Developing a feedback-rich culture in academic medicine: the effect of coaching and 360-feedback on physician leadership

Abstract

Background This is a time of unprecedented change in healthcare. More physicians are being tasked with stepping into a variety of leadership roles without having received the training needed to be an effective leader. Previous data have demonstrated the effectiveness of both leadership coaching and 360-feedback tools to foster physician well-being and leadership growth. In this proof of concept study, we explore the combined effect of these two tools. The objective of this study was to examine the effect of a brief physician 360 leadership coaching intervention on perception of professional dynamics and acquired leadership skills. Methods Participants completed a tailored 360-feedback tool to gather input on their leadership skills, then engaged in five bi-weekly leadership coaching sessions. We conducted a post-intervention semi-structured qualitative interview. Qualitative data were coded using an inductive thematic analysis approach. Results Twenty-three primary care physicians at an academic medical center engaged in the 360 leadership coaching study. Participants reported that the intervention yielded valuable benefits in five coaching sessions. Two overarching themes emerged: a Shift in leadership awareness and Navigating their environment. Leadership awareness included increased clarity of purpose and role, and recognition that routine feedback is critical to leadership development. Navigating their environment included gaining relationship-building communication, organizational awareness and navigation strategies. Conclusions Combining a tailored 360-feedback tool with a five-session leadership coaching intervention provided physicians with valued support infrastructure for becoming more effective leaders. Physicians described a nuanced understanding of the leadership challenges physicians face, and identified the leadership tools needed to navigate the evolving healthcare delivery landscape. Curricula for physician leadership learning could consider this combination of a customized 360 plus targeted leadership coaching for training physician leaders.

Implementing coaching programmes for healthcare professionals—A review of the barriers and facilitators

“…work demands were a barrier to both participant (health professional) engagement and deliverer (coach) availability. [41][42][43][44][45][46][47][48][49] This emphasised the need for allocating protected time to coaching interventions. In addition to this, delineating programme time-commitment and responsibilities was viewed as a key facilitator to programme success.…”

“…First, for all occupational groups, nurses, 42 specialists, 47 multiple professions 44,45,49 and trainees, 42,43,46,48 the implementation and delivery of coaching interventions was hindered by, 'insufficient protected time for participants (healthcare professionals)'.…”

“…49,51,[54][55][56][57]63 In addition, where 'sufficient leadership buy-in' was a critical facilitator, 'embeddedness in a larger educational or professional development programme' also supported implementation/delivery. 47,50,61,63…”

“…In addition to this, delineating programme time-commitment and responsibilities was viewed as a key facilitator to programme success. 50 To create clarity around roles and time-commitment informational videos, 47 in-person discussions with HCPs, 42 word-of-mouth, 51 and e-mail or social media [52][53][54] were used.…”

“…For (novice) faculty coaches, coaching was 'a distinctly new experience', 57 therefore, coaches were often provided a formal training, step-by-step guidelines, and refresher trainings. 42,47,52,54,[57][58][59][60][61] Within Learning-Centeredness facilitators included a positive learning climate, psychological safety, and trust.…”