Medical School Academic Coaches Can Boost Competency-Based Medical Education

All medical students follow their own path to growth. A competency-based medical education model (CBME) firmly recognizes this, but it also relies on medical students to subject themselves to a level of vulnerability unusual in today’s medical education system. today.

In a Publish On the International Clinician Educators Network blog, two medical education experts explored how academic coaching in medicine can advance the goals of short-term and long-term competency-based medical education.

“We suggest that coaching — whether in-the-moment or longitudinally — is an essential component to implementing CBME with fidelity,” wrote the authors, Kimberly Lomis, MD, vice president of medical education innovations. undergraduate at the AMA, and Denyse Richardson, MD, assistant professor and clinician educator in the Department of Medicine at the University of Toronto, in the Division of Physiatry.

“A compelling distinction is in coaches’ orientation to the demand rather than the spoken word,” the authors wrote. “Coaching focuses on solutions: directing and guiding, not telling, any learner through a process of reflection, which enables them to identify personalized goals within a larger framework and create individualized learning paths. “

A manual published this spring, Coaching in medical education: students, residents and professors, explores how successful medical school coaching programs contribute to learners’ personal goals. The handbook is part of the AMA MedEd Innovation series, which provides practical guidance for local implementation of educational innovations tested and refined by the AMA Accelerating Change in Medical Education Consortium.

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According to Drs. Lomis and Richardson, the dyad of individual learner and coach is a critical, trust-based relationship essential to optimizing patient care.

“But it is important to recognize that, even in the context of medical education and CBME, coaching is not always going to look, feel or be the same,” the authors wrote, “and it is unlikely let it be”.

In Canada, for example, the implementation of CBME includes Competence by Design, a coaching model that incorporates two distinct coaching roles: coaching in the moment and coaching over time.

The first component, in-the-moment coaching, requires physicians to establish a relationship and set expectations with their residents by observing them doing their daily work, providing coaching feedback, and recording their encounters.

It follows a step-by-step process known as RX-OCR, which stands for:

  • RContribution: Establish an educational relationship between the resident and the clinician.
  • Set thXexpectations: To do this, discuss the resident’s learning goals.
  • Oserve the resident: This can be direct or indirect.
  • VScoaching: starting a conversation to improve your work.
  • Record: Make a summary of the meeting.

“In medical learning environments, where acquiring skills and expertise in patient care is paramount, coaching may need to be more directive and less reflective, unlike longitudinal models of coaching, which are based on causes the coach to ask challenging or reflective questions,” the authors. wrote.

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The second prong, coaching over time, “requires a more longitudinal relationship between a designated coach, not necessarily a clinician, and the resident,” the authors wrote, adding that it spans many clinical settings and experiences and is motivated by multiple sources of performance. evidence.

“The resources needed to invest in programmatic coaching are not trivial,” they noted. “As thousands of trainees prepare to take on responsibilities this summer amid highly individualized disruptions to their education, the medical education community may be challenged to consider the costs of not knowing and responding to the individual development needs of each of them. .”

The AMA Academic Coaching in Medical Education video series nine short videos which explore academic coaching skills through hypothetical situations involving both experienced and inexperienced coaches. All these videos are available for free on the WADA YouTube Channel and the AMA Ed Hub.

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