Dataset Information

Beyond the Sandwich: From Feedback to Clinical Coaching for Residents as Teachers.

ABSTRACT: Introduction:Senior trainees (residents) are poised to be unique effectors of clinical feedback. While several curricula are available to teach residents to give or elicit feedback, our curriculum is unique in that it teaches both the giving and elicitation of feedback and focuses on the longitudinal coaching relationship as opposed to onetime feedback interactions. This curriculum provides a framework, called clinical coaching, for streamlining and enhancing feedback interactions between senior and junior trainees. Methods:This curriculum consists of: (1) a video module, (2) an interactive workshop, and (3) role-plays. Participants view the module, which simulates traditional feedback contrasted with the suggested approach. Next, an interactive workshop stimulates reflection on feedback, then defines and demonstrates clinical coaching. Finally, participants practice coaching with prewritten scenarios that illustrate critical steps in clinical coaching. Results:This workshop was initially conducted in September 2014 with 50 participants. Thirty-nine house staff completed the postcurricular survey (13 had attended the workshop, 26 had not). Recognition of interns soliciting feedback one or more times per week was greater amongst workshop attendees (83% of residents, 78% of interns), as compared to nonattendees (53% of residents, 67% of interns). Preparation to give feedback differed amongst resident attendees versus nonattendees (0% vs. 19%, respectively, reported no preparation). Discussion:These results highlight a need to increase awareness of and preparedness for the vital role that trainees can play in coaching. Training house staff in coaching has the potential to transform feedback for teachers and learners alike.

SUBMITTER: Brown LE

PROVIDER: S-EPMC6354721 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Beyond the Sandwich: From Feedback to Clinical Coaching for Residents as Teachers.

Brown Lorrel E LE Rangachari Deepa D Melia Michael M

MedEdPORTAL : the journal of teaching and learning resources 20170918

<h4>Introduction</h4>Senior trainees (residents) are poised to be unique effectors of clinical feedback. While several curricula are available to teach residents to give or elicit feedback, our curriculum is unique in that it teaches both the giving and elicitation of feedback and focuses on the longitudinal coaching relationship as opposed to onetime feedback interactions. This curriculum provides a framework, called <i>clinical coaching,</i> for streamlining and enhancing feedback interactions ...[more]

PMID: 30800828

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Project description:ObjectivesTraditionally, evaluation is considered a measurement process that can be performed independently of the cultural context. However, more recently the importance of considering raters' sense-making, that is, the process by which raters assign meaning to their collective experiences, is being recognised. Thus far, the majority of the discussion on this topic has originated from Western perspectives. Little is known about the potential influence of an Asian culture on raters' sense-making. This study explored residents' sense-making associated with evaluating their clinical teachers within an Asian setting to better understand contextual dependency of validity.DesignA qualitative study using constructivist grounded theory.SettingThe Japanese Ministry of Health, Labour and Welfare has implemented a system to monitor the quality of clinical teaching within its 2-year postgraduate training programme. An evaluation instrument was developed specifically for the Japanese setting through which residents can evaluate their clinical teachers.Participants30 residents from 10 Japanese teaching hospitals with experience in evaluating their clinical teachers were sampled purposively and theoretically.MethodsWe conducted in-depth semistructured individual interviews. Sensitising concepts derived from Confucianism and principles of response process informed open, axial and selective coding.ResultsTwo themes and four subthemes were constructed. Japanese residents emphasised the awareness of their relationship with their clinical teachers (1). This awareness was fuelled by their sense of hierarchy (1a) and being part of the collective society (1b). Residents described how the meaning of evaluation (2) was coloured by their perceived role as senior (2a) and their experienced responsibility for future generations (2b).ConclusionsJapanese residents' sense-making while evaluating their clinical teachers appears to be situated and affected by Japanese cultural values. These findings contribute to a better understanding of a culture's influence on residents' sense-making of evaluation instruments and the validity argument of evaluation.

Project description:ImportanceSurgical coaching is maturing as a tangible strategy for surgeons' continuing professional development. Resources to spread this innovation are not yet widely available.ObjectiveTo identify surgeon-derived implementation recommendations for surgical coaching programs from participants' exit interviews and ratings of their coaching interactions.Design, setting, and participantsThis qualitative analysis of the Surgical Coaching for Operative Performance Enhancement (SCOPE) program, a quality improvement intervention, was conducted at 4 US academic medical centers. Participants included 46 practicing surgeons. The SCOPE program ran from December 7, 2018, to October 31, 2019. Data were analyzed from November 1, 2019, to January 31, 2020.InterventionsSurgeons were assigned as either a coach or a coachee, and each coach was paired with 1 coachee by a local champion who knew the surgeons professionally. Coaching pairs underwent training and were instructed to complete 3 coaching sessions-consisting of preoperative goal setting, intraoperative observation, and postoperative debriefing-focused on intraoperative performance.Main outcomes and measuresThemes from the participants' exit interviews covering 3 major domains: (1) describing the experience, (2) coach-coachee relationship, and (3) facilitators and barriers to implementing surgical coaching. Surgeons' responses were stratified by the net promoter score (NPS), a scale ranging from 0 to 10 points, indicating how likely they were to recommend their coaching session to others, with 9 to 10 indicating promoters; 7 to 8, passives; and 0 to 6, detractors.ResultsAmong the 46 participants (36 men [78.3%]), 23 were interviewed (50.0%); thematic saturation was reached with 5 coach-coachee pairs (10 interviews). Overall, coaches and coachees agreed on key implementation recommendations for surgical coaching, including how to optimize coach-coachee relationships and facilitate productive coaching sessions. The NPS categories were associated with how participants experienced their own coaching sessions. Specifically, participants who reported excellent first sessions, had a coaching partner in the same clinical specialty, and were transparent about each other's intentions in the program tended to be promoters. Participants who described suboptimal first sessions, less clinical overlap, and unclear goals with their partner were more likely detractors.Conclusions and relevanceThese exit interviews with practicing surgeons offer critical insights for addressing cultural barriers and practical challenges for successful implementation of peer coaching programs focused on surgical performance improvement. With empirical evidence on optimizing coach-coachee relationships and facilitating participants' experience, organizations can establish effective coaching programs that enable meaningful continuous professional development for surgeons and ultimately enhance patient care.

Dataset Information

Beyond the Sandwich: From Feedback to Clinical Coaching for Residents as Teachers.

Publications

Beyond the Sandwich: From Feedback to Clinical Coaching for Residents as Teachers.

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