<p>Coaching by design: exploring a new approach to faculty development in a competency-based medical education curriculum</p>

Abstract

As curricula move from a time-based system to a competency-based medical education system, faculty development will be required. Faculty will be asked to engage in the observation, assessment and feedback of tasks in the form of educational coaching. Faculty development in coaching is necessary, as the processes and tools for coaching learners toward competence are evolving with a novel assessment system. Here, we provide a scoping review of coaching in medical education. Techniques and content that could be included in the curricular design of faculty development programming for coaching (faculty as coach) are discussed based on current educational theory. A novel model of coaching for faculty (faculty as coachee) has been developed and is described by the authors. Its use is proposed for continuing professional development.

In-the-Moment Feedback and Coaching: Improving R2C2 for a New Context

“…As expected, there were differences and similarities in use of the R2C2 in-the-moment model compared to its use in formal meetings with physicians and residents in discussions that drew on collated data. 3,4,11,12 Of necessity, in-the-moment discussions were shorter, yet participants indicated that all 4 phases of the model remained important. They pointed out the need to use communication approaches and phrases within each phase that would engage the learner and yield an impactful conversation in the brief period of time available in busy clinical settings.…”

“…Coaching in the moment requires specific communication and facilitative strategies to engage the learner and ensure commitment, similar to more longitudinal coaching. 12,22,23 Specific differences arose in wording for phase 1, where relationship building differed between residents who worked with the supervisor for a brief time and those with a longitudinal relationship. As reported in earlier research related to feedback, 4,12,24,25 participants confirmed that relationship building was critical to success of the learning conversation.…”

“…[1][2][3][4][5][6] Since residents may reject feedback that conflicts with their self-assessments due to a perceived lack of credibility or lack clarity on how to use it, coaching techniques can enable supervisors (ie, clinical supervisors or preceptors) and residents to collaboratively reflect on performance, focus on growth and development, and embrace performance gaps as catalysts for learning. [7][8][9][10] The R2C2 resident formal model 3,4,11,12 was developed to facilitate formal feedback and coaching conversations, enable collaborative discussions between supervisors and residents, and establish a safe environment through a series of open-ended questions that emphasize reflection and continual improvement.…”

“…The R2C2 model has been applied in a variety of health care settings with practicing physicians, nurse practitioners, and residents. 3,4,11,12,15 Residents and supervisors indicated that the open-ended questions facilitated self-reflection, and action plans enabled the dyad to co-create a concrete action plan that emphasized development and progress. Collectively, the research to date suggested that the R2C2 resident formal model can be used effectively for feedback and coaching with residents who are either excelling or struggling.…”

“…However, the focus of research thus far has been on summative settings, where a variety of performance data are available for review from multiple points in time (eg, daily encounter forms, objective structured clinical examinations, multisource feedback), and participating supervisors questioned whether the model can also be adapted for inthe-moment feedback. 3,4,12 The need for high-quality in-the-moment feedback is evident given research reports of performance improvement following immediate feedback, issues of recall post-feedback, and the association between depression and lack of timely and appropriate feedback. [16][17][18][19] It is of particular interest to those working in competency-based medical education (CBME) settings where learners are expected to meet milestones or complete entrustable professional activities (EPAs).…”