Doctor Coach

Don't teach more, coach better!

Engaging in Apprenticeship

Clear objectives guide how the learner and coach use the coaching environment and practice methods to provide the appropriate level of guidance, supervision and independent practice.

An apprenticeship is defined as learning by practical experience under skilled practitioners in a trade, art, or calling. Skilled coaches use all of the following methods of practice, combined with appropriate feedback, to tailor their coaching methods to an individual learner’s goals and practice objectives in the setting of a clinical apprenticeship.

Modeling and mental practice

Modeling is used when you need to focus the learner on the core techniques and sequence of steps of a given skill, and is best applied when coaching novices, or for coaching more advanced learners in specific components of a more complex skill. During modeling you, the coach, are deconstructing your own expertise for the learner by describing aloud the components of a skill as you demonstrate for the learner, or by thinking aloud when modeling reasoning skills. At the same time, your learner is mentally rehearsing or practicing the skill in order to prepare for their performance. Consider asking your learner: “What is the next step?” or “How would you do the next step?” and then reinforcing or correcting their responses as appropriate.

Guided practice

During guided practice the coach observes the learner’s performance and steps in frequently to assist with correct technique and to correct mistakes. During guided practice your learners “construct expertise” by demonstrating their skills and techniques to you, and explaining their rationale and thinking aloud as they move through the steps. Be sure to provide continuous and immediate feedback, generally aiming for a ratio of 3:1 reinforcing to corrective feedback. Guided practice is best for novices and advanced beginners, or for more seasoned learners who are advancing their mastery of a more complex skill.

Observed/supervised practice

This type of practice occurs when the coach observes a learner’s skills practice in real time with limited assistance. Observed practice is the most powerful of all practice types, and is appropriate for all levels of learners. For advanced beginners, it is used to prepare learners for independent practice, and to further ground their practice in correct technique. Supervised practice is used in higher stakes environments where learner entrustment must be determined prior to independent practice. Many of the same coaching principles used in performance observation are also used with observed practice. Your feedback should be more limited than in guided practice and is often reserved for the end of the performance. A good coach pays particular attention to ensuring that observed or supervised practice does not turn, inappropriately, into guided practice. Focus on providing balanced feedback to both reinforce technique and to correct mistakes.

Independent practice

During independent practice the learner is responsible for designing and intentionally practicing skills in real time without the coach in attendance. Independent practice is appropriate for learners who have demonstrated sufficiently correct technique and entrustability during guided and/or observed practice. Independent practice focuses on improving learner skills and technique through ongoing repetition. You should help your learner take advantage of a broad variety of practice opportunities to ensure consistent outcomes. Remind your learner to practice “observing themselves” through reflection in action, and self-assessing their own performance through reflection on action.  Ask them to discuss their insights with you regularly, and suggest additional strategies for practice as needed.

Independent practice of sufficient duration must be followed by re-observed practice until your learner’s skills and technique are consistently correct. Independent practice alone, without intentional design, learner reflection and coach observation is not truly practice – it is independent performance.