A definition for coaching in medical education

Abstract

Consider world champion tennis player Roger Federer. As the number 1 ranked tennis player for a record 310 weeks, he represents one of the most successful professional athletes of our time. To what does he owe his success? While he undoubtedly possesses a remarkable amount of self-motivation, dedication, and athleticism; there is another factor to consider: he has a coach. In fact, he has a team of coaches who work on every aspect of his game with a common goal of performance enhancement. In a recent tribute to his coaches on social media, Federer wrote "Could never have been the oldest #1 without my team. Thank you to everyone who has helped me along the way". 1 Despite its wide application in other high-performance professions such as athletics, music, and business, coaching has only recently gained attention within medicine and medical education. The adoption of Competency-Based Medical Education (CBME) and emphasis on observation has led to increased use of coaching terminology within the medical education community. However, a clear definition of coaching is lacking, and people often use the term coaching interchangeably with related terms such as teaching and mentoring. 2 We need a clear operational definition of coaching in order to advance the use of coaching within medical education and to conduct meaningful research on this topic. We believe, coaching is a process that guides a learner towards performance improvement. Coaching requires establishment of supervisor-learner rapport, setting of expectations, and observation of the activities that are being developed. Following observation, the supervisor and learner engage in a bi-directional conversation which leads to meaningful feedback and practical suggestions for performance improvement. Supervisors may document their conversations to provide a developmental trajectory over time. Educational researchers have previously defined coaching as a "one-to-one conversation focused on the enhancement of learning and development through increasing self-awareness and a sense of personal responsibility, where the coach facilitates the self-directed learning of the coachee through questioning, active listening, and appropriate challenge in a