Notes on “You can have both: Coaching to promote clinical competency and professional identity formation” by @andrewparsonsMD @rachelkon Plews-Ogan and Gusic (@MedicineUVA)

Parsons, Andrew S., Rachel H. Kon, Margaret Plews-Ogan, and Maryellen E. Gusic. ‘You Can Have Both: Coaching to Promote Clinical Competency and Professional Identity Formation’. Perspectives on Medical Education, 17 August 2020. https://doi.org/10.1007/s40037-020-00612-1.

Why am I making notes on this?

  • I thought this article came via the Dalhousie R2C2 website, but actually it’s not listed there. In the end, I’ve got no idea how this article ended up in my Zotero!🤣

What is it telling me?

  • This article shares the experience of developing a coaching program in a medical school in the USA
  • They used polarity thinking (I first experienced this in a workshop at AMEE 2019 in Vienna – that’s where I also met Eric Holmboe for the first time) trying to incorporate or manage the tensions between identity formation and competence formation (and the necessary evaluation required to judge competence).
  • “Longitudinal coaching to build trust” – it’s all about relationship, relationship, relationship. (I’ve heard this for so many years in the Christian leadership context from John Maxwell. I’ve also explored the concept of trust in other posts, here and here.)
  • “Coaching to promote clinical competency” – self-regulated learning, self-evaluation, goal setting. Looks a bit like developing evaluative judgement to me.
  • “Coaching to foster professional identity formation” – reminds me of the phrase from Brian Houston that I heard on Sunday – “What is caught is always greater than what is taught.”
  • There was an enormous amount of investment put into developing the coaching program.
    • Weekly meetings with students in pre-clinical phases
    • Started small with a pilot program of 2 mentors and 12 students, then 6 mentors and 36 students.
    • longitudinal clerkship for the students with a patient to follow through the journey
    • In the clinical phase, coaches met quarterly in groups and individually
    • Monthly coach development sessions, quarterly large group retreats
    • Twice monthly “brown bag sessions”
    • Peer coaching and development
    • Dedicated coaches with a 30% FTE to the professional role.😱
    • Coaching performance reviewed annually, and how program leaders can provide greater support to the coaches

So What?

  • There are elements of this coaching curriculum that reminded me of unofficial coaching elements during my time in medical school – the attempts at longitudinal follow-up of a paediatric case from MBBS I-V (not greatly successful in my opinion, probably because of execution rather than intent); and the weekly anatomy and physiology tutorials by residents/registrars trying to get onto the surgical training programs in MBBS I and II (and most importantly the relationships we formed with these junior doctors).
  • Working at UVA sounds like a dream job for a medical educator. I am not sure whether medical schools and hospitals are prepared to put this much investment into the next generation of doctors to be honest. I’m not even sure how we could even begin to get there.

Now what?

  • Time to move to the next article.

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