Feasibility and acceptability of virtually coaching residents on communication skills: a pilot study

Abstract

Background Developing communication skills is a key competency for residents. Coaching, broadly accepted as a training modality in medical education, has been proven a successful tool for teaching communication skills. Little research is available thus far to investigate virtual coaching on communication skills for telemedicine encounters. The purpose of the study was to test the hypothesis that virtually coaching residents on communication skills is feasible and acceptable. We surveyed 21 resident-faculty pairs participating in a “fully virtual” coaching session (patient, coach, and resident were virtual). Methods We asked 50 neurology resident-faculty coach pairs to complete one “fully virtual” coaching session between May 20 and August 31, 2020. After each session, the resident and coach completed a 15-item survey, including Likert-style scale and open-ended questions, assessing feasibility and acceptability. Descriptive statistics and qualitative content and thematic analyses were performed. Results Forty-two percent (21/50) of all eligible residents completed “fully virtual” coaching sessions. The overall survey response rate was 91 % (38/42). The majority of respondents agreed that the direct observation and debriefing conversation were easy to schedule and occurred without technical difficulties and that debriefing elements (self-reflection, feedback, takeaways) were useful for residents. Ninety-five percent of respondents rated the coach’s virtual presence to be not at all disruptive to the resident-patient interaction. Virtual coaching alleviated resident stress associated with observation and was perceived as an opportunity for immediate feedback and a unique approach for resident education that will persist into the future. Conclusions In this pilot study, residents and faculty coaches found virtual coaching on communication skills feasible and acceptable for telemedicine encounters. Many elements of our intervention may be adoptable by other residency programs. For example, residents may share their communication goals with clinic faculty supervisors and then invite them to directly observe virtual encounters what could facilitate targeted feedback related to the resident’s goals. Moreover, virtual coaching on communication skills in both the in-person and telemedicine settings may particularly benefit residents in challenging encounters such as those with cognitively impaired patients or with surrogate decision-makers.

Implementation and Evaluation of a Communication Coaching Program: A CFIR-Informed Qualitative Analysis Mapped onto a Logic Model

“…Stanford University implemented a faculty-led communication-focused coaching program in the Departments of Surgery and Neurology in 2020 as previously described. 5 Brie y, the program was designed using Kern's 6-step model of curriculum development and utilized the Consolidated Framework for Implementation Research in Formative Evaluation (CFIR) as an implementation framework. 14,15 The CFIR framework breaks down the implementation into 5 domains; see Fig.…”

“…2 More recently, coaching programs at the graduate medical education (GME) level have been implemented to address the speci c needs of trainees. [3][4][5] Coaching, which is distinct from mentorship or advising, involves a true partnership between a coach and a coachee. 6 A coaching framework is learner-centered and helps the coachee identify opportunities for improvement through facilitated self-re ection and goal setting.…”

“…7,8 Coaching programs have enormous potential to impact resident growth across multiple core competencies, including practice-based learning and improvement, professionalism, and interpersonal skills and communication. 3,5 Pro ciency-focused efforts are critical to help learners progress along milestones in the current era of competency-based medical education.…”

Tips for developing a coaching program in medical education

“…Examples of coaching program goals include enhancing professional development or wellbeing [ 6 ], improving clinical or technical skills [ 7 ], and bolstering communication skills [ 23 ]. Your goals should align with available resources and existing programs.…”