focus groups, composed of 13 pediatric subspecialty fellows. Participants perceived that fellows who provided successful resident supervision advanced residents' professional growth and supported residents' development along 5 "bridges": (1) generalist to subspecialist, (2) trainee to autonomous practitioner, (3) individual to member of the interprofessional team, (4) emerging physician to patient-facing care provider, and (5) newcomer to engaged clinical learner. Fellows can further residents' growth in these areas by demonstrating approachability, empathy, appreciation, and kindness.

CONCLUSIONS

As newcomers on inpatient subspecialty rotations, residents engage in legitimate peripheral participation. Fellows who are successful supervisors move residents toward full participation in their profession via the bridge model. The fellow-resident dynamic carries advantages of near-peer learning. Fellows can harness their role, subspecialty knowledge, and familiarity with the training environment to enhance resident supervision.

The role of mentoring, supervision, coaching, teaching and instruction on professional identity formation: a systematic scoping review

BACKGROUND

Mentoring's pivotal role in nurturing professional identity formation (PIF) owes much to its combined use with supervision, coaching, tutoring, instruction, and teaching. However the effects of this combination called the 'mentoring umbrella' remains poorly understood. This systematic scoping review thus aims to map current understanding.

METHODS

A Systematic Evidence-Based Approach guided systematic scoping review seeks to map current understanding of the 'mentoring umbrella' and its effects on PIF on medical students and physicians in training. It is hoped that insights provided will guide structuring, support and oversight of the 'mentoring umbrella' in nurturing PIF. Articles published between 2000 and 2021 in PubMed, Scopus, ERIC and the Cochrane databases were scrutinised. The included articles were concurrently summarised and tabulated and concurrently analysed using content and thematic analysis and tabulated. The themes and categories identified were compared with the summaries of the included articles to create accountable and reproducible domains that guide the discussion.

RESULTS

A total of 12201 abstracts were reviewed, 657 full text articles evaluated, and 207 articles included. The three domains identified were definitions; impact on PIF; and enablers and barriers. The mentoring umbrella shapes PIF in 3 stages and builds a cognitive base of essential knowledge, skills and professional attitudes. The cognitive base informs thinking, conduct and opinions in early supervised clinical exposure in Communities of practice (COP). The COPs' individualised approach to the inculcation of desired professional characteristics, goals, values, principles and beliefs reshapes the individual's identity whilst the socialisation process sees to their integration into current identities.

CONCLUSION

The mentoring umbrella's provides personalised longitudinal support in the COP and socialisation process. Understanding it is key to addressing difficulties faced and ensuring holistic and timely support.