“It’s All About the Trust And Building A Foundation:” Evaluation of a Longitudinal Medical Student Coaching Program

Abstract

Problem

Coaching is increasingly implemented in medical education to support learners’ growth, learning, and wellbeing. Data demonstrating the impact of longitudinal coaching programs are needed.

Intervention

We developed and evaluated a comprehensive longitudinal medical student coaching program designed to achieve three aims for students: fostering personal and professional development, advancing physician skills with a growth mindset, and promoting student wellbeing and belonging within an inclusive learning community. We also sought to advance coaches’ development as faculty through satisfying education roles with structured training. Students meet with coaches weekly for the first 17 months of medical school for patient care and health systems skills learning, and at least twice yearly throughout the remainder of medical school for individual progress and planning meetings and small-group discussions about professional identity. Using the developmental evaluation framework, we iteratively evaluated the program over the first five years of implementation with multiple quantitative and qualitative measures of students’ and coaches’ experiences related to the three aims.

Context

The University of California, San Francisco, School of Medicine, developed a longitudinal coaching program in 2016 for medical students alongside reform of the four-year curriculum. The coaching program addressed unmet student needs for a longitudinal, non-evaluative relationship with a coach to support their development, shape their approach to learning, and promote belonging and community.

Impact

In surveys and focus groups, students reported high satisfaction with coaching in measures of the three program aims. They appreciated coaches’ availability and guidance for the range of academic, personal, career, and other questions they had throughout medical school. Students endorsed the value of a longitudinal relationship and coaches’ ability to meet their changing needs over time. Students rated coaches’ teaching of foundational clinical skills highly. Students observed coaches learning some clinical skills with them – skills outside a coach’s daily practice. Students also raised some concerns about variability among coaches. Attention to wellbeing and belonging to a learning community were program highlights for students. Coaches benefited from relationships with students and other coaches and welcomed the professional development to equip them to support all student needs.

Lessons Learned

Students perceive that a comprehensive medical student coaching program can achieve aims to promote their development and provide support. Within a non-evaluative longitudinal coach relationship, students build skills in driving their own learning and improvement. Coaches experience a satisfying yet challenging role. Ongoing faculty development within a coach community and funding for the role seem essential for coaches to fulfill their responsibilities.

Keywords:

• coaching
• medical student
• professional development
• wellbeing
• program evaluation

Acknowledgements

The authors thank the medical students, coaches and coaching program staff for their commitment to the coaching program; Kristen Fitzhenry, EdM, for her contributions to program development; the UCSF Educational Evaluation team including evaluation analysts Sylvia Decourcey and Sandi Borok, and research assistant Sally Collins for their assistance with data collection and analysis; the American Medical Association Accelerating Change in Medical Education consortium for a curriculum innovation grant; and Gail Gazelle, MD, Master Certified Coach and Assistant Professor of Medicine at Harvard Medical School, for critical review of the coaching program intervention and manuscript.

Declaration of interest

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.