Understand the Fundamentals of Coaching
Becoming highly competent in any complex skill is extremely difficult without the help of a coach. Very few of us can create a detailed and honest assessment of our own performance through self-observation, especially at the beginning. A coach can see a learner in a multitude of ways that a learner themselves cannot. Without this clear and unbiased view, delivered through ongoing feedback, choosing the best practice activities to further improve performance is difficult. In addition to improving skill performance, working with a coach over time also models the process by which learning can be regulated, so that learners may acquire skills that improve their own self-regulation of learning.
We use the following terms throughout the Doctor Coach web site:
- As a clinical coach you may be a faculty member, community preceptor or teaching resident, or other professional who is responsible for a learner’s clinical skills development. Coaches must be able to effectively engage and empower their learners by combining their passion, dedication and high standards with empathy, support and flexibility.
- Your learner may be a resident, a medical, nursing, or physician’s assistant student, or even a colleague. To engage effectively in the coaching relationship, your learners must have a desire to improve their performance and be comfortable enough to reflect on their experiences, accept your feedback, set goals and commit themselves to practice. The most coachable learners are those who draw energy from the process of working to develop their skills.
- An open and mutually respectful bi-directional dialogue between you and your learner is the essential foundation of a successful coaching relationship. Effective dialogue is necessary to set goals and expectations, to continuously discuss feedback and to plan for practice.
- The performance is defined as a practitioner’s knowledge or expertise demonstrated through a visible skill or set of skills. Both coaches and learners use their clinical performance as the principle observable behavior around which coaching interactions occur. Coaches perform for their learners in order to model technique or individual steps in a skill, and to demonstrate how the steps are combined into a fluid single skill. Learners use performance to provide their coaches with data for formative assessment, goal setting and practice planning.
- Deliberate practice refers to activities that the coach and learner intentionally design and carry out together for the purpose of further improving the learner’s skills. Practice activities are chosen based on the coach’s observation and assessment of the learner’s clinical performance. Identifying the proper practice methods and activities to advance the learner’s skill development is one of the most difficult, yet critically important, coaching skills.
Define Your Approach to Coaching
Reflect On Past Coaching Experiences
You might start by thinking about yourself as a learner and how you were coached whether that was in medicine, sports, dance, or other activities. Think about what your good coaches were like and what they did to help you. Then think about yourself in the role of coach. What aspects of coaching come naturally to you, which do you enjoy most, and which are most challenging? How does this vary with different learners or contexts? As you navigate through this website think about which aspects of coaching you might want to target to improve. You may want to review your own teaching evaluations to target specific areas that your learners have identified for improvement.
Set Your Own Coaching Goals
Becoming an excellent clinical coach takes practice and begins with setting your own coaching goals, and developing an intentional plan for your own deliberate practice. Please take a few minutes before you begin the Doctor Coach program to consider your individual teaching goals, using the Doctor Coach framework and the SMART system. You may want to review your own teaching evaluations to target specific areas that your learners have identified for improvement. Post a bright note with your teaching goals in a prominent place on your desk, and share your individual teaching goals with members of your clinical practice and with your learners. Working toward your teaching goals is an important part of your own quest to coach yourself toward deliberately improving your own teaching performance. Talking with learners about your own deliberate practice towards coaching mastery will help you “walk the walk” and will further strengthen your coaching relationship.
Identify Your Observation Lenses
Observation lenses define what competencies or skills you will deliberately and systematically focus on when observing your learner’s performance. Choosing which aspects of the learner’s performance to focus on is a one of the most important coaching skills.
Lenses can be defined by:
- Requirements of the training program
- Context of the practice environment (e.g. ward vs. clinic) and the safety and entrustment decisions that need to be made.
- Your specialty domain (e.g. cardiology vs. general pediatrics)
- Your areas of personal coaching expertise and professional values (e.g. clinical reasoning skills, communication skills, patient advocacy).
- The learner’s goals, learning needs that arise during your work with the learner or as requested by the training director.
Know the Relevant Skill Milestones
Once you have identified your most important observation lenses, spend the time to understand the progression of developmental steps that learners take towards skills mastery in the areas you intend to observe and assess. Knowing these milestones is necessary to develop a calibrated approach to learner assessment, to plan for effective feedback and to collaboratively design the right practice activities.
Once you have defined your coaching approach, you can more effectively Establish a Relationship with your learner.